21 Things You Should Know Before Getting a Boob Job

From Cosmopolitan magazine

According to statistics by the American Society of Plastic Surgeons, breast augmentations were the most requested cosmetic surgical procedure in 2014. Double board certified New York plastic surgeon Adam R. Kolker, M.D. who specializes in breast enhancements, shares his insider tips on what you should know before getting breast surgery.

1. Your first breast surgery probably won't be your last. Twenty-five percent of women will need another surgery after 10 years because implants don't last forever. The implant could begin to leak over time or a "scar shell" could develop around it, warping the shape and causing a need for new implants. Weight loss, pregnancy, and change in preference are other factors that could lead the patient having another surgery after a few years.

2. It will cost you around $3,678. This average total, according to the 2013 statistics from the American Society of Plastic Surgeons, is based on the surgeon's fee only and does not include the cost of anesthesia, facilities, and materials (stitches, bandages, drapes, etc.). The price will also depend on doctor, patient, and region. The cost of reduction, though, varies greatly patient to patient. A reduction procedure could take three to four times longer than an augmentation, and the cost would reflect that.

3. Generally, patients will only have to take five to seven days off work for a breast augmentation and about the same for a reduction. You won't be feeling 100 percent after that week, but you'll be in good-enough shape to head back to the office if your job doesn't require manual labor. However, if the implant is placed behind the muscle instead of on top (many women choose to do this for a more realistic look and less chance of a scar shell forming around the implant), recovery will be a little harder and you might be sore longer.

4. Breasts with implants feel different to the touch than real breasts. Although silicone breasts feel similar to real breasts, they are still manmade and don't feel like natural breast tissue. You'll be more likely to notice there's an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.

5. You can try on different boob sizes before deciding on one. Using "sizers," a bead-filled neoprene sack, you can stuff your bra to give you an idea of the size you might like.

6. You can't go from small to huge all at once. If you're starting with a small A cup, don't expect to go up to a DD cup in one procedure. It's important to set realistic goals. Your body and skin need time to adjust to drastic changes, so a surgeon will likely suggest going up only a couple cup sizes at first, then increasing the implant size over the course of a few years.

7. Breast augmentations and reductions could possibly affect your ability to breastfeed in the future. Women who have implants oftentimes choose not to breastfeed so the data sets on these women are unclear. However, if you have an areola incision, there's a small risk you could damage minor ducts and could disconnect the areola complex with the main portion of the gland, hindering your ability to breastfeed. Women who have underarm incisions or incisions in the crease of the breast should not have a problem.

8. You might lose feeling in your nipples after a breast augmentation or reduction. Loss of sensation in the nipples can occur whenever there is surgery to the breasts. This depends on a number of factors, including breast shape and surgery type. Even if you lose sensation in your nipples, they will still respond to cold and stimulation (aka they will still be able to get hard even if you can't feel it).

9. You're not a great candidate for a breast augmentation if you have a very strong family history of breast cancer, are obese, or smoke. All these factors increase risks and complications during and after surgery. If you have any significant medical issues, you need to be evaluated and cleared before surgery.

10. Not all "plastic surgeons" are board certified and trustworthy. Thoroughly research surgeons that meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other "boards" that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that surgeon has experience in the type of surgery you're wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon's approach.

11. You have a choice of two different implants: silicone and saline. Seventy-seven percent of implants used in 2014 were silicone and the rest were saline. Both implants have upsides and downsides. Silicone implants look and feel more realistic, but it's harder to detect if there are ruptures in the implant due to its gel-like consistency. Saline implants, on the other hand, will show ripples in certain areas of your breasts, but since they have a water-like filling, they will sooner alert you if there is a leak by visibly decreasing in size over time.

12. You can move fat from elsewhere on your body to your boobs. It's a new process called autologous fat transfer. Few people are candidates for this procedure.

13. You can get an areola reduction. This is also called a mastopexy. Oftentimes women who get a reduction will also have an areola reduction so the areola is proportional to the new size of the breast. The area around the nipple is very forgiving when scarring.

14. You can't walk in to a consultation and say you want X implant type through X incision location. You and your surgeon will together decide which incision choice is best for you: underarm incision, incision in the crease of the breast (inframammary fold), or through removal of the areola. Your doctor will take into consideration your beginning breast size and shape, breast tissue, and a number of other factors before recommending which options are best for you and your body.

15. Any breast surgery can have a small effect on breast cancer screening in the future.Breast health is important. Before the surgery, have a proper breast exam with your gynecologist. If you're of age, get a mammogram. Most mammographers don't have an issue if the implant is placed behind the muscle, but it is important to discuss with your surgeon.

16. Exercise, especially cardio that involves bouncing, is restricted after surgery. Although you can start doing light cardio again after a week, most women will need to limit their exercise for up to 12 weeks.

17. Implants are more comfortable if the procedure is done postpartum rather than before the patient has kids. But any implant placed under the muscle will increase the discomfort levels.

18. Augmented breasts will affect your posture just like the weight of natural breasts would. The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects.

19. Your boobs do not need to be a minimum size for a reduction. This is all based on personal preference. Think of boob size in terms of a scale from small to large. Based on breast size before the procedure and desired breast size afterward, there are a number of incision options for a reduction for a huge range of results. You can even choose to get a reduction and an implant to replace some of the volume that you've lost over time.

20. It is possible that your boobs can grow back after a reduction. However, if the procedure is done after pregnancy and your weight stays consistent, your breast size is unlikely to change.

21. Ask yourself the following questions and be comfortable with your answers before going through with the surgery:

• How much does my current situation bother me?
• Why do I want this procedure?
• How excited am I to go through with this?
• Can I handle the time off from work and exercise?
• How much am I willing to expose myself to certain risks?

Reference: http://www.cosmopolitan.com/health-fitness/advice/a38708/things-you-should-know-before-getting-a-boob-job/

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FDA Speaks: 5 Things to Know About Breast Implants

Should I get breast implants? Are there alternatives? Will they need to be replaced?

And if you decide to get implants, there are even more questions. Saline or silicone? What style? How much monitoring is needed?

Researching breast implants can be overwhelming and confusing. The Food and Drug Administration (FDA) has online tools available to help women sort through the information and provides questions to consider before making the decision.

Know the Basics

FDA has approved implants for increasing breast size in women, for reconstruction after breast cancer surgery or trauma, and to correct developmental defects. Implants are also approved to correct or improve the result of a previous surgery. 

A number of studies have reported that a majority of breast augmentation and reconstruction patients are satisfied with the results of their surgery.

FDA has approved two types of breast implants for sale in the U.S.: saline (salt water solution)-filled and silicone gel-filled. Both have a silicone outer shell and vary in size, shell thickness and shape.

Know the Risks

Silicone implants sold in the U.S. are made with medical-grade silicone.  These implants undergo extensive testing to establish reasonable assurance of safety and effectiveness. Nonetheless, there are risks associated with all breast implants, including:

• additional surgeries
• capsular contracture—scar tissue that squeezes the implant
• breast pain
• rupture (tears or holes in the shell) with deflation of saline-filled implants
• silent (without symptoms) rupture of silicone gel-filled implants

FDA experts suggest five things women should know about breast implants.

1. Breast implants are not lifetime devices. The longer a woman has them, the greater the chances that she will develop complications, some of which will require more surgery.  The patient can also request additional surgeries to modify the aesthetic outcome, such as size or shape.

“The life of these devices varies according to the individual,” says Gretchen Burns, a nurse consultant at FDA’s Center for Devices and Radiological Health (CDRH).  “All women with implants will face additional surgeries—no one can tell them when.” While a few women have kept their original implants for 20-30 years, “that is not the common experience.”

2. Research products.  Review the patient labeling. FDA advises that women look at the Summary of Safety and Effectiveness Data (SSED) for each implant to learn about their characteristics and the fillers used. SSEDs have been produced for all approved saline and silicone gel-filled breast implants. These summaries provide information on the indications for use, risks, warnings, precautions, and studies associated with FDA approval of the device. Look at the frequency of serious complications found in the SSED. The most serious are “those that lead to further surgeries, such as ruptures or capsular contracture,” says Tajanay Ki, a biomedical engineer in CDRH.

FDA advises health care providers to give women the full labeling—all of the patient information from the manufacturer—for an implant. Ask your surgeon for the most recent version of the labeling. You should have at least 1-2 weeks to review the information before making a decision, but with some reconstruction or revision surgery cases, it may be advisable to perform surgery sooner.  

3. Communicate with the surgeon.  Surgeons must evaluate the shape, size, surface texture and placement of the implant and the incision site for each woman. Ask the surgeon questions about his or her professional experience, the surgical procedure, and the ways the implant might affect an individual’s life.

Also, tell the surgeon about previous surgeries and your body’s response—for example, whether surgeries resulted in excessive scar tissue—and discuss your expectations. This helps the surgeon make operative decisions that achieve the desired appearance (i.e., incision location and size, implant size and placement).  Many women undergo reoperation to change implant size.  To achieve optimal results after the first procedure, careful planning and reasonable expectations are necessary. 

4. Learn about long-term risks. Some women with breast implants have experienced connective tissue diseases, lactation difficulties or reproductive problems. However, current evidence does not support an association between breast implants and these conditions. FDA has identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin’s lymphoma. Women who have breast implants may have a very small but increased risk of developing ALCL in the fluid or scar tissue surrounding the implant. Like other lymphomas, ALCL is a cancer of the immune system and not of breast tissue.

5. Monitoring is crucial. FDA recommends that women with breast implants:

• promptly report any unusual signs or symptoms to their health care providers, and
• report any serious side effects to MedWatch, FDA’s safety information and adverse event reporting program.

Furthermore, women with silicone implants should get MRI screenings to detect silent ruptures three years after their surgery and every two years after that.  Insurance may not cover these screenings.

Burns recommends that women with breast implants continue to perform self-examinations and get mammograms to look for early signs of cancer. “Just because you have implants doesn’t mean you can ignore other breast health recommendations,” she says.

FDA’s Online Resources

FDA has a breast implants web page (www.fda.gov/breastimplants) with resources that include:

• Links to patient information and data for each product.
• Information about risks and complications
• Questions to ask health care professionals regarding breast implant surgery
• Contact information for manufacturers of FDA-approved breast implants and related professional organizations

This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.

Reference: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm338144.htm

The Surprising Thing That's Ruining Your Botox

From New Beauty magazine

The sun gets a bad rap for so many skin-aging issues, and now there might be a new negative side effect to add to the list: The cause behind Botox breaking down. Here, the experts debate this snag in anti-aging—and make the case for one more reason you need to be wearing sunscreen.

It might make it metabolize quicker.
According to New York dermatologist Jody Levine, MD, at certain times, a patient may metabolize Botox quicker than other times—meaning, it doesn’t last as long as it had in the past. “There may be many factors responsible for this, one of which is ultraviolet exposure, which increases the metabolism of Botox,” she says.

It’s the loss collagen that’s doing the damage.
“The sun does not directly affect Botox,” says New York dermatologist Marina Peredo, MD. “It’s the UV radiation inducing collagenase in fibroblasts, which in time causes degradation of collagen. This is what leads to lines and wrinkles.” One thing Dr. Peredo says she does see shorten the duration of injectables at certain times: Concomitant treatments (procedures performed at the same time, such as lasers), when performed in the same area on the face.

Either way, you need SPF.
Regardless of whether or not you are worried about your injectable treatments having a shorter span because of the sun, the American Academy of Dermatology stands by its recommendation that you should wear a broad-spectrum sunscreen of at least SPF 30 or higher, every day, rain or shine.

Reference: https://www.newbeauty.com/hottopic/blogpost/8976-can-the-sun-break-down-botox/

Lipo B12 Injection for Weightloss and Energy

The Treatment That Will Enhance Your Anti-Aging Routine

from New Beauty magazine

When it comes to rejuvenating the skin, nothing does the trick quite like what’s offered at dermatologists' and plastic surgeons' offices. These doctors are privy to all the new technologies, but despite what’s groundbreaking and trendy, there’s something to be said about the tried-and-true treatments that have staying power, such as Intense Pulsed Light (IPL).

IPL is a light-based treatment (even though it’s often grouped into the laser category) that is used to erase discoloration—think freckles, sun damage and brown spots—as well as rosacea, acne, broken capillaries and unwanted hair. “Current IPL systems are very versatile, allowing us to cover a lot of the skin's surface while treating a variety of skin conditions,” says Miami dermatologist Adriane Pompa, MD.

It's often the weapon of choice when dealing with pigmentation issues because it targets melanin in the skin. “Melanin increases from chronic sun exposure, as do the freckles that result from it,” says Dr. Pompa. “With just a few treatments (three to five) of IPL, dark spots can improve dramatically. The treatment is able to cover a large area and there is little downtime associated with it.” Each session, according to Dr. Pompa, feels like a hot bright light on the surface of the skin, similar to a bright flash being fired. IPL is also said to feel like a rubber band snap, too. A few days post treatment, the treated areas become darker (like a coffee grind) before they naturally fall off and fade. “After about two to three treatments, the results will be noticeable, but many patients notice a difference after the first treatment.” 

Because IPL relies on the power of a broadband light source plus filters, Dr. Pompa says that different molecules in the skin can be focused on to selectively treat a specific target with minimal impact on other skin structures. “That’s why it works best on benign pigmented skin lesions.”

In addition to all the benefits that IPL offers—did we mention it also stimulates collagen production—it can be used to rejuvenate the skin from a textural standpoint, too. “We’ve seen that IPL patients' skin looks younger and tighter after treatment,” says Dr. Pompa. In the future, Dr. Pompa says IPL may be used to treat stretch marks, scars and atopic dermatitis, and even nail and plaque psoriasis.

Call us today at 713-909-3088 to learn if IPL is right for you.

Reference: https://www.newbeauty.com/hottopic/blogpost/8639-benefits-of-intense-pulsed-light-treatment/