What are breast implants?

A breast implant is a medical device (prosthesis) inserted under breast tissue or chest muscle to change the size, contour or shape of the breast. In plastic surgery, breast implants are used to increase breast size, replace breast tissue removed due to trauma or cancer surgery, or to correct severe birth defects and deformities of the breast and the chest wall.

There are three main types of breast implants used in plastic surgery: saline implants, silicone implants and structured implants.

Saline breast implants

Saline breast implants are filled with saline solution. They are placed by means of a less invasive surgery through smaller incisions. During the surgery, empty saline implants are inserted into implant pockets and then filled with saline solution. The incisions made for this insertion are smaller and shorter compared to the relatively longer incisions required to place pre-filled implants.

Saline breast implants offer an increased breast size with a realistic texture and smooth contour. However, they are associated with cosmetic problems such as the wrinkling of breast skin and the implant being more noticeable to the eye and touch, particularly in women with less breast tissue. For women with enough breast tissue, saline implants produce aesthetically better results.

Silicone gel breast implants

The current models of silicone gel breast implants are filled with a high-strength, highly cohesive silicone gel which reduces the likelihood of filler leakage to the body. These form-stable implants can retain their shape even when their shells are broken. They are also less likely to wrinkle and tend to feel a bit more like natural breasts. However, they require slightly longer incisions for placement and they can spread into the breasts, causing lumps. Breasts augmented using silicone gel implants require regular ultrasound or MRI images for assessing the condition of the implants.

Structured breast implants

Structured implants incorporate both saline and silicone gel implant technologies. They use the saline solution as the filler while having the natural feel of silicone. Their internal structure consists of a series of nested shells that support the upper pole and two lumens (cavities) where the filler material is added.

During surgery, a structured implant is inserted while empty and then filled with saline once placed, requiring a smaller incision than a pre-filled implant. And if one of the lumens ruptures after the procedure, it just leaks and empties, leaving the other lumen intact and the implant only partially deflated. This feature allows for ease of removal and replacement.

How are breast implants placed?

When choosing a plastic surgeon for breast implant surgery, finding someone experienced reduces the risk of complications after the procedure. Before the surgery, you will have an appointment with the surgeon for a medical evaluation. Your consultation will allow you to share your goals and expectations with the surgeon, and learn how to prepare for the procedure.

Breast implant surgery is usually carried out under general anesthesia. The plastic surgeon makes a cut in the skin below or next to the breast. The implant is positioned either behind your chest muscle or between your breast tissue and chest muscle. The doctor then closes the incision and covers it with a dressing.

The procedure usually takes 60 to 90 minutes. You may be able to return home the same day, or you may need to remain in the hospital overnight if the operation is scheduled late in the day. You will be given pain medication to help manage the discomfort after the anesthesia wears off. Your breasts will be covered with compression garments, and drainage tubes will be applied in order to drain the surgical area. Expect to need rest for a few days after the surgery and avoid heavy lifting for at least 6 weeks.

Are breast implants safe?

Breast implants are quite safe and rarely cause issues. Though it is possible for the implants to rupture and leak, they rarely cause medical problems. When saline implants rupture, the salt solution is safely absorbed by the body. For silicone gel implants, the gel either remains in the shell or leaks out following a rupture that results in no obvious symptoms.

How are breast implants maintained?

Breast implants are, by design, not intended to last a lifetime. They may have to be replaced if there are complications or if the breasts change in size and shape over time. If you have silicone gel-filled implants, you will need an MRI scan three years after your implant surgery, and then MRI scans every two years to check for silent ruptures. Ruptured implants should be removed or replaced.

At Politis Plastic Surgery, we offer breast implant surgery to enhance the natural appearance of your breasts, create fuller curves, and give you a more aesthetically pleasing shape. We understand that your breasts are a defining feature of your body and enhance your femininity, sexuality and beauty. Through breast augmentation, you can change the size and shape of your breasts and, in turn, your self-confidence.

Are you considering breast augmentation?

Schedule a private consultation today with Dr. Effie Politis and have your questions answered and concerns addressed. For more information on breast implants and breast augmentation, visit the Politis Plastic Surgery website.

“Breast in a Day” Surgical Technique

 
 
 
 
 
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Another ‘Breast in a Day’ case, but executed differently since she has much larger ptotic breasts (sagging breasts). ⁣

She basically had a mastectomy performed through a Wise pattern skin mastopexy and I kept the nipples on an inferiorly based adipodermal flap. ⁣

I reduced her mastectomy envelope, reduced and repositioned her nipple areolar complexed, and placed a cohesive Natrelle Inspira SCF 520cc implant in the prepectoral position with anterior Galaflex sheet. ⁣

“Wise pattern or inverted-T mastopexy has traditionally been used in patients with severe excess of skin relative to breast parenchyma (tissues of the breast essential for functioning) in a patient with severe ptosis. Incisions are made around the areola with extensions for the vertical limbs as in a vertical mastopexy.” (Qureshi, Myckatyn, & Tenenbaum, 2018)⁣

“The Wise-pattern incision addresses any redundant mastectomy skin envelope and avoids excessive and unsightly scarring on the “social” aspect of the breast mound.” (Newman, 2016)⁣

“The pattern allows removal of skin in both vertical and horizontal dimensions allowing for lifting and coning of the breast into a less ptotic shape.” (Todd, 2016)⁣

20-Year Old Implant, Capsular Contracture

These implants were placed in the sub-glandular condition, which has a higher incidence of capsular contracture. ⁣⁣ ⁣⁣ I performed a change of plane and placed him in a partial submuscular position and supported the lower pole with GalaFLEX scaffold (P4HB). ⁣⁣

Breast Revision Case: Before and After

 
 
 
 
 
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𝐁𝐫𝐞𝐚𝐬𝐭 𝐑𝐞𝐯𝐢𝐬𝐢𝐨𝐧 𝐂𝐚𝐬𝐞 ⁣⁣

⁣⁣
Before: ⁣⁣
Saline implants, dual-plane⁣⁣
– Breast and nipple-areolar ptosis⁣⁣

After: ⁣⁣
– Removal and replacement of saline implants for Sientra 385cc moderate profile hsc+⁣⁣
– GalaSHAPE 3D ace

What is Kybella

 
 
 
 
 
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This is my lovely 49-year-old female patient with submental (under chin) excess fat deposit which takes away from the youthful neck contours. ⁣
 
When evaluating a neck and jaw for rejuvenation, we first examine skin quality and rigor, cervicomental angle (105-120 degrees), chin projection (should be in line with the lower lip on lateral view), platysmal bands in the neck (treated with toxin), and then glands, digastric muscles, hyoid bone position, and whether subcutaneous fat is pre-platysmal or post-platysmal. ⁣

This patient was an ideal candidate for Kybella with reasonable expectations to slim her neck by treating the fat just under her neck. ⁣

Kybella is an injectable that permanently dissolves fat without surgery, incisions, or downtime. It chemically destroys the fat cells permanently. Typically require several treatment sessions but again helps patients avoid downtime associated with surgery. It is a great option for improving the cervical mental angle by destroying the under chin pre-platysmal fat. ⁣

Treatment used: Three vials of Kybella⁣
Treatment session: 20 minutes ⁣
Downtime: Minimal. Expect 5 to 7 days of swelling. ⁣

This is the perfect time to get this treatment given most of us are wearing masks. ⁣

You can also cover the area with a scarf because there is some swelling associated post procedurally. ⁣

What is Bruxism?

Bruxism is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them during sleep (sleep bruxism). Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems.

What is botulinum toxin used to treat?

In our clinic, botulinum toxin is a safe, effective treatment for patients who grind, clench, develop temporal-mandibular joint pain, or have masseter hypertrophy. ⁣⁣
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Botulinum toxin when injected into the temporalis and masseter muscles also helps with tension headaches and migraines related to clenching of the jaw. ⁣⁣
⁣⁣⁣⁣⁣⁣

What is Breast Augmentation?

 

Sagging breasts can be disappointing and conspicuously small breasts can feel inadequate. Clothes that fit neatly at the shoulders and waist but appear too large at the bust line can be awkward. But you don’t have to be self-conscious when you wear swimsuits or form-fitting tops. You can achieve your desired breast size through the medical procedure known as breast augmentation

Read more about Breast Augmentation

GalaFLEX Surgical Scaffold for Plastic or Reconstructive Surgery

 
 
 
 
 
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Another important technique to point out from the case that we’ve recently posted about(please see our grid @dreffiepolitis ), is the use of Galaflex Ravioli construct⁣⁣⁣⁣⁣.⁣⁣

The GalaFLEX Scaffold (Galatea Surgical, Inc., Lexington, MA) for plastic and reconstructive surgery belongs to a new generation of products for soft tissue reinforcement made from poly-4-hydroxybutyrate (P4HB)⁣. ⁣

It is comprised of high-strength, resorbable P4HB monofilament fibers. It is a knitted macroporous scaffold intended to elevate, reinforce, and repair soft tissue. The scaffold acts as a lattice for new tissue growth, which is rapidly vascularized and becomes fully integrated with adjacent tissue as the fibers resorb.⁣

The “ravioli” technique involves using 2 pieces of extra thick ADM to completely wrap the TE/implant. The 2 pieces of ADM are cut to the size of the TE/implant with 1 piece covering the anterior and the other covering the posterior surface of the TE/implant.⁣⁣

Acellular dermal matrix (ADM) is a soft connective tissue graft generated by a decellularization process that preserves the intact extracellular skin matrix. Upon implantation, this structure serves as a scaffold for donor-side cells to facilitate subsequent incorporation and revascularization. In breast reconstruction, ADM is used mainly for lower pole coverage and the shaping of a new breast. It helps control the positioning of the implant in the inframammary fold, and prevents the formation of contractile pseudocapsule around the breast implant.⁣⁣

The “ravioli” construct is something Dr. Stephen Sigalov came up with which involves performing a 360 degree wrap of the implant with Galaflex to stabilize the implant in the breast pocket given the normal landmarks are obliterated with the mastectomy. The Galaflex or P4HB totally resorbs (turns in CO2 and H20) in 18-24 months and is replaced by the patients own Type 1 collagen to provide long lasting implant support. Type 1 collagen is the strongest collagen in the body. This prevents issues such as stretch, bottoming out, malposition, implant flipping etc. ⁣⁣

Tummy Tuck: All You Should Know

Do you have loose skin, stubborn fat deposits and stretch marks in your abdomen? Are you feeling embarrassed and self-conscious because of your protruding belly? Have you tried to achieve a flat tummy through diet and exercise without success?

If so, a tummy tuck is ideal for you.

Abdominoplasty, better known as a “tummy tuck,” is a surgical procedure to reshape and flatten the abdominal area. The surgeon removes excess sagging skin, gets rid of stubborn fat, tightens abdominal muscles, and corrects a protruding belly. The surgeon also removes some, if not all, stretch marks.

More detailed information about Tummy Tuck here.