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). View this post on Instagram
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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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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.View this post on Instagram
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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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.
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.
SPY Elite imaging uses an injectable fluorescing agent to intraoperatively assess the perfusion and viability of tissue, including skin flaps, during post-mastectomy reconstruction for breast cancer patients.
We evaluated the patient preoperatively and also used intraoperative SPY imaging (intraoperative laser angiography) to ensure adequate perfusion of the mastectomy flaps prior to engaging in single stage reconstruction.
Intraoperative laser angiography using indocyanine green (ICG) is a vascular imaging methodology that can be used in the intraoperative or postoperative setting to visually assess superficial blood flow.
Characteristics of ICG angiography make it a desirable option for tissue evaluation. The technique provides real-time assessment of tissue perfusion that has been correlated with clinical outcomes and guides surgical decision making, such as flap design or intraoperative tissue resection. ICG has an excellent safety profile and short plasma half-life, allowing for repeat evaluations during the same operative procedure.
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Please note: These are my individual patients who have provided written photo consent. These photos and posts do not constitute medical advice. Results may vary. See a board certified plastic surgeon for evaluation.
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Type of Recon: Single Stage Direct to Implant Breast Reconstruction after Mastectomy, Galaflex Ravioli construct
Type of Mastectomy: Nipple Sparing or Nipple Preserving through inframammary approach
Implants: Natrelle Inspiration Cohesive SCF 295
SPY Elite Imaging
“Breast in a day” direct-to-implant breast reconstruction represents an emerging technique in the field of postmastectomy reconstruction and holds appeal, as it shortens the reconstructive process, eliminates the expansion period, and avoids a second operation.
This case was performed with bilateral nipple sparing mastectomy and single stage reconstruction with cohesive implant and Galaflex ravioli construct placed in prepectoral position.
The advantage of this technique is that it is performed at time of mastectomy whereas traditionally, we place tissue expanders partially under the muscle and expand the patient and then perform a second procedure in 3-6 months where we exchange the expanders for permanent implants.
Therefore, instead of a staged process, we can achieve stable and long term results with a single stage or direct to implant reconstruction. This requires collaboration with the surgical oncologist, meticulous dissection, scaffold material (Galaflex to stabilize and secure implant in mastectomy pocket ), and cohesive implants, we are able to perform implant based reconstruction in a single stage.
Also, the implants are typically placed over the muscle, which decreases pain, animation deformity, preserves shoulder/arm strength, and creates a more natural result.
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Please note: These are my individual patients who have provided written photo consent. These photos and posts do not constitute medical advice. Results may vary. See a board certified plastic surgeon for evaluation.
Bothered by stubborn fat deposits that won’t go away even with regular exercise and healthy eating? At Politis Plastic Surgery, we recommend you consider liposuction to achieve a more comfortable and confident look.
Liposuction is a minimally invasive procedure that removes unwanted fat deposits from specific areas of the body. A plastic surgeon makes incisions to reach the fat deposits and uses a cannula to draw them out. The areas commonly treated include the abdomen, arms, thighs, hips, ankles, calves, neck, love handles, tummy, face, chest and buttocks.
read more here
