What is Breast Explantation Surgery

Hi everyone, this is Dr. Effie Politis and I’d like to talk about a great article on the April edition of the PRS called contemporary strategies in breast explantation surgery.

So, what is explantation surgery? It is a surgery in which someone proceeds with removing their implants and not replacing them. I’m seeing quite a few patients that are interested in this surgery for various reasons. We all know that implants are man-made devices.

The first reason that women would opt to undergo the surgery is because of implant rupture. I tell women that breast implants are not a “one and done” device, they are a prosthetic that is placed in your body so you need surveillance and you likely will need one or several surgeries in the future if you opt for breast implants. There is a small chance of them rupturing. We can discuss more the difference between saline and silicone ruptures in the future.

Number two is Breast Implant-Associated ALCL (anaplastic large cell lymphoma), this is a rare lymphoma associated with textured implants which I do not use. So it’s not really an issue with my practice but I do see some patients with prior history of textured implants.

Number three is breast implant illness. This is a large topic that’s often discussed on social media. It’s a name given to patients for a wide range of symptoms. The current data shows that there is no cause and effect relationship between implants and these symptoms, however, we certainly are proponents of what women want to do with their bodies. So if they want their implants removed they certainly have the right to have that done. However, the data based on long term studies does not show whether explantation surgery reliably reduces these symptoms.

The last reason women want their implants removed is for non-medical reasons like effects of aging, weight changes, pregnancy, and shifting perspective in aesthetic beauty, as we know there is a movement towards smaller breasts. So women seeking explantation surgery just need to be aware of the risks and benefits in any adjunct surgeries that can be done to enhance their breasts. We look at each woman on an individual basis. It’s a woman’s choice to have their implants removed and we consider the patient’s risk profile, patient preference as well as safety when guiding them on whether explantation surgery is the right surgery for them. I would advise you all to always consult with a board-certified plastic surgeon with a specialty in breast surgery when considering these types of procedures. You can always DM me or look at my website as I’ll have more information. Thank you so much.

Subfascial Breast Augmentation with GalaSHAPE 3D Scaffold

This patient is 5’7″ and 166lbs. She is a massive weight loss patient and had a mastopexy when she was younger. After having 5 children, she wanted to correct the deflation in her breast and restore upper pole fullness. She underwent bilateral breast augmentation with Sientra smooth round HSC+ silicone implants, 355cc, moderate profile. This was a quick turn-over, 24-hour recovery breast augmentation procedure. A massive weight loss patient who had a mastopexy or breast lift in the past likely has week tissues and ligaments that require internal support or scaffold for stable and optimal long-term results. I had Galaflex placed to support her lower breast pole, so the implants do not bottom out. Each patient is evaluated whether there is a need for the Galaflex “internal bra”. Post-op photo is 5 days after. [Tap to view in full on IGTV!] Are you a candidate for this procedure? Your best bet is to come in for a consultation to determine whether you are an ideal candidate, but typically, the ideal candidate is relatively healthy and maintains a healthy weight. If you are a candidate for traditional breast augmentation, you are likely a candidate for this procedure too. For more info on our 24-hour breast augmentation procedure, check the link in our bio.

Do breast implants make you float?

Do breast implants make you float? Will it save you from drowning?

Those are some questions that a few may have wondered about breast implants at some point.

Here’s the thing, breast implants are NOT a floatation device. They will not make you buoyant, nor are they a suitable alternative for a life vest.

“Breast implants are different from the weight of the natural breast, but not by much. While fatty tissue weighs slightly less than water, saline will, as mentioned, weighs roughly the same, and silicone, slightly more. “

“The differences between the natural tissue and a breast implant are minor, and, to the untrained eye, virtually undetectable.”

While breast implants are naturally buoyant (as seen in the video), “when placed in the body, however, the buoyancy of breast implants demonstrated by benchtop testing becomes irrelevant. Post-surgery breasts are no more likely to drown you than they are to save you from drowning.”

So, to answer the question above, no, breast implants will NOT make you float, and it will NOT save you from drowning.

Now, if you know someone who says they want to get large implants to have a built-in life-jacket, you can conclusively tell them to take some swimming lessons instead. 😅

Fat Grafting Shows Promise for Cancer Patients with Radiation-Induced Skin Injury

Radiation Therapy (RT) is an effective treatment for a range of malignant conditions. It involves projecting high-energy photons towards a tumor, destroying the DNA of the tumor cells. With their DNA destroyed, the cancer cells lose their ability to divide and grow, and they eventually die.

Radiotherapy goals

When applied in the early stages, or when cancer has just begun to spread, radiotherapy can shrink or completely cure it. But radiation may also be used before surgery to shrink the tumor (neoadjuvant or pre-operative therapy) or after surgery to keep it from recurring (adjuvant therapy).

For cancer that has spread too much to be cured, radiation may be applied to keep the tumor smaller and help relieve problems such as pain, trouble swallowing, breathing difficulty or bowel blockages caused by advanced cancer.

Collateral damage

As radiation is projected to destroy cancer cells, the nearby normal cells may also be exposed to high-energy particles. Though most of the exposed normal cells tend to recover and go back to working the way they should, some cells, like skin cells, are extremely sensitive to the damaging effects of radiation and do not recover.

Because skin-sparing radiotherapy techniques are not yet possible, the skin is particularly vulnerable during radiation therapy for breast cancer, anal cancer, and head and neck cancer. A few months after radiotherapy, patients may develop acute radiation injury characterized by skin inflammation, peeling, pain, swelling and itching.

The symptoms may resolve with time, but in some cases the inflammation continues, resulting in tight, stiff skin (fibrosis) which leads to poor wound healing, skin ulcer and tissue loss. In addition, soft-tissue fibrosis may cause potentially severe functional and cosmetic problems which can adversely impact the quality of life.

Fat grafting after radiotherapy

Fat grafting is the process of removing fat from one area of the body and transplanting it into another area. It can be done in different body areas, including the breasts, buttocks and face.

During fat grafting, the surgeon removes fat from the donor area—usually the belly or thighs—using a liposuction machine. After the fat is harvested, it is prepared and then injected into the desired area. About 50-60 percent of the fat transferred survives; thus, more fat is usually injected than may be needed.

What happens after fat grafting?

Following the injection, the quantity and quality of fat tissue improve around the injection site. The surviving fat cells re-establish their blood supply at the new site and begin to divide, grow and differentiate.

Grafted fat contains adipose stem cells (ASCs) that have healing and regenerative effects on surrounding tissues.

After grafting, some stem cells in the grafted adipose tissue transform into different types of cells around the treated site, helping in wound healing, epithelization, and growth hormone secretion, all of which repair the damaged areas.

Adipose stem cells stimulate the secretion of factors needed for the regeneration of damaged areas. For example, they induce dermal fibroblasts and keratinocytes to release anti-oxidant enzymes such as superoxide-dismutase, helping to protect cells against oxidants. This process reverses radiation-induced soft tissue fibrosis and promotes healing.

Adipose stem cells also promote cytokine production, increase collagen production, and reduce collagen disorganization, resulting in improved skin quality.

The grafted fat inhibits apoptosis—a process that brings about death and removal of cells—helping to relieve fibrosis, minimize skin stiffness, relieve pain, and restore lost cell volume caused by radiation-induced skin injury. That is why, soon after fat grafting, the skin feels and looks healthier.

Benefits of fat grafting after radiotherapy

  1. Minimizes pain and itchiness of the skin
  2. Reduces tightness and stiffness of the skin
  3. Heals radiation damage
  4. Treats chronic skin ulcers
  5. Prevents disability
  6. Improves overall skin appearance, removing scars and depressions
  7. Make the skin thicker, softer, and healthier
  8. Gives improvements that continue over time
  9. Improves the treated area permanently
  10. Has no risk of rejection or allergic reaction

Exploiting the power of fat grafting

Do you have a scheduled radiotherapy session? Have you undergone radiation therapy and are struggling with radiation-induced skin injury?

At Politis Plastic Surgery, we provide fat grafting services for patients undergoing radiotherapy as a way of preventing or reducing post-radiation effects on the skin and subcutaneous tissue.

Dr. Effie Politis is a skilled and experienced plastic surgeon who uses fat grafting in cosmetic and reconstructive procedures. She understands that the stem cells in adipose tissues and organs can play a critical role in repairing post-radiation skin injuries. She makes sure to share the benefits of fat grafts with her patients.

If you have undergone radiotherapy, Dr. Politis can help you avoid or reduce pain and other symptoms of radiation-induced skin injury through fat grafting. After the grafting procedure, you will enjoy a more normal skin appearance, have seamless recovery following radiotherapy, and improve your quality of life.

For more information on fat grafting after radiotherapy, visit the Politis Plastic Surgery website.

What to consider before you get a breast augmentation

 

 

 
 
 
 
 
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Considering breast augmentation?

Whether your reasons are for the enhancement of your appearance, correction of uneven breasts, or following a mastectomy procedure, there are several things you have to keep in mind.

When considering breast augmentation, it is important to speak with a plastic surgeon who will help you decide whether the procedure is right for you. At Politis Plastic Surgery, we will conduct a physical exam, get your medical history, listen to your concerns, consider your aesthetic goals, and offer options for how to proceed. We only recommend this surgical procedure to patients in good health who have realistic expectations. This is why the consultation is critical.

While your surgeon may use implants, fat transfer, or both to augment your breasts, the decision primarily depends on your existing breast tissue, body mass, and frame, as well as your desired body shape. The surgeon will create a personalized plan and provide you with pre-operative instructions to ensure the experience is as easy, safe, and comfortable as possible.

There’s more info on breast augmentation in our website. You can check the link in our bio.

Here is a sneak peek of our recent breast augmentation patient. Will share a full before & after soon, along with the behind-the-scenes of the procedure! Stay tuned!

How Many Units of Botox Do I Need?

Areas where toxins/neuromodulators can be injected and corresponding units that you need per area. Individual facial muscle requires different amounts of toxin in order to fully relax & prevent wrinkle formation. ⁣ ⁣ There are also other characteristics that influence how your body reacts to injections: your gender, size and strength of your facial muscles, and your metabolism.⁣ ⁣ ⁣ It’s important to make sure that you receive the proper amount of units required for your individual needs and goals. Dr. Effie will make sure you meet your needs and desired results. ⁣ ⁣ The goal is always to achieve balance on the needs of what the patient wants, and what the plastic surgeon advises to give, as the best result. ⁣⁣⁣ ⁣⁣⁣ ⁣ Attempting to save money by undertreating an area will not create a satisfying result and could end up costing you more money if a fix is needed. An experienced toxin injector will determine the right amount needed to deliver the results you are looking for.⁣ Do you have some questions? Let us know in the comment section below! Or better yet, book a consultation with us!

Mommy Makeover with Dr. Effie Politis

Childbearing can bring significant changes to a woman’s body. After experiencing the beauty and struggles of raising a child, many women try to improve their bodies after their pregnancies. They do various workouts and try different diets to get back into shape.

However, the effects of pregnancy and breastfeeding—sagging breasts, lax tummy muscles, abdominal stretch marks, and the increased fat in the upper arms and thighs—are still all over the body. Plus, working out consistently while managing the household or keeping a career can prove challenging and increasingly frustrating.

However, there may be a way to help you get back your pre-pregnancy body.

At Politis Plastic Surgery, we offer a safe and effective mommy makeover that restores the shape and appearance of a woman’s body after childbearing.

What is a mommy makeover?

Mommy makeover is a broad term for total body rejuvenation after having children. It is a personalized series of surgical procedures designed to revitalize the body after the stress of pregnancy and breastfeeding. It involves addressing any problem areas of the breast, the abdomen, and the body as a whole. For the breast, you may either require a breast reduction, breast augmentation, or mammoplasty. When it comes to the abdomen, it usually requires a full abdominoplasty or tummy tuck.

A delicate blend of procedures

If you qualify for a mommy makeover, your treatment is tailored to suit your unique needs. Since your breasts and abdomen are the primary areas that change with motherhood, your procedure will begin with breast and abdomen contouring before adding the other elements.

For breasts that are disproportionately large and uncomfortable, you can get a breast reduction to bring them to your ideal size and appearance. You may also get a breast lift to raise your breast and nipple position. It can help eliminate sagging skin, restore volume, shape, perkiness, and give a more youthful look. Breast implants may also be used in this process.

For pockets of fat, sagging skin or stretch marks, a tummy tuck will be considered for your mommy makeover. A tummy tuck (also called abdominoplasty) repairs separated muscles and removes excess, sagging skin, creating a smooth, taut tummy.

When you have stubborn fat accumulated on your midsection, particularly on the lower stomach or around the hips—that won’t go away no matter how often you go to the gym or how good your diet is, liposuction will be included in your mommy makeover. Liposuction will improve the contours of your hips, balance your body proportions, and enhance the results of the other procedures.

How soon will you get back to routine activities?

Your mommy makeover may be conducted in a single operation or spread out over multiple surgical sessions. You will have the surgery on an outpatient basis, allowing you to recover at home.

After your surgery, you may be recovering at home for 1 or 2 weeks, depending on your specific procedures. It would be best if you made prior arrangements for your recovery period by ensuring that you have a caregiver at home who can help you with chores, childcare or other tasks.

Early in the recovery period, you will feel sore, swollen, and bruised. Pain can usually be managed effectively with pain-relieving medication. By the second week, the pain and soreness should have subsided and your drains should be out, but the swelling may have only partially subsided.

You will be back to your routine and regular daily activities within a week. And in the following weeks, you should see steady healing culminating in full recovery by the sixth week.

Why Politis Plastic Surgery?

At Politis Plastic Surgery, we prioritize your comfort, safety, and privacy. We allow you to work with a reputable, board-certified plastic surgeon with a track record for excellent results.

Dr. Effie Politis is a skilled, compassionate, and experienced surgeon who has performed many mommy makeovers. Rest assured that your procedure will be physically and emotionally transforming and give you more confidence and zest for life.

If you are struggling with sagging breasts, stubborn fat deposits, and a protruding abdomen even when you eat healthily and exercise regularly, trust Dr. Effie Politis to help you bring your post-baby body back to its pre-pregnancy shape.

For more information on mommy makeovers and other plastic surgery procedures, visit the Politis Plastic Surgery website.

Before and After: Mini Facelift

This lovely patient underwent a mini-facelift in-office under local anesthesia, as well as hyperdilute Radiesse injected into cheeks and central face for composite facial restoration and skin tightening.

Her goal was to address her excess skin and jowls of the lower face The procedure involved elevating the skin and identifying the SMAS layer, which is a thin layer of muscle and fibrous bands that cover the muscles and deep fat pads of the face.

When the SMAS becomes loose and sags with age, it creates laxity along the lower face and jawline, creating jowls, marionette lines, nasolabial folds, and neck bands.

A mini facelift is a corrective cosmetic procedure that targets sagging skin around the lower face and jawline. The incision is still placed in front of the earlobe and curves gently under the earlobe, depending on the amount of skin to be excised. The neck and lower face are carefully evaluated in order to see if one is a candidate.

Please note the patient also had hyperdilute Radiesse for skin tightening and also for volumization.

Procedure: Mini Facelift
Area of Concern: lower face and jowls
Anesthesia: Local
Downtime: patient can drive home, may not engage in vigorous exercise for 7-10 days
Recovery: 2 weeks
Pain Control: Tylenol and NSAIDS
Expect long-lasting results given this is not a skin procedure but addresses the SMAS or strength layer. Can be complemented by composite fat grafting or hyperdilute Radiesse for skin tightening as well as microneedling with topical dilute botox and exosomes.

What happens when implants too large for your chest/thorax are placed?

 

 
 
 
 
 
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What happens when implants too large for your chest/thorax are placed?

Implant displacement, stretched-out thin breast tissue, and asymmetry.

This can only be fixed with revision, implant exchange, implant place change, and tissue scaffold for support.

Patients, do your homework. Implants need to be sized through tissue-based planning techniques by a board-certified plastic surgeon.

The 14-step plan is then initiated in OR to prevent contamination of implants leading to capsular contracture. Otherwise, tissue distortion and collapse as well as device malposition and capsular contracture are guaranteed down the road. This ultimately leads to more surgeries and low patient satisfaction.

Upper Lid Blepharoplasty

 
 
 
 
 
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One of our wonderful patients that underwent the upper lid blepharoplasty procedure under local anesthesia. ⁣
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Blepharoplasty rejuvenates the upper and lower eyelids through the removal or repositioning of excess skin and fat. It gets rid of loose or sagging skin folds that create a heavy eyelid, eradicates excess fatty deposits, and eliminates the puffiness around the eyelids that create bags under the eyes. The final result is a more relaxed, refreshed, and youthful appearance. When surgery is done for functional reasons, patients are usually able to see better when driving or reading at night.⁣
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For more info on this procedure, we have it posted on our website, and you can check it out. The link is in our bio.