Breast Implants
Are There Any Alternatives To A Pedicles To A TRAMflat For My Breast?
August 23rd, 2010In recent times more advanced techniques have been employed in which tissue is transferred after complete removal from the body.
The blood vessels which supply blood to this skin are then reattached to either vessels in your underarm area or from your chest.
These techniques are known either as a free TRAMflat reconstruction or DIEPflat breast reconstruction.
The differences between these two different techniques lie in the amount of muscle removed.
Reconstruction of the breast following cancer with breast implants – pros and cons.
August 15th, 2010
One of the simplest ways to reconstruct the breasts following mastectomy or removal of breast tissue following breast cancer removal is with a breast implant.
The pros of this procedure are that it is relatively straight forward and this does not involve removing tissue from another area of the body.
The cons of this procedure is that it does involve the insertion of a breast implant which is not a natural body tissue and this does have some implications in the long term.
In particular there is often very little breast tissue left after a mastectomy which means there will be little natural breast tissue coverage over the implant.
This means that there is an increased risk of the outline of the breast implant showing through the skin which is known as rippling.
The other main downside of this technique is that particularly if you have had radiotherapy there is an increase risk of capsular contracture around the breast implant.
Capsular contracture is caused by the body creating a shell of tissue around the breast implant.
This happens in after all breast implants but in most cases the breasts does remain soft.
However, there is a increased risk of developing firm capsules around breast implants and this is more common if you have had radiotherapy to treat the breast cancer.
Capsules can cause distortion of the appearance of the breast as they contract in some cases can also cause firmness and discomfort in the breast tissue in the breast itself.
I will discuss the causes of capsules and the treatments available for them in future blog posts.
The double-bubble effects – How I treated a patient
July 19th, 2010
Today I saw a very interesting patient who had a breast augmentation five years ago. From examination the implants were lying in a very high position under the muscle.
I could tell the implants were under the muscle by asking the patient to place her hands on her hips and press inwards. This causes the muscles to contract and you can feel the movement and also see it compressing the implant as the muscle contracts. This is a good way of telling whether the implants are placed infront or behind of the muscle as the muscle contraction has no effect on the implants and if they are in front of the muscle as the muscle is behind them and cannot compress them.
At surgery the implants were noted to be in a very tight position totally under the muscle and I replace them in front of the muscle. I also removed tissue from the lower part of her breast as her nipple to inframammary-fold distance was very long.
The combination of this treatment will give her a more natural softer appearance without the double-bubble effect.
Is it possible to remove breast implants and still achieve a reasonable size bust?
July 12th, 2010
Yesterday I performed an operation on a lady who previously had breast augmentation performed by another surgeon.
She felt that her breast were too large and I performed a removal of the implants and redistributed the remaining breast tissue.
This gave her a smaller better bust with a slight uplift.
I found that in many patient it is possible to redistribute the existing tissue after removal of implants to give a good bust appearance although it will be smaller than it was previously.
Saline or Silicon breast implants?
July 5th, 2010There are two main types of breast implants saline (salt-water filled implants) and silicone implants.
Since the silicone controversy 20 years ago, silicone implants were removed from the market in the United States. However, there was never enough evidence for them to be removed from the market in the UK and most of Europe.
There have now been a number of very large studies showing no significant risks from silicone breast implants and they have now been allowed back into the United States.
In my opinion silicone offers a better long term results with a more natural feeling breasts and should be the first choice of a breast implants for most people.
Which is the best incision for breast implants?
June 21st, 2010
Essentially there are 4 ways of introducing a breast implant and these are as follows:
1. through a 3-4 centimeter incision in the fold underneath the breast
2. through the armpit
3. through an incision at the base of the areola (from the brown area which surrounds the nipple)
4. via the tummy button
Option 4 is any suitable for saline implant which are collapsible and can be inserted through a very small holes.
In my knowledge no one in England uses this incision and it’s very difficult to accurately place the implants. An incision underneath the nipple has advantages in having a concealed scar but can only be performed if the areola is wide enough to allow for insertion of implants. Read the rest of this entry »
Polyurethane Implants – What’s all the fuss about?
May 30th, 2010Recently, there has been a lot of interest in the use of polyurethane implants. This are silicone implants coated with a polyurethane foam.
This implants are now used much more than previously, and the principle reason for this is they have a very low capsular contraction rate.
Breast Enlargement Surgery – Under the Muscle or Over
May 27th, 2010
I find the decision as to whether to place implants above or below the muscle a difficult one and each surgeon that I talked to has a different percentage of patients in which they place the implant under or over the muscle.
I never use a total sub-muscular coverage and neither do any of the surgeons I know. Total sub-muscular coverage involves coverage of the implant by serratus-anterior in the lower portion of the breast and pectoralis in the upper portion. Read the rest of this entry »
Model Identified by her Implants
February 2nd, 2010Model identified by her implants
A murdered women was recently identified by the serial number on her implants. No other distinguishing features were available to identify her.
To see more watch this video
When should you replace your Implants
December 23rd, 2009Hello, my name’s Adrian Richards, I’m a consultant plastic and cosmetic surgeon and I’m also the surgical director of Aurora Clinics. Today I’m going to be talking about replacement of breast implants. This is an increasing problem and I’m seeing more and more patients who come to me to ask should I have my implants exchanged, what are the pros, what are the cons.
So basically, implants, the current ones we estimate they last about 15 years so you’ll probably need them replaced after 15 years. But what I tell my patients is if there isn’t a problem with the implants, you don’t necessarily need to change them. So if you had breast implants 20 years ago, your breasts are nice and soft, you’ve had an ultrasound which shows that the implants intact, there’s not a problem, you don’t need to change them because in fact an operation has risks in itself. So if you’re happy with them, you haven’t got any problem, it’s probably best to leave them alone.
If you have got problems, what could these problems be? These problems can be capsulisation which is basically where the implants go firm. So normally when the go firm, this is the body forming a capsule around, the lining around the implant which compresses, makes them go firm and often high. So the implants are slightly higher and the breasts slightly lower. So that’s capsule formation which I’ve talked about in another video which is an indication of change in the implants. Another one is if there’s any indication that the implant may have ruptured so if you feel there’s been a recent change, we’d normally arrange an ultrasound or an MRI to look at the integrity of the breast implant and if there is any rupture, that is a good reason to have them removed and replaced. Another reason might be what’s called a silicone granuloma. So sometimes you can get lumps in your armpits, you have lymph glands which act as sieves under your armpit and they would drain any silicone. So if there is any silicone bleed which is a slight ooze from the implant, that can cause a lumpiness under the armpit. Again, that’s a reason to remove them. The final main reason is you’re not happy with the aesthetic results of the implant. They may have been fine but they’ve changed, maybe you’ve had pregnancies or your breast shape has changed. So that is an indication if aesthetically you’re not pleased with the appearance of the breast. In particular, I’ve seen a lot of patients who’ve had the implants put in a sub muscular position, that’s under the pectoralis muscle, where the implants lie high because the pectoralis muscle tends to hold the implants high and with time, breast tissue itself goes down and this leads to a phenomenon called the double bubble effect which I’ll talk about in another video.
So essentially, if your breasts are okay and you haven’t got a problem, probably best to leave them alone. If you’ve got any of the problems that I’ve just talked about, you could consider having them removed but you need to think long and carefully about the pros and cons of doing this.
So thank you very much for listening to the video, we hope to see you soon and please feel free to contact us at any time, either via the website, email or phone if you’d like to arrange a consultation or just like some advice. Thank you.