High Profile versus Moderate Profile Breast Implants: How Does It Affect Breast Projection After Breast Augmentation?

The majority of breast implants used in cosmetic surgery have a round base.  When one views the breast implant from the side, the implant would have a certain height, which is called “projection.”   Thus, when the breast implant is placed underneath or over the chest wall muscles, that height would project out.  Some women who want to undergo a breast augmentation often want their breast to have more projection after the breast implant is placed. 

There are two ways to have more projection for breast augmentation.  The first way is to add volume into the implant, which can be done in a saline implant.  The more saline is injected into the implant, the more projection the breast will have after the breast augmentation procedure.  One should note that the volume that can be injected into the saline implant is limited.  Moreover, this cannot be done in a silicone gel implant since that particular breast implant has a fixed volume of silicone.

The other way of having more projection is to use a breast implant that has a smaller diameter.   If one would imagine a balloon with a fixed volume of fluid, and then press the balloon’s base and make the diameter smaller, the more projection the balloon will have.   This is the difference between a high profile versus a moderate profile breast implant.  The high profile implant has a smaller base diameter, and thus would have a higher projection than the moderate profile breast implant. 

Are there any downsides (complications) of having a high profile breast implant?

There are potential consequences when one receives a high profile or even an extra-high profile breast implant.   Potential deformities may occur that may be difficult to correct and possibly uncorrectable.  The weight and pressure of a high or extra-high profile breast implant may likely cause stretching and thinning of the breast.  This potential consequence can be disastrous and may cause some problems, such as problems with breast sensation, inability to lactate (breast feed),  visible traction rippling (breast implant rippling seen underneath the skin), and chest wall deformities (ribs and chest muscles getting deformed.)

Being an educated patient is very important prior to having any procedure done.  Thus, it is very important for one to ask one of your Houston plastic surgeons for these potential complications.

Emmanuel De La Cruz M.D.
www.delacruzplasticsurgery.com

                                                                                                                  

Houston Cosmetic Surgeon

Merry Christmas and a Happy New Year!!!  ~ Houston Cosmetic Surgeon

Emmanuel De La Cruz MD
Houston Cosmetic Surgeon
www.delacruzplasticsurgery.com

Top 5 Things to Know Before Getting a Breast Implant

Breast augmentation is one of the most common cosmetic procedures performed in the United States. Most patients who undergo a breast augmentation are very satisfied with their results. However, being an informed patient is critical prior to having any surgery. The following facts are important information that all patients should know before having a breast augmentation.

1)Implant lifespan:  Like any other medical device, breast implants can not be guaranteed to last an entire lifetime. Any patient who undergoes breast augmentation should know that at some point in their life, the implants will most likely need to be replaced. This would require further surgery.

 2)Need for further surgery:  A recent clinical study had shown that up to 25% of women who had a breast implant may need further surgery within 5 years of the initial surgery.  Another study showed that about 1 in 8 women who received breast implants for augmentation needed another surgery within 5 years.  One should note that the surgical revision rate among different studies, however, varies which ranges from 8% to 25%. 

The need for revision breast augmentation may be due to several reasons.  The most common reason according to a recent study at UCLA was malposition (62%) followed by capsular contracture (hardening of the implant due to surrounding tissues.)  However, a different study showed that the most common indication for revision breast surgery was patient desire for implant size change followed by capsular contracture.  Other reasons for revision breast augmentation include: drooping of the breast, change in breast shape or volume from aging or pregnancy, implant rupture (0.5% at 3 years), and unwanted implant movement.  Regardless of the difference of results from clinical studies, most women with breast implants will most likely need to have further surgery at some point during their lives.

3)Mammography:  A mammogram prior to breast surgery is a screening technique to detect abnormalities of the breast before cosmetic surgery. Women over the age of 40 may need a preoperative mammogram prior to a placement of a breast implant.  If the patient has a significant family history of breast cancer, it is recommended for the patient to have a mammogram before any cosmetic breast surgery is contemplated.

Women with implants need to have their mammograms done at centers where the staff is accustomed to working with patients with implants. The mammography technician uses special displacement techniques to visualize the breast tissue in women with implants. This may require more views and possible more radiation exposure. Mammography may not be as sensitive in women with implants, although women with implants do not have increased chances of getting breast cancer. Also recent studies show that implants have not been shown to delay the diagnosis of breast cancer. MRI is the study of choice for women with implants and a history of cancer.

4)Breast feeding: Although the ability to breast feed is not guaranteed whether one would have breast augmentation or not, the ability to breast feed may be affected depending on the surgical technique used for breast augmentation . The periareolar incision (nipple approach) may disturb the milk/lactiferous ducts of the breast which may lead to problems with breast feeding.  You should express your concern to your plastic surgeon prior to any breast surgery if you have plans of breast feeding in the future.

5)Alteration of Nipple and Breast Sensation:  The feeling in your nipple and breast may change following breast implant surgery.  The sensation may increase or decrease after a breast implant is placed.  This can range from intense sensitivity or pain, to no feeling at all.  Note that these changes may be temporary or permanent, and may affect ones ability to nurse a baby as well as your sexual response.

I recommend you to ask one of your Houston cosmetic surgeons any potential questions before undergoing any breast augmentation procedure.  Again, being an informed patient is critical prior to any surgery. 

Emmanuel De La Cruz M.D.
http://www.delacruzplasticsurgery.com/
P.S.

Please take the poll after reading this blog article.  Thank you.

Breast-Feeding after Breast Implants

Breast Feeding after Breast Implants ~ Houston Cosmetic Surgeon

    There are two main types of implants being used for breast augmentation:  silicone gel and saline implants.  Neither silicone gel nor saline implants interfere with breastfeeding.  Although there have been concerns about passing the silicone into breast milk during breast feeding if the implants were to rupture, studies have shown that silicone molecules are too large to pass into the milk ducts and breast gland tissue.
     Although there are no guarantees that one would be able to breast-feed whether you undergo breast augmentation or not, the type of incision may affect one's ability to breast-feed.  There are few choices for incision location for breast augmentation:  periareaolar incision (around the edge of the nipple), inframammary incision (incision underneath the breast), axillary incision (along the arm pit), and periumbilical (around the belly button).
      A periareolar incision may interrupt or disturb the lactiferous/milk ducts of the breast. Clinical studies have shown that women who had breast surgery through a periareolar incision were five times more likely, when compared to women without breast surgery, to have insufficient milk during breast feeding.  A study from Texas Children's Hospital showed that 64 percent of women with breast implants had lactation insufficiency compared to just 7 percent of women without implants.  The study showed that the lactation insufficiency among breast implant patients were mostly seen in patients who had a periareolar incision.  An inframammary incision and placement of the implant under the pectoral (chest) muscles, however, are less likely to affect one's ability to breast-feed.  
     I recommend discussing your concern and your plans to breastfeed with your plastic surgeon when you decide to have a breast augmentation (breast implant placement.)  The type of incision that one of your Houston cosmetic surgeons may use may vary based on individual considerations.

Emmanuel De La Cruz M.D.
http://www.delacruzplasticsurgery.com/

Potential Complications of Injectible Dermal Fillers, such as Restylane & Juvederm

Complications of Dermal Fillers (Restylane/Juvederm) ~ Houston Cosmetic Surgeon

       There are several facial filler materials that have been approved by the Food and Drug Administration for use in the United States that have been employed by physicians for the past several years.  These dermal fillers are very effective and popular cosmetic treatments for today's anti-aging and facial rejuvenation for aesthetic patients.  One of the dermal fillers include hyaluronic acid, which is a ubiquitous carbohydrate polymer normally found as a major component of skin where it is involved in tissue repair.  Hyaluronic acid injections temporarily smooth wrinkles by adding volume under the skin, with effects typically lasting for six months.  Although they seem to be simple procedures, complications may potentially occur.

       These complications may include intraarterial embolization of hyaluronic acid (Restylane & Juvederm) which can have disastrous consequences.  The dermal filler may be injected accidentally into tiny vessels if not performed properly by a trained medical professional.  Intraarterial embolization of hyaluronic acid may lead to superficial to deep necrosis of the skin (premature death of cells and living tissues.)  This will then lead to ulceration and severe deformity of the face.  Embolization of dermal fillers may also lead to blindness, which is a rare complication.

How can one treat intra-arterial injection of hyaluronic acid? Progression of the skin necrosis can be further prevented by injection of hyaluronidase (Amphadase) into the area of previous injection site.  Thus, ask your provider if they have hyaluronidase in their office just in case a complication may arise.

How can one recognize this complication of Restylane or Juvederm? This can be recognized clinically by a bluish discoloration of the face that may eventually progress to necrosis and/or ulceration of the face.

Once this complication occurs, can my provider fix the problem? Once necrosis/ulceration of the face occurs, injection of hyaluronidase into the previous injection site may prevent its progression.  Once the necrosis has demarcated, one of your Houston plastic surgeons may perform a plastic surgery procedure, such as removal of dead tissue and possibly a flap,  depending on the severity and location of the facial skin necrosis.

Emmanuel De La Cruz M.D.
http://www.delacruzplasticsurgery.com/