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May 8th, 2013 admin
Although it is not always apparent, no woman’s breasts are perfectly symmetrical. For some, the difference between their breasts is very noticeable and can be extremely embarrassing.
Breast Asymmetry Disorder is a condition characterized by extreme differences in size, position, or shape; differences in nipple height, areola diameter, and breast height and width are some irregularities that are more common than you may think. Breast asymmetry can negatively affect women’s personal and social lives by causing stress, social inhibition, lack of self-confidence, and difficulty finding appropriate clothing, especially swimwear. Studies have shown that these issues were improved following breast asymmetry surgery, resulting in higher self-esteem and quality of life.
How Breast Asymmetry Occurs
Breast size abnormalities can be the result of genetics, random growth patterns, traumatic injuries during the developmental phase, and hormonal changes. Another condition that causes breast asymmetry is Poland’s syndrome — a lack of pectoral muscle and an underdeveloped breast.
During puberty, the hormone estrogen activates the growth of breast tissue in girls, and the breasts are generally fully developed within four years thereafter. By the age of 21 most women’s breasts are fully developed, and if breast asymmetry exists at that age it is likely permanent unless corrected with breast surgery.
Breast Surgery to Correct Asymmetry
Many women who suffer from Breast Asymmetry Disorder decide to undergo surgery to alleviate this problem. There are many different techniques that can be used to correct a woman’s particular condition. This includes:
Breast reduction to the larger breast: Women who have excessively large breasts but an asymmetrical appearance can choose to have the larger breast reduced and lifted to the same height as the smaller one.
Breast implant for the smaller breast: To make breast size even, an implant can be placed in the smaller breast. For this method, the larger breast often needs a small lift and adjustment to balance out the surgically enhanced breast.
Two different sized implants: In the case where both breasts are small and asymmetrical, implants of different sizes can be inserted to enlarge both breasts to the same proportion.
A lift for one breast: When one breast (and nipple) is lower than the other, a lift can be performed on the lower breast to raise it to the same level as the higher breast.
During an initial consultation, Dr. Oliver or Dr. Jack will evaluate your individual circumstances to determine the best method for correcting your breast asymmetry. To schedule your consultation today with one of our board certified plastic surgeons, please fill out call (205) 298-8660. We look forward to hearing from you!
Posted in Breast Enhancement, Breast Implants | No Comments »
April 15th, 2013 admin
Pregnancy and childbirth can have an unfavorable effects on a woman’s breasts, abdomen, hips, and thighs. Extra skin, sagging, and stretch marks can appear on some or all of these areas. A “Mommy Makeover” may combine several procedures, such as a breast lift, breast augmentation, tummy tuck, and liposuction, in order to improve these problems. If you are considering a Mommy Makeover, you are probably curious about the details of recovery…and we are here to make sure that you completely understand what will be involved during this period!
A Mommy Makeover can include a combination of procedures performed in the same operation, which means the patient will be able to recover all at once versus requiring separate recovery periods for each individual procedure.
After surgery, some minor swelling, pain, and discomfort may occur. Bandages will be applied to the surgical areas to aid the healing process and to keep the incisions clean. Drainage tubes may be placed to remove any fluid that collects beneath the skin early on in the post-operative process. A pain pump or oral medication can be used to control pain and discomfort while in the hospital, and an overnight stay may be recommended for patients who undergo extensive surgery.
Mommy Makeover patients should arrange for someone to drive them home upon leaving the hospital. It is also advised that patients arrange for someone to help with daily activities during the first two weeks, especially for mothers with children younger than two years old at home.
A compression garment is recommended to be worn during the entire recovery period to provide support and reduce swelling as the body takes on its new shape. Expect to take at least two weeks off from work, and oral medications will be prescribed to help manage the pain during this time. As able, patients will need to practice deep breathing exercises and walk around comfortably, which will aid in the recovery process. Heavy lifting and strenuous activity should be avoided for up to six weeks depending on the extent of your procedure, and tummy tuck patients should avoid twisting motions and using their core muscles during this time. Incision scars can take up to two years to fully heal. They may not completely disappear, but they will be placed inconspicuously and well-hidden underneath clothing and bathing suits.
If you are considering a Mommy Makeover in Alabama, please call Plastic Surgery Specialists at (205) 298-8660 today to schedule a consultation. Either of our board certified surgeons, Dr. Robert I. Oliver or Dr. Jason M. Jack, will further explain the Mommy Makeover recovery process during your visit and determine which procedure(s) will benefit you the most.
Posted in Body Contouring, Breast Augmentation, Breast Enhancement | No Comments »
April 3rd, 2013 admin
Breast revision is a secondary procedure that can be performed if a woman is unsatisfied with the results of her first breast enhancement surgery. Breast implants can last well over a decade but may eventually need to be replaced due to gravity and normal aging. Other reasons that breast revision surgery may be performed include:
Capsular Contracture – This is the development of scar tissue that causes the breasts to appear asymmetrical or distorted. To correct this condition, the implant and scar tissue are removed, and a new implant is inserted into the breast pocket.
Post-Pregnancy – After pregnancy and breastfeeding, many women’s breasts begin to droop
and develop sagging skin. A breast revision can elevate the breasts to a more youthful position, restore lost volume, and eliminate excess skin.
To Change the Breast Size – Following breast enhancement surgery, some women are not satisfied with the resulting size of their breasts, or they may eventually decide that they want to change the size for one reason or another. Volume can be increased or decreased with surgery to remove the current implants and replace them with larger or smaller implants.
To Change the Type of Implant – Sometimes women decide to change the type of implant they chose for their original breast enhancement (saline ←→ silicone) because of certain desired benefits that a different implant type may provide. The old implants are removed and the new implants are inserted into the breast pocket.
Candidates
The best candidates for breast revision surgery are in good overall health and do not smoke. Potential patients who do smoke should discontinue cigarette use for at least two to four weeks prior to surgery. As with any procedure, patients should have realistic expectations for their surgical outcome.
At our Alabama office, plastic surgery specialists Dr. Robert I. Oliver and Dr. Jason M. Jack are certified by the American Board of Plastic Surgery (ABPS) and routinely perform breast revision surgery. They are dedicated to making sure that each and every patient is completely satisfied with their results the second time around.
To schedule a consultation with Plastic Surgery Specialists, please call (205) 298-8660 today.
Posted in Breast Revision | No Comments »
March 5th, 2013 admin
Breast augmentation is one of the most popular plastic surgery procedures in the world, providing women the ability to enhance the size and shape of their chest. Although uncommon, there are a few instances where patients can experience a complication known as an implant rupture. If an individual experiences a saline implant rupture, then they should contact a plastic surgeon as quickly as possible.
Causes of a Rupture
The exact cause of a saline implant rupture cannot be attributed to just one reason. However, individuals have been known to experience implant ruptures following certain occurrences, such as:
- Excessive pressure on the implant due to intense physical activity
- Normal aging of the implant shell
- Complications during insertion of implants
Signs of a Rupture
If a saline implant ruptures, it will begin to leak and eventually go flat. A noticeable difference will appear in the symmetry of the breasts, and a lack of volume in the breast with the ruptured implant will be evident.
What Should I do if an Implant Ruptures?
If your saline implant ruptures, the first thing you should do is stay calm and not panic. Although the salt water solution in a saline implant is harmless to your body, the sooner you get in touch with a plastic surgeon the better. (Saline implants are filled with a salt water solution, so the body will safely absorb any leakage that happens during a rupture.) If you wait too long, scar tissue can tighten around the ruptured implant (capsular contracture) which may create the need for additional work in order to remove the damaged implant.
Overall, you should have a ruptured implant removed as soon as possible in order to prevent further problems.
When you come into our Alabama practice, we will be sure to discuss every available option and take care of your individual needs. If you would like to schedule an initial consultation with either of our board certified plastic surgeons, Dr. Robert I. Oliver, Jr. or Dr. Jason M. Jack, please call Plastic Surgery Specialists at (205) 298-8660 today. We look forward to your visit!
Posted in Breast Augmentation, Breast Implants | No Comments »
March 5th, 2013 admin
Tubular Breast Syndrome, also referred to as “hypoplasia” or “tuberous breast deformity,” is a rare condition that is caused by a congenital abnormality of the breasts. This condition usually becomes fully apparent during puberty, which is due to underdeveloped breast tissue. This leads to an asymmetrical breast appearance, and particularly a droopy, “tube-like” shape. Hypoplasia also causes the areolas to enlarge and the breasts to be spaced unusually far apart. Unfortunately a vast majority of women with tubular breast syndrome go undiagnosed throughout their entire lives.
Fortunately, treating tubular breasts is not as simple as just augmentation the breasts with saline or silicone gel implants. In fact, if the condition is not diagnosed properly, then a breast augmentation can actually make the breast look even worse than before. This is why choosing a plastic surgeon with board certification and extensive experience in the correction of tuberous breast deformity is of utmost importance.
The extent of the patient’s condition will determine the amount of surgery that will be required and exactly what procedures will provide optimal results. In severe cases, patients may need more than one surgery and the use of tissue expanders over a few weeks to correct the abnormality between the breasts.
Living with tuberous breasts can cause a woman to feel less confident about her body, as well as make it difficult to wear certain types of clothing, including bathing suits. Luckily, at our Birmingham practice, we can correct this condition by restoring volume and fullness to women who have tubular breasts.
If you would like to improve the overall shape of your breasts, please feel free to contact Plastic Surgery Specialists at (205) 298-8660. We encourage you to schedule a consultation with either of our board certified plastic surgeons, Dr. Robert I. Oliver, Jr. or Dr. Jason M. Jack.
Posted in Breast Augmentation | No Comments »
March 1st, 2013 admin
Finally!
After sitting on clinical trial data on their most advanced breast implant for the better part of a decade, the USFDA finally gave their blessing to Allergan Corp. to sell their “410″ breast implant in the United States. This is a moment we have been waiting for a long time. As far back as 2005 we were telling patients that release of this device was imminent and if they were interested in using it for their breast cancer reconstruction or cosmetic procedure they should wait a little bit.
The 410 implant uses the most stiff or cohesive silicone gel polymer available in a breast implant and allows the implant to be anatomically shaped rather then round. The clinical data from these type of implants was amazing in that it virtually eliminates the risk of visible implant ripples and is almost impossible to rupture (as it’s a solid rather then liquid form).
Several issues with these types of implants exist however:
1. they’re almost 30-40% more expensive then round silicone implants and almost 4x the cost of a saline implant. This is a big premium you’re asking to use these devices for which there may not be a high demand. Quite frankly, if the cost does not come down this will be a very small niche device.
2. shaped implants are not for all patients. They’re best employed on people with relatively small and nice-shaped breast. A larger breast or a breast with more loose skin or sage are likely best treated with round implants. In the right patients however, they fantastic and better looking then round implants.
3. These are firm implants, much more so then the shaped implant alternative from Sientra that’s available. Will that firmness be a turn-off for patients? Apparently in the rest of the world it is, and these devices are used less for cosmetic cases then some alternatives (including some from Allergan which are not going to be available here in the United States). It begs the question of whether the great clinical data they’ve shown demands the extra firm composition of the 410 or whether you can reproduce that with something a little softer like the Sientra or Mentor devices.. We won’t know for a few years.
We’re eager to see how this device compares in practice to alternatives from Sientra (which have been available since last year) and Mentor Corp. (which has their own version of this type of device in FDA limbo). In their favor, they have (by far) the best and longest term data on their devices and that may be a compelling reason to command a premium price. The longevity and resistance to hardening they’ve shown for the 410 is going to make their competitors step up to the plate with their follow-up studies to prove equivalent outcomes.
Dr. Rob Oliver
Posted in Breast Augmentation, Breast Implants | No Comments »
January 17th, 2013 admin
We’ve been very pleased with out early experiences with the recently approved silicone breast implants from Sientra. The implants from this company are significantly different then traditional devices from other manufacturers in several ways. Most notably their implants possess the most highly cohesive silicone gel available in the United States at present which should translate into increased durability and more resistance to implant rupture and hardening of the implants. They also have the only available shaped silicone gel breast implants on the market as well. The combination of the more stable “gummy bear” gel with a shaped device allows previously unavailable ability to control the breast shape in certain patients.
If you’re interested in discussing whether these advanced breast implants are the right choice for you, please give us a call at (205) 298-8660 to set up a consultation.
Dr. Rob Oliver
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July 15th, 2011 admin
In a not unexpected conclusion, yesterday the United States Food & Drug Administration re-affirmed their 2006 decision to reintroduce silicone gel breast implants into the United States market for cosmetic indications. In statements from the FDA, they explained that no new information has arisen to question the safety or efficacy of the devices for intended use. As has been discussed on Plastic Surgery 101 a number of times, this is not really news and has been accepted world-wide for a number of years now. Hopefully this statement from FDA heralds the availability of the new form stable “gummy bear” silicone implants here in the United States which have been available everywhere else for almost 15+ years.
Breast augmentation remains the most popular cosmetic surgery in the U.S., with nearly 300,000 women undergoing it last year. According to the American Society of Plastic Surgeons (ASPS), more than 70,000 others received implants for breast reconstruction.
The most disappointing finding was that only ~60% percent of women enrolled in a 1,000-patient study of one manufacturers implants are still accounted for after eight years. A larger study of 40,000 women conducted has lost nearly 80 percent of its patients after just three years. Diana Zuckerman of the National Research Center for Women and Families, one of the most prominent (and persistent) anti-implant activists, cried foul and suggested that most medical journals would not publish the studies cited by the FDA because of the missing data. I’d agree with her, but for different reasons. She’s implying safety issues exist (which they don’t by and large), while I’m more interested in outcome data to understand how to reduce re-operations.
Why the relatively poor follow up in the FDA trials?
Dr. Phillip Haeck, president of the American Society of Plastic Surgeons (ASPS)sums it up saying that, “When women are happy with their implants they tend to feel that a regular follow-up is pointless – it becomes a nuisance and an unnecessary expense”. I’d agree 100% with that.
It also begs the question of what exactly are we trying to demonstrate with the FDA follow up studies. There is overwhelming world-wide information that suggests safety at this point. It would be nice to have a little more data on longevity so as to better counsel patients on when to consider routine exchange with prior devices, but as we’re on the cusp of a major design change in the polymers that make the implant almost impossible to rupture (the “gummy bear” form stable devices) we’re going to quickly lose interest in exhaustively studying older devices. This kind of technology advance has always created problems about making conclusions with medical devices, as you end up comparing apples to implants 
(bad pun alert).
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November 2nd, 2010 admin
In the last few years, an alternative to traditional implant position has been described. As opposed to the simple over/under the pectoralis muscle decision, a technique which places the implant over the muscle but under the muscle fascia (covering tissue) has interesting properties that offer several benefits.
# Subfascial placement prevents the “bolted on” appearance often caused by the submuscular placement, offering a more natural slope to the breast similar to traditional subglandular implant placement.
# Has a lower rate of visible wrinkles or “rippling” then the pure subglandular position
# Less disruption of the patient’s anatomy than the submuscular or partial submuscular positions, as the pectorlais muscle is not released off of the chest wall.
# Significantly less discomfort early after surgery. Generally, patients can return to work after a 2-3 days, and are able to resume workouts early on.
# Prevents the muscle “animation” of the implant that is often visible after submuscular placement in extremely active or thinner individuals.
In patients with enough tissue to consider this type of surgery, I am increasingly recommending this approach to patients considering breast augmentation.
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September 2nd, 2010 admin
A new study of women with the “breast cancer gene ” (BRCA1 & BRCA2) confirms that pre-emptive surgery to remove the breasts and ovaries in women with BRCA genes can sharply reduce the risk of contracting cancer and dying.
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