Below are some of the most frequently asked questions patients have about plastic surgery issues. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
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The issue of breast implant safety has been a hot topic throughout the last few decades. As a result, more stringent standards have emerged in order to protect patients. Current breast implant procedures primarily use silicone shell implants filled with a saline solution. Occasionally, silicone-gel filler is used; but this is highly regulated by the FDA, and generally only acceptable in reconstructive surgery procedures. Rarely, an implant will rupture or leak. With saline implants, the saline is safely absorbed into the body. The effect of silicone-gel leaking into the body is still being researched. If rupture or leaking is detected early, the implant can be easily replaced. Other possible complications from breast implant surgery may include blood clotting or pooling, overly sensitive breasts or loss of sensation in the breasts, and capsular contracture (a hardening of the tissues surrounding the implant). Our expert team is dedicated to making your operation a smooth one. We take every precaution necessary to reduce the possibility of any complications.
Dr. Brantner offers all of the available approaches for breast augmentation. What you choose will depend on how you view the pros and cons of each approach. At the time of your consultation you will have time to discuss your preference or any other questions with Dr. Brantner. The presently available approaches are 1) Inframammary, 2) Periareolar, 3) Transaxillary, 4) Transumbilical, and 5) Transabdominal.
Inframammary: The incision is placed under the breast about 1/2" above the crease. It is a simple approach that provides good visibility. The length of the incision will depend on whether gel or saline implants have been selected This incision may not produce the best scar. It be the best approach if the breasts have dropped, the patient does not wish to have an uplift, and therefore, the implants need to be placed in a lower position.
Periareolar: This approach was developed to get better scars. Generally the scars extend from 9 o'clock through 6 o'clock to 3 o'clock. There is a somewhat increased risk of permanent decrease of sensation of the breast or nipple with this approach. This incision is placed at the edge of the areola. The resulting scars can be nearly invisible but can also be lighter or darker than the color of the areola, which can tend to make them more visible also. This approach is indicated for gel implants larger than about 420 mL.
Transaxillary: The incision is placed in the apex of the armpit area in a crease that is usually present. This is a privileged area and will predictably heal quite nicely. It also has the advantage of being a distant incision that is off the breast in a concealed area that is usually considered of little interest. The size of the incision will relate to the size of the gel implants used or can be much smaller if saline implants are used. There should be no contribution to any sensory change since this incision is off the breast. The recovery is a few days longer with this approach. Generally, these patients will need to use the pain medication for 7-10 days after surgery.
Transumbilical: This approach uses one small incision placed within the belly button. It generally heals nicely and does not call attention to the fact that an augmentation has been performed. It requires instrumentation specific to the procedure because of the distance from the incision to the breasts. The implants can be placed either below or above the muscle. Only saline inflatable implants can be used with this approach. If an implant leaks, this approach cannot be used a second time to retrieve the implant and insert a new implant. Usually there is very little abdominal discomfort and overall the recovery is usually quicker. It is common for these patients to have stopped using pain medication by the time of their first postoperative visit 3 or 4 days after surgery. The TransUmbilical Breast Augmentation is often referred to as a TUBA.
Transabdominal: The same techniques and instrumentation used for the transumbilical approach can be used to perform a breast augmentation through the abdominal approach. This can be done for an abdominoplasty or mini-abdominoplasty. Essentially, it is a variation of the TUBA procedure with the addition of the abdominal surgery.
All surgical procedures are accompanied by a certain degree of risk, whether the procedures are for medical or cosmetic reasons. Our expert team is dedicated to making your operation go smoothly. We carefully review your medical history and current health condition before deciding if it is safe for you to proceed with surgery. It is important that you fully disclose all pertinent information so that we are able to make an accurate assessment of the risks involved. Prior to surgery, Dr. Brantner may suggest that your own doctor comlete your preoperative clearance for surgery. Occasionally, consultations with other specialists may be indicated before surgery depending on your medical history. We will take every precaution necessary to reduce the possibility of any complications. Yoor safety and well-being are of utmost concern to us!
There several important factors that come into play when deciding whether plastic surgery is the right option for you. One of the most important factors is your health. Being in good health greatly reduces the risk of complications occurring during surgery and leads to a speedy recovery. Next, you need to ask yourself what your motivations are. People who have plastic surgery generally find that the surgery enhances their overall appearance and self-esteem. Thirdly, you should have realistic expectations. Plastic surgery is both a science and an art, neither of which are perfect. Set reasonable goals as to the result you wish to achieve and be prepared to thoroughly discuss these goals during your initial consultation.
It is a relatively common practice for a plastic surgeon to perform multiple procedures during one operation. This allows the surgeon to better “sculpt” your final appearance. In addition, having several procedures done simultaneously saves you the expense of paying the operating room and anesthesia costs more than once. However, having too much done at one time can lead to complications. The decision to have multiple procedures done depends on which procedures are being done, the extent of surgery, the operating time, and your age/health. Ultimately, the surgeon decides whether or not it is appropriate to include more than one procedure in your operation.
Due to the variety of procedures available in plastic surgery, there can be no blanket rule on age although age will be taken into consideration when planning your operation. People of all ages have taken advantage of the image-enhancement offered by plastic surgery. There are even procedures appropriate for young children! It is important to realize the limitations of plastic surgery. Plastic surgery cannot “fix” every situation or reverse the aging process. What is a good procedure for one person may not be an appropriate procedure for another. We are committed to making your plastic surgery experience a successful one.
During your consultation we will discuss your desired changes and expectations, review your medical history and current health, and make an assessment on whether the procedure(s) in question are right for you. This is a good time to ask specific questions about the procedure so that you are fully prepared, mentally and emotionally, for surgery. We will discuss the results that can be achieved, with the aid of photos and/or computer imaging. When a final decision is made, you will need to sign an informed consent stating that you are fully aware and understand what is entailed by your pending operation, including the potential complications and secondary effects.
Generally, post-operative instructions call for rest and limited movement in order to speed up the healing process and recovery time. The length of recovery varies with each procedure and is different for each individual. Bruises usually disappear within a few days, and most swelling is gone in a matter of weeks. If you follow our post-operative instructions carefully, you will be able to enjoy your normal activities within no time. Your scars will fade over time but are permanent. We take care to conceal any scars so that they are barely visible, if at all. The image-enhancing effects of plastic surgery become more evident over time with certain procedures taking up to a year for your body to fully adjust and settle into its new look. When you come in for your consultation we can discuss your expected recovery period and any post-operative instructions in detail.
Insurance providers generally cover costs for reconstructive surgery but not for cosmetic surgery. For example, insurance providers will often pay for breast augmentation to reconstruct a breast following a mastectomy; breast reduction to remedy back pain caused by heavy breasts; eyelid surgery to remove sagging skin that blocks vision; nose surgery to allow for a patient to breathe better; or tummy tucks to remedy the vertical separation of abdomen muscles known as diastasis. Insurance providers are required by law to cover breast reconstruction surgery and any cosmetic operations necessary to create symmetry in either breast. If your surgery is covered by insurance, pre-certification is required. We will be happy to assist you with the process.