Archive for January, 2011

Breast Implants and ALCL

Monday, January 31st, 2011
Plastic surgery

In the last few days I have received questions from several patients who heard about the U.S. Food & Drug Administration’s recent guidance regarding a possible connection between breast implants and anaplastic large cell lymphoma (ALCL). Both for women who have implants and those who are considering a breast augmentation procedure, I would like to provide more information about this guidance and suggest some next steps.


What the FDA Is Doing

An initial review by the FDA has identified 34 unique cases of ALCL in women with breast implants throughout the world. To put this in perspective, it is estimated that 5 to 10 million women worldwide have breast implants. The FDA believes that women with breast implants may have a very small but increased risk of developing this disease, and is asking health care professionals to report confirmed cases of ALCL in women with breast implants to the FDA.

What the FDA Is Not Doing

The FDA is not taking back its approval of saline and silicone gel breast implants. To quote the organization: “The FDA believes that the totality of evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.”

What You Need to Know

If you have had breast augmentation, I advise you to continue to follow your doctor’s regular implant care instructions. Because ALCL is not a breast cancer, there is no benefit to performing additional self exams, but it is worth talking with your surgeon in more detail if you are particularly concerned, if only for added peace of mind.

For women who are thinking about breast augmentation, it is important to get the latest facts. Additional fact finding on this issue will be ongoing and informed surgeons will be able to give you the most current information while providing additional context for the scientific findings so far.

Is Post-Op Breast Asymmetry a Sign of a Bad Surgeon?

Wednesday, January 26th, 2011
Slim attractive blond model in lingerie

During consultations, I hear from some women that they are concerned about having asymmetry after breast surgery. Many of my breast augmentation patients felt anxious as they searched for a Los Angeles or Santa Monica plastic surgeon. They want to feel confident in their choice and, most of all, want to enjoy “perfect” results from their surgery.

A few years ago, a study of breast asymmetry found that after breast augmentation, 88% of patients had some degree of asymmetry and 65% of the women had more than one type of asymmetry. These numbers may seem very high, but before we start questioning the skills of plastic surgeons, we should consider the issue from every angle.

While a beautiful result is always the goal, some asymmetry is simply a result of each patient’s unique physiology. For instance, asymmetry following breast augmentation may be the result of slight pre-op asymmetry that has been magnified by the increase in breast size. However, skilled surgeons can minimize asymmetry by:

  • Performing a thorough chest wall evaluation before surgery to determine your individual needs
  • Carefully choosing your implant size, profile and placement based on your physiology
  • Using an areolar (around the nipple) incision to ensure areolar symmetry (if necessary)
  • Performing a breast lift in conjunction with augmentation
  • Considering inframammary fold position before surgery to help prevent the implants settling in different positions.

Choosing a surgeon who is highly qualified can help prevent some of these issues, but keep in mind that asymmetry is a natural occurrence. Discussing your concerns with your surgeon is a great way to ease your anxiety and find out what he or she can do to help improve your symmetry after surgery.

The Worth of Cosmetic Surgery Predictions

Tuesday, January 11th, 2011
Close-up Of A Doctor Examining You

According to iData Research, the cosmetic surgery, facial aesthetic, and laser industries are expected to double in size and exceed $3 billion in annual revenue over the next 7 years. While it is hard to predict how fast these industries will grow for certain, there are many factors which have contributed (and will probably continue to contribute) to the rapid growth of the cosmetic industry. Among these reasons are wider social acceptability and innovative technological advances.

Even within the last 20 years, plastic surgery has become more legitimate in the eyes of mainstream America. While some people still think cosmetic plastic surgery is “wrong” or “unnecessary,” more and more people are appreciating the fact that plastic surgery can radically transform a person’s life.

For example, consider some of my Los Angeles breast reduction patients. These women get the cosmetic benefit of having shapely breasts that are in better proportion with the rest of their body contours, but more importantly, they are often able to transform their lifestyle, exercising more regularly and performing other activities they may have thought would never be possible for them given their uncomfortable, overly large breasts.

Of course, the safety of cosmetic procedures also plays a role in the increasing amount of money being spent. With laser technology particularly, rejuvenation can be entirely painless, promote faster healing or make procedures that used to take extensive surgery quicker and easier – all without making an incision. As technologies and procedures change dynamically, it’s hard to imagine what the next 7 years have in store for plastic surgery. One thing is for sure: the industry will continue to grow as it has in the past and may even exceed our predictions. As they say, only time will tell.

Silicone Implants and Breast Reconstruction

Thursday, January 6th, 2011
Silicone-Implants-and-Breast-Reconstruction

A recent study published in the online edition of the journal Cancer reported that breast reconstruction patients who chose silicone implants following their mastectomy were more satisfied than those who chose saline implants. Although saline implants have been continuously available for decades, the look and feel of silicone implants is now leading many women to choose silicone implants, both for cosmetic and reconstructive procedures.

It comes as no surprise to me that more and more women are choosing silicone implants in general; at Marina Plastic Surgery Associates, we’re participating in a Los Angeles breast implant clinical trial for the fifth generation of silicone implants, also known as “gummy bear” implants, and we are finding very high satisfaction rates with this implant type. We are also seeing high satisfaction with the silicone gel implant type widely available to women today.

For breast cancer reconstruction, silicone implants also make sense. Since most or all of the breast tissue can be removed during a mastectomy, many women not only want their breast to look how it used to look, but want it to feel just like their old breast as well. Coupled with the fact that gummy bear implants retain their shape when torn or punctured, how they feel makes silicone breast implants a great option.

This is not to say that silicone implants are good for every woman. There are several situations where saline implants can give the desired effect or even be preferable to silicone implants. Of course, this should be decided on a case-by-case basis with your surgeon.

Tummy Tuck: Not a Weight Loss Method

Monday, January 3rd, 2011
Couple at gym

A tummy tuck is a surgical procedure that can help remove excess fat and skin around the midsection. This procedure is helpful for contouring the body as well as tightening the underlying muscles of the abdomen. Tummy tucks are particularly popular among mothers who experience sagging or excess skin around the midsection following pregnancy. But while a tummy tuck can help Los Angeles women and men improve the shape of their bodies, it is not meant to be a substitute for eating a proper, healthy diet or exercising regularly. In fact, it is helpful for those considering the procedure to be close to their ideal body weight beforehand.

Some common benefits of a tummy tuck include:

  • Removal of excess skin and fat
  • Tightening of the underlying muscles
  • Improvement in overall body contour

A tummy tuck can also be combined with liposuction for optimal results. Combining liposuction with a tummy tuck is particularly helpful for those who have lost a significant amount of weight and experience loose, sagging skin. A tummy tuck also can be combined with other cosmetic surgery procedures after weight loss for more complete sculpting of the body.

Dr. Grant Stevens

I am a board-certified Beverly Hills plastic surgeon with over 20 years of experience researching and implementing new approaches to plastic surgery. At Plastic Surgery Insider, you get the benefit of my experience and authority when you read my perspectives on the latest news and procedures in plastic surgery.
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