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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.

Tag Archives: breast implants

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.

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.

Capsular contracture can be a relatively common complication after placement of silicone breast implants or saline breast implants. Scar tissue normally forms around breast implants in all circumstances. In some cases, over time, it can tighten and compress the implant, making it feel firm and painful, causing what is called a capsular contracture. Capsular contracture is more common following infection, hematoma, or seroma, and the chance of it happening may increase over time. It occurs more commonly in revision breast augmentation than in primary breast augmentation.

Capsular contracture is also a risk factor for implant rupture, and is the most common reason for re-operation after breast implant placement. Symptoms of capsular contracture can range from just mild firmness and discomfort, to severe pain, distorted appearance of the breast, and the ability to feel the implant. It is classified into 4 levels, depending on its severity:

Baker Grade I: The breast is soft, and looks natural.

Baker Grade II: The breast is a little bit more firm, but looks normal.

Baker Grade III: The breast is firm and looks abnormal.

Baker Grade IV: The breast is hard, painful, and looks abnormal.

The data for both silicone and saline breast implants says that about 1 in 6 women will develop a severe capsular contracture, either grade III or IV, through 7 years after breast implant placement. For women receiving revision breast augmentation, this risk increased to about 1 in 5. When pain and firmness or abnormal appearance is particularly severe, additional surgery may be required. This usually requires removal of the breast implant capsule and replacement of the breast implant.

Should you be developing firmness, hardness, or distorted appearance after your breast implant placement, you may have a capsular contracture. To learn more about this condition, please contact Dr. Jejurikar at 214-827-2814, at the Dallas Plastic Surgery Institute.

Yesterday, the Food and Drug Administration (FDA) issued a warning that silicone and saline breast implants may be associated with a rare form of cancer. The cancer, known as anaplastic large cell lymphoma (ALCL), has been found in 34 women with breast implants. ALCL has been found in the capsule surrounding the implant, but not the breast tissue itself. The FDA concluded that there may be a link between breast implants and ALCL after examining scientific literature that described ALCL in 34 women with breast implants, as well as data from national and international regulatory agencies, scientific experts, and breast implant manufacturers.  In most cases. ALCL was found years after breast implant surgery.

It is estimated that 5-10 million women worldwide have breast implants. With only 34 cases of ALCL described, it’s impossible to say at this time that breast implants cause ALCL. Even though the risks of getting ALCL with breast implants, if real, are exceedingly small, given that the usual incidence is around 1 in 500,000, it’s important to investigate this matter more thoroughly. To that end, the FDA and the American Society of Plastic Surgeons (ASPS) are establishing a registry of ALCL patients who have breast implants. FDA scientists hope the registry yields enough information to better understand what the risks for developing ALCL are for women with breast implants.

Ultimately, what’s a patient to do? If the risk of getting ALCL from breast implants is real, it is exceedingly small.  Says Caroline Hove, spokesperson for Allergan in an article from the Wall Street Journal, “”A woman is more likely to be struck by lightning than get this condition.” That being said, ALCL has the potential to be fatal; the informed patient should be aware of this very small but possibly significant risk associated with breast implants.

Many patients complain of changes in nipple and breast sensation immediately after breast augmentation. It is common for patients to complain that the breasts have diminished sensation, and, in rare situations, are hypersensitive.

The good news is that the changes in sensation, in most cases, are temporary. It can take several months to a year for the changes in sensation to resolve, but they do almost always improve. There is a slightly greater chance of nipple numbness with a periareolar incision; this is an incision around the areola, which is the pigmented skin surrounding the nipple. Even with this incision, most patients tend to regain normal sensation.

Should you have any questions regarding this, breast augmentation or breast implant surgery, do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

Many patients complain of changes in nipple and breast sensation immediately after breast augmentation.  It is common for patients to complain that the breasts have a dull sensation, and, in rare situations, are hypersensitive.

The good news is that the changes in sensation, in most cases, are temporary.  It can take several months for the changes in sensation to resolve, but they do almost always improve.  There is a slightly greater chance of nipple numbness with an incision around the areola (pigmented skin surrounding the nipple) than with other incisions.

Should you have any questions regarding this or breast implant surgery, do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

There are many advertisements on the internet for “awake breast augmentation”. Many of the surgeons that offer this procedure are not truly board certified plastic surgeons, and thus do not have privileges to perform breast augmentation or breast implant placement at an accredited surgical facility. For that reason, their only recourse is to perform the procedure in their office without general anesthesia.

Make sure that your provider is a board certified plastic surgeon. The process to achieve accreditation by the American Board of Plastic Surgery is quite rigorous, and you can be assured that a surgeon that has achieved these credentials has the necessary expertise and training to perform this operation. A variety of other doctors who have not achieved this presentation, may not even be plastic surgeons.

Should you have any additional questions, please do not hesitate to contact Dr. Jejurikar at 214-827-2814. Dr. Jejurikar is accredited by the American Board of Plastic Surgery.

Patients are obviously interested in knowing the likelihood of their saline breast implants or silicone breast implants rupturing. Although breast implants can remain intact for decades, all mechanical devices will fail at some point. When saline breast implants rupture, they deflate rapidly; rupture is usually easily detectable clinically. Studies of Allergan (Natrelle) saline breast implants showed rupture/deflation rates of 3–5% at three years and 7–10% at 10 years.

When silicone breast implants rupture they rarely deflate, and the silicone from the implant can leak out into the space around the implant over many years. It is often difficult to detect a rupture clinically. For that reason, the FDA recommends that patients undergo a screening MRI to look for rupture 3 years after placement of silicone breast implants, and then every 2 years thereafter. Rupture rates are thought to be similar between silicone and saline breast implants. It is reasonable to estimate the risk at approximately 1% per year.

Should you have more questions regarding breast implants or breast augmentation, contact Dr. Jejurikar’s office at 214-827-2814.

Many women experience changes in the appearance of the breasts after massive weight loss, pregnancy, or breast-feeding.  Oftentimes, these women will come in for consultation, looking for either a breast lift or placement of breast implants.  It is important to realize that breast implants are primarily aimed at increasing lost volume in the breasts, particularly in the upper portion of the breasts, and have very little effect on sagging breast skin and on downward-pointing nipples and areolas.

For patients that do suffer from severe droopiness of the breasts, as well as sagging breast tissue, breast lift (mastopexy) tends to be the best option.  Oftentimes women are resistant to hearing this, as they do not want the scars that are associated with the operation.

There are a large variety of incisions that can be utilized for performing a breast lift.  In the most limited incision form of breast lift, known as a circumareolar lift or Benelli mastopexy, an incision is made just around the areola (the pigmented skin surrounding the nipple).  This operation is useful only for very mild forms of breast droopiness, and is best performed in combination with placement of a breast implant.  The reason for this is that be Benelli mastopexy does very little to restore lost volume in the upper portion of the breasts, which is usually seen in association with mild droopiness.  For mild forms of droopiness (ptosis), however, the performance of a Benelli mastopexy in combination with breast implants can lead to a very pleasing shape.

The next form of mastopexy is known as a circumvertical, or lollipop mastopexy.  In this form of breast lift, an incision is made around the areola, and a vertical incision is made from the areola along the middle portion of the breast to the crease at the bottom of the breast.  This is far and away the most common type of incision utilized for mastopexy.  This access allows the surgeon to reshape breast tissue, and place a large portion of breast tissue from the bottom portion of the breast into the upper pole of the breast, where breast volume is lacking.  It can be utilized for mild to severe forms of breast droopiness.  It can be performed in combination with either saline breast implant or silicone breast implant placement, but can also be performed without breast implant placement.

The last form of mastopexy is known as a Wise pattern mastopexy or anchor pattern mastopexy.  This involves an incision around the areola, a vertical incision from the areola to the crease at the base of the breast, and an incision along the very base of the breast.  This is the traditional type of incision utilized for mastopexy, and is most often reserved for patients that have lost massive amounts of weight, and have a severe amount of extra skin.  Like the lollipop mastopexy, it can be performed with or without the placement of breast implants.

If you have any questions, please do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

Many patients ask me if their breast implants have any type of warranty. The answer is yes. Here are the details of Allergan’s ConfidencePlus® breast implant warranty program:

  • Lifetime Product Replacement – regardless of the age of the implant, Allergan provides product replacement in the event of a deflation or rupture
  • 10 years of guaranteed financial assistance
  • Up to $1200 in out-of-pocket expenses for surgical fees, operating room and anesthesia expenses not covered by insurance
  • Silicone filled and saline filled breast implants covered

If you’d like more information on breast augmentation in Dallas or Plano, or would like to schedule a consultation, please contact Dr. Jejurikar’s office at 214-827-2814.

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Our Location Dallas Plastic Surgery Institute

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