Archive for the ‘Breast Surgeon’ Category

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French Government Calls for Removal of Defective Implants

Monday, January 2nd, 2012

Two years ago, reports of defective silicone breast implants manufactured by PIP (Poly Implant Prothèse) prompted authorities to halt production of the devices.

The breast implants are said to have a very high failure rate and a non-medical type of silicone gel. France is now encouraging women with these implants to have them removed, and they’ll pay for the removal if the implants were originally used for breast reconstruction.

PIP silicone gel-filled implants have never been approved for use in the United States. The only way an American patient would have these implants is if she had undergone breast surgery in another country.

ASPS Monitoring the Situation

The American Society of Plastic Surgeons (ASPS), working with the French Society of Plastic Reconstructive and Aesthetic Surgery, is monitoring the recent developments on PIP silicone gel breast implants.

The ASPS issued a statement to its members practicing outside the United States:

“We believe that while the current focus of attention is in France, approximately 80 percent of PIP implants were exported to other countries including the United Kingdom, Spain, Brazil, Argentina, Chile, Colombia and Venezuela. There are also reports that implants under the brand name “M,” distributed by a Dutch company in Germany – and possibly elsewhere in Europe – may also be PIP implants that were rebranded as “M” implants.”

According to Reuters, Italy is working with cosmetic surgery clinics to compile a list of women who received the implants. Meanwhile, officials in Brazil and Britain are urging women to check in with their surgeons.

Allergan Inc, American Breast Implant Maker Assures Quality of Their Implants

In response to the French situation, Allergan issued a lengthy press release to reassure surgeons and patients about the quality of their breast implants. Allergan’s products are marketed under the names Natrelle, McGhan and CUI. None of these implants are included in the French investigation.

“The health authorities are specifically concerned about breast implants made by the company called Poly Implant Prosthese (PIP),” states the Allergan Press Release. The release also describes the extensive checks that are in place to ensure quality of their implants. “Allergan maintains rigorous clinical development processes, extensive manufacturing and quality assurance testing, as well as an industry-leading post-marketing surveillance program, to ensure the highest quality and safety of its breast implants that patients and surgeons can rely on.”

AP Video: France Calls for Breast Implant Removal

This one-minute video from the Associated Press briefly explains the situation in France.

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Transaxillary Breast Augmentation

Tuesday, December 20th, 2011

The transaxillary technique in breast augmentation uses an incision in the axilla. The axilla is the space beneath the shoulder through which vessels and nerves enter and leave the upper arm. It’s commonly known as the armpit.

If you’re considering breast enhancement, this technique may be appealing to you, since the incision (and scar) is placed in a remote location, away from the breast. That’s why some have called it a “scarless technique.” If the scar is visible, is not associated with your breast augmentation.

Implant Choices

The surgical incision is small. Space is also limited when passing the implant from the armpit to the breast. Therefore, only a saline breast implant can be used.

Before it is filled with saline, the shell of the implant is passed through the axilla to the breast pocket. Through a port in the implant shell, your surgeon fills the implant to a specified volume, while it’s inside the breast pocket.

Challenges of the Technique

One known challenge of the transaxillary technique is difficulty seeing the breast pocket and muscle tissue. Lacking direct access to the breast (such as with the inframammary technique), it becomes more challenging to control implant placement.

Plastic surgeons have addressed this challenge by using endoscopy, a minimally invasive surgery technique. Using an endoscope, equipped with a tiny camera, your surgeon will have a clear view of the breast pocket and pectoral muscle.

The majority of breast augmentation procedures still use the inframammary technique, which involves an incision in the breast crease. However, transaxillary breast augmentation is an accepted technique with rigorous studies evaluating its safety and effectiveness.

Ask your plastic surgeon if this technique is suitable for you and read more about the breast augmentation techniques used here in Savannah, GA.

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How Effective is Male Breast Reduction?

Wednesday, December 7th, 2011

Study Reveals Patient Satisfaction Scores

For men affected by gynecomastia, male breast reduction improves quality-of-life, according to a recent study by plastic surgeons in Siena and Pisa, Italy.

Men who have gynecomastia have too much breast tissue. The problem can develop during adolescence or adulthood. Gynecomastia can negatively affect a man’s self-image, harming his quality of life for years.

Male breast reduction is common solution to the problem. A surgeon can remove glandular tissue and fat, sculpting the chest into a more masculine shape.

The Italian study evaluated 126 cases of gynecomastia during a six-year period. The average patient was a 28 year old male. Most patients had symptoms of gynecomastia on both sides of the chest, while a smaller number (11.9 percent) had the condition on one side.

During procedures, the surgeons employed different techniques as necessary. They frequently performed “adenomammectomy with periareolar inferior or inverted Omega incision,” while another alternative was “circumareolar or vertical scar incision and liposuction.”

The procedures effectively removed the excess glandular tissue and fat from the patient’s chest.

Effectiveness of The Procedure

Before and after their male breast reduction surgery, patients filled out questionnaires for their experiences. They answered questions like:

  • Why did you choose to undergo male breast reduction?
  • How satisfied are you with your results?
  • Has the quality of your life improved after surgery?

According to the study, patients had high satisfaction: “all patients reported an improvement in their quality of life with an average satisfaction score of 8.2 out of 10.” The complication rate was reportedly 17.72 percent.

“We suggest to the patients affected by gynecomastia to undergo surgery always and as soon as possible,” the authors conclude.

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ASPS Warns Public of White Coat Deception

Monday, October 24th, 2011

“Anyone can wear a white coat” says the American Society of Plastic Surgeons, “but not everyone is board certified in plastic surgery.”

A new media campaign is spreading awareness about physicians who are performing plastic surgery without the rigorous training of board certified plastic surgeons.

“Despite all she’s been through, Denora Rodriquez feels lucky. She underwent surgery to have her breast implants replaced, but woke up to much more than she ever bargained for.”

“The surgeon botched her implants, causing them to merge together (a complication called symmastia). To make matters worse, during the same surgery, he decided to operate on Denora’s eyes, without her permission.”

Now she says she can’t close her eyes completely and must care for them constantly. She says she has to use medication and the experience has been “very uncomfortable.”

Dr. Steve Teitelbaum, plastic surgeon in Los Angeles, was able to fix her breasts. “We reconnected her skin over the breastbone down to the breastbone and then created two separate pockets for the breast implants, one behind each breast,” explained Dr. Teitelbaum to CBS2 news.

The doctor also criticized the medical system that allows non-board certified plastic surgeons to perform plastic surgery. Only a few states have laws that require physicians to be transparent about their credentials, and there’s no law on a national level.

It’s up to you, the patient, to learn exactly what your doctor is qualified to do, before doing anything at all, warns the ASPS.

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Did Shot from a Paintball Gun Rupture Woman’s Breast Implant?

Monday, August 29th, 2011

A recent story from the BBC claims that a 26-year old woman experienced breast implant rupture after being hit with a paintball.

The UK woman wasn’t sure that any damage had been done until she visited her surgeon’s office the following Monday. The woman, who remains anonymous, is expected to fully recover.

Shots from a paintball gun can travel 190mph and are known to cause bruising, especially after being fired at close range. However, the possibility that one could rupture a breast implant is questionable.

Paintball

Paintball by ViNull, on Flickr

One UK cosmetic surgeon responded to the story and commented: “In my opinion, this type of accident is highly unlikely – if there was an incident with a breast implant patient, it would be unlikely to have been caused by a paintball gun.”

Whether the incident is true or a fabricated publicity stunt, an alert on UK paintball‘s website tries to address the issue for future participants who have undergone breast augmentation or breast reconstruction:

We respectfully ask that any ladies with surgical breast implants notify our team at the time of booking. You will be given special information on the dangers of paintballing with enhanced boobs and asked to sign a disclaimer. You will also be issued with extra padding to protect your implants while paintballing.

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FDA Releases New Information About Silicone Breast Implant Safety

Wednesday, July 13th, 2011

silicone implant safetyAfter you make the choice to undergo breast augmentation surgery, you will need to make additional choices related to your surgery. Perhaps the most important decision you will make is whether you want to have saline or silicone implants placed during your breast augmentation.

In 2010, silicone breast implants were placed during half of all breast augmentation surgeries. In the past, there have been concerns that silicone breast implants may be associated with possible negative complications. While no surgery is without risk, new data has been released by the FDA that addresses the short- and long-term safety of silicone breast implants.

The History of Silicone Implant Safety

In 1992, the FDA removed all silicone breast implants from the market, due to concerns about silicone breast implant safety that arose in the 1080s. In 2006, the FDA approved the improved breast implants that are currently available.

One of the conditions of the FDA’s approval was that implant manufacturers would conduct studies tracking risks and complications over time. The results include a review of medical literature about silicone breast implants. The literature review found that:

  • Most women were highly satisfied with the feel, shape, and size of their breast implants, and had a good body image.
  • Women who received silicone breast implants are not at a higher risk for developing breast cancer.
  • Silicone filled breast implants do not seem to affect breastfeeding or fertility.

There is not yet enough data to address some other concerns, but many of the safety concerns of older model silicone breast implants are being proven incorrect. Silicone breast implants are also used for breast reconstruction surgery, and can be placed during a revision breast augmentation. If you are interested in learning more about breast augmentation surgery, contact our office.

You can read the full study details and results about silicone implant safety here at the FDA’s website.

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Breast Lipoaugmentation Offers Unique Benefits

Tuesday, May 24th, 2011

Saline or silicone implants may be the most well-known approaches to breast augmentation, but autologous fat grafting may be the most viable alternative.

It’s called “breast lipoaugmentation” because the procedure uses your body’s own fat to augment the shape of the breast, allowing the surgeon greater flexibility in shaping the breast.

Breast lipoaugmentation has particular benefits that recommend its use in certain cases, but it’s not for everyone. There is some disagreement about how much transplanted fat can survive the move, and there have been fears about the procedure’s effect on cancer detection methods.

Advantages

  • There are risks associated with tissue grafts and implants that are avoided through the use of breast lipoaugmentation.
  • There is no compelling evidence to indicate that the procedure interferes with breast cancer detection, according to a comprehensive literature review published in 2009. Women can have mammograms or MRIs before the procedure to assist radiologists and further ensure their safety.

Disadvantages

  • Breast lipoaugmentation doesn’t provide the dramatically increased volume made possible by breast implants. The procedure can only upgrade a breast from one-half to a full cup size.
  • Up to a quarter of the transplanted fat is likely to die as a result of the transplant. Fat is a living tissue and requires nourishment from the blood to survive, and an autologous fat graft may cut portions of the fat from receiving proper circulation. There has been promising research using bodily stem cells and other approaches to enhance the retention rate.

According to ModernMedicine’s Cheryl Guttman Krader, these unique pros and cons make breast lipoaugmentation well-suited to being combined with breast implants. Surgeons can use both techniques to maximize the beauty and natural feel of the breast.

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Some Mastectomy Patients May Be Ill-Informed About Breast Reconstruction

Thursday, March 17th, 2011

Are breast reconstruction patients making high-quality decisions about their procedures? This is the question posed by a recent article in the Journal of Plastic and Reconstructive Surgery, which has revealed that women treated with mastectomy were not well-informed about breast reconstruction. This is particularly serious since these patients were highly involved in making treatment decisions with their doctors.

The study was a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making.

Here are the survey questions, followed by the answer and the percentage of participants who answered correctly:

  1. Are women more satisfied with reconstruction at the time of the mastectomy or with delayed reconstruction? (They are equally satisfied, 33.3%)
  2. Are women more satisfied with the look and feel of breast implants or flaps? (Flaps, 15%)
  3. Does an implant use fat and tissue from other parts of the body to make a breast? (No, 13.1%)
  4. Does breast reconstruction with a flap usually require more than one surgery? (Yes, 28.6%)
  5. Which breast reconstruction surgery heals faster? (Implants, 57.1%)
  6. Roughly what percentage of women who have breast reconstruction will have a major complication, such as needing hospitalization or an unplanned procedure, within 2 years? Is it below 25, 25-50, 50-75, or more than 75? (25-50%, with only 3.6% knowing the correct answer!)
  7. How does breast reconstruction affect future screening for breast cancer? (Little to no effect, 35.7%)

A mastectomy is a life-changing experience, and reconstruction surgery offers many women a path to renewal and normality. Before taking that step, however, it’s always a good idea to ask lots of questions to make the best possible decision.

Women considering reconstruction surgery should ask their plastic surgeon about their options, and talk to others who have had similar experiences. They can also view resources from the American Society of Plastic Surgeons (ASPS) website, which has lots of information about breast reconstruction procedures.

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How Common is Breast Asymmetry?

Wednesday, January 12th, 2011

Size discrepancy between the breasts is actually quite common. Most women exhibit at least some minor asymmetry, while others have as much as a cup size difference or more. In severe cases, a woman may experience difficulty finding the right bra and may be very embarrassed by her condition.

A new study in the European Journal of Plastic Surgery explains the details of over 300 breast augmentation patients and the prevalence of breast and chest asymmetry among that group.

The author, Umar Daraz Khan, found that breasts were symmetrical in only 53.5% of the cases, and the left breast was more often larger than the right breast.  Because the asymmetry often stems from a chest wall deformity, the author measured for that as well, finding “thoracic deformities or asymmetries” in over 8% of the patients. Of the 312 breast augmentation patients treated, the doctor used different sized breast implants in 9% of them.

Read more about breast surgery at Coastal Empire Plastic Surgery

Read the study abstract via Springerlink

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Obese Patients Receive Equal Treatment in Breast Reconstruction

Monday, January 10th, 2011

A recent study presented at Plastic Surgery 2010 examined whether physician biases affected the treatment received by obese patients undergoing breast reconstruction.

In this video, Anita Kulkarni M.D. of the University of Michigan Department of Surgery, section of plastic surgery, explains the study, “Patterns of Use and Surgical Outcomes of Breast Reconstruction Among Obese Patients: Results from a Population Based Study.”

She explains that, for certain outcomes like “clothing fit and sexual attractiveness,” obese patients in the study were actually more satisfied with their treatment than normal weight patients. “ASPS (American Society of Plastic Surgeons) members are providing excellent care to this sometimes difficult patient population,” she says.

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