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    What’s new in breast augmentation?

    What’s new in breast augmentation?

    Much like everything else in life, technology and techniques are constantly changing in plastic surgery. With the advent of new products, plastic surgeons can refine and improve the procedures they offer patients. This is particularly true with breast augmentation, which has evolved considerably in the past few years. So, what’s new you ask?

    The biggest changes involve improvements in breast implant gel and breast implant shells. Although silicone implants have been around for years, not all silicone implants are the same. The earliest silicone implants consisted of a mostly liquid silicone covered by a relatively wispy shell. Not surprisingly, these implants tended to leak, either from the breast implant shell rupturing or from silicone gel bleed, which occurred when silicone gel would leak through the breast implant shell to the surrounding tissue. When this happened, patients were plagued with severe pain, not to mention hard and deformed breasts. The problems were so bad that the Food and Drug Administration (FDA) removed silicone breast implants from the United States market in 1992. The implants remained available elsewhere in the world, however, and scientists and plastic surgeons worked diligently to improve them. The first change consisted of making the silicone gel material within the implant more cohesive, meaning the gel became stickier and thicker. The other substantial change involved improving the implant shell so that the implants were less likely to rupture and less likely to leak. The results of these changes were an improving safety profile throughout the world. Because of this, as well as numerous clinical trials conducted in the U.S., The FDA allowed silicone gel implants back on the market in 2006.

    Since then, breast implant technology has continued to improve. In 2013, the FDA approved the first of the cohesive gel implants that are most commonly used today. These are commonly called gummy bear implants, because they feel remarkably like the candy. Safety data from these implants are promising because, not only do these implants give the best aesthetic results for patients, but they are less likely to result in capsular contracture than other commonly used silicone and saline implants. Depending on the feel desired by patients, implants manufactures have even varied the cohesivity of implants. Allergan, for instance, offers a relaxed, soft touch (intermediate) and more cohesive implants. These options not only allow plastic surgeons to get better results than ever before, but to customize these results more than ever before to the preference of their patients.

    Other big advancements have come in the fight to prevent capsular contracture, which is one of the worst complications that can happen with breast augmentation. Capsular contracture essentially is pathologic scar tissue build up around a breast implant, resulting in painful, hard and deformed breasts. Usually, surgery is required to fix this problem when it develops, so prevention is obviously of paramount importance. It’s thought that capsular contracture is the result of subacute bacterial infection.

    The Keller Funnel is a device most plastic surgeons believe will reduce the incidence of capsular contracture. The Keller funnel essentially functions as a condom for breast implants; the implant is completely sheathed in the funnel as it passes through the skin into the breast pocket. Once in the appropriate location, the breast implant can be squeezed out of the funnel into the breast, never having touched the patient’s skin. With no skin contact, the chances of contaminating the implant with even a small number of bacteria is reduced, theoretically diminishing the likelihood of capsular contracture.

    Another way to reduce the incidence of capsular contracture is through antibiotic solutions which bathe the breast pocket and the implant prior to insertion into the patient. Compelling data has demonstrated that the combination of three antibiotics (cefazolin, bacitracin, gentamycin), with the addition of an iodine containing solution markedly reduce bacterial biofilm around implants. This should also lessen the likelihood for bacterial colonization of a breast implant, thereby lessening the likelihood of capsular contracture.

    Finally, preoperative doctor-patient communication has been significantly improved with the advent of three-dimensional imaging. Dr. Jejurikar finds that it’s relatively simple to create an accurate 3D rendering of a patient and then use that rendering to point out relevant anatomy to patients. Patients can see differences in size and symmetry from all angles and then better understand the rationale behind using different sized implants or recommending a breast lift. In addition, it is possible to simulate a breast augmentation on these 3D models with varying sized implants, tremendously helping with the process of preoperative implant selection.

    Obviously, innovative technology and implants must be used in concert with good surgical judgment and technique. If you’d like to learn more about breast augmentation consult with Dr. Jejurikar, please do not hesitate to contact our office to set up a consultation. If you’d like to submit photos prior to your consultation to create your every own 3D rendering, follow this link.

     

    Skin lightening without hydroquinone

    Recently, the state of Texas banned the dispensing of hydroquinone, the most popular skin bleaching cream, in concentrations of 4% of more, because of safety concerns. Hydroquinone had been used by many patients in pre-surgical and post-surgical therapy, as well as by many patients as part of their skin care reigmen. So what are patient’s to do?

    Elure™ Advanced Skin Lightening Technology (http://www.elureskin.com) is a new topical cosmetic product available at EpiCentre Park Lane and EpiCentre Legacy. The appearance improvement provided by elure is based on a patented natural enzyme, known as Melanozyme™, which temporarily reduces the dark-colored pigment in your skin. In several clinical studies, elure produced a brighter and more even toned skin appearance for most subjects in just 28 days. Elure™ does not contain hydroquinone. Early results with this product have been quite promising.

    To learn more, contact Dr. Jejurikar’s office at 214-827-2814.

    Free Latisse or Botox with your Breast Implants

    Allergan, one of the major breast implant manufactures in the United States, is offering patients a free one-month supply of Latisse or 20 units of Botox free with purchase of breast implants. If you’ve been thinking of having breast augmentation surgery, take advantage of this great special today! Call Dr. Jejurikar’s office at Dallas Plastic Surgery Institute (214-827-2814) to set up a complimentary consultation.

    Rates of silicone breast implant placement are on the rise

    Recently published statistics from the American Society of Plastic Surgeons says the number of women undergoing “augmentation mammaplasty” rose 39 percent between 2000 and 2010, when more than 296,000 American women underwent the procedure. Not only does the number of women seeking the procedure seem to have increased, but also it seems as though many more patients are seeking bigger implants. A big reason for this is the increasing acceptance of the safety of silicone gel implants; with these implants, large cup sizes are achievable while still maintaining a natural looking result.

    Obviously, there’s an upper limit to what appears natural and what the breast ligaments can support. Still, in most patients, a 2 or 3-cup size increase, if desired, if possible.

    To learn more about breast augmentation or silicone breast implants, don’t hesitate to contact Dr. Jejurikar’s offices in Dallas or Plano at 214-827-2814.

    Can A Breast Lift Be Performed With Breast Implants Alone? Dr. Sam Jejurikar, Breast Augmentation Specialist, discusses breast lift and breast implants in Dallas, Texas.

    It is not uncommon for many patients to ask me whether they can avoid the scars associated with a breast lift by simply placing a really big breast implant.  This notion may have been placed in their mind by other surgeons, or by information that they have picked up from the Internet.

    I certainly understand the motivation behind this question.  I have never had a patient come to my office requesting more scars than necessary for surgery.  Ultimately, people want to avoid scars on their breasts, and I am no different in this regard.

    However, only a very minor breast lift can be accomplished with a breast implant.  There are surgeons out there, many of who are not plastic surgeons and do not have specific training or experience with breast lifts, who will attempt to place an overly large breast implant into the patient’s breast rather than perform a breast lift.  Not only can this give patients larger breasts than they want, but it can cause long-term negative consequences on the breast tissue and breast-supporting ligaments.  It is in these situations that long-term complications such as implant malposition (the implant sliding down too far) are more likely to happen.

    Ultimately, my goals for the patient always remain the same.  First, it is important that the patient have a nice breast shape and size.  This differs from patient to patient, but it is important for me and the patient to come to a mutual understanding of this prior to surgery.  Two, if a breast lift is needed, I want to do it with the fewest number of scars possible, as well as the most aesthetically pleasing scars as possible,.

    If you have more questions about breast implants and breast lift surgery, do not hesitate to contact me at 214-827-2814.

    Are Breast Implants Better In Front of or Behind the Chest Wall Muscle? Dr. Sam Jejurikar of Dallas Plastic Surgery Institute discusses optimal placement of saline and silicone breast implants.

    In most cases, when I perform breast augmentation, I place the breast implant, whether it is a saline breast implant or a silicone breast implant, behind the chest wall muscle.  There are many reasons for this.  The first is that the chest wall muscle (pectoralis major), actually serves as camouflage for the breast implant.  Some of the visible rippling that can be seen, particularly with saline breast implants, tends to be obscured to some degree with coverage by the pectoralis major muscle.  The second reason to put the implant behind the muscle is that it interferes with screening mammography much less.  There is good data from the radiology medical literature that demonstrates that placement of breast implants in front of the chest wall muscle can obscure a substantial amount of the breast field on mammogram.  The third reason is that traditional data with silicone and saline implants shows that the rate of capsular contracture, or pathologic scar tissue formation, is much higher when the implants are put in front the chest wall muscle as compared to behind it.

    There are a few anatomic conditions in which aesthetic outcomes are improved when the implant is placed in front of the chest wall muscle.  Careful examination and discussion with my patients are important in these situations to determine what will be best.

    If you have any other questions regarding this or breast augmentation in Dallas and Plano, please do not hesitate to contact my office at 214-827-2814.

    Gluteal Augmentation With Fat: The Brazilian Butt Lift at the Dallas Plastic Surgery Institute with Dr. Sam Jejurikar, Board Certified Plastic Surgeon

    One of the most commonly sought out procedures in Dallas and Plano is the Brazilian butt lift.  This procedure involves performing extensive liposuction elsewhere on the body and using the removed fat to augment and lift the patient’s buttocks.  It is a well-tolerated procedure that generally takes about 3-4 hours.  Areas that undergo liposuction traditionally involve the inner and outer thighs, abdomen, love handles, and lower back.

    One of most important thing a patient needs to know before the procedure is the expected recovery time.  Patients are asked to refrain from lying on their back, so as to avoid pressure on their buttock, for 2 months after the procedure.  Patients are also asked to avoid directly sitting on their buttock for 2 weeks after the procedure.  After 2 weeks, patients are asked to place a rolled towel or a pillow under the back portion of the thighs, specifically where the hamstrings lie.  With this, the pressure on the buttock is off-loaded, and this is thought to help fat heal quicker after the operation.

    If you would like to learn more about one of the most popular procedures in Dallas, please do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

    What Do You Need To Know About Laser Resurfacing? Dr. Jejurikar at the Dallas Plastic Surgery Institute discusses the full spectrum of laser services.

    How much swelling and bruising you have after Dallas laser resurfacing depends entirely on how much time you have to recover from the procedure. Laser resurfacing in Dallas and Plano must always be individualized to the needs of the patient.  If you have a few weeks, I can be very aggressive with the procedure. This will lead to dramatic improvement in facial wrinkles and pigmentation; redness may last 3-6 months after the procedure. If you only have 3 or 4 days, there are still excellent laser treatments I can perform, with much less redness thereafter. Ultimately, the specific laser treatment must be tailored to the amount of time you have to recover after the procedure.

    So, what are the different options for laser resurfacing in Dallas?  One of the ways we classify different laser resurfacing procedures is by whether or not they are fractional or full field resurfacing.  Full field laser resurfacing includes some traditional types of laser treatments, including carbon dioxide and erbium lasers.  With these types of procedures, all of the skin on the face is treated. Although the results can be beautiful, if the treatment is done at a deep depth, it will take longer to heal.  A full field laser can be done at a more superficial depth to speed up the recovery.  Fractional lasers treat some of the skins but leaves tiny islands of skin cells untreated.  Two of the most commonly used fractional lasers used in my practice is Fraxel re:pair and Fraxel re:store.  While all the differences between these lasers are too much for this blog entry, the re:store is non-ablative, which means it is not destructive, and the re:pair is ablative, which means that it destroys columns of skin. Re:pair usually is performed in the operating room and re:store is usually performed with the patient awake in a treatment room.

    Regardless of the amount of time you have to heal, there are great treatments available to you.  Benefits of all of these laser treatments include elimination irregular pigmentation, treatment of fine or deep wrinkles, and a healthier glow to the skin.

    If you would like to learn more, please do not hesitate to contact Dr. Jejurikar at 214-827-2814.

    What are my limitations after Dallas Mommy Makeover? Dr. Sam Jejurikar at the Dallas Plastic Surgery Institute

    It is common for patients to negotiate an appropriate level of activity after undergoing tummy tuck, breast augmentation, liposuction, or any other combination of surgeries that make up a Dallas mommy makeover.  The thought is, if they can convince me that they need less time to recover than other patients, somehow the surgery will be lessened in magnitude, or that they will be able to recover more quickly after the procedure.

    Childbirth takes a dramatic toll on the female body.  To reverse those changes with a mommy makeover, significant surgery is involved.  With a Dallas tummy tuck (abdominoplasty), in addition to removing skin, extensive sculpting of the waist and upper abdomen is performed with liposuction, and the muscles of the abdominal wall are significantly tightened.  Undue straining for a period of time after surgery can disrupt the sutures, and lead to a less then desirable postoperative result.  In addition, straining after surgery can cause problems with wound disruption and bleeding, not to mention prolonged swelling in the abdomen, breasts, and lower extremities.

    I usually recommend that my patients take 1-2 weeks off of work after surgery.  Some patients will take less time and others more, depending on the level of physical exertion required at their work place.  I also strongly advise my patients to refrain from any vigorous exercise for 6-8 weeks after surgery.  Although it is important to walk almost immediately after surgery to prevent blood clots and respiratory problems, too much activity can lead to infection, bleeding, and wound healing problems.

    Ultimately, to get the best result after mommy makeover, a patient has to allow herself the appropriate amount of time to recover.  Should you have any questions, please do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

    One Day BOTOX Cosmetic and Juvederm Special – Wednesday, May 4, 2011 – Dr. Jejurikar at Dallas Plastic Surgery Institute

    We’re having a very special event and you’re invited! Please join us on Wednesday, May 4, 2011 from 9 am to 5 pm at Dr. Jejurikar’s Dallas office for light refreshments and special savings on BOTOX and Juvederm! For one day only, Dr. Jejurikar will be injecting BOTOX at $10.50/unit (minimum purchase of 20 units, normally $15/unit) and Juvederm for $525/syringe (minimum purchase of 1 syringe, normally $700/syringe). At the end of the day, two drawings will be held for a free treatment with BOTOX, up to 50 Units (must be redeemed by September 15, 2011; prize is nontransferable, with patients eligible for winning one treatment only). Two patients will win a future free treatment with BOTOX!

    Patients who sign up their friends will be eligible for more opportunities to win a free treatment with BOTOX. Each additional friend signed up will be good for one additional entry for a free BOTOX treatment. The winners will be notified via telephone the following day.
    Space is limited! Patients will be eligible for these savings by appointment only, so call 214-827-2814 to reserve your time today!

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    9101 N. Central Expwy.
    Suite 600, Dallas, TX 75231
    Tel: 214.827.2814
    Dallas | Dr. Jejurikar

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