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.

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“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)⁣

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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). ⁣⁣
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Breast Revision Case: Before and After

 
 
 
 
 
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𝐁𝐫𝐞𝐚𝐬𝐭 𝐑𝐞𝐯𝐢𝐬𝐢𝐨𝐧 𝐂𝐚𝐬𝐞 ⁣⁣

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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

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

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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. ⁣⁣

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Facial Rejuvenation

Dr. Effie Politis - Facial RejuvenationBothered by creases between your eyes? Or by the “angry” look your face has turned into? You can smooth out the troublesome area between your eyes and eliminate wrinkles on your forehead and around your eyes through facial rejuvenation using the neurotoxin called Botox. The use of Botox has revolutionized facial rejuvenation as injections can be safely and rapidly delivered to wipe out wrinkles without surgery.

What is Botox?

Botox is a special, non-harmful neurotoxin (neuro-modulator) used to temporarily paralyze the small facial muscles that contribute to wrinkle formation. The primary ingredient is the extract of botulinum protein derived from the bacterium, Clostridium botulinum.

Botox is just one of the brands of neurotoxins used in facial rejuvenation—the other brands approved by the FDA are Dysport and Xeomin. All the brands work in the same way by targeting specific muscles to make them more rejuvenated.

Interestingly, Botox can be used for both upper and lower face rejuvenation. For the upper face, Botox is approved for injection into the Glabella (frown) lines and the lateral orbital lines (Crow’s feet). The Glabella lines are found between the eyebrows, and tend to give a tired angry appearance. In the lower face, Botox helps address corners of the mouth and flattened upper lips.

Botox has been a success in another area as well: patients with gummy smile. The neurotoxin is injected deeper into the muscles under the nose, leading to relaxation of these muscles and elimination of the smile. While this treatment is a little more invasive, it offers good outcomes.

Who needs Botox therapy?

You may see a doctor for Botox injection when:

  1. In the lower part of your face, the corners of your mouth are riddled with peri-oral wrinkles that appear in a sunbeam pattern of lines.
  2. In the area between your eyebrows, you have frown lines that appear as two or three vertical wrinkles, making your face to look serious and severe.
  3. You have Crow’s feet, which are fine lines that emerge from the corner of the eye to the temple.

The ideal candidates for Botox are people of all ages, who are generally healthy, and very transparent with their providers to avoid any possible complications.

When talking to your plastic surgeon, be open and honest about:

  • Any chronic medical conditions you may have.
  • Any medications you are currently taking.
  • Any supplements you are taking, including herbal and over-the-counter ones.
  • Any allergies you may have.
  • Any history of frequent cold sores, edema or conditions that may affect the treatment.

How is Botox therapy done?

What patients seem to like about Botox is that there is no downtime. It is done in the doctor’s office and takes 5-15 minutes. Using a micro-needle, a small amount of the neurotoxin is injected into the specific facial muscles responsible for the creation of facial lines and wrinkles. The pain associated with the injection is minimal and short-lasting.

The most commonly targeted areas are the forehead and outer eye area, with 1-3 injections delivered to every muscle. Once in the muscle, the neuro-modulator causes relaxation and allows the skin to remodel and the lines to fade over time. With proper injection of adequate quantities of the neurotoxin, anatomic structures such as eyebrows get delicately shaped to achieve improved appearance.

Although Botox is a minimally invasive procedure, it should still be done by a skilled, experienced board-certified surgeon such as Dr. Effie Politis. Working with a plastic surgeon who frequently administers neuro-modulators will help you achieve your treatment goals and expectations.

At Politis Plastic Surgery, each and every patient is treated by Dr, Politis because her knowledge of facial anatomy and broad experience give her the ability to customize treatment that suits the needs of a patient. Doing so also enables her to provide patients with the safety and precision necessary for remarkable results. Rest assured that Botox and the other neuro-modulators on the market are all FDA approved, safe and have been used for years for other medical conditions.

Delightful results

Following Botox injection, you will notice the fine lines and superficial wrinkles disappear or decrease altogether within a couple of days. Results are apparent in 1-2 weeks and last 3-4 months after a single treatment. The neurotoxin also reduces signs of aging and premature wrinkles. 

When the effects start to wear off, you can return for a re-injection. You can have your re-injections done every 6 months, but 4 months is better.

In summary, for a successful Botox therapy:

  • Have it done by a licensed, board-certified physician.
  • Be medically transparent with your provider.
  • Prepare by avoiding blood thinners and blood thinning medications.
  • Have realistic expectations that are in line with your provider’s assessment.

If you have additional questions and concerns about Botox, schedule a consultation with Dr. Effie Politis at (813) 542-2587. For more information about facial rejuvenation procedures, visit the Politis Plastic Surgery website.

Why Face-Aging Selfie Apps Encourage Healthy Skin Behaviors in Teens

You need some sun exposure. We all do. When your skin is exposed to the sun, your body is able to make Vitamin D, which in turn helps with calcium absorption for stronger and healthier bones. But it only takes a short amount of time in the sun to make the Vitamin D you need, and too much exposure can be dangerous. In fact, excessive unprotected exposure to the sun’s ultraviolet (UV) rays can cause skin damage, immune system suppression, eye damage and skin cancer.

Sun exposure and skin cancer

Skin cancer is the most common cancer in the United States. One in five Americans will develop skin cancer before reaching 70 years of age. According to the Skin Cancer Foundation, every year almost 7,000 people die of melanoma, the most severe form of skin cancer. Up to 90-percent of melanomas are related to UV exposure–specifically with severe sunburns–and are therefore highly preventable. Fortunately, daily sunscreen use is effective in preventing sunburns and skin cancer.

Low sunscreen use among teens

Why Face-Aging Selfie Apps Encourage Healthy Skin Behaviors in TeensA lot of unprotected overexposure to the sun occurs during childhood and teenage years. Because skin cancer is associated with cumulative UV exposure and sunburns early in life, the lack of protective behavior among teens is a major contributing factor to the cancer. For many teens, skin tanning is perceived as attractive and future problems such as skin atrophy and melanoma are seen as quite far away, encouraging unhealthy sunbathing behavior. Tanning damages skin cells, speeds up visible signs of aging and may lead to skin cancer, even in people in their twenties.

Using a broad-spectrum sunscreen with an SPF of at least 30 can protect the skin against both UVA and UVB rays. Those who learn to apply generous amounts of sunscreen on their skin every day can prevent skin cancer. Sadly, only about 15% of teens apply sunscreen regularly, just roughly 26% perform skin self-exams, and more than 19% use artificial tanning products. Promoting sunscreen use among children and teens while discouraging risky behaviors is therefore an effective approach to preventing skin cancer.

Face-aging app as an appearance-based intervention

Studies with adolescents and young adults indicate that appearance-based interventions are more effective than classic health education approaches in encouraging regular sunscreen use and healthy skin behaviors. Among teens, self-perceived attractiveness has a strong influence on self-esteem and is the primary motivation for tanning. This is why appearance-based interventions are ideal for promoting positive skin behaviors among the young. In fact, appearance-based face-aging interventions have already provided better outcomes for young people in other areas, such as tobacco use prevention.

One such appearance-based intervention is the face-aging app. With these apps, teens are able to witness ultraviolet (UV) radiation-induced facial aging firsthand. Face-aging apps show the effects of UV on the skin in general and on skin cancer development in particular, thus creating photo-aged selfies with sagging skin, spots, wrinkle formation, and malignant skin lesions.

The apps work by having the users take front-facing close-up pictures of their faces and then selecting skin tones from graded options. Users can then see simulated images of how they would look after being aged 5, 10, 15, 20 or 25 years into the future based on skin type. The users are also able to see how the images would differ if they used or did not use sun protection or underwent weekly tanning.

The simulated images give users varying degrees of wrinkles, spots, discoloration, loss of volume, age, as well as showing pre-cancerous and cancerous spots on the face. These face-aging apps include a feature that indicates how skin cancer risks increase with different skin practices and while providing useful information about sun protection.

Great results with face-aging apps

Snapping selfies (self-taken photos) and using filters to modify them is a popular teen activity. App-based interventions engage teens with familiar technology and show them how their faces can age due to excessive exposure to ultraviolet light from the sun or from tanning beds.

And while UV photography can be effective in monitoring sun damage, it is very expensive. This makes a free mobile face-aging app—available in Google Play, Apple’s App Store or other platforms—a cost-effective alternative and a fun intervention for skin-protection strategies.

Face-aging apps have been proven effective in changing habits to reduce UV exposure in children and adolescents. According to a JAMA Dermatology study conducted by a multinational team of researchers to assess the potential benefits of apps as educational tools (among nearly 1,600 students in grades 9 through 12 in southeastern Brazil) the results were remarkable. For example, students shown how to use a freely available mobile face-aging app had a daily use of sunscreen increase from 15% to 23%.

The study also demonstrated that overall use of sunscreen increased by roughly 50% among teens who used the app. It helped to achieve almost double the percentage of teens who performed at least one skin self-exam, while also reducing youth engagement in other risky skin behaviors.

Working with a plastic surgeon

A plastic surgeon can help you and your loved ones improve your skin care routine and prevent skin problems. Plastic surgeons such as Dr. Effie Politis are increasingly integrating new technologies in their practice to boost positive outcomes. Tools such as face-aging apps are being embraced by physicians to educate patients about sun exposure, preventing skin problems and reducing the risk of skin cancer. 

If you have questions about your skin, skin care and encouraging healthy skin behavior, speak with Dr. Effie Politis for expert guidance. For more information on plastic surgery and appearance enhancing services, visit the Politis Plastic Surgery website.

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