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Answer: they will look bigger, yes. JG 7.2.09
Answer: I think it is pushing it and on your frmae I think those will not look too real. JG 7.2.09
Answer: Not really a a double bubble, it is a crease where the muscle ends and the breast tissue begins, it happens not infrequently with below the muscle augmentation and in most cases gets better on its own, if not, the muscle migt have to be cut a little to let it relax and not have the indentation when it flexes. It should not hurt your implant though. JG 6.30.09
Answer: hard to say wihtout seeing you in person, if it has been like that since the begining, then it is likely a pocket issue. If it was not there since the begining nad started later and slowly got worse, then it is a capsule issue. Either one can likely be remedied with a capsulotomy. JG 6.29.09
Answer: possibly, or that the tissues are too thin and no matter what size you had placed, it was going to happen. JG 6.29.09
Answer: it is from a tight muscle and is not really a double bubble, it might require the muscle to be surgically released if it does not get better with a little time. It will not damage the implant though and no need to freak out. JG 7.1.09
Answer: no, it varies from patient to patient. But in general, the larger the implant, the greater the chances, I do think they ones getting those large implants are gearing up for problems later, yes. JG 6.25.09
Answer: cannot say about Kendra Wilkinson, and I would need to know at least the diameter of your breast tissue to tell. JG 6.9.09
Answer: because the tissues are virgin, not scarred, have normal blood supply and are not tethered nor limited by any previuos scar tissue. The anatomy is more predictable and not distorted. JG 6.9.09
Answer: the first surgery is the easiest one. JG 6.9.09
Answer: I think the 13.2 is already at the limit. JG 6.9.09
Answer: that is a personal choice, I do not think saline will make it look any better, though. JG 6.9.09
Answer: it is because they are under the muscles and them move around and will change location to some extent within the pocket, not much that can be doen about it, what you are seeing will likely continue. JG 6.4.09
Answer: hard to fix unless the location is changed to above the muscle because the tissues now are stretched out and will likely not heal into a smaller pocket. JG 5.31.09
Answer: likely due to tight skin and maybe a larger size implant, if they are soft, then it is not a capsular contracture, it migth also be that way if they are textured implants as textured implants do not feel as soft as they kind of velcro into place. JG 5.28.09
Answer: might be the skin just not draping over the implants properly, hard to say. JG 5.26.09
Answer: would likley be able to weer most of your bras still. JG 5.26.09
Answer: they are getting fuller due to the cells in the breast lobules enlarging in case you get pregnant. JG 5.26.09
Answer: both those things contribute to the elevation of the skin over the breastbone in between the breasts, it is not able to be predicted as it should not happen. JG 5.25.09
Answer: 20-24%.JG 5.25.09
Answer: usually the cut is done at the bottom to avoid the potential of the scar being more easilly seen. JG 5.21.09
Answer: I would not have put the 500`s in for you as I think those are too big for the long term on your frame. JG 5.19.09
Answer: I am sorry but I am not aware of any surgoens doing pro bono work for that problem, sorry. JG 5.15.09
Answer: no way to tell visually besides in experienced hands, but in general skin thins as it ages, males have thicker skin than females, the oilier your skin is in general, the thicker it is too. JG 5.14.09
Answer: can be due to either a pocket issue or the shape of your own breast tissue and muscle to start off with. JG 5.13.09
Answer: well, here is the thing, if he could not put them under the muscle the first time and they were riding high and he kept them under the second time, how can that be. If you cannot place them under the muscle the first time the second time is not magic. If the tissue had softened enough to allow him to place it still below the muscle it would nnot be riding to ohigh. He likely made the pocket bigger, and the only way to make the pocket bigger is going down and to the side where there is no muscle, and when you do that the muscle pushes on the implant and pushes it out from below the muscle. It is hard if you are not experienced to tell the difference. JG 5.12.09
Answer: that all depends on what is done on the second opeation, more bleeding can lead to higher capsular contracture rate, but that can happen in some second surgeries more than the first. I would be willing to bet he put them on top of the muscle the second surgery. JG 5.12.09
Answer: if you can feel the edge of the implant one either the inner, outer or lower edge of your breast, then it is too wide. JG 5.12.09
Answer: to some degree it might help. JG 5.12.09
Answer: only you can decide if it is worth it, that is less than one cup size. JG 5.12.09
Answer: gaining weight cannot be directed to your chest so the appearance you have might be the way it is going to look due to your anatomical limitations. JG 5.8.09
Answer: there is some small change, about 2 oz or less. JG 5.7.09
Answer: more likely than a surgical error is that yours are no longer under the muscle, have slipped down lower or elss the muscle was released properly and the size of your implant allowed the muscle to window shade upward after it was released and the muscle is not covering the implant any longer. If the implant is below the muscle there is almost always some animation upon muscle flexion,at least to some degree. JG 5.5.09
Answer: look at them in the mirror in the relaxed position and then stand the same way and flex your muscles and see where they move. JG 5.5.09
Answer: your native breast measurements are difficult to obtain now, but if you can feel the edge of the implant now you likely cannot go any larger. By what you are telling me I think you are about at the limit. JG 5.5.09
Answer: OK to do, yes. JG 5.3.09
Answer: no, not done on purpose, at times the tissue soften more on one side than another and at times some scar tissue can form that will reduce the size of the pocket, that is what capsular contracture is. If it is noticeable the likely best solution would require more surgery to enlarge the smaller pocket. JG 5.1.09
Answer: could be a difference in the size of the pocket that the implant is sitting in, the fuller one likely has a smaller pocket so it pushes the implant up higher. JG 5.1.09
Answer: maybe another 4 months or so to settle into position. Once the muscles have relaxed we stop the massages. JG 4.30.09
Answer: in cases of tubular breasts, there usually needs to be something done to splay the tissues open, this even more so if the implant is placeed below the muscle rather than above it. Going larger without incising into the breast tissue will likely not help, sorry. JG 4.30.09
Answer: well, statements that 200cc will give certain cup size are never accurate and are at best approximations, and going under the muscle tends to flatten the implant so, so that can contribute to it also. I doubt seriously that much of your implant will remain under the muscle and going larger will make them slip from below out even faster, the muscle will not be large enough to accomodate a larger implant. JG 4.30.09
Answer: actually the opposite, it is more common to feel folds in cases where the pocket is too small for the implant. JG 4.29.09
Answer: hard to say, they might be assuming a capsulectomy needs to be done on your friend which is more involved than a straight forward initial breast augmentation, and also you were likely given a discount by your surgeon on the second procedue he was performing for you. JG 4.29.09
Answer: it might not be possible to go to the larger size without having some degree of malposition. JG 4.29.09
Answer: it is liklely the implant, a fold caused by the nature of the material,he is correct, there is likely not much that can be done to permanently eliminate it, sorry. JG 4.29.09
Answer: the answer is easy, especially in times like this. MONEY. Very sad... JG 4.28.09
Answer: do not think so. JG 4.28.09
Answer: well it is also controled by the diameter of yoru breast tissue you already have, but I think likely somewhere about 300cc or so. JG 4.25.09
Answer: sorry, but they do not work. JG 4.23.09
Answer: sounds like they have settled, yes. JG 4.23.09
Answer: I am sorry but the truth is there is no other way besides surgery, sorry. JG 4.23.09
Answer: I think the thighs will smooth out in time and I have never seen the implants cause a rash, might be something else this far out from the surgery. Wish I had more to offer. JG 4.21.09
Answer: impossible for me to tell without seeing you and the appearance of your breasts before the surgery. JG 4.9.09
Answer: I do not routinely see that, maybe because the base gets wider, or they gain weight, not sure what has occured in those cases without having more information. JG 4.9.09
Answer: ther is no measurement that says that, it is relative. JG 4.9.09
Answer: well after it is placed, if it sticks out past the edge of yoru breast tissue, it was too big, as to before, your beast tissue is measured and then compared to the chart that lists the implant dimensions. JG 4.9.09
Answer: sometimes their skin is tighter and takes longer to relax and let it drop. JG 4.9.09
Answer: for an infection to cause a capsular contracture would take weeks, so it happening right after is likely a coincidence. Taking it now might not help I am afraid. JG 4.7.09
Answer: I think the chances of bad thinsg happening goes up the larger the implant, I try to stay at 450 or smaller if at all possible. JG 4.7.09
Answer: it is due to the edges of the implant and whatever the fill inside moving around, but saline stays put less than silicone, and they both are constantly moving around within the bag. Might be due to slight less swelling of your own breast tissue during your monthly cycle. JG 4.6.09
Answer: in time they normally balance out more. JG 4.4.09
Answer: I do not think the Vitamin E caused them to get harder but if you are concerend you should stop, the vitamin E does not work quickly, but in the face of worsening of your capsular contracture, it likley will not work. As to the Silimed implants, they do not reduce capsular contracture compared to others, that is ultimately up to the patient`s response to the foreign material. Best of luck. JG 4.3.09
Answer: because the tissue on the lower part of the breast stretch with time. It can be gradual but usually once it starts, it goes quickly. JG 4.2.09
Answer: they are narrower, that`s for sure with the HP, but size encompasses the volume, so the size is the same. Therefore the 500 will look bigger. JG 4.2.09
Answer: we allow our patients to wear underwire bras for short periods of time after one month if they are under the muscle, if they are on top, then you can wear it as much as tolerated after 4-6 weeks. Nipple might ake a few more weeks to settle down. Everyone responds differently to the swelling and what you are having is not uncommon. JG 4.1.09
Answer: if you desire a smaller size, that would be a good time to consider it being done. JG 4.1.09
Answer: as to negative posts on the internet, in my experience, people that are not happy with their results spend an enormous amount of time bad mouthing their surgoen becsause they are angry. At times it is not the surgeon`s fault too. The happy people, which is usually the vast majority of the patients, almost never post anything good, they are happy and have gotten back to enjoying their lives, so in general, I take negative comments posted on blogs with a gigantic grain of salt. As to your case, a second opininon might settle your mind a bit. JG 3.31.09
Answer: because nature does not make a breasts that have that amount of volume with that narrow of a base. It also depends on one`s perception, one person might think they look fake and another might think they look fine, so there is no way to tell because it depends on your personal impression, but in my opinion, they look fake, at least I can usually spot them on a female relatively easily. JG 3.31.09
Answer: there are no measurements that determine that, it is all relative. JG 3.31.09
Answer: it is done because we need to use the nipple as the bulls eye so to speak, so if your nipple is to the side due to your ribcage, then the implant needs to be placed out there to accomodate for that, otherwise the nipple would look out of place and even more out of position than it does now. JG 3.31.09
Answer: I have seen it and performed it many times, I think it will likely give you a better and more natural appearance. The cleveage will depend greatly on our muscles and the size of your breast bone too, no way to guarantee cleavage, especially if under the muscle. Also, in general, high profile implants I feel look pretty artificial. JG 3.31.09
Answer: we do need to center the implant behind the nipple so the pocket created for your left implant sounds like it needed to be in a different location on your ribcage than the right. Also, if the tissue stretchs more on one side versus the other, that can also happen. JG 3.31.09
Answer: it is some, and in narrow chested women it can make a difference. JG 3.31.09
Answer: look for how much of the mound of the implant is above or below the crease underneath the breast. JG 3.31.09
Answer: sure sounds like it. JG 3.31.09
Answer: the cause for the lactation has to be determined by your physician first. JG 316.09
Answer: lactation carries with it more bacteria so it can be contributing to it, yes. JG 3.15.09
Answer: impossible for me to tell without seeing you in person and a breast lift might be indicated, although loss of nipple sensation is rare, not in all cases. JG 3.13.09
Answer: it can get worse and there are also cases where it will stay like that for long long periods of time, no way to tell. If the Vitamin E does not help I think the only thing is surgery, correct. JG 3.13.09
Answer: all normal, swelling will be different from one side to the other, give it some time and follow up at youe next scheduled appointment with your surgeon. Best of luck. JG 3.12.09
Answer: you would need to see the surgeon you choose to do that as prices will vary, best of luck. JG 3.12.09
Answer: yes, OK to do. If it is going to work you should feel something after two months, if nothing by then, it will not work. JG 3.12.09
Answer: well, thre are degrees of capsular contracture, so it might just be a mild case so far. It can be the muscle too, so just give it some time and see what happens. JG 3.11.09
Answer: you cna take the Vitmain E, it is a low risk, I have not found the Singulair or Accolate to make much difference to be honest though. As to the Vitamin E, I suggest taking 1000IU daily in three divided doses. Best of luck. JG 3.11.09
Answer: hard for me to say without seeing you in person to see the size and pliability of your breast tissue.That is something your surgeon can help you with after an inperson consultation, having said that, it might never be possible without risky issues such as a double bubble, bottoming out, faster ptosis and palpable/visible ridges. JG 3.11.09
Answer: massage and Vitamin E at 1000IU in three divided doses per day is about all. Best of luck. JG 3.10.09
Answer: I think for the most part you are where you are going to be at this point, I would not anticipate more changes to any significant degree. When we say the implants drop, they are already in the pocket but the pocket and skin can stretch in time and give different look as time goes by after the surgery. As they drop they will usually move lower and to the sides, more so if they are under the muslce. JG 3.10.09
Answer: would likely be bigger but not more than a D cup. JG 3.10.09
Answer: almost two ounces. JG 3.10.09
Answer: c-d, maybe. JG 3.9.09
Answer: all normal and that all goes away over the first 4-6 weeks. The shape also takes time to settle in, just give it some more time. Massage is good. JG 3.7.09
Answer: maybe a d cup. JG 3.6.09
Answer: I am sorry but I do not thnk using textured implants will make much of a difference. JG 3.5.09
Answer: impossible for me to tell without seeing you and the other thing is that in order to minimize long term complications, you cannot always go as big as you want, the controling issue is the width of your breast. Having said that, 25 cc is a very small amount, less than one ounce, so I would not lose too much sleep between a 350 and a 375. JG 3.3.09
Answer: light duty typically in two weeks, full activity in 4-6, we allow walking in a jog bra after about 10 days or so. JG 3.3.09
Answer: I still think you have lots of swelling at this point, give it some time. JG 3.2.09
Answer: not much the doctor can do to thicken the skin, it might be aggravated due to some element of capsular contracture that is causing it to fold more. Might need the pocket made larger but that will not make it less palpable. JG 2.26.09
Answer: should start seeing it go down starting the next few days. I do think you should see youe surgeon though. I suggest alternating some warm and then cold packs too. JG 2.25.09
Answer: call the doctor and go see them so they can put some new steristrips on, in the meantime just cover it with Neosporin and a bandaid. JG 2.24.09
Answer: to let the tissues relax and allow the impalnt to settle into proper position. JG 2.23.09
Answer: could be swelling, but if the difference is getting bigger over time I suggest seeing your surgeon ASAP to make sure you do not have a hematoma that needs to be drained. JG 2.22.09
Answer: it is because of the limitations of your underlying anatomy. If you put too large of an implant in, then the breast tissue you have will not properly drape over the implant and it will not look good. You cannot always get what you want I am afraid. JG 2.21.09
Answer: I have used them, they do help decrease the pain but it does not remove it all, but reduces it so you are more comfortable. In most cases the pain pills are enough though. JG 2.21.09
Answer: I am afriad not, it might get worse, unless you get a capsular contracture again and then that might hide the ripples. JG 2.20.09
Answer: just normal healing, glad all is well. JG 2.20.09
Answer: what is considered large is a relative term, as to larger implants, in my expereicne of over 21 years in the field, the larger the implants the higher the chance of problems. As to why they want them, that answer will vary from person to person too. JG 2.20.09
Answer: if you were my patient I would not place any larger than what you already have in. I likely would have not even put in an implant as big as you have the first time around either. JG 2.11.09
Answer: still can be normal, usually it is just the tissue stretching. Cdeefox
Answer: I think the breast augmentation pain will be less than your jaw surgery, in my experiences, even with patients with low pain tolerance the pain pills are good enough to control it. I have used pulsed magnets for post op pain along wiht pain pumps that infuse local anesthesia for a few days too, they also help. Best of luck. JG 2.9.08
Answer: yes, you are just feeling the sutures that are below the skin that have yet to dissolve, but they will in time. JG 2.9.08
Answer: hard to explain it from the surgery or the implants this far out, I suggest you see the surgeon for an inperson evalaution. JG 2.7.09
Answer: yes, it can happen in some cases. JG 2.6.09
Answer: hard for me to say, it should not be related to the implants this far out as surgical swelling should be all gone. JG 2.6.09
Answer: I woudl leave it alone. JG 2.6.09
Answer: might just be that things got softer, it also could mean the implant ruptured if it is silicone, if it is saline you would know if it broke because you would slowly get smaller from your body absorbing the saline but the body does not absorb the silicone. JG 2.6.09
Answer: I think they might feel sofer, but size should not change much at this point. JG 2.6.09
Answer: well, it could be muscle spasms, but also it sounds like they used the same implant as the first time as PIP implants, at least here in the US, are no longer sold. Using a new implant when dooing a capsulectomy for capsular contratcure is a good idea to lessen the chances of the capsule coming back. I hope it is just muscle spasms in your case, otherwise it will be a recurrence of the capsule. JG 2.6.09
Answer: that is somethng that was suggested to be done back in the 80`s, long term follow up has not shown to it make much of a difference past the first 6 weeks when the tissues need to heal in a larger pocket. I think your friend has not developed a capsule not because of the massage but just due to the way she reacts to the silicone envelope. After that, the massage likely does not affect the avoidance of capsular contracture. JG 2.5.09
Answer: well, the Alloderm I do not think will help anything that is going on, I do not think that recurrent capsular contracture will be different between silicone and saline implants. I am afriad you might be one of those small number of patients that cannot tolerate foreign materials and you might have to have the implant removed and left out. I am sorry. JG 2.4.09
Answer: yes, muscle spasms can cause things like that. Not a dangerous thing though. JG 2.4.09
Answer: yes, always under general anesthesia. Attempting to do this under local anesthesia can lead to areas that are not numb and then increase bleeding during the procedure. I have also seen punctured lungs from trying to do it without general anesthesia due to the depth and number of needle insertions. I think under general anesthesia it is a safe and comfortable procedure where another medical professional is monitoring you while the surgeon is doing the surgery. I find that at times, people will do procedures under local anesthesia so they can do it in their office and not have to obtain a supervising hospital make sure they are properly trained to perform it also. Best of luck. JG 2.3.09
Answer: predicting cup size is very difficult at is varies on your breast dimensions and also the manufacturer of the brasierre. The sensations under your nipple are also normal, they will get better in time. All the best. JG 2.3.09
Answer: well, keloids can happen, especially in lift scars, injections of steroids can help at times but do not work all of the time. Usually most of the healing is done 6 mnths after the surgery but subtle changes can occur for up to one year. I prefer smooth implants as I feel they leak less. Best of luck. JG 2.3.09
Answer: as the swelling goes down they should get better slowly. Tanning might help, yes. JG 2.2.09
Answer: it should have started by now and sould continue for a few months in most cases. JG 2.1.09
Answer: no worries, just remove them and if the area is tender, wear a little gauze on it under your bra. You can leave the incision dry at this time if you wish. JG 2.1.09
Answer: well, that recommendation will vary from surgeon to surgeon, I think at this point if you wear a push up bra for a short period of time, it will likely not make a big difference though. JG 1.31.09
Answer: I think the pain in your breast can be due to the nerves exiting from the ribcage that course through your breast being stretched and causing the pain, that is why when you support it, it feels better. I do not think you have popped anything. All the best. JG 1.30.09
Answer: if all looks fine, I think I would just wait for your one year follow up. If you have any questions or concerns then I think it appropriate to see him sooner. JG 1.30.09
Answer: as the breast drops, in fact the incision might appear higher up on the breast. JG 1.30.09
Answer: I think if the space that was opened near the breast bone is not closed with sutures tha the degree of the implant moving over to that area again will not change and the degree of synmastia you have will not change. That medial pocket needs to be sutured closed and the external pressure applied in conjunction, essentially nonstop for at least 6 weeks. Best of luck. JG 1.28.09
Answer: it depends on what surgery you had done, I think it best to ask your surgeon to be safe. They can tell you what you are able to do in their practice. JG 1.27.09
Answer: well, if it is under the muscle it could also be just muscle spasm, very hard to say without knwoing all of the information and also examining you. I think the evidence for ultrasound treating capsular contracture is not well documented yet as to its effectiveness. I think it best to see your surgeon as they knwo your tissues best and see what they say. JG 1.27.09
Answer: I do not perform that surgery any longer but can refer you to other surgeons in town that do perform it, prices are not cheap and the chances of it recurring are there, but as long as a reasonable size implant is chosen, it should be able to be controlled. JG 1.27.09
Answer: well, capsualar contracture forms slowly, so if it is not muscle spasms, then it migtht be recurrent capsular contracture at least partially reforming. JG 1.26.09
Answer: wait at least 6 weeks if you can. JG 1.26.09
Answer: it is normal from the irritation of the nerves in the area. You might not have felt it before as the nerves were not working as well yet. Typically nothing to worry about. JG 1.26.09
Answer: those are called steri strips and I suggest you leave them on until the fall off, all normal. JG 1.25.09
Answer: have not seen that happen related to the silicone implants, no. JG 1.24.09
Answer: the muscles when tight can make them look flatter and as the muscle relaxes they obtain a rounder fuller shape. JG 1.24.09
Answer: I believe the smallest implant generally available is 180cc. There is no maintanence unless you get a silicone implant which is suggested to be checked with an MRI scan every three years. If they are not broken, there is no need to exchange them. I personally prefer the round implants as they look tear drop while standing and round while lying, which is the normal change. JG 1.24.09
Answer: I think you need to relax, wait until you see him and then decide in conjunction with him what is the best thing to do. If the muscles have weakened it is not always that you bottom out as that is more controlled by the skin. JG 1.24.09
Answer: if it is still contained by the capsule that forms around the implant after the surgery it can be removed pretty well. Silicone does feel a little more natrual, more so when placed above the muscle, compared to saline, below the muscle the differences are small I feel. They both ripple but saline does ripple more than silicone. JG 1.23.09
Answer: the MRI is accurate for silicone implant rupture but is recommended every three years. The only way the silicone can migrate is locally if the capsule is torn, it is not something that becomes clinically significant. JG 1.23.09
Answer: all normal, how long they drop depends on whether they are above or below the muscle and also on your skin tightness before the surgery and the size of the pocket made. They might continue to drop for months, although it will not progress quickly after 6 weeks, after that it will be slow. JG 1.23.09
Answer: I do not think there is anything external you can do to maintian them except avoid large weight fluctuations, try wearing a good support bra when jogging and no need to wear it at night either. JG 1.23.09
Answer: diastosis de los musculos is a splitting of the muscle, a weakness of the muscles that is allowing it to pooch through, it is not bottoming out though. I would just give it some time and see what happens and not do anything for now. JG 1.22.09
Answer: well, I guess in theory they could, but what happens if the needle hits and ruptures the implant? I think in general, if rippling exists, there is little you can do to keep it from getting worse because of the piston effect of the implant moving in the pocket will cause progressive stretching of the inferrior asspect of the breast skin and the ripples will become more visible. The bra will help versus no bra but will not entirely prevent it, even if worn all of the time. JG 1.22.09
Answer: some of it is bad tissues, some of it is surgical misadventure, no 100% on that I am afraid. JG 1.22.09
Answer: not sure why , let me look into it. JG 1.22.09
Answer: if you add an implant, yes, if not, then possibly not. JG 1.22.09
Answer: padding would be good and if it gets better with that, then after 6-8 weeks you should be out of the woods if you wear it that long. All the best. JG 1.22.09
Answer: if it is capsular contracture, it might get worse with time, if it is due to a pocket that is just not large enough, then no. Either one will need surgery to fix though. If it is muscle spasms, it might get softer over the next few months, might want to speak with your surgeon and see what is going on. JG 1.21.09
Answer: it has been used and reported on, initially it looks quite good, but long term results show little improvements, so after 6-12 months you are back to where you were. JG 1.21.09
Answer: yes, that is because of the bra and also, you might now look like you did in a padded bra before, but now, if you wear a padded bra again, you would look alot bigger. The muscle tends to flatten them out for awhile and in time they will look rounder, fuller and have more projection. JG 1.21.09
Answer: all breast implants ripple, it is seen in patients with thinner skin more than on patients with thicker skin and more fat and tissue below the skin. It happens because of the structure of the implant and how it is filled. JG 1.21.09
Answer: we do direct pressure on the implants but there are lots of ways to get the muscles to relax and allow the implant to settle into position. I think it will not do anything long term to prevent capsular contracture though. It is to keep the pocket open for the first 6 weeks or so is all. JG 1.20.09
Answer: all normal at this point, yes. Capsules biologically cannot form for about 6 weeks, so that is not the problem. All normal healing.Hang in there. JG 1.20.09
Answer: it might help, no way to tell, but it is at least something that might help with no surgery. Best of luck and keep me posted. JG 1.20.09
Answer: it is part of the swelling and in most cases they go away with time, but it might take months. Fair skinned people see the blue veins easier, yes. JG 1.19.09
Answer: we offer financing through CareCredit. JG 1.19.09
Answer: I think what you have chosen will give you a more natural appearance and they will feel much softer than the gummy bears, yes. All the best. JG 1.18.09
Answer: yes, normal and will get better in time. JG 1.16.09
Answer: all normal and will get bettter with time, yes. JG 1.16.09
Answer: actually, very common, the sterss and the medications can cause that. I would wait until next month, and on the outside chance, might want to get a pregnancy test although it is doubtful as most surgicenters check that prior to surgery. JG 1.15.09
Answer: yes, I would likely stay with about a 12 cm diamter implant. JG 1.11.09
Answer: might look a little fuller, all depends on how much breast tissue you have and the size of the implants now. The changes after 7 months are small I feel. I personally would try to talk you out of the exchange to try to limit future problems with sagging or ripples. JG 1.11.09
Answer: well, it will make you visibly bigger but it will likley not change your cup size. You would also need a new implant to be used for that addition as overfilling the old implant by an additional 100cc will distort the appearance and feel of the implant. JG 1.11.09
Answer: I think the change will not be worth it as it will give you a barely visible difference. I would not do it. JG 1.11.09
Answer: if it is a small area and the rest of the tissue is not doing the same thing then the implant should not bottom out. I suggest wearing an underwire bra as much as possible at this point and hopefully the small area of tissue weakness you feel where the implant bubbles through will scar in and make it less palpable. Best of luck. JG 1.10.09
Answer: some doctors feel patients bleed more easily when on their cycle and try not to operate at that time but I have never found it to be any differEnce myself. I thiNk it is likely safe, yes. JG 1.7.09
Answer: no, colds are usually a virus and they will not infect the breast implant. In my experience the only way to reliably treat the capsule is with surgery. JG 1.7.09
Answer: I think it is to soon to tell, and without knowing exactly what was done during the surgery, I cannot tell much. I think at this point things are stil helaing though and I suggest giving it some time to let it heal and soften so more. Best of luck. JG 1.7.09
Answer: yes, once healed you can return to that activity although your chest will be a little weaker on a permament basis if placed below the muscles. JG 1.6.09
Answer: Ideally 6 weeks if possible. As long as the tooth is not infected you can start the antibiotics at the time of surgery. JG 1.5.09
Answer: well, as long as you are on antibiotics starting now and until the tooth is removed and for at least one day after, it is likely OK, the risk would be infection. Best of luck. JG 1.6.09
Answer: if the shape and dimension of the bag is the same, then it will make no difference. JG 1.6.09
Answer: well, look at your breasts in the mirror and see where the fold below yoru breast is on your chest wall. As the tissues of the breast fall below that line and as the nipple and areola descend below that line, that is the sagging. JG 1.6.09
Answer: in most cases the V tracks get better but they do not always go away. It can take months for them to get better, even with the shots. The navel approach has as many problems as all other techniques, as to the hardness, it most likely is due to an inadequate size pocket being made at the time if surgery by the surgoen, that might need surgery in the future to correct. The navel technique also invalidates the warranty the companies offer if the implant were to leak, sorry to tell you all that. JG 1.4.09
Answer: It is likely the difference in the pockets, the more natrual one having a larger pocket, your surgeon should be able to see that. Might just need the one pocket made larger. JG 1.4.09
Answer: I never use them, they look too fake for my liking. JG 1.2.09
Answer: well, I think the regular profile will be the most natural option, and if you are not happy with the appearance and there is something that can be done, then I think it is reasonable to do it. Not sure why they went with a 500 high profile to begin with.JG 1.2.09
Answer: might use an anatomical shaped textured implant. JG 1.2.09
Answer: would go with the regular profile for the most natural appearance. JG 1.2.09
Answer: can happen, not usual, but can happen. JG 12.31.08
Answer: yes, usually is possible. The silicone implant is compressable. JG 12.30.08
Answer: the silicone implants are compressable and can fit though normal sized incisions. JG 12.30.08
Answer: I am afraid narrow is a relative term. JG 12.30.08
Answer: attempt to close the pocket can be tried but it is hard to get it to stay closed I will say, sorry. JG 12.30.08
Answer: I think both massage and ultrasound will help if relatively recent, but if time has passed it might not help much, would not hurt to try it though. JG 12.30.08
Answer: it is my pleasure and the best to you for the New Year. JG 12.30.08
Answer: I would leave it alone, the scars around the areola will likely not be worth the surgery. Merry Christmas and Happy New Year. JG 12.27.08
Answer: not sure, might need different size implants to correct that problem. Closing the pocket that was made and getting it to stay closed can be very difficult. Hard to comment more without seeing you in person. Merry Christmas and Happy New Year. JG 12.27.08
Answer: resolving accumulation of blood or a low grade infection. Merry Christmas and Happy New Year. JG 12.27.08
Answer: no need to wear underwires. Visually telling whether they are below or above takes an experienced eye. You might not be able to tell.JG 12.28.08
Answer: usually the incison is placed in the fold and in some cases with downward migration of the implant the scar appears like they rose up. Its is not the doctor`s fault, it is the way the implant settled. Merry Christmas and Happy New Year. JG 12.27.08
Answer: yes, without a doubt, wait until you are done having all of the children. Merry Christmas and Happy New Year. JG 12.27.08
Answer: well, if you are going larger the risks are the same because the pocket has to be made larger, if it just an exchange and no treatment of the capsule, it might be a little smaller but it is a low grade infection and not bleeding that is the major cause of capsular contracture and that can happen years later. Merry Christmas and Happy New Year. JG 12.27.08
Answer: well, capsular contractue is what happened. I think he might have tried putting them under the muscles the second time too and if I had to bet, they are now on top, that allowed a larger implant and a larger pocket to be maintained, Glad they are soft now. Merry Christmas and Happy New Year. JG 12.27.08
Answer: it is just scar tissue that is adherent and massage and time should make it all get better. Merry Christmas and Happy New Year. JG 12.27.08
Answer: leave them as they are. JG 12.24.08
Answer: it is genetically determined to a great degree. JG 12.24.08
Answer: no different risks, cannot say about the size without seeing her though, all the best. JG 12.23.08
Answer: no different risks with that incision. The size depends on her ribcage, so hard for me to tell. JG 12.23.08
Answer: no concerns, they are good implants made by Allergan. JG 12.23.08
Answer: possibly some differnt coatings or material saturated into the surface to attempt to keep them softer, but not for a while. JG 12.18.08
Answer: it is when an implant that is too large is placed and the impalnt hangs out past the side of the ribcage. If you look at yourself in the mirror with your hands slightly away from your body and the mound of the implant goes out past the ribcage, or if from the same pose someone can see the implants when looking at you from behind, they are hanging out. JG 12.18.08
Answer: I think so, more like 12.5 to 13. JG 12.18.08
Answer: it should not have any long term negative impact to use the crease incision again. JG 12.18.08
Answer: aproximada $7500. JG 12.16.08
Answer: same as the placement, just reversed, pull a little bit out then squeeze the pocket. JG 12.12.08
Answer: well, in most cases it is due to an infection around the implant that will not allow the incision to heal and it will likely require the implant to be removed for a period of a few months and then replaced for it to heal and close. It can happen anytime you have another surgery, but it is rare. JG 12.12.08
Answer: it can be due to the amount of breast tissue you had to start with, it can be due to some element of scar tissue pushing and shaping the implant differently, it can be due to the pocket that was created at the time of surgery being uneven, or healing unevenly. JG 12.11.08
Answer: likely more will pop through on their own in time. The tiny holes will close on their own. JG 12.10.08
Answer: as long as there is not a hematoma, there is not much that can go wrong, in very rare cases the pocket will be uneven though so the implant migth look or sit a little different. JG 12.10.08
Answer: there is no good way to tell, until and unless the repair fails and the implants move back to the undesired position. Sorry. JG 12.10.08
Answer: it is possible, yes, after 6 weeks there is usually enough scar tissue to hold it in most cases but the repair does not gain maximum strength for one full year I am afraid. JG 12.9.08
Answer: capsules can tear at any time, no limit there, it is not always a good thing but usually not a bad thing either. JG 12.9.08
Answer: most likley just the scar tissue or capsule has torn a little, nothing to worry about, should get better with time and ice. JG 12.9.08
Answer: can be done under local anesthesia and usually a small suture is placed to close the skin JG 12.8.08
Answer: permanent sutures do not dissolve, correct. I think requesting your records from the original surgeon and going to see a surgoen in your new location would be the thing to do. Making a nick is a very small cut and then removing the knot and the suture. JG 12.8.08
Answer: how long they take to dissolve depends on what type of sutures the surgeon used, could be weeks to months, and at times they use permanent ones. If they begin to bother you they can always be cut out with a small nick over the bump. JG 12.8.08
Answer: it is common becasue the tissue is quite thin so they are easy to feel. Usually they dissolve or come to the surface and can be removed. JG 12.8.08
Answer: on their side about 2 weeks, and face down about 1 month. JG 12.8.08
Answer: I think the pain is just stretching of the tissues as they are stil tight. I do not think it is anything to worry about, all part of the normal healing process. JG 12.7.08
Answer: not a surgical error, it is the tissue that cannot hold the weight, due to gravity, and to a great extent the size of the implant, but I have seen even small implants bottom out. It varies from person to person depending on their tissues. If the implants are large and they are placed unde the muscle, that can in some individuals, accelerate the bottoming out as the muscle pushes the implant down and out if it is too large. JG 12.4.08
Answer: I doubt you would be able to direct any weight gain to your breast area. Breast size will usually vary with weight fluctuations with or withour implants, but not dramatic in all patietns. From what you describe I think you will not be able to get the fat to where you desire. Sorry. JG 12.4.08
Answer: it most likely is due to the way the pocket that was opened healed and closed off. JG 12.4.08
Answer: sounds like what you are feeling is a fold in the implant that you are feeling as the skin in that location is thin, folding of the implant is normal and can move and not always be there, should not be anything to worry about in most cases. JG 12.1.08
Answer: bereast size and turgor can change with menstrual cycles, yes. JG 12.1.08
Answer: can vary from 1-5%. JG 11.26.08
Answer: it is normal in thin tissue people, it might get a little better with time but not always. JG 11.25.08
Answer: at that point in time we allow a normal bra, we allow an underwire bra for a few hours but not for extended periods of time, especially if the implants were placed below the muscle. JG 11.25.08
Answer: yes, I think you can, it would not happen in one small area like that, it would be the whole width of the implant from side to side. JG 11.25.08
Answer: well as to infection, usually a few weeks, but as to rippling and capsular contracture, I am afraid never. JG 11.25.08
Answer: I honestly doubt it. JG 11.25.08
Answer: well, there are no rules on this issue, it is between your surgoen and you, the revision might be covered if it is only the cleavage issue and you forgo the size change. JG 11.25.08
Answer: it is not common, more common in thin skinned patients with large implants, especially ones that are very active like running. The first thing you usually see is that the skin between the nipple and the inframammary crease starts to stretch out. JG 11.24.08
Answer: 6 weeks to 6 months, it varies widely. JG 11.24.08
Answer: 6 weeks to 6 months, it will vary widely. JG 11.24.08
Answer: I think the scientific proof for less capsular contacture with textured implants is almost non-existent but I will say that a new set is certainly a much better idea than using the same ones due to the potential development of an infected biofilm around the old implants that can contribute to the recurrence. I also think textured implants leak more as they fold repetitively again and again in the same area if the texturing really does adhere. Best of luck. JG 11.23.08
Answer: well, if the capsule was entirely removed or at least aggressively removed, it is early for scar tissue capsular contracture to form again, I would give it some time and not get too worried just yet. JG 11.22.08
Answer: well,no that does not happen in the body if the shell is intact, either the mouthwash deteriorated the shell and it leaked or there was a small hole in the shell created at some time durng the removal or after that allowed the fluid to leak out, if it would leak like that inside the body the implant would go flat. JG 11.22.08
Answer: I do not think the footprint of the implant chosen will be properly covered by the footprint of your native breast tissue, and it might hang out and give you visible ripples or a possible double bubble issue, I would likely not go that large. JG 11.20.08
Answer: implants do fold and in areas where the skin has gotten thinner, it can be felt, I suggest her seeing her surgeon to make sure that is all it is. It is hard to fix if the tissues above that area are too thin, should not be a problem to leave it alone though. JG 11.20.08
Answer: once or twice per day for the fisrt 4-6 weeks is enough if it is needed. JG 11.20.08
Answer: I think the balll is likely just the internal sutures, yes. It usually just dissolves in time. Not uncommon and usually not dangerous. I think the bubble is also not something to worry about and will also get better in time. Best of luck. JG 11.18.08
Answer: well if you feel fine and there is nothing going on that you see or feel, then wait for the one year, if you have any concerns, then you should see him at least at the 6 month or sooner if something perceptible is happening. JG 11.17.08
Answer: well, actually, most surgoens see the patient at one year and have an open door policy to return whenever they wish for follow up or questions. JG 11.17.08
Answer: it usually takes weeks for capsular contracture to form, so what you are feeling is likely just normal post-operative pain. More antibiotics will not affect it, just give it some time. JG 11.16.08
Answer: you can but you do not need to, it is a way to tell you he has an open return policy for check ups, that is not a bad thing. JG 11.13.08
Answer: normal, I cannot say with certainty what is causing the change in feeling though. I think in leaner patients the implants show more when the swelling goes down and that might be it. JG 11.13.08
Answer: might just have some fluid or swelling around the implant that makes them move like that, if it is that it will get better in time. JG 11.10.08
Answer: swish is normal and will all go away over the next few weeks. Hang in there. JG 11.10.08
Answer: they are semi-solid implants that are filled with silicone also, just that it is made differently, they feel like the bra inserts women use, the ripples are essentially zero, that is their greatest marketing along with no leak rate, but they always will feel somewhat firm and will need larger incisions to have them placed and the skill required will be greater as they are shaped and need to be placed exactly correct. They have not been approved here yet as they are still going throiugh the FDA review process for long term safety. JG 11.10.08
Answer: could be in the next year we hope. JG 11.8.08
Answer: yes, I think your desires are possible, juts wait until the gummy bears are released. JG 11.8.08
Answer: pro`s for saline are smaller incision and if it leaks you know because it goes flat, pros for silicone are slightly more natural feel, slightly less ripples, cons for saline, slightly more ripples, slightly less natural feel, cons for silicone are larger incisions needed for palcement and if they rupture you need an MRI for $1000 to diagnose it. If there is no capsule problem at present then the risk of capsules after the redo is the same. JG 11.7.08
Answer: the rupture rates are the same and the capsular contracture rates are also the same. JG 11.7.08
Answer: in most cases that all should work, but there are no guarantees, I would do that, and maybe even remove a little more from the implant if possible, best of luck. JG 11.7.08
Answer: I think you shoudl tell the surgeon what it is that you do not like and let him, with his experience, decide about implant shape. I cannot decide for you whether you should have more surgery or not though. Best of luck. JG 11.7.08
Answer: well, not normal but many women have difficulty with accepting what an implant can, and more importantly, with what an implant cannto do. It might be that your expectations were not realistic, not everyone can acheive the look they have in their head. There are overiding anatomical limitations that implants cannot correct. In general though, I do not use HP implants as they look more unnatural. JG 11.7.08
Answer: no, not really. JG 11.7.08
Answer: should be very soft and pliable as long as there is no capsular contracture. JG 11.5.08
Answer: likely they do not lok natural as they are too narrow for that volume, the moderate plus would be a move in the right direction I feel. JG 11.5.08
Answer: I think since it is elective surgery you should postpone it until your medical condition is optmized, best of luck. JG 11.3.08
Answer: the pressure of the muscle, it is made more common wth implants that are too large for the pateint`s frame and also if the tissues of the chest are not too strong and give way to the pressure. JG 11.2.08
Answer: that is irritation of the nerves in scar tissue. JG 11.2.08
Answer: it should get better as the scar tissue heals and softens. JG 11.2.08
Answer: the pain in the left nipple is due to the nerves being trapped in scar tissue or that they have been stretched, some oral medications might help but not much can be done surgically. The placement of the incision and therby the nipple might be able to be improved with an opening of the pocket to a greater degree and some creation of adherence of the incision to the ribs to avoid it from recurring. The synmastia might need some sutures to be placed to reattach the skin and going to a smaller implant will help too. All the best. JG 11.1.08
Answer: I do not think external sutures alone will do the repair, I think removing them and then replacing them after a few months is an option and the tissues due heal. Smaller implants would help down the road if more surgery is done, yes. Best of luck. JG 10.31.08
Answer: I am not sure why anyone would say that. JG 10.31.08
Answer: if they are not noticeable I am not sure why you would use the creams, but there is no harm in using them. JG 10.31.08
Answer: the implants themselves will not affect the gland of the breast, but the weight of the implant might affect the skin and its ability to shrink after the pregnancies. JG 10.31.08
Answer: the pocket needs to be adjusted to accomodate the diameter of the new implant is all. As to what is better, a capsulectomy or otomy depends on what is needed, if there is restriction of the implant then removing the caspule through a capsulectomy would be better. Removing the capsule can thin the covering, that is true. JG 10.30.08
Answer: I think the difference with the 240 will be very small, might want to go to the smaller if you want more of a slope. As long as they are under the muscle I think the rippling issue is a small concern. I do not see how a smaller size would lead to more rippling if you do not have it now, unless you have rippling now that is concealed by scar tissue. Best of luck. JG 10.29.08
Answer: it likley will be OK, but I would certainly go no bigger than that. The limiting factor is the diameter so if you go to a low profile the size will be smaller for the same diameter, also realize that you might not be able to get to the size you desire without increasing future risks.JG 10.29.08
Answer: I think you have hit your max. JG 10.28.08
Answer: I think it is likely swelling, if you can try placing a rolled up small towel inbetween your breast in yoru bra to apply some pressure and get the swelling to decrease, best of luck. JG 10.25.08
Answer: well, it is more likely that you will get firmer in time, it will not get any softer, but it could stay the same for years too, no way to tell 100%. In your case, as you have had it before, I think it will likely progress over the next few months I am afraid. JG 10.23.08
Answer: I think as the swelling goes down there is a decrease in size, that is normal, but in general I do agree, patients get used to the new size and think they do not see as big of a difference. JG 10.23.08
Answer: yes, pretty much so. JG 10.23.08
Answer: likely you would look more natural as they would be wider if the pocket were enlarged but would not look bigger. JG 10.22.08
Answer: most likely just more exhuberant scar tisuse and swelling, give it some time. JG 10.21.08
Answer: it will require surgery in order to make the pocket larger and let the implant lay flat. I do not think fillers are going to help much and will not help long term. Best of luck. JG 10.21.08
Answer: usually the same incison is used for the subsequent surgeries if at all possible. I will say that using the armpit incision though can be difficult except for a saline implant deflation and quick exchange. The arteries do not die but if the exchange is for capsular contracture, that is very difficult if not impossible to correct thorugh an armpit incision. JG 10.20.08
Answer: more likely scar tissue, there is no true herniation of the implant that would cause that. I think it best to see the surgeon that operated on you or another plastic surgoen if the original one is not around, a mammogram will give some information but not much in this case. JG 10.20.08
Answer: to a slight degreee, yes. As to whether you can tolerate a higher profile implant will depend on the skin elasticity, if your skin is very stretchy you might be able to tolerate it, if it is tight it will not be as easy and will not look as good. One last thing, not everyone can get the size they want and look natural and normal breast never have the shape of a high profile implant so understand that high profile implants typically look fake. JG 10.20.08
Answer: yes, it applies to all breasts, if that problem happens then you will need a breast lift in the future to remove the excess skin and position the breast and implant in a better location, but breast lifts only last a few years and then need to be redone. JG 10.20.08
Answer: I doubt it is a slow leak and the bottle cap you are feeling is probably the disc on the implant which has likely flipped over, it also sonds like your tissues have stretched over time you have lost some breast tissue and this has added to the difference in appearance and size. If that is the case, going to larger implants will accelerate the problem, and even if you change to silicone the ripples will presist, albeit it decreased, but not zero. JG 10.19.08
Answer: breast are normally not high in profile so a low profile implant will yield a more natural resutl and also it should not extend past the width of the native breast tissue to allow adequate coverage. JG 10.16.08
Answer: maybe 1/2 cup difference, if that. JG 10.16.08
Answer: well, to some extent it depends on how big the ones you have now are, the greater the percentage change that 100cc is to the present volume, the larger the difference. JG 10.16.08
Answer: I personally would try to use something much smaller. I think something that size will hang out to a significant degree on the sides. JG 10.16.08
Answer: it should be relatively the same, yes, but there are always small differences that might be more perceptible to the patient than anyone else. JG 10.15.08
Answer: it is due to the skin over the sternum or breast bone being elevated due to the pressure applied by an implant placed either above or below the muscle. The pocket is created in order to accept the implant and if the pocket is made too large over that area, or if the tissues are too weak and elevate later due to the pressure from the implant, tenting of the skin can occur over the breastbone. JG 10.14.08
Answer: I think it is due to slow progressive loss of your own breast tissue and stretching of the skin that allows it appear that way, the amount lost from an implant, if any, would not be perceptible. JG 10.14.08
Answer: I think the exchange will most likely not fix the problem, yes they are narrrower but the higher projection will raise the skin off the chest wall as much if not more. The best way to fix that problem is to either change the site, moving them into a different plane, they are under now so move them above into a totally new pocket, or take them out, wait 6 months for the pocket to close off and try to go back in and not open the pocket as much, that is hard to do, tough problem. Best of luck. JG 10.13.08
Answer: could be a little of both but mostly the skin being thin and too little breast tissue. JG 10.13.08
Answer: by how much the implants move around after the surgery. JG 10.13.08
Answer: an implant alone will only make what you have large in all regards. You will go from small and saggy to larger and saggier. JG 10.13.08
Answer: I would have tried to talk you out of the ones you have now and tried to go smaller. JG 10.10.08
Answer: to a certain degree yes because you are opening the old pocket to make it bigger to accept the larger implant that likely would not fit correctly in the older smaller pocket. Healing will be a little shorter than the first one but not by much. JG 10.10.08
Answer: correct. JG 10.10.08
Answer: it is not uncommon but at the present time we are only doing revision breast surgery on our own previous patients, sorry. JG 10.7.08
Answer: no way to tell how much of a cup size but about 1/2 cup, maybe a little more.JG 10.7.08
Answer: well, I also prefer to wait 3-6 months but there is certainly nothing wrong with doing it sooner. If it is merely a size change for somethng larger, as there is likely swelling at this point, going to a smaller implant is better to wait as the swelling might be contributing to the too large effect. JG 10.7.08
Answer: sorry, it will not make any difference. I usually let patients resume normal activity after one month and I suggest trying to minimize direct pectoral muscle exercises forever after a submuscular breast augmentation. JG 10.6.08
Answer: the limitations posed by the breast tissue is because a crease can result where the breast tissue ends and the implants extend past that crease. In breast reconstruction, all the breast tissue has been removed so there is no limitation of base diameter, but serious other limitations exist. JG 10.5.8
Answer: there is no cost by implant size, you need to see a physician, decide on which one you like and then get the fee as the fees vary greatly from doctor to doctor. JG 10.5.8
Answer: I doubt the implants are causing your probelms and if they are not hardened or deflated I see no need to change them. JG 10.4.08
Answer: I place then in either position, after careful discussion with the patient and I use Mentor implants. JG 10.3.08
Answer: my personal opinion is no, but that is unimportant, if it can be done safely with low post operative complications, that decision is the patient`s. JG 10.3.08
Answer: your doctor would need to examine you and make that decision for you although it can be determined before the surgery as to what dimension the implant can be, no way I can tell you that without a physical exam. JG 10.3.08
Answer: that decision is entrely between your surgeon and you, it can be done safely from the anesthetic point of view if that is your question. All the best, thnalks for the kind words but we are all mortals here I hope and have a safe trip. JG 10.3.08
Answer: I would wait 6 months so the lowest part of the capsule is well formed and then you could exchange the implant for a larger size with less risk of further dropping. The only way to lift the nipple is to cut around it and move it, if the lowest part of the pocket is not opened further and only the top is opened, it might give the appearance of a better position. The breast tissue diameter is what controls the potential safe implant size, not the skin itself. I think at two months you can work out, as to the dimensions it is difficult for me to say without having seen you before the surgery and getting your measurements, sorry. JG 10.2.08.
Answer: no, it is the base diameter of your own breast tissue and that usually will not change much. JG 10.2.08
Answer: well I would wait a few months to change them and also, not everyone can take all sizes of implants, it is determined but your tissues, so it might be the case that you cannot have a larger implant, I cannot tell without having seen you before the surgery. It can certainly be done sooner though if those circumstances exist. JG 10.2.08
Answer: it appears to go away as the day goes on because likely a small amount of swelling occurs around the implant and makes te rippling less visible and that swelling can come and go. JG 10.1.08
Answer: a small number of doctors believe that Sngulair can decrease the chances of capsular contracture, it is not a reliable method of doing so,is an off label use of the drug. I have tried it with no improvement, and it can cause liver damage, so blood tests need to be done to make sure all is OK while on the medication. It is an attempt to modify the inflammatory process that is common between a capsular contracture and allergies to lessen the inflammation and attempt to therefore decrease the formation of scar tissue. JG 10.1.08
Answer: impossible for me to tell, but likely just from the pressure of sleeping in a certain position and should get better in time. JG 10.1.08
Answer: well, the truth is he does not know, if he is so sure, pose this question to him, if he puts in what he thinks is correct and your bra size is not the desired cup after the swelling goes down, will he re-do the operation at no cost? Your tissue might never be able to give you a D cup, unless illadvised sizes are used. JG 9.29.08
Answer: there is no such translation, sorry. JG 9.29.08
Answer: it will likely be a little saggy as you have had so many surgeries already. JG 9.27.08
Answer: well, the larger the jump the greater the difference but it all depends on whether her tissues can take the jump in size. JG 9.27.08
Answer: you coudl put 1 2/3 ounce of fluid in a small ziplock bag, squeeze the air out and put it into a bra to see the difference, not much I am afraid. JG 9.27.08
Answer: hard to say but a guess would be 10-20% decrease. Best of luck. JG 9.27.08
Answer: there will be more motion and potential distortion of the implant under the muscle when you are holding certain poses. JG 9.25.08
Answer: three is no way to tell you what cup you will end up after an augmentation, you will be bigger, but there is no 100% accurate way to determine the cup result. As to the difference between a 350 and a 400cc implant, the 50cc will not make you a cup larger. JG 9.25.08
Answer: unles the pocket was made larger, they will not drop any more and that will not help swelling either. If no work was done on the pocket, you can probabaly do all of that without much concern after 2-3 weeks, just not heavy lifting for the first month. We limit activity for the first two weeks to avoid delayed bleeding. JG 9.24.08
Answer: At this point there is likely lots of swelling, too early to determine end size. For the most part you should be about there in 4-6 weeks if there was not extensive capsule work done as that adds time to the resolution and to the amount of swelling in general. Since the pocket was made long ago, we usually do not have the patient massage at this time in cases similar to yours. JG 9.24.08
Answer: 20 cc is not enough to worry about. JG 9.24.08
Answer: stationary bike is the best, after that would be the elliptical trainer, but that is less effective. I think jogging has its negative effects due to the bouncing and stretch induced by the implants on the skin. JG 9.24.08
Answer: no, but it will not do anything helpful either. JG 9.23.08
Answer: well the carrier gel does not migrate very much so it should be close to a site of injection if it is due to the filler. If it is filler, then massage will help, along with some warm packs. JG 9.21.08
Answer: sounds like the swelling went down and that is why they look and feel different. JG 9.19.08
Answer: sounds like the pocekt is tight, either from it being not made large enough or tight skin with too large of an implant, might need to have the pocket made larger to improve the appearance. JG 9.19.08
Answer: might be an infection or a fluid collection of some sort. Asking him for some anitbiotics is a good safeguard just in case. JG 9.18.08
Answer: it can make it look smaller, rounder and distorted, yes. JG 9.17.08
Answer: I think it is a shape thing and a perception thing, yours are more narrow and might be contributing to that look, but 500cc is always larger, at least in size, to 400cc. JG 9.17.08
Answer: when going bigger I would say yes. JG 9.17.08
Answer: if they are getting firm it is a return of the capsule, the same thing would have likely occurred if you had received new saline implants. Swellling gets better with time and should make the breast feel softer with time, not the other way around. JG 9.17.08
Answer: I think you would be smaller yes. I cannot say without seeing you to what degree a periareolar lift will help, I do not peform them very commonly due to the potential for stretched out scars and flattening of the breast mound. I think two failed attempts within that time frame, assuming new implants were used each time, would point me to not trying implants again. JG 9.16.08
Answer: they look small becasue of your perception. Silicone of the same cc size as saline will not look any different I am afraid. I personally would not put a larger implant in for you with those dimensions. JG 9.15.08
Answer: well on physical exam, if you flex your chest musles a doctor can usually tell, otherwise a mammogram will tell also. What makes the muscle not hold is the size and the fact that the implant is never totally under the muscle, the bottom part is not and therefore the muscles push it down and out. JG 9.15.08
Answer: well, I will will say that exchanging the implants to new ones should help as at times small microscopic amounts of bacteria can settle on the shell of the implant creating something called biofilm and can contribute to recurrence of the capsular contracture. Best of luck. JG 9.12.08
Answer: in that case much of the hardness is because the implant was over filled past the recommended amount, that makes it feel firmer. JG 9.12.08
Answer: well, although a 500 cc implant will move out from under the muscle easier, a smaller implant can still do so if the muscles are tight, if there is less release of the muscle to accomodate the implant and if the tissue of the lower aspect of the dissection are loose enough to alow the implant to drop out from below the muscle. I would not say it is normal, bt it is common over time. The incidence of saline implants staying hard is no different than for silicone, it is not the filling that causes that, it is the pocket and the capsue. JG 9.12.08
Answer: it is very common for implants of that size to not stay under the muscle, yes, the muscle will try to push something that size out from below it. I seriously doubt the tests are wrong. JG 9.11.08
Answer: no, it should not shorten it. I do not think working out will alter their size. JG 9.11.08
Answer: yes, I feel it is narrow. As to a secondary breast aug and the post operative course, it all depends on what it is being done for, the more surgery involved the onger it will take to settle. No way for me to tell without more information on what is being done. JG 9.10.08
Answer: it is about 1 2/3 of an ounce. JG 9.10.08
Answer: in that case it is almost all gone by now I would say. Placing it into the same position does reduce swelling, yes. JG 9.8.08
Answer: usually takes about 3 months, a little longer if under the muscle. JG 9.5.08
Answer: I feel they help fade the redness to some degree, we use ScarGuard or Mederma usually. JG 9.8.08
Answer: the most common cause is the tissue cannot spport the implant, in a small percentage of cases, due to a large implant being desired, the pocket is made larger and then that can secondarily weaken the tissue but that is the less frequent cause. The pre-operative measurements can tell what size implant the patient can support but many patients want larger implants that they can hold and then it becomes a problem. JG 9.8.08
Answer: it is likely becasue they made the pocket larger this time and in time I am afraid the same feeling you had with the saline might be present with the silcone implants. As to how large the pocket was made can only be answered by the surgeon. JG 9.5.08
Answer: It is an attempt to diminish the chances of a capsular contracture but the success of the medication is small and unpredicatable and has side effects on your liver. The allergy medicine is trying to reduce the inflammation that can cause the scar tissue is the theory. There is little evidence it works and none that taking it longer than three months is better. JG 9.5.08
Answer: it can becoma obvious in as little as 4 hours, the larger the hole where it is leaking from the faster it goes flat, if the hole is small it can take a couple of weeks too. JG 9.2.08
Answer: all possible, not necessarily abnormal, I think you need to give it some time though and see what happens. JG 8.31.08
Answer: that is quite variable from patient to patient, should see size differences in about 6 weeks. If you are 2 weeks out you will lose some visible size I feel. I would wait on buying bras for 6 weeks. We allow our patients to exercise in 3-4 weeks and go out in the sun then. These are really questions your surgeon should have gone over with you before surgery though. JG 8.25.08
Answer: I am asorry but I do not have an answer for that. JG 8.25.08
Answer: due to thin tissue between the implant and the skin is what is the cause as all implants sold in the US now will ripple. If you have swelling that comes and goes that can hide the ripples at times. JG 8.25.08
Answer: the only real option is to go in and have the capsule cut out, but there is likey about a 50% chnace of it coming back in time. JG 8.25.08
Answer: neither breast impalnts nor scar tissue there cause cancer. JG 8.25.08
Answer: there is a potential for rupture of the implant and the self exam will never give as much information as a mammogram. JG 8.25.08
Answer: I do not see how it could cause that. JG 8.25.08
Answer: yes, there is, but if they drop, they likely will no longer be under the muscle, it can take up to one year in some patients. Not much you can do at this point except wait. Sorry. JG 8.22.08
Answer: cutting the muscle will likely allow the implant to slip out from below the muscle, and a larger implant might do the same thing. I think with your degree of weigth loss and likely loose skin and breast ptosis, you more appropriately need a breast lift to position the nipple better and remove the excess skin. JG 8.22.08
Answer: I do not think the saline or silcone will differ much as the outer cover is the same and the incidence of capsule formation is equal, best of luck. JG 8.22.08
Answer: well, no, it should be softer, hard for me to say more without knowing what exactly was done, where the implants were positioned, whether there was a capsule formation after the initial surgery or just an inadequate pocket, whether the implants were exchanged the second go round. Might need another surgery I am afraid to say. JG 8.21.08
Answer: just swelling mostly. JG 8.21.08
Answer: at this point all is stil healing, all that you are seeing and feeling can still be normal, I would take it easy and follow your doctor`s instructions and see him in the next week or so to make sure all is progressing well from this point on. JG 8.19.08
Answer: well, although the implants can be changed once agan, I will say, that without knowing more about the surgery and why it was done for and what was done, it might end up with little to no difference, you might not be able to go back to the way they looked before. JG 8.19.08
Answer: as the caspules are cut, it is not uncommon for the muscle to retract superiorly and then cover less and less of the implant. The fat and breast tissue that is around the implant when a capsulotomy or capsulectomy is done can get thiner due to injury to the blood vessels and subsequent atrophy of the tissues. JG 8.19.08
Answer: breast tissue and fat that provide a covering for the implant. I would venture to say that in your case that very little if any of your implant is still under the muscles after repeated capsulotomies. JG 8.19.08
Answer: there is less normal healthy tissue and the less there is of that the greater the chance of recurrance of the capsules. JG 8.19.08
Answer: I am sorry but small is a relative term, there is no translation from diameter to small, medium or large. JG 8.19.08
Answer: when a capsule is scored, it is just cut and allowed to stretch in-between the cuts, there is nothing removed, that is why it very commonly comes right back. They use a cautery unit or a scalpel to score it. JG 8.19.08
Answer: sounds like the capsule is slowly reforming. The end to the repeat capsulotomies and capsulectomies is the permanent removal of the implants without replacing them. I think if it becomes an annual thing they need to be removed and left out I am afraid. JG 8.18.08
Answer: you can measure the diameter of your present breast tissue is the best way. It is the distance from inside to the outer edge. JG 8.16.08
Answer: because using a HP profile only fills the top of the cup, an augmentation, regardless of the shape of the implant, does not necessarily enlarge the cup you wear. In many cases just fills the top making you look rounder or fuller. One cannot compare one person`s results to another due to anatomica differences. JG 8.18.08
Answer: the shifting is due to the size ands shape of the pocket that was made or ensued after the first surgery, and going to a larger implant will not fix that, actually if they are under the muscle it can aggravate the problem. Closing the pocket off is also not relaible,a whole new pocket would have to be created to attempt to correct the problem. Not much more I can say without seeing you in person, sorry. JG 8.18.08
Answer: I think you need to be vocal with the surgeon and tell him your desires and concerns, otherwise it will never be corrected. Some issues are impossible to correct but many can be fixed so there is no need to live with it if it can be fixed, all the best. JG 8.18.08
Answer: not uncommon, surgery has lots of stresses and getting emotional is actually not uncommon, hang in there it will get better, just think about how good you are going to look. JG 8.16.08
Answer: sorry but we do not offer it and not sure who does. JG 8.15.08
Answer: I am sorry but there is no such thing as a best profile for an implant, just understand that different profiles of the same base diameter will be of different shapes is all. JG 8.14.08
Answer: your ribcage does not change with surgery, ribs are ribs and the implants are on top, yes, but it can be measured below the implant to see what it is. JG 8.13.08
Answer: I cannot say that your cup size will change dramatically to a larger size when the implants drop, size and projection will likely not change that much. I do not think the company that makes the implants will create any difference, and with the ribcage dimensions you have, and with you saying you did not want narrow implants, there will be limitations and you might never be able to achieve what you have in mind. It is impossible for me to say more without seeing you in person, but you need to understand that you might not be able to get what you desire with your anatomical limitations, no matter what is done, at least if you want to look anywere natural. JG 8.13.08
Answer: maybe a C. JG 8.13.08
Answer: no, those stitches were likely meant to dissolve and just had not done so yet, not a problem. Hard to say what the lumpyness can be, could be swelling and could be the edge of the implant too. I think a GP will not be able to help, I think a plastic surgeon is what you need but it might be difficult to get one to see you if they did not do your surgery. JG 8.13.08
Answer: I do not believe it would. JG 8.13.08
Answer: 32 would be considered small and then large above that, maybe 38-40. It is measured around the ribs at the level of the crease of the breast. JG 8.13.08
Answer: no way to tell 100% but it usually takes about 150 or more per cup, and the wider your ribcage or native breast tissue is the more it will take, it also depends on the shape or profile of the implant. So difficult to compute, there is no formula. JG 8.13.08
Answer: you have lost lots of your own tissue and due to the implant size the skin has stretched and gotten thiner. I think the only thing that might help is a breast lift with the permanet scars and the improvement that will not last forever. There are no injections to dissolve cellulite that work. JG 8.12.08
Answer: well, it normally varies from patient to patient. If your present implant is centered over your nipple and you replace it with a larger and wider implant and open the capsule only medially, then your nipples will look like they are pointing out to the side. JG 8.12.08
Answer: if your breast diameter is 13.2, that is all I would personally put in. JG 8.12.08
Answer: well, not harmful but the risks are increasing for problems, like sensation loss, tissue losing their strength and bottoming out, skin getting thinner and therefore feeling and seeing the implant more easily. JG 8.12.08
Answer: high profile looks more fake, normal breast do not have those dimensisons. JG 8.12.08
Answer: most likely not much of a visible difference with that change, it is essentially less than a 15% change in the implant and when you factor in your own breast it is likely much less than that overall. JG 8.12.08
Answer: it is just spasms, normal at this point I am afraid. The muscles are always tighter in the morning and they relax as the day goes on. JG 8.11.08
Answer: I am not sure, you have almost 7 ounces more now so they cannot really be the same size. JG 8.11.08
Answer: could be a leak of the saline and as the saline is absorbed the breast shrinks and can look like it is sagging. JG 8.10.08
Answer: I have only seen it happen in patients that had not had children and I have only seen it happen once or twice in over 1000 cases. JG 8.8.08
Answer: I think that small of a change will not influence the risk of stretch marks much. Hope all this helps. JG 8.7.08
Answer: no, they would not. JG 8.6.08
Answer: might get a similar look but it will not be close to the same size, maybe somewhere around 325-340 or so, hard to say as the tissue pliabilty has to come into play and that cannot be determined on you versus her. JG 8.5.08
Answer: in most cases it would involve repeat surgery. JG 8.5.08
Answer: it is variable, no way to 100% tell what will happen. The implants under the muscle should not be affected but your own breast tissue might sag over them. JG 8.5.08
Answer: a hematoma from a break up of a capsular contracture done by external pressure will cause discomfort, not from the hematoma but from the tearing of the scar tissue. Warm packs and massage might help it get better slowly but in most cases where a hematoma occurs, the capsular contracture will return in time too. JG 8.5.08
Answer: this in not the appropriate site to ask those types of questions, this is a plastic surgery site and if yo have those concerns you need to see your doctr or go to the emergency room. JG 8.5.08
Answer: the symptoms of a hematoma are that of a bruise, if it is around your heart or in your head you would have other medical problems. You need to be specific about where this hematoma you are concerned about is. JG 8.4.08
Answer: correct. A hematoma, unless around the heart or in your head, will not kill you. JG 8.4.08
Answer: a blood collection. JG 8.4.08
Answer: I hav enever seen that occur with Juviderm and exercise. As oo manually breaking capsular contractures, just understand that it can cause a hematoma, can rupture the implant, and at times cannot be done completely so the new shape might end up not round but distorted. Also, some medical malpractice companies will not cover the doctor for that procedure too. JG 8.4.08
Answer: tissues and skin stretch, without seeing her, it is difficult for me to say, my guess though is if she had wanted that I would likely not have doen it for her and sent her elsewhere. JG 8.4.08
Answer: no, it will not. JG 8.4.08
Answer: we have our patients wear jogging bras all of the time when they run. JG 8.4.08
Answer: sorry but I do not think it will make any difference, short or long term. The pocket was likely made larger but it continues to scar down causing it to become smaller with time, that is how capsular contracture works. Rippling will still occur under the muscle out to the side and when placed under the muscle the texturing at times does not even work the way they wanted it to as the muscle motion can at times prevent it from adhering to the implant. JG 8.1.08
Answer: if all goes well and there are no complications they can be left in for life, but the rate of repeat surgery is about 25%. JG 7.31.08
Answer: there are three different profiles, all with progressively smaller base diameters for the same volume, what you are best suited for needs to be determined by your surgeon after an in-person consultation. What makes you larger totally depends on how you define larger because a volume of 300cc in a low profile versus a high profile is stil 300cc. JG 7.31.08
Answer: can be due to muscles being tight, not uncommon. As to size fluctuations that can be due to swelling too. JG 7.31.08
Answer: if one is healthy, it can be yes, but there will be more downtime and the time period you will need assiatance for will be greater. JG 7.31.08
Answer: without seeing you I am afraid it is impossible to tell, also, understnad that not everyone can get the cup size they desire, there are limits. JG 7.30.08
Answer: well in your case that is because the implant is a high profile implant and cup size is determined mostly by the base width of the implant, not the volume, I will also say that most women wear an incorrect bra size as the stores do not carry all sizes so they are put into the size available. Understand that years ago studies were done and they showed that a total of 300-350cc was a C cup, and that was just breast tissue, no implant. So 500cc is more than enough for a C cup, if properly fitted and not of a high profile shape as breasts do not normally have a volume to base diameter of that implant. JG 7.30.08
Answer: it can affect yuur liver so blood tests should be done to see where your liver enzymes are before you start and then likely tested once per month, the medication when used for capsular contracture is used for three months. JG 7.28.08
Answer: I have not seen ultrasound make any differnce in the long term, it might help a small amount in the short term but the evidence is very anecdotal. I have not used Singuair, but have used Accolate at a twice daily dose, and have drawn blood tests once a month to monitor for toxic effects,the results have been disappointing though. All the best. JG 7.28.08
Answer: most likely because the skin had to stretch out alot the first time and the second time the skin was already stretched out to such an extent that the pimples did not happen this time. JG 7.27.08
Answer: too early to tell, only time will give you the answer. JG 7.27.08
Answer: I do not think you would see any change in bras size with a 50cc change. JG 7.27.08
Answer: there is no upper limit for that, sorry it was lost somehow. Having said there is no age limit, the older one is the less time it will last. As to the youngest, legally, a breast lift can be done on anyone over 18, just like saline implants but for silcone you have to be 22. JG 7.22.08
Answer: not much, not as much as with the first surgery because that one created more swelling than this one. JG 7.22.08
Answer: mostly softness as the minimal swelling goes down, shape might get a little more teardrop and less round too. JG 7.22.08
Answer: they make them as there are at times differnces in women`s breasts and most surgeons will try to match them up as best as they can. But deciding on whether to use a 400 or a 450 with the same size being use on both breasts will not lead to much of a visible difference. JG 7.22.08
Answer: that varies form city to city I ma afraid. I think silicone implants will likely not change much from where they are now, maybe a little stickier but not significantly different within that time frame due to testing requirements. JG 7.22.08
Answer: after about 6 weeks one can likley sleep without a bra with little worry about pocket shift.JG 7.22.08
Answer: I do not think that would happen. JG 7.19.08
Answer: yes, I agree. We let people wear a normal bra after one month, if placed under he muscle we ask them to limit the underwires bras to 4-6 hours at a time for the fisrt 3 months or so. If the bra worn is too tight it can push the implant up and close off the pocket that was opened for it to lie in. JG 7.18.08
Answer: I think you should follow the instructions of the doctor who did the surgery for you. JG 7.18.08
Answer: well the high and square look is usually due to scar tissue formation or an inadequate pocket, sounds like your pocket was big enough to handle the larger implant without much manipulation and that is why you are recovering the way you are. I think the swelling will vary for the second surgery depending on what they did, it might take less or might take more time, no way to tell without knowing what was done. JG 7.18.08
Answer: adequate release of the muscle from the ribs and breast bone can assist in having the implants stay in a more centralized location, yes. JG 7.17.08
Answer: I think the best thing would be to come in in person and re-consult I will say that numbers are arbitrary, and at times peopel are fixated on a certain cc volume, but at times, even with that, it will not give them the appearance they desire. As to going against my instincts and your anatomical measurements, there wil be a limit that I wil do. You might have to have a high profile implant placed if you desire that size, but as I explained to you, it might leave you looking artificial due to the narrow yet highly projected shape. The hardest part about being a doctor is telling a patient that what they want is not possible or should to be done, not a fun scenario, but although a patient says they are willing to take the risks of a less than perfect result, the degree of deformity has not been seen or felt by you but has been by me, and I am also aware of the large number of patients that claim that certain things will not bother them until they get it and then they are distraught.Lot sto think about, but al the office nad coem back in so we can talk more at length. JG 7.17.08
Answer: nope, most surgeons I know that lecture on a national basis regarding breast augmentation routinely do a breast augmentation under the muscle in 1 to 1 1/2 hours. JG 7.16.08
Answer: I would not use it. 13.2 would be the max and I would try to go less than that if possible. JG 7.16.08
Answer: it is a big implant, it is likely your definition of big is different from most. JG 7.16.08
Answer: it will likely not hange your cup sze at all, it will look narrower and it will have slightly more projection, so the shape will change but not the size to any appreciable amount. JG 7.16.08
Answer: should still be able to do so, but the incision around the nipple might have cut some but not all of the ducts, so impossible to say 100%. JG 7.15.08
Answer: the biggest issue with lifting and working out is elevating your blood pressure and causing a delayed hematoma that would possibly lead to capsular contracture down the road, so just take it easy. You do not have to be a couch potato, but I would not strain. JG 7.10.08
Answer: I feel between the crease of the breast and the navel, the crease is a better incision and the gummy bear implants are not availabe efor general use in the US yet. JG 7.10.08
Answer: areolas can be moved, and nipples themselves can be shortened or reduced, but there is some scarring and there can be loss of sensation. JG 7.8.08
Answer: if the size of the implant used makes the skin stretch, they can get worse or develop new ones, if it is within the size of the skin at present, there should be no more. JG 7.4.08
Answer: I am afraid there is nothing she can do to rmove or improve the stretch marks, lasers might help fade the redness is about all, sorry. JG 7.4.08
Answer: si, olvidate de todo eso, estoy deacuerdo con tu medico. JG 7.4.08
Answer: cannot do any of that for one month. 2 weeks keep heart rate low. You might heal faster but the restrictions are to avoid post-operative bleeding and those risks are the same the second time around. JG 7.1.08
Answer: implants do not come in cup sizes, in order to minimize long term problems it is best to use an impalnt of the base diameter of your native breast, different projections can lead to slightly larger size between them once chosen. The projection described is not of your breast but of the implant when filled. JG 6.30.08
Answer: I think there will be a size difference,yes. JG 6.30.08
Answer: usually the scar is about that, yes. There should not be any beneath the butt itself. You will need to wait 4-6 weeks before running. Shape and size depends on your own measurements, no way for me to tell that. JG 6.24.08
Answer: I think the patient is looking for something to blame, but I seriously doubt her new implants caused anything. If she had taken a blood test before the surgery she would have found that she has silicone in her body before the surgery. That is because silicone is everywhere around us, in OTC pills, in deodorant, hair and skin products,in many things we eat, even in our water. I think she is incorrect is her statement.JG 6.26.08
Answer: many times the small amount of surrounding tissue has to be removed if the silicone has formed scar tissue around it. The spread with the newer silicone is just much less, but still some tissue removal is occasionally required.JG 6.26.08
Answer: the cohesive gel implants that are sold at present are more cohesive than in the past so the tendency to spread the leak is much less but are not the no-leak` cohesive gels that are awaiting release. In terms of the leaked silicone and what it causes, it can cause nodules or lumps as the body tries to wall off the silicone but the illness that had been attributed to the silicone years ago has not proven to be true in the medical literature. As to freaking out over these issues, all people have different triggers I am afraid. JG 6.24.08
Answer: what I mean to say is the chances of you getting a capsular contracture or a firm breast in the future is the same with a silicone versus a saline implant. If the capsule is scored, that will allow a large impalnt to be placed and might make it feel softer, but there is no guarantee it will stay that way and could contract to a firm feeling in time. JG 6.24.08
Answer: I have honestly never heard that saline looks bigger than silicone, and I am afraid your chances of hardness will be the same and the ripples will lessen but not be totally eliminated too. JG 6.24.08
Answer: the armpit incision has been around for almost thirty years, certainly not new. It is used for placing implants under the muscle, it is difficult to place them above the muscle from that approach. It is not any more dangerous and has all of the same risks as the other incisions. Implants have about a 1-2% chance of altering nipple sensation, no matter which incision but should not preclude you from breast feeding in the future if done through the armpit incision. JG 6.10.08
Answer: no, that is just once of the styles, there are many diferent base diameters in that model. JG 6.5.08
Answer: no, no implants are covered for that. The implants are purchased by the surgeon, not the patient. A patient cannot buy their own implant. JG 6.5.08
Answer: it is the actual base width of the implant, that is the diamter, it is not the volume of the implant. What you have is what a properly done breast implant should do, it should not go beyond the diameter of your breast. JG 6.5.08
Answer: yes, they are still made, they come in many different sizes and that is what controls the diameter of the implant, the size.JG 6.5.08
Answer: no way to tell I am afraid, but somewhere between a large B and a C cup. JG 6.5.08
Answer: non-textured. JG 6.5.08
Answer: sounds like just irritated form the acute skin stretching. The rash, if it lasted that long can be from either the pain pump or from some fluid placed around the implant at the time of surgery, such as an antibiotic or some local anesthesia. The pain meds also could have caused it, usually the anestehsia drugs are metabolized quickly as they are given through an IV. JG 6.5.08
Answer: I think in general most women are hapy with them, as to what is best, under or over the muscle, it varies from person to person, there is no universal one that is better, I think in A cup sizes, a fuller look is certainly acheivable, but do not have it done unless you are sure you want to have it done. JG 6.4.08
Answer: you need to measure from one side of the breast to the other at the level of the nipple, and then measure the distance from the nipple to the crease, then double that measurement. JG 6.4.08
Answer: I think they both have their good and their bad points, I do not think there is one better than the other in generla though. I think the best incision will depend on the individual patient, there is no one incsion that is best for all people. I do not think the endoscope is used much anymore, it was more of a marketing thing as the armpit approach was used for many years with great success without the endoscope. I think the quality of the scars will likely be similar in all of the locations, the inframammary might have a sligtly higher risk of being a little thicker. The muscles are only cut if the implant is placed below the muscle, and it is only a partial muscle transection. Going under the muscle I feel lowers the risk of capsular contracture. JG 6.3.08
Answer: it can be becasue the muscle is pushing them out, or the pocket was made too far to the side, or from choosing too large of an implant to place. I think you are justified and going and asking them what they think is going on. JG 6.3.08
Answer: sounds like a pocket dissection issue. JG 6.2.08
Answer: sounds like a capsular contracture, less common when under the muscle but can still happen I am afraid. Might need more surgery. JG 6.2.08
Answer: well, it can be done in some cases when you can see or feel where your own tissue ends and the implants starts, mostly near the edges. JG 6.3.08
Answer: it wil take weeks, and if under the muscle it will take longer. JG 6.2.08
Answer: I think the size reduction you are thinking about will reduce them by about 1/2 cup, and the same sensations can happen with the silicone. JG 6.2.08
Answer: you would need a large caliper to get that measurement, it cannot be done with a tape measure, but it is the same dimension. JG 5.30.08
Answer: there is no best implant for all patients, there are personal variations that make one better in some people than in others, I very rarely use high profile implants and I never use textured implants. JG 5.30.08
Answer: well, if you lay down on your back and it moves to the armpit, you have your answer. The only way to attempt to fix it is to try to close off the pocket in that area, it does not always work though. The tugging is likely some scar tissue is all, not dangerous. JG 5.28.08
Answer: silcone will not help prevent that issue. It sounds like what you have is capsular contracture and the pocket and capsule need to be operated on to improve it. JG 5.28.08
Answer: sounds like saline it is, the silicoen has some issues where it feels somewhat more natural, btu it is not night and day. JG 5.27.08
Answer: no 100% way to prevent it. Activity level will not influence it. JG 5.27.08
Answer: they ripple less than saline, but they still ripple. I think actually silicone will hold its shape more so that saline though. Over time the tissue stretchs on the lower pole of the breast and that round full look will not stay, no matter what implant is used. JG 5.27.08
Answer: it is almost one cup or so. JG 5.27.08
Answer: I do not think capsules form in just one area but it sounds like you will need more surgery to correct all of that. JG 5.27.08
Answer: well, I have to say , all implants sold now ripple, saline ripples more, but whereeer the tissue is thin, the ripples will be usually at least felt if not seen. I will also say that textured implants show more ripples due to the traction effect you mention. In cases where you see it by the center of the breast bone, even if under the muscle, it is because the muscle is thin and cannot hide them. There is essentially not much visible or practical difference between just plain ripples or traction folds. The ripples are all on the surface or edge of the implant. The weight restrictions are to avoid popping a little blood clot off of a blood vessels and getting excessive bleeding that can result in a return to the operating room. Our weight restrictions are lifted completely after 4 weeks though. The ripples have nothing to do with anything you did, it is just thin tissue. Best of luck. JG 5.23.08
Answer: the risks are all the same as the other incisions, even as far as loss of nipple sensation using an incision through the areola. As to being sure how not to cut the muslce, it is done under direct vision so they can see it. The difference between the high and moderate profile implant is the height or prjection of the implant off of the chest wall.As to the capsular contracture, all peopel get scar tissue, but a percentage, roughly 20-24% wil get stiffness of that scar tissue as it contacts.Best of luck. JG 5.23.08
Answer: weeks to months if it is going to help at all, it might not help the capsular contracture. The capsule, if it is not going to repsond to the Vitamin E might continue to get worse while on the vitamin too. JG 5.22.08
Answer: the pocket is created using instruments to lift the muscle off of the ribcage, a tissue expander is used by a small percentage of surgeons to assist them in opening the pocket at times. The muslce is pulled off of the ribs but not cut. The sutures only close the skin, they do not attach to the implant. There might be some oozing at the incision but we do not routinely use drain tubes as the amount of fluid is very small. The bruising should be small and gone within 7-10 days. Best of luck. JG 5.22.08
Answer: well, I think the doctor has confused you, a TUBA is an augmentation done through the belly button and it invalidates the company warranty on the saline implant, the arm pit ncison can also be used and some doctors use an endoscope to perform the procedure but it is not needed. As t the difference between a cosmetic surgeon and a plastic surgoen, cosmetic surgeons are doctors from other fields like gynecology or family practice and even dentists who never did a board certified training period in an accredited plastic surgery university based program and have decided that rather than practice what they were trained to do, they take week long or weekend course to learn how to peform certain cosmetic surgery procedures as they are a cash basis and present better return than insurnace reimbursement from the type of medicine they were formally trained to do. JG 5.22.08
Answer: I cannto give you a percentage of the women that are happy. A woman may not be able to get the size she wants due to anatomical limits out of her control. JG 5.21.08
Answer: yes, the restrictions are the same to avoid bleeding and tearing the incision open. I would also suggest waiting the sae alloted time before physical activity. I would not run for 3-4 weeks, you can walk on an incline treadmill with no bouncing after 2 weeks in our practice. JG 5.21.08
Answer: possibly, if the native breast tissue widens afer the implant. JG 5.20.08
Answer: there are anatomical limitations on what can be placed, these are the size of your native breast tissue, location of your nipples and shape of your rib cage that will influence that, so no way I can tell. JG 5.19.08
Answer: no, the need for MRI scans every 2-3 years applies for silicone implants only. Mammograms are still needed, no matter what type of implants are placed, for cancer monitoring, yes. JG 5.17.08
Answer: I think the only thing would be a capsulotomy or capsulectomy to alleviate the contracture, but there is a high recurrance rate. JG 5.16.08
Answer: works in a very small number of cases, even less if not combined with surgery. JG 5.16.08
Answer: well, I think the Vitamin E softens scar tissue and if it is going to work on the capsule, it coudl also work on the bottoming out repair in a negative fashion I guess, tough call.I have never had to use the Vitmain E at the time of repairing two opposing issues I am afraid. JG 5.15.08
Answer: I am not sure what is causing the pain but I do not think it will get any better or worse with an implant being placed. I think when you go to the web to find information you typcally get a distorted view as happy patients to not get on message boards or blogs, so it sounds more negative than it really is in real life. There are risks, but they are small. JG 5.15.08
Answer: I believe smooth show less ripples. JG 5.14.08
Answer: the definition of large is not the number, but how it compares to the breast tissue and anatomy you have, a 300 could be small on a large framed person and too large for a small frame, no way to tell without seeing you in person. The docotr might have the information, and Mentor might also. JG 5.14.08
Answer: 2 months, if it is no better by then you can stop the extra Vitamin E. JG 5.14.08
Answer: if it is a textured anatomical shaped implant, then changing it to a smooth round implant might alleviate the issue because anatomical textured implants can look triangular in some women when the implant chosen is large. JG 5.14.08
Answer: well, if you have a non-textured implant, then the triangular shape is not due to the implant, it is either some degree of capsular contracture or inadequate pocket dissection. You will need more surgery but changing the implant will not affect it. JG 5.14.08
Answer: it is true, mammograms are not adequate to detect leaking in silicone implants, ultrasounds are not as good at picking up small tumors as a mammogram is. JG 5.14.08
Answer: I do not think it is too late but I cannot say what size you could be, it depends on your anatomy. JG 5.14.08
Answer: well, some doctors do it that way, and they might guess right most of the time, but I prefer to measure and be sure. You can be measured now and see what you can have implanted safely, yes. JG 5.13.08
Answer: at 8 weeks a capsuln can start, yes. If you are going to take Vitamin E, I usually start at 3000 units per day in three divided doses for one month and then decrease by 1/3, it will thin your blood though. JG 5.13.08
Answer: I think it is the best thing to tell them what you want to see them for otherwise they will think you have not been honest. JG 5.13.08
Answer: if it occurrs that soon after the surgey it is not capsular contracture but likely either implant size choice or size of pocket dissection causing the issue. JG 5.13.08
Answer: shoulder width has no effect on implant choice, or at least should not, it is the width of your breast tissue that will limit the implant choice in order to lessen long term risks, to some degree the width of the ribcage will come into play, but not the shoulder width. JG 5.13.08
Answer: pretty straightforward, just open the incision and the capsule and remove one and replace it with the other. JG 5.10.08
Answer: sounds like with all that you are describing you had a hematoma develop from probably a partial tear of the pectoralis muscle off of the breastbone and that has caused all of what is going on. If there is a hematoma the best thing is to drain it so that will let the implant settle into place and also help reduce the risk of capsular contracture down the road. The strap and massaging might help but it can literally take months to settle down in some cases. JG 5.10.08
Answer: it might be scar tissue, yes. I suggest seeing your surgeon for a check up. JG 5.8.08
Answer: it is due to the swelling going down and also something called a piston effect where the implant bounces and puts strain or traction on the skin to make it slightly thinner thereby allowing the ripples to be more easily seen. The smaller breast can also have some element of capsular contracture that may hide some of the ripples. Silicone lessens but never eliminates the ripples, at least with the silicone implants sold now in the US. JG 5.8.08
Answer: not much that can be done besides the lift, a larger implant I think would not fix that issue. JG 5.8.08
Answer: I think either silicone or saline can be done, the silicone might feel a little more natural, and yes, many women in the 40`s have them placed, even for the first time. JG 5.8.08
Answer: it is likely to to the pocket size and when implants are placed under the muscle that can happen from the pressure of the muscle pushing on the implant. It can be attempted to be fixed by closing the pocket, but it is not a guaranteed result as it depends greatly on how the tissues heal. As to why the doctor did not discuss that all with you before, that is really up to him, but it is usually discussed at length prior to surgery. I think the revision surgery can be done through either approach so I suggest letting him use the incision he prefers. Best of luck. JG 5.8.08
Answer: yes, but the degree of size reduction required will need to be discussed with the surgoen and they will likely need to know the size implant originally used to make that determination. JG 5.8.08
Answer: well, in most cases it is due to improper pocket location for the implant. JG 5.7.08
Answer: that is absurd, I think you need to seek out another surgeon. The right side might have some capsular contracture or just a larger pocket, hard to say. I think pictures help some but in your case it would require a physical examination as the implant needs to be moved to see what can be accomplished, sorry. JG 5.7.08
Answer: to be honest, I am not sure how that makes it safe, it might avoid one problem, synmastia, but the issue is the implant needs to be centered behind the nipple evenly, that might require an adjustment on the size though. I think you need another surgery and possibly different implants and a pocket adjustment, sorry. JG 5.6.08
Answer: I think it would be OK for you still. JG 5.6.08
Answer: it might help, yes. It might also require the tissues to be closed off medially next to the breast bone to push the implants out even further in some cases. JG 5.6.08
Answer: could be a neuroma formed on the nerve, and yes, it might be there forever. That is a very rare problem. JG 5.6.08
Answer: sutures would no cause that and an MRI will not show much I am afraid, sounds like the nerves were injured during the placement of the implant. Although there can be improvements in the sensation occuring for 12 months, most of it should be normal by now. I am afraad there is not much I can offer for now. The implant can be sitting too low due to the muscle pushing the implant lower over time from the pocket being made slighty larger at the time of the surgery. JG 5.4.08
Answer: I think what mmight be happening is that the implants are attached to the tissue and when in the bra it pulls on the skin. I do think a smooth walled implant would solve some of the issues. The tenting will not get better if the implant is too large though. JG 5.3.08
Answer: the muscle is lifted, the capsule is opened and the implant removed intact and then the capsule cut to allow it to open enough to accept the larger implant. The muscles will not need to be cut anymore than they were the first time, it should not be a bloody mess. The implant is wider than the incision and will not fall out becasue it will heal and the tissue will be strong enough to suoport it. JG 5.3.08
Answer: if it has been there from the begging it is a pocket thing, if it looked sloped first nd then got rounder, it is scar tissue. JG 5.3.08
Answer: about one half inch so it will be visible. JG 5.3.08
Answer: collections of fluid after surgery are from blood or serum accumulating in the open space created by the surgery or the removal of something during the surgery. At times placing a drain tube at the time of surgery will help decrease that risk, but it is not 100%. Even if you removed the implants en bloc, the cavity it was removed from can create a fluid collection, it is not a case of implants being removed in pieces that causes it. If repeat aspirations are needed, it might warrant the placement of a drain tube to control it. JG 4.30.08
Answer: well, there are no new developments in terms of avoiding capsular contracture I am afraid, your initial resutl was to a great deal due to the Meme implants and they are no longer available. There are surgeons that do only breast urgery but without the Meme implants, results will likely not be as good and also your tissues have degraded due to time. Wish I had suggestions for you. JG 4.30.08
Answer: not being done here yet. JG 4.29.08
Answer: well, I think you can tell him that you have chatted with other surgeons that have suggested that there are sizes past a certain size that might not be well supported by your body and you are wondering how much bigger he thinks would be safe for the long term. You need to be able to talk with him, candidly, if you cannot talk to him, or his is unwilling to listen, then there can be issues once again, finding a surgeon that you can speak with is paramount, if you cannot do that with him, you might need to go elsewhere, at least for a consultation. JG 4.29.08
Answer: there is no slow leak with saline, if they leak, you go flat, the longest it would tkae to go flat would be about one month. If they are not broken they do not need to be replaced unless there is something else going on. JG 4.28.08
Answer: it is possible but many times it will stretch out again due to the pressure from the implant. JG 4.28.08
Answer: sorry,but it won`t do that. JG 4.28.08
Answer: it goes out to the side and down and will be covered by breast tissue if there is enough, otherwise it will be covered by skin only. The biggest thing when not covered by the muscle is being able to see and feel ripples. I cannot tell you what the max size would be without examining you, sorry. JG 4.28.08
Answer: about. JG 4.28.08
Answer: there is still soreness, but less than the first in most cases. JG 4.27.08
Answer: the native breast tissues needs to be measured to determine BWD, not the ribcage. JG 4.27.08
Answer: implants do not cause cysts, but during the removal of the implants there cna be fuid collections that develop that look like cysts. JG 4.27.08
Answer: the thiness does nothing to do with the profile, it is the width of their tissue that it will influence it. I think a bigger implant in a thin person with low body fat will likely show rippples due to thin skin. I can guarantee you an implant in the 480 range or higher will only have a small portion below the muscle. JG 4.27.08
Answer: I do not think it will make much visible difference. JG 4.23.08
Answer: 50cc on top of 650cc will not make much difference. JG 4.23.08
Answer: no need to stop, the discomfort will likely be no different. JG 4.24.08
Answer: well, it is one of those honesty is the best policy, tell him how happy you are with ehe one side first and then ask if the other one can be improved to look like the nice one. JG 4.21.08
Answer: it depends on how much the were filled, they should be pretty pliable in general though. What you are describing sounds more like a small amount of capsular contracture.JG 4.18.08
Answer: I am afriad there is no 100% way, I suggest talking to previous patients and other doctors. Credentials do nto give honesty per se, sorry. JG 4.18.08
Answer: I likely would not fill them past 400-410 in most cases. JG 4.18.08
Answer: I am sorry but that is not a professional decision, it is a personal choice. JG 4.15.08
Answer: it varies from patient to pateint, one size that is fine for one patient might be too big for another patient. JG 4.14.08
Answer: hard for me to tell that without examining you I am afraid, but if you made me guess, I think it would not be easy to do with a smaller implant. JG 4.14.08
Answer: usually the capsule is either cut and allowed to expand to allow the newer implant to be placed, in a small number of cases the capsule is entirely removed. It is almost unheard of for a larger implant to be placed without something being done to the capsue unless it was a very large pocket to begin with. JG 4.14.08
Answer: I think you can certainly ask him for a copy of your operative record, or get it from the surgery center and read it there. JG 4.13.08
Answer: no, it should not. JG 4.10.08
Answer: in most cases if the same medications are used, yes. But anytime you have anesthesia, there can be differences. In general, local anesthesia has less risks though. JG 4.10.08
Answer: he can say no, I do it all the time. Not all surgeons say no though. I think you need to ask the surgeon their motivations for doing it as larger implants might end up not giving the patient what they want long term. JG 4.10.08
Answer: borderline I would say. Tenting is stil tenting, yes. It worsens with the push up bra because the implant lifts the skin off your breastbone. JG 4.10.08
Answer: I think mammograms are worth the trade off for the radiation. MRI is better if you have silicone implants though. JG 4.10.08
Answer: it can happen from wanting too large of an implant, from the surgeon opening the pcket to a certain degree, to the quality of their tissues and degree of support it can sustain, to previous pregnanacies, to many issues. I think the biggest contributor is an implant that is too large for the anatomy of the patient. JG 4.10.08
Answer: I think it is safe to do it all at one time but if there is not enough loose skin to revise the reverse abdominoplasty scar, the scar will eventually end up looking the same. JG 4.9.08
Answer: I think the risks are almost the same as the first one. JG 4.8.08
Answer: I would use the same cc, yes. Overfilling is up to the surgeon in terms of amount. The implant has an amount it can be filled to, overfilling it will make it feel firm as it is past the recommended amount and can also lead to more leaking. JG 4.8.08
Answer: well there is no breast tissue that woudl need to be removed. Not knowing why you had the surgery, but if you had ruptured silicone implants it could be scar tissue from the silicone that could not be removed and 6 weeks is way too early to determine symmetry of size after your surgery, 6 months is more like it. As to size, I have found there is no way to guarantee size of cup after a breast surgery, all we can do is make you larger and certainly you have had a significant increase in the volume of the implant, I would say t give it some time for some healing to occur. JG 4.8.08
Answer: not necessarily so, especially when in a bra. JG 4.8.08
Answer: I really can`t say, I would have used the same size if possible, maybe he had the 360 and did not want to order another one. JG 4.8.08
Answer: to the amount you previously had. JG 4.8.08
Answer: yes, but if overfilled enough you will get scalloping, which makes it look like those mylar balloons at the mall that have firm ridged edges. JG 4.7.08
Answer: well, the real answer is that you cannot, The reason is, in a smaller diameter implant, overfilling it will achieve a certain amount of projection. If you use a larger implant the next time with a wider base, then overfilling it will give you more projection but also a wider base, so they will never be the same. The closest you can get in terms of size is to use the same volume, but then the projection will be less than the first time. If you use more volume to get the same projection, in truth they will have to be bigger. JG 4.7.08
Answer: well, let me say I already disagree, saline and silicone do not look very different, maybe in a person with very low body fat in certain positions you might see more ripples on the lateral chest with saline over silicone but they both ripple. Silicone feels better, but is more expensive to follow up for ruptures as you need a $1000 MRI to evaluate it. JG 4.7.08
Answer: there are many veins in that area, some bleed during the surgery and we can stop them, at times, after the surgery, small veins that were not previously bleeding will start and that can cause the bruising, it does not mean anything went wrong, it can happen with any of the incisions for a breast surgery too. JG 4.4.08
Answer: there should be none. JG 4.4.08
Answer: most likley a response to one of the medications. JG 4.3.08
Answer: nothing is 100%. You are actually at risk for capsular contracture which most likely comes from subclinical infection, but in terms of regular infection, I would say that after 30 days you are out of the woods. JG 4.3.08
Answer: well, it is just that if not needed for a medical reason, the risks you take, like infection that would require the implant be removed for 6 months and scar tissue are somethig that needs to be balanced out. No easy answer. JG 4.3.08
Answer: we usually do under the muscle and silicone might fell a little more natural but requires an MRI scan to check for leaks every 2-3 years, and that test costs $1000. JG 4.2.08
Answer: I think they will be nearly the same size and fullness in time, as to if it is fixable, it is impossible for me to say without knowing what you had done, the reason for the repeat surgery and seeing you, sorry. JG 4.1.08
Answer: they both have ripples, it is just the silicone ripples less, but it ripples also. If you over fill a saline implant what you feel is called scalloping, not ripples,like those mylar ballons sold at the mall that are overinflated and have ridges. JG 3.31.08
Answer: in most peopele that is less than a cup difference, but in some women, that is enough. JG 3.31.08
Answer: correct. But the most important diameter is the vertical one, so the distance from nipple to breast crease should be half of the largest suggested diameter size. JG 3.29.08
Answer: some people are just more tough than others. As to the eyes, there can be swelling on the upper lids too even if they did not have surgery. All will get better in time. JG 3.28.08
Answer: silicone implants will not change your concerns, they can likely look just like the saline ones if the same size and shape is used. If you are that unhappy I think removing them is the best. JG 3.28.08
Answer: well, it is likley that the muscle was released to aggressively and the muscle has pulled away and no longer covers the muscle, or the muscle is very thing. If you had some capsule there that was thick before it could have hidden the ripples too. JG 3.27.08
Answer: I am afraid you are likely stuck until the true cohesive gel implants become available. The silicone implants for sale now do ripple, they just ripple less than saline, so I am not sure why they told you that. JG 3.27.08
Answer: I think overfilling can be done, but they will feel more firm and the leak rate is higher when overfilled, I think the difference will be small though. I think if you want it done, and the surgeon is agreeable, the sooner the better. JG 3.27.08
Answer: more visible rippling, greater chance of double bubble problem, greater degree of sagging. I think if they look fine I would leave them alone. JG 3.27.08
Answer: 100cc is a significant increase but the larger you go the greater the long term complications from the implant. JG 3.27.08
Answer: if you had local anesthesia with sedation, there is no need for a tube down the throat, that is only for general anesthesia. JG 3.27.08
Answer: hard for me to say whether that size is correct for your frame without seeing you but the difference between 510 and 480 is relatively small. JG 3.26.08
Answer: there are always risks but in trained hands the risks are small, and that young girl died due to complications from the anesthesia, not the surgery, full details have not be released so I cannot comment on the cause any further. I think if you follow all of the doctor`s advice after the surgery the chances of death are extremely small. JG 3.26.08
Answer: most cases the sweling at this point will make it go about 10-15% smaller and it might take 6 weeks for most of it to go down. JG 3.25.08
Answer: not necessarily as the implants wil pull the skin down and back due to their weight. JG 3.25.08
Answer: it is most likely swelling, but it can happen even without the surgeon lifting the muscle as the muscle can tear from a large implant applying pressure medially. Hang in there and give it some time. JG 3.25.08
Answer: well, there is no reason to do it or not to do it, there is some small evidence that using them will cause the implants to displace downward and outward though. JG 3.24.08
Answer: I would just give it time, I do not think the ScarGuard will help anything below the surface, might be small sutures that still need to dissolve. JG 3.24.08
Answer: bleeding increases with anything done to the capsule, if an exchange is done to go smaller, then the risk of bleeding is small, but if a larger impalnt is placed, opening of the capsule needs to be done and that increases bleeding, but certainly no higher than the original surgery. JG 3.24.08
Answer: that license is granted by the state and that is still not a guaratee the doctor is propery trained. JG 3.24.08
Answer: yes, they can, the skin might be tight to begin with but in many cases with time and bouncing the skin will relax. As to whether surgery is needed, if they do not hurt and you can live with them I would leave them alone, with little breast tissue the chances of it recurring exactly the same is high so I would reserve surgery until really needed. JG 3.23.08
Answer: the pop might just be the implants shifting position and the veins will swell and subside with activity and position. JG 3.23.08
Answer: it might be aggravated because the muscle was previously lifted but there will be motion of the implant with motion of the pectoral muslce even if there was no previous under the muscle palcement as they are adjacent and as the capsule moves with the muscle the implant will move, that is normal. JG 3.23.08
Answer: it can happen, it happens more in textured implants, but they are man made and they do fail in time, your scenario is unusual though. It might be a flaw in the implant or a small injury at the time of surgery when placing the implant that weakens the wall of the implant. JG 3.22.08
Answer: well, not totally abnormal but if it is red on only one side I would suggest seeing your surgeon to make sure there is no infection that needs to be treated. JG 3.21.08
Answer: I think silicone implants are safe. As to the skin, as long as you allow 10-15 minutes between the apllication of each, it is OK to use them all. JG 3.20.08
Answer: I think in some cases the implant alone can be exchanged as long as the breast tissue and nipple location are in good position. The costs will vary from surgeon to surgeon and you need to decide on your surgoen and then ask. Best of luck. JG 3.20.08
Answer: yes, that is the way it is usually done and it can take 4-12 weeks to settle in. JG 3.19.08
Answer: sounds like a grade 2 capsule on the right and the symmetry would be better possibly with a capsulectomy of the rigth side now. JG 3.19.08
Answer: no real way to tell for the B cup, but a guess would be about 200-225. I think you might need to get the implants taken out and left out to go down two sizes. JG 3.10.08
Answer: insurance typically will not pay for a cosmetic procedure like that. Sorry. JG 3.10.08
Answer: in Las Vegas $4000-$7900. JG 3.8.08
Answer: if they are doing fine there is no need to replace them. JG 3.8.08
Answer: I strongly believe you should leave it as is and not do anything else for now. JG 3.6.08
Answer: if they are ripples in the implant that are showing through due to low body fat and not much breast tissue over the implant, they wil be permanent. There is no surgical procedure that will reliably fix it, fat injections have bee tried but the improvement is variable and not predictable.Best of luck. JG 3.6.08
Answer: well, they have the same incidence of scar tissue which is what the problem is now apparently, so both could potentially feel the way they do now in time. If they remin soft, then the silicone one might have less ripples, but will still have some ripples. JG 3.5.08
Answer: nope, it will track the return but will not cause any nerves to grow back.Sorry. JG 3.5.08
Answer: how they feel now is a reflection of caspular contracture most likley and can happen at the same rate for both silicone and saline implants. I think silicone will have less visible ripples, but it is less, not none. JG 3.6.08
Answer: it is mostly genetic, in terms of the strength of your tissues. JG 3.5.08
Answer: yes, but if they lift the areola and pull the tissue below up to fill in the depressed area, that should correct it, at least partially. Just cutting and sewing wihtout transposition of tissue will not work. JG 3.4.08
Answer: since it is a revision of the pocket, and since both of those activities place a larger stress on the repair of the pocket, I would say at least 4-6 weeks, after three weeks you could walk on an incline or ride a stationary bike in a jog bra at all times when do it too. JG 3.4.08
Answer: most likely scar tissue, it might be abe to be revised under local anesthesia without going too deep. Not uncommon from repeat opening of the incision like that. JG 3.4.08
Answer: could be how they are sitting in the pocket and also due to swelling still there. As to 650 being big or not big, I guess it is all a matter of opinion, considering that a C cup, including breast tissue and implant, is about 300-350cc. JG 3.4.08
Answer: I think it could be from swelling or from the implant laying differenty in the pocket and both of those issues will change substantially in the next few weeks, you need to give it time for the swelling and the implnat to settle into its place. Hang in there. JG 3.4.08
Answer: nowadays, general anesthesia is much safer and there should not be any long term negative effects from three anesthetics in one year. I think the risk of a lung injury would be very small, it is very rare, all the best. JG 3.3.08
Answer: skepticism in silicone is based on the ruling by the FDA in the early 90`s to pull it off the market for questionable reasons, that was followed by a class action suit that everyone assumed was based on truth and when the companies settled, everyone thought the claims were proven, but in fact it was a financial reason to settle, not one based on science. As to the difference, I feel, as do most people, that the silicone implants feel more like a natural breast tissue than the saline ones do. JG 3.3.08
Answer: pain is greater with a capsulectomy and the capsulectomy is the removal of the scar tissue where the capsulotomy is just the cutting and weakening of the scar tissue without removal. JG 3.3.08
Answer: there is still a small chance, but it is small. JG 3.3.08
Answer: after this much time, if the sensation issue is due to the surgery, it will not change, all the best. JG 3.3.08
Answer: I think at this point in time if the sensation issue is due to your surgery, it will stay that way. All the best. JG 3.3.08
Answer: the only other thing would be that the pocket opened at the time of the surgery was not large enough or that the muscle of the right side is tighter and stronger and did not relax as much as the left during the first couple of months and allowed everything to heal up higher on your chest. Under the muscle can at times take 8 months or longer to settle in, hang in there. JG 2.29.08
Answer: if it is a muscle spasm, there is not much to do or worry about, but I cannot diagnose it long distance so if it persists you need to be examined in person to make sure it is nothing else. JG 2.28.08
Answer: sounds like a small muscle spasm, should be OK but if it occurs again I think you should see your doctor. JG 2.28.08
Answer: nothing to look for, it is all a matter of feel, it is just a gradual and progressive hardening or firming of the mound, it is progressive and does not get harder and softer, it is either unchanged or gets progressively worse. JG 2.27.08
Answer: he is cutting through the skin and lifting the edge of the breast until he gets to the edge of the muscle and then he goes below that leaving the breast tissue attached to the anterior surface of the muscle. As to the armpit, there is very loose tissue below the skin that is very thin and almostimmediately he can gain access to the edge of the muscle and then go below it. JG 2.27.08
Answer: well, it is less than 10% of a differecne, I would not do surgery for that small of a change. I see no reason why silicone would sag more, that has not been my experience with them, the weight of a 300cc implant with silicone or saline is the same. JG 2.27.08
Answer: it cannot be removed through the armpit or the belly button incisions, correct. As to removing scar tissue when exchange for size is the reason, if the size change is large, some treatment of the capsule is needed to allow it to lie correctly. JG 2.26.08
Answer: well, the differences are small, there are advantages and disadvantages to both, if they are under the muscle I will tell you the diference is quite small, on top of the muscle, there is maybe less rippling with silicone and they might feel a litle more like Jello, but the temperature changes are slower with silicone so they are not your body temperature as fast when you change locations. Scar tissue and leak rates are about the same. If you are not having any problems I would leave them alone, no need to change them unless there is an issue. JG 2.26.08
Answer: the prices will vary from surgeon to surgeon, no way to tell, but the original surgeon usually wil give a discount since you are already a patient. JG 2.25.08
Answer: I think capsular contracture can get worse but it does not go hard and soft back and forth, once it gets worse it does not get better on its own. I suggest getting it treated once it causes you serious concern or pain. JG 2.25.08
Answer: the implant does not fall through that incison because only the tissues above the incision are weakened, and not below, you could also go through an incision around the areola. The getting back to running and lifting will be the same amount of time as the first go round I am afraid. Best of luck. JG 2.24.08
Answer: the capsule formation and its location is completely non-predictable so all women will get a different capsule if they get it. Not all capsules progress in time, no. As to the why some women respond better, I think it is how their immune system perceives the implant surface and there is no way to predict that. JG 2.22.08
Answer: I do not think it is a surgery you need to have until the scar tissue starts to cause you pain. I think it best to leave it be if you can deal with the size. JG 2.22.08
Answer: well, the pocker has healed to the size of your present implant in your case because you say it does not move much. If you want to go bigger, a larger pocket is needed as the implant would not fit otherwise so a capsulotomy or casulectomy is needed. I think he is splitting hairs on the capsular contracure though, there are 4 degrees of capsular contracture and you just may have a level 2 out of the 4, nothing severe, but certainly some stiffness. I will say though that in the case of textured implants, even without a capsular contracture, they do not move as the texturing acts like velcro, that is why I do nt use them. Best of luck and hope that helps. JG 2.21.08
Answer: removing the scar tissue is difficult when it is below the muscle for fear of damaging the muscle so only a partial capsule removal is usually done. Overcorrection of the lower side is the usual thing to. It is not uncommon to have to revise both breast, best of luck. JG 2.19.08
Answer: well, hard to say without seeing before and after pictures and reading the operative report, at times there can be things done to get a little more symmmetry but perfect symmetry is never possible. JG 2.18.08
Answer: normally women lose breast tissue as they age, but the implant, since it causes some stretching of the skin, can also stretch it so it looks looser. I think changing them after 9 months unless something needs to be done is a little too soon. I think a redo should only be done if really needed. JG 2.18.08
Answer: could be just the loss of your own breast tissue and the skin relaxing so they do not feel as firm. JG 2.13.08
Answer: when the muscle flexes the implant folds in half and it looks like the fold appears like the mound is winking or creasing. JG 2.12.08
Answer: I totally believe that a smaller implant has less long term complications, without a doubt. JG 2.12.08
Answer: to a great extent it depends on the size implant that you have had, at times the muscle is big enough to covert it, also I will say that at times the implant is placed below the muscle but it can pop out from below and go above and in those cases there will be no winking. Not everyone that has an implant below the muscle has the winking issue. Going to a larger implant in your case might make it behave differently, yes. JG 2.11.08
Answer: it is not a bad thing to do if the redo is going to help. The chances for the capsular contracture rate is the same but the possibility of more visible and palpable edges and riples goes up. There might nto be anything you can do due to the anatomical limitations you had to start with. JG 2.11.08
Answer: well, the width is partially due to the implant and also partially due to the native breast tissue you have, going to a wider implant might make your base width wider but can also leave you with an edge laterally or near the inferior part of your breast where it is visible and palable to where the breast tissue ends and the implants starts. There are anatomical differences that make perfect symmetry impossible at times. JG 2.11.08
Answer: if you are content with how it is, then wait, if it is not the way you can deal with it if it were to be permanent, then take them out. I think a good support jog bra is all that is needed at this point when working out. Going back under the muscle is possible, yes and should limit the chances of it getting synmastia all over again. I would leave them out for at least 6 months. Best of luck. JG 2.10.08
Answer: it might be imporved but it appears that not totaly, I think wearing the thong bra at this time will probably help it from lifting off the sternum any more but will not make it stick back down. It might stay that way without more repair. It might require significant more intervention, potentially even including removing the implants for 6 months and starting over again after the tissues have readhered I am afraid. Synmastia can be difficult to repair without concessions. High profile helps to some degree as it is narrower, but at times a significant size reduction is also needed along with the higher profile implant. JG 2.10.08
Answer: the split method is what was done by most surgeons doing the submuscular approach, it was just not termed the split method is all. A subfascal placement is essentialy over the muslce, the layer of fascia is as thick as a wet piece of paper and will avoid the winking of the muscle but also has all of the limitations of placement above the muscle.Once you have had capsular contracture, the incidence of recurrenece is high,no matter what the original cause. JG 2.8.08
Answer: no harm done, just the tissues trying to heal, a little massage might help it feel better. JG 2.6.08
Answer: I do not think you did anyting bad by wearing the other bra, it would have happend with the sports bra too, it is just the tissues trying to heal together, massage might help, but in time those tissues want to readhere to one another. JG 2.6.08
Answer: you will only need the lift if they sag over the next few years. JG 2.5.08
Answer: at present we are not accepting patients for repeat breast surgery done elsewhere due to our schedule but when we did the fees did not always go up, it depended on what needed to be done. It is possible to go from unders to overs, yes. The old pocket usually shrinks and heals flat. JG 2.5.08
Answer: well, first of all, what is new is the attempt by surgeons to claim something as new when we have all been doing it in that fashion for years, so nothing new and nothing significantly different from what you have already had and I do not think it will alleviate your capsular contracture issue I am afraid. If you have undergone 5 breast surgeries already I am afraid your chances of a repeat problem are way over 50% if not higher. JG 2.4.08
Answer: it varies but about 1 1/2 hours or so for that surgery in most cases. The scar tissue is never attached to the implant so it is gently peeled off of the normal surrounding tissues, best of luck. JG 1.30.08
Answer: the capsulectomy for large implants is a good option in order to avoid any potential limitation from the previous capsule not allowing the implants to lie in the best position. The pain is no larger than the original surgery. JG 1.30.08
Answer: I do not think wearing tight clothing will cause a deflation. Not wearing a bra might allow the eventual sagging to go faster, as will the added weight of the implant. I think sleeping position will have little effect. JG 1.30.08
Answer: the biggest isk is that the fat doesn`t survive and you end up looking the same. JG 1.29.08
Answer: if you enlarge it by 120cc it will likely look different. JG 1.29.08
Answer: they will settle pretty quickly unless the pocket had to be enlarged, but it will still take less time than the first time. JG 1.29.08
Answer: it can be from the degree of lifting or stretching, in some cases it can be if the skin started off less strong, for example in areas with large amounts of stretch marks, placement over or under the muscle will also affect the pressure applied to the implant and therefore the tissues also. The stronger the muscles the greater the chance of the muscles causing the problem as when they flex the muscles flattten and that tends to push the implant down and out more. JG 1.29.08
Answer: to some degreee yes because the muscle is not there to cause the mild flattening that it usually does, but if the same implant is used it will likely not be very noticable. The placement towards the center will totally depend on how wide the pocket is opened during the exchange. JG 1.29.08
Answer: revision surgey is much more complicated than the first surgery and if the second surgeon tries to fix it and cannot, then, in many cases the patients will hold the second surgoen responsible and not the first. JG 1.29.08
Answer: well, different pocket sizes in breast augmentations can happen either from unequal pocket dissectiosn at the time of surgery or the tissues not holding up. Just because a surgeon is highly qualified and well trained is no guarantee that there will not be things that happen that might result in your scenario. No surgeon is perfect all of the time. I think speaking frankly with him and telling him what you see and that you would like it fixed is the best approach. I wish you the best. JG 1.29.08
Answer: they do not work. The models are paid endorsers that will say whatever they need to say to get paid. JG 1.29.08
Answer: no way to avoid them I am afraid, but under the muscle limits projection and size. I think the above or below isses does not affect the double bubble, I have seen it happen in both sites. As to your shape, I respectfully disagree with him. JG 1.28.08
Answer: yes, correct. JG 1.28.08
Answer: over the muscle is needed and size will depend on yout anatomy. JG 1.28.08
Answer: could consider fat injections to smooth out the double bubble but I think going larger will potentially make all of your problems worse. You might not be able to get the size and projection you desire. JG 1.28.08
Answer: all saline implnats have ranges in the sense that it is up to the doctr to fill it in, it is impopssible to tell if a higher profile will give you the fullness you desire as fullness is a genral volume, not a specific dimension, sorry, wish I could make it easier for you. The truth is that the picture you have in your head of what you want your breasts to look like might never be possible with man made breast implants due to your own anatomical limitations. JG 1.25.08
Answer: well if you are not happy I think a redo is about all you can do, you have waited and things have not changed so I think it is OK to think about moving forward. JG 1.22.08
Answer: it wil apply to both but more obvious when above the muscle. JG 1.21.0l8
Answer: the larger you go, the greater the chance of destroying the original shape, yes. As to losing breast tissue during an augmentation, it is not a true phenomenon, it is an illusion to a certain degree. The weight of the implant, especially when placed above the muscle, though will over time act like a piston to stretch the skin envelope out and as the skin stretches and the amount of original breast tissue stays the same, the breast looks smaller as it is in a larger skin envelope. Along with that, as one ages, most women loose fat in the breast leading to a smaller breast. JG 1.21.08
Answer: could be some slight scar tissue on the muscle that needs to soften and relax with time. JG 1.17.08
Answer: could be the tissues relaxing on the lateral aspect of the chest wall and now allows the implant to move that way, it can be very difficult, if not impossible to correct, without new incisions.JG 1.15.08
Answer: it is common if the amount of breast tissue is small. It does not always lead to bottoming out though, that depends on many other factors. JG 1.15.08
Answer: I think it is just the swelling on the nerves from opening the pocket to place the implant. Doubt it would be anything serious though. JG 1.13.08
Answer: I think if you are unhappy, the sooner the better, only wait if there is any doubt. The risks of that surgery are the same as the first, and I do not think the droopyness will be a problem with that change. Best of luck. JG 1.13.08
Answer: that implant can only be filled in another 50 cc so that is about 1 1/2 ounce.JG 1.13.08
Answer: sorry, but that claim has been made but is absolutely no different than the partial submuscular and then not submuscular. Lots of hype that in time shows no difference, sorry. JG 1.12.08
Answer: the diameter of your original breast is what ultimately wil determine what size implant can be plaed without potetnial long term repercussions, I would need to see yo in person then I am afriad. JG 1.11.08
Answer: gel bleed is a leak and I suggest you have them replaced, yes. At present, unless you are a previous patient of ours, we are not accepting patients operated on elsewhere due to our schedule, the fees will vary from surgeon to surgeon though. JG 1.11.08
Answer: I would need pictures but also your breast measurements that your doctor has for that to tell. JG 1.11.08
Answer: we certainly try the make the folds even, at times the pressure from the implants can stretch the fold out allowing the implant to drop lower, yielding what you have. The larger the implant the greater the chance of that happening, especially when placed under the muscle It can be attempted to be repaired but resuturing the crease higher. That should not make you lose the round contour that you have. Best of luck. JG 1.11.08
Answer: it is somewhat easier. JG 1.9.08
Answer: well, there are limits as to what your body can cover in terms of size and diameter of the implant and going bigger is often desired but can be problematic, depending on the size increase. I think you need to discuss this all with your surgoen and get their advice. JG 1.9.08
Answer: unusual for muscle spasms to last that long but since you have had so many surgeries in a relatively short period of time, it can happen. I think in time with massage and stretching, the muscle should go away, but the medicine might keep you comfortable until they do. JG 1.8.08
Answer: it sounds like you need a capsulectomy to remove scar tissue. At present we are not accepting patients that have had surgery done elswhere due to our schedule being booked, you might want to contact the local medical society for a referral. Best of luck. JG 1.6.08
Answer: never seen anything like that, hard for me to tell without seeing you I am afraid. JG 1.5.08
Answer: need to drop by about 150 cc and as to the cleavage that will lessen with the smaller implants, best of luck. JG 1.5.08
Answer: it might be and it might require the implants being removed in order to fight the infection. JG 1.4.08
Answer: about $6000 if the capsules do not have to be removed or revised. JG 1.3.08
Answer: well, the implants can move but the silicone inside of the implant shoudl not move in a gummy bear implant, maybe I misunderstood your previous question. If they are textured implants and if the texturing allowed tissue ingrowth, then they will not move, but in cases of smooth walled implants, they will move within the pocket, all normal, no problem with that. JG 1.2.08
Answer: well, in a true gummy bear implant that shouldnto happen, the gummy bear implants are not sold in the US yet, unless you are part of a study, so if you are not part of a study and live in the US, then you have the regular non-gummy bear implant which has silicone that will move. JG 1.2.08
Answer: at most, the Moderate Plus from Mentor, I feel the High Profiles look artificial in most cases. JG 12.28.07
Answer: ther is no chart where that can be figured out, but a general guess would be 300 for the B and then 400-450 for the C, but again that is a guesstimate. JG 12.28.07
Answer: the level of swelling will be less this go round but your activity level will be reduced and you will not be able to enjoy your honeymoon, that size change will be less than a cup in either regard. I would avoid direct pressure for at least 2-4 weeks and the sutures will be out but the incision will still be pink and not too strong. JG 12.28.07
Answer: the scar should not change, as to the size change, if it is wider than the native breast tissue you might see and feel more ripples , that is the most common problem. JG 12.27.07
Answer: the reaction of the breast tissue to pregnancy is quite variable, in my experience, most women actually lose breast tissue so they end up smaller than they were prior to the babies. JG 12.27.07
Answer: in some cases it can take as long as one year for the sensation to return. If the nerve was cut out on the side of the breast near the ribcage where it emerges from the ribs it might never come back though, that is a known risk of the surgery, and the chances of that are the same for all incisions. JG 12.27.07
Answer: I think a minor scar revision under local anesthesia in the office is likely warranted, the surgeon who did your surgery will most likely do it for you at little to no cost. JG 12.27.07
Answer: I agree the pocket may be to large and at this point it is unlikely the pocket would close off on its own with a support bra but it can help it from getting worse. Repairing the pocket is also not an easy thing to do I am afraid. JG 12.27.07.
Answer: I think it is OK to do so now if you wish. JG 12.26.07
Answer: well if you are firmly convinced you want them smaller, then the sooner the better, but there is likey some visible swelling in most cases for 6 weeks and residual small swelling for 3-6 months at times. JG 12.24.07
Answer: the Memory Gel is more cohesive than the older implants but it is nto the gummmy bear implant everyone has been talking about. The solid or liquid nature of silicone has a wide range of cohesiveness properties. The true cohesive implant will not leak but is not for sale yet in the US. No side effects from weigth gain after a breast augmentation. The leak rate of the present implants starts to become clinically significnat after 8-10 years but many last many years past that. JG 12.22.07
Answer: if it is a small hematoma it should dissolve on its own with little problems, maybe some warm packs until you can see the surgeon for an in-person examination. I would not worry too much though. JG 12.22.07
Answer: yes, there are silicone implants but the ones available in the US, although thicker in consistency than many years ago, can still leak, the semi-solid gummy bear implants are not widely available in the US yet. JG 12.18.07
Answer: well, the Becker implants have a leak rate higher than the regular implants and I am not sure it will give you the anatomical shape you desire. You are correct, the vast majority of the time those implants are used for reconstructive cases. I really do not have any leads on where you can find a surgeon willing to do that for you. Sorry. JG 12.16.07
Answer: I doubt that is the culprit. I also never use steri-strips on the drains, I prefer to allow it to close on its own over a day or so. JG 12.16.07
Answer: I think it can be the begining of a capsular contracture and what was attempted to be done to salvage the implant might not work and you might need to have it removed for a few months and then replaced. JG 12.16.07
Answer: I would wait 4-6 weeks at least. JG 12.16.07
Answer: well it can show up at this point, maybe place a wrapped up towel over the breat bone in your bra until you can see your surgeon. JG 12.16.07
Answer: once sutures are out, which should be about now. JG 12.13.07
Answer: I think after 6 months you are likely in the clear, maybe a little sooner. JG 12.13.07
Answer: well, not much surgically that can be doen besides moving them on top of the muscle. Some physicians have tried injecting Botox in a relativley large dose to weaken the muscle but it can get pricey and it is temporary, if it works. JG 12.12.07
Answer: should be OK at that point in time. JG 12.12.07
Answer: could be from the anesthesia or the pain pills, breast surgery can cause lots of nausea, but nothing permanent. JG 12.12.07
Answer: they can stay in for a week or more in some cases. Infection is rare, but I keep the patient on antibiotics while the drain is in place. Cutting down on the blood left there will hopefully decrease the capsular contracture recurrance rate. JG 12.11.07
Answer: nope, just fluid from the surgery causing the sound, it is way too early for capsular contracture to form, that would take at least 6 weeks or more to form. JG 12.11.07
Answer: I suggest 4 weeks. JG 12.9.07
Answer: I think the best option is to change location and change implant both, so new implant and over the muscle. It needs a new plane for it to have a chance, best of luck. JG 12.8.07
Answer: very hard for me to say without seeing you I am afraid. JG 12.8.07
Answer: I think you need to ask the surgoen to make sure it is OK with him. JG 12.8.07
Answer: depends n the surgoen, but about $4500-$7000. Depends on how it is done and whether it is above or below the muscle. JG 12.8.07
Answer: I would apply some pressure on a constant basis over the breast bone to try to get the skin to re-attach, hopefully it will and you can avoid a repeat surgery to correct the synmastia. Best of luck. JG 12.7.07
Answer: the breast does soften with time from surgery in most cases, yes. It depends greatly on what was done during the revision too. I usually do a double layer of permanent sutures and many times will use a non-absorbable mesh too. I am not quite sure what he means by cauterizing the skin to get it to heal, all that will do is stop bleeding or it might close a pocket off if he is talking about cauterizing the capsule to get it to shrink or close down and limit the motion. Best of luck. JG 12.6.07
Answer: well, if you go to a larger size, then the diameter of the implant is wider so on the side it might show more ripples, that is true. Moderate plus profile will give you more projection but likley not a different cup, just fuller or rounder. High profile even more so. As to the surgeon going back and going larger, that is possible but you need to balance it out with the potential down sides. The first thing you need to understand is that achieving a desired cup size is not only difficult, but it can also deman