Dr. Bae:
I’m very official. I don’t just play a doctor on the radio.

Greg:
No, leave that to me. I will play a doctor on the radio. I do get a lot of questions from people. Some of them, thanks to you, I can actually answer. I can actually answer a lot of lipo questions now, because I’ve asked you so many questions about lipo in the past. But we need you here to really give us the professional’s opinion.

Breast augmentation

Greg:
And what I have been wondering is a lot of women, when they get breast augmentation… Generally, if they’re doing that, they’re wanting to go bigger, right? How do you help them decide which implants to get, how big to go, what’s right for your body? Because I think a lot of people may have one thought in their head, and maybe you see it a different way.

Dr. Bae:
Yeah. I try to break it down to make it as easy as possible and to give them… Basically, I tell them that you have five decisions to make when they come in for a breast augmentation consult. So five decisions. What are those five decisions? One is whether you want saline or silicone. The next is whether you want round or shaped. Third, where you want the incision. Around the edge of the areola, through the armpit, or under the breast? Fourth, whether you want it on top of the muscle or under the muscle. And fifth, what size you want.

Saline vs Silicone

Dr. Bae:
And so, after I tell them, those are the decisions, then we go through and explain each one. So starting off with saline versus silicone, I just tell them the pros and cons. Silicone feels more natural, looks more natural. That is what most people are getting. Saline is less expensive, but it does look more like a balloon and feels a little more firm, whereas silicone, like I said, just feels more natural.

Dr. Bae:
There’s also something with rippling. If you look on the side of the breast of somebody that has a saline implant, you can see this rippling in the skin a little bit more with a saline implant versus a silicone implant. And then, the other thing is that, if you get a hole in the implant, a silicone implant, they’re more of a gel. So even if you get a hole in the shell of it, it can actually keep its shape because it’s a gel. It’s not a liquid. It doesn’t just spill out. Whereas, with a saline implant that gets a hole in it, that’s a liquid, obviously. And that just spills out, and it deflates completely. And then you have to get it replaced, whereas with a silicon-

Greg:
You’ll have a deflated breast.

Dr. Bae:
You’ll have a deflated breast. Whereas, with a silicone implant, because it’s a gel, it keeps it shape. And that capsule or scar tissue that naturally forms around the implant can actually keep it self-contained, so it doesn’t spill all over your body, like the way you’ve heard those kinds of things happening back in the nineties and things like that.

Shaped vs Round

Dr. Bae:
So, that’s the first thing. Second one… And by the way, there’s no right answer to any of these. I just give them the facts, and then they can make the decision. The second one is round versus shaped. So a round implant is kind of what you think. It’s round, where it gives a more fullness up top, which patients really like that, versus a shaped implant. And a shaped implant? It’s got more fullness at the bottom and less fullness up top. So it doesn’t give them that fullness up top. So it looks more natural. Not having a lot of fullness up at the top of your breast is more natural, but patients don’t really want that. They say they want natural, but then, when you get down to the nitty gritty of it, they really want that kind of buxom look up top.

Greg:
Yeah, I’ve noticed. I watch a lot of reality TV, and I noticed a lot of the breasts. They want them here. They want this spilling out.

Dr. Bae:
Up close to their neck, even though they say they don’t.

Greg:
Yes. Yes. They do.

Location of the incision

Dr. Bae:
But anyway, so I give them the option. So, round is more fullness up top. Shaped, less fullness, more natural looking. Then the third option is the incision. And that really kind of depends on a few things. As far as the incision, people talk about going through the nipple. Nobody really goes through the nipple. It’s an incision along the edge of the areola, which actually can be really well hidden between that junction of your natural skin tone and that darker reddish pigment of the areola. And so, you can hide in an incision well, within that.

Dr. Bae:
You can make an incision underneath the breast, which most people do. And there’s the incision through the armpit, which people like because that’s well hidden. The thing people have to understand is that going through the areola, going through the armpit, that even though we prep everything with betadine, make it as sterile as possible, there’s still bacteria down in your sweat glands in your armpit. There’s still bacteria down in the milk ducks of the nipple.

Dr. Bae:
So even though we clean all that up, that bacteria can still get on the implant and possibly cause an infection but more likely cause something called capsular contracture, which is that natural scar tissue that forms around the implant, totally normal on all types of implants. But if it gets too much bacteria there, called colonization, it can make that scar tissue get thick and distort the breast. And that’s called capsular contracture. So that’s less likely if you make an incision under the breast.

Dr. Bae:
But then the downside, potentially, of making an incision under the breast is you could have the implant bottom out. So lots of pros and cons with all these things because, if there was one right way, then everybody would just do it that way.

Over or under the muscle

Dr. Bae:
Then the fourth decision is on top of or under the muscle. And one of the things about going under the muscle, it helps camouflage the implant. So it makes it a little more natural-looking. But the other thing is that thing I was talking about, capsular contracture, where the scar tissue gets really thick and distorts the breast? There’s some suggestion that, by putting the implant under the muscle, it reduces that risk of capsular contracture. So I tend to put implants under the muscle. And it also depends on if the patient has enough breast tissue to begin with, because if they don’t have that much breast tissue to begin with, you probably don’t want to put it on top of the muscle because there’s not a whole lot of skin to camouflage it, and it looks more like a water balloon.

What size implant should I get

Dr. Bae:
And then, lastly, what size? And we just have people try on implants in the office. They bring a sports bra. We have them put in all of the sample implants we have in the office and try them on and see what size they like best. And we go with that. And we usually have a range of options in the operating room the day of, to make sure we have whatever eventuality comes up of what they’re looking for. So that’s the buffet of decision-making and answers and suggestions that I make to them, recommendations. And then, they go from there.

Greg:
You know what? The main key here, again, as we always talk about, especially if you’re doing something like this, research, research, research. Talk to your doctor and then make the best decision for you and your body.

Dr. Bae:
That’s right. That’s right. Thanks for always promoting board-certified plastic surgeons. That’s probably the person you want to go to. They have a lot of experience. They do a lot of training, too. You know, it’s one thing. Anybody can put in an implant, but it’s knowing how to put in the implant, when to put an implant, and what other kind of surrounding issues are involved to make sure you’re making the right decision because, quite frankly, the biggest thing with breast augmentation is the pre-planning, the decisions made before the operation, not the actual operation.

Greg:
And not anybody can put in an implant. A lot of plastic surgeons and a lot of other surgeons can, but not anybody. So that’s why we have you here. And we are grateful for it. Thank you so much, Dr. Bae. Give out all your information, social media.

Dr. Bae:
Yeah. I appreciate the faith you have in me, but yeah. Check me out. Real Dr. Bae. R-E-A-L-D-R-B-A-E, not B-A-Y, on Instagram, Snapchat, and TikToK, and realdrbae.com. Check pricing on there and watch us on social media when we operate, so you kind of know what to expect when you come in for your operation.

Greg:
Absolutely. We’ll see you next time.

Dr. Bae:
Thanks a lot, Greg.

Greg:
Thank you.

The post The 5 decisions of breast augmentation first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m good. I’m good. All is well, all is well.

The big news on textured breast implants

Greg:
Well, I’m happy to hear that. I’ve been seeing a little bit in the news lately, these textured silicone breast implants that I think were done, you can correct me if I’m wrong, done years ago. I don’t know that they do them anymore. Maybe they do, but there is some concern about them and a lot of people who have those are wondering, do I need to go and get those replaced? Or, what do I do, because everybody wants to stay as healthy as they possibly can.

Dr. Bae:
Right. Well, I’m glad you asked me about that, because I just happened to have some breasts implants with me right here.

Greg:
Oh, wow. Look at that, props.

Why textured breast implants are textured

Dr. Bae:
What are the chances? So I guess the first thing we should talk about is just kind of some baseline knowledge, fundamental knowledge that there’s the difference between round implants, which are kind of the typical round silicone implants you always think of, versus these teardrop or shaped implants. You can see it’s fuller at the bottom. And so, when you have a round implant, if it spins in the breast tissue, like in the breast pocket, inside the patient’s breast, if it spins, no problem. It’s still a round implant. But if this spins, then you’ve got sort of a sideways boob. So what they do is, they now texture-

Greg:
Nobody wants a sideways boob, Dr. Bae.

Dr. Bae:
I think a lot of people gave that up for their New Year’s resolution, right? So the thing is, the reason they texture these implants, as opposed to being smooth like the other implant I showed you, they texture these-

Greg:
So they don’t move.
Dr. Bae:

So they don’t move, exactly. So, what the … you’re pretty smart. Producer, check out the big brain on Greg.

Greg:
Maybe I’ll go to medical school.

Dr. Bae:
Maybe so, and I’ll go back to being … I’ll be a radio host.

Greg:
We better keep what we’re doing.

Dr. Bae:
So, the thing is, that texturing has become an issue over the last couple years, that people have noticed an issue with it. And what it is, is that there’s something called anaplastic large cell lymphoma, which is kind of like cancer, but not really. And what it is, is that after a few years, two years to 28 years they found, after getting textured implants, what they found is that the scar tissue that naturally forms around breast implants, whether they’re saline, silicone, round, shaped, your body naturally formed scar tissue. But in some cases, specifically with a certain type of textured implant, that scar tissue could get really thick and starts secreting some fluid. And the patients would have this huge seroma or fluid collection that would form around their breast implant. Like I said, two years or 28 years after.

Anaplastic large cell lymphoma (ALCL)

Dr. Bae:
And that was caused by this lymphoma, or this thickened scar tissue. So the way to treat it is you go in, you take out the breast implant, you take out the scar tissue and typically a hundred percent of the time people would be cured if you found that early enough. So that’s anaplastic large cell lymphoma, ALCL, that’s associated with textured implants. But not just any textured implant, specifically one that was made by Allergan, and that one’s been taken off the market. So statistically speaking, is a very low risk for people to get this problem if they have textured implants. If you have smooth implants, there’s really been no evidence that smooth implants cause that problem. And the reason it’s been in the news lately, and also which, I should say, the reason I’ve been thinking about this lately because it’s been in the news, I’ve had patients reach out to me saying, “Hey, I’ve got this brand of a MENTOR silicone textured implant. Does that mean I need to come back in?”

Dr. Bae:
And the FDA says, just like I told this patient, that because they took the main offender off the market and because the risk is so low, that if you have textured implants and it’s not that Allergan product, if it’s MENTOR or Sientra and you’re not having any problems, your breast isn’t blowing up with a bunch of fluid, if you’re not having problems, you don’t have to do anything. You don’t have to go in and get them changed out. So just FYI, the more you know, public service announcement, that if you’re happy with your breast implants, you don’t need to do anything with them. You don’t have to get them taken out every 10 years like some people mistakenly think. So again, just keep going, get your mammograms, get your checkups from your doctor. And as long as you’re happy with your breast implants, you don’t have to do anything else about them.

Greg:
But, if somebody has a question, if somebody has a question about their implants, or if they just want you to examine their breasts and check out where they are, they can reach out to you on social media.

Dr. Bae:
Absolutely. They can reach out to us. Instagram, TikTok, Snapchat @realdrbae. R-E-A-L-D-R-B-A-E, not B-A-Y. And check us out on our website, realdrbae.com, where they can check pricing, all that good stuff. But yeah, people message us all the time. All my surgical patients, they always have my email address and my phone number. So they’re able to reach out to me afterwards if they’re worried. So, there’s no excuse. You can absolutely get in touch with this doctor.

Greg:
And if you’re not a previous patient of Dr. Bae’s, and you’ve never even spoken to him before, if you Instagram him with a question, DM, he will answer you. Right, Dr. Bae?

Dr. Bae:
That’s absolutely true. Yeah. As long as you’re not saying anything mean, I will respond to you.

Greg:
That’s my policy on social media, too. All right. Well, thanks Dr. Bae. Appreciate it.

Dr. Bae:
My pleasure. My pleasure.

The post What you need to know about textured breast implants [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Kaplan on Instagram Live with New Beauty

This is huge and you don’t want to miss it! The award winning, widely read self-care and cosmetic “bible,” ie NewBeauty Magazine will be interviewing Dr. Kaplan on Instagram Live! Sarah Eggenberger, editor-at-large of NewBeauty and Dr. Kaplan will discuss all things breast augmentation.

Dr. Kaplan is thankful to Breast Implants by Mentor for making this possible behind the scenes. So where will you be on Tuesday, November 10th at 9am PST? The same place you always are – looking at your phone! Just make sure you’re tuned to @newbeauty or @breastimplantsbymentor on Instagram Live for the details on breast augmentation.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Dr. Kaplan joining NewBeauty on Instagram Live! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Anaplastic large cell lymphoma (ALCL) vs Breast implant associated illness (BIAI)

Compared to BIAI, it’s “easier” to determine if someone has ALCL. They’ll present with a late onset fluid collection or seroma around their breast implants (most typically textured implants), 1 to 20 years after surgery. And when sent to the lab, that fluid collection will test positive for the CD30 protein or negative for the anaplastic lymphoma kinase (ALK) protein. ALCL is treatable, and cure is possible, with removal of the implant and surrounding scar tissue when performed early. Again, the most encouraging aspect of ALCL is that it is diagnosable and treatable.

While BIAI and ALCL are similar in that they both seem to affect patients with textured implants, they are very different in other ways. For example, BIAI has many vague symptoms also associated with other disease processes, including those not involving breast implants. Symptoms that women commonly report are fatigue, anxiety, foggy thinking, memory loss, headaches, muscle pains and even hair loss and skin rashes. A caring sympathetic doctor would not dispute that a patient is feeling these symptoms. But this is not enough to make the diagnosis of BIAI.

BIAI is difficult to diagnose for two reasons. First, there’s not always a physical symptom like seroma formation. And secondly, there’s currently no diagnostic lab test, as in the case of ALCL. However, in an exceptional case, I had a patient with BIAI that actually had physical symptoms and a positive lab test. But a word of caution. The lab tests referenced here are not specific to BIAI and are certainly not diagnostic of BIAI in the same way CD30 is diagnostic of a symptomatic patient with ALCL.

A BIAI patient with symptoms and lab abnormalities

A previously healthy, thin, fit, female patient of mine had breast augmentation with 320cc round-base, shaped, textured implants in April of 2016. Approximately 6 months after surgery, she started to experience rashes (see photo), extremely high blood pressure (168/110) and numerous food allergies (gluten, dairy, alcohol, coffee) which would lead to more rashes.

Her hands would turn white and purple, a sign of Raynaud’s disease (see photo) – changes she never experienced prior to breast augmentation. Soon after, she started to experience muscle weakness and a sensation that her legs were very heavy. Upon going to the ER, her lab tests showed very high levels of creatine kinase (CK). This is an enzymatic protein found in the heart, brain, skeletal muscle, and other tissues. It is released into the bloodstream when there is damage to those tissues. Measuring high levels of CK is  a common test for someone actively experiencing a heart attack. CK levels are high when there is damage to the heart muscle because coronary arteries are clogged and the heart isn’t receiving enough oxygen.

Despite a high CK level, there was no reason to suspect she was having a heart attack. She was young, had no chest pain and no changes on EKG. But they were concerned that elevated CK levels, whatever their cause, could damage the kidneys, as is possible in rhabdomyolysis. Rhabdo, for short, is the rapid breakdown of muscle tissue and release of proteins into the bloodstream. The large amount of proteins can damage the kidneys and cause acute renal failure.

While the doctors had not yet diagnosed the cause of the elevated CK protein in the blood, they worried about its effect on the kidneys. In an overabundance of caution, she remained in the hospital for 3 nights with IV fluids to help flush out the CK protein before it could damage the kidneys, which was successful.

Unsure of the cause of her full body symptoms, she dramatically shifted her lifestyle. This included alcohol cessation, which she already used in moderation beforehand, and avoidance of foods that could cause any bodily inflammation.

After another admission to the hospital in July of 2019 (3 years after surgery) because of weakness, muscle wasting and an elevated creatine kinase level of 411 U/L (normal is 24-173 U/L), she decided the implants were the underlying cause of these symptoms and made the decision to remove them.

In November of 2019 (3+ years after implantation), I removed the implants and the surrounding scar tissue (capsulectomy). Since then, her rashes, Raynaud’s and all other symptoms have disappeared. As of January 2020, 2 months after implant removal, her creatine kinase level returned to the normal range.

So what does it all mean?

This represents one of the few examples in the literature when demonstrable physical symptoms (rash and Raynaud’s disease) in combination with a lab test, both had resolution after removal of implants. And while resolution of elevated lab tests and symptoms should be seen as a success after implant removal in patients experiencing BIAI, the true success remains elusive.

What we need is a preoperative antigen test that can predict, with a high degree of certainty, that if someone gets implants, their body may react to the implants and enter a sustained, chronic phase of inflammation. And if the patient is found to be “reactive” to such a test, they wouldn’t get implants.

Testing like this is not unheard of within aesthetic medicine. For example, one component of the dermal filler Bellafill is bovine collagen. Because some patients can have a reaction to bovine collagen, they receive a skin test one month before Bellafill treatment. If they have a skin reaction, they are not a candidate for this long-lasting dermal filler. Similarly, if someone would have a reaction to some future “breast implant antigen” test, they would not be a candidate for breast augmentation.

Conclusion

For those who believe no one should get breast augmentation until the development of such a test, that is an unreasonable approach. There are millions of women around the world who currently have breast implants and over 400,000 undergoing the procedure for cosmetic or reconstructive reasons each year.  And with a relatively small percentage experiencing ALCL or BIAI, the benefits of breast augmentation greatly outweighs the risks. While continuing to provide this service to women for cosmetic reasons or for reconstruction after mastectomy, we should also continue to develop prognostic techniques to avoid augmentation in the few patients that will have very real adverse reactions.

And for those few patients that do have symptoms after implantation, luckily there’s treatment. They can be potentially cured with explantation (implant removal) and capsulectomy.

Dr. Jonathan Kaplan is a board-certified plastic surgeon based in San Francisco, CA and founder/CEO of BuildMyBod Health, a price transparency-lead generation platform. You can watch him operate and educate @realdrbae on Instagram, Snapchat and TikTok.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post The difficulty in diagnosing Breast Implant Associated Illness (BIAI) first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Chrissy Teigen becomes the latest famous person to open up about getting a boob job. She joins the ranks of Kaley Cuoco, Victoria Beckham and Anna Faris. For what it’s worth, does it really matter anymore? It’s not shocking and that’s a good thing.

Chrissy Teigen and her boob job

As time passes, the news of someone getting a boob job has lost its sheen as “big news!” The truth is, it’s no longer taboo to get a boob job. This is partly due to the #metoo movement. Obviously the #metoo movement is about someone abusing their position of power in how they treat women. But in a #metoo-adjacent sense, if anyone comes off as sexist or treating a woman differently for feeling “feminine,” they’re very quickly shut down. Plus, being critical of what someone else does with their body is just ridiculous. Who cares what you think about so-and-so’s choices?!

As far as Chrissy Teigen is concerned, she got a boob job a little over a decade ago. She says that she got implants to make her breasts perkier when modeling bathing suits. Many women feel this way. They want implants simply to help fill out clothes, so they fit better.

In the article above, she appears someone despondent that she wants them out and will have to get a lift now. For what its worth, she need not feel this way. She doesn’t need a lift only because she had implants. She’s had two children and that causes breasts to become pendulous. If she ever wants perky breasts again, implant or not, she would need a lift anyway. No need to blame herself.

And in a twisted sort of way, the fact that a celebrity getting a boob job isn’t as big as deal as it once was, shows society is maturing as a whole!

To check pricing on a boob job from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Chrissy Teigen Opens Up About Her Boob Job first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

J Lo get plastic surgery? Nope!

As you can see in this Instagram post, I stated unequivocally that J Lo looks as amazing as she does through hard work, diet and exercise. And as you’ll see in the comments on that post, many people vehemently disagreed with me. Some went so far as to suggest that I wasn’t a good enough surgeon if I couldn’t make someone look like that! Or that I didn’t have enough confidence in myself to provide someone with a result as natural as J Lo’s body! They’re missing the point.

For those naysayers out there, tell me what plastic surgery you think J Lo had? Her arms are tone and buff. Did she get bicep implants? No, she worked out!

You think she had breast implants? Oh really?! J Lo got breast implants so she could have B cup, small, shapely, appropriate-for-her-body breasts? And she got them 35 years ago before anyone took a photo of her? I mean, her breasts have looked the same at least as far back as her Grammy dress from 2000!

A tummy tuck? Yes, her abdomen looks amazing after kids. So she had a tummy tuck to tighten her rectus diastasis without any evidence of a tummy scar or incision around her belly button? With her exposing her abdomen on the reg, it’s not possible to hide scars like that, that well.

This is my point. Whatever plastic surgery people think she had, there’s no physical evidence of that, other than she looks great. Honestly, I believe people want her to have had plastic surgery more than they think she actually had plastic surgery. Because if she had plastic surgery, then they could say she has money and was able to afford plastic surgery. Whereas if she has that body through hard work, diet and exercise, then we all collectively have no excuse!

Video: J Lo did NOT get plastic surgery

Finally, to reiterate, I’m not saying plastic surgery can’t make someone look amazing. Of course it can. I have patients to prove it. But in J Lo’s case, there’s no evidence of a tummy tuck scar to suggest she got that body from anything other than hard work, diet and exercise.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Did J Lo get plastic surgery? I say no! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

As a plastic surgeon, I’ve heard many myths about aesthetic medicine. It doesn’t matter how often they’re repeated, it still doesn’t make them true. But consumers and potential patients certainly think they’re true after hearing them so many times. So here is the truth!

5 myths about aesthetic medicine

1. Liposuction – Myth: After lipo, I’ll get fat in other parts of my body!

Fact: Your fat isn’t that smart. It doesn’t change direction based on previous surgery. Sure you have fewer fat cells in the area where you underwent liposuction, so other areas may look fuller by comparison. But any fat intake you have will go to the same places it is genetically predisposed to go to.

For example, if most of your fat goes to your hips, it will continue to go to your hips even after liposuction to the hips. That’s why you should use liposuction as a launchpad to get in even better shape, not a shortcut.

2. Botox – Myth: I can’t lay down or work out after treatment!

Fact: Botox is not like sauce in a saucepan, it doesn’t slosh around after treatment. So when you lay down, the Botox will not diffuse over to your eyelid and give you a droop. If you get a droop, it may be because the Botox was injected too close to your eyelid in the first place.

3. Surgery in general – Myth: I can’t get the incisions wet

Fact: What’s the alternative to getting your incisions wet? They’ll just get grimy and sweaty if you don’t clean them. How is that good for a fresh incision?! Not everyone agrees so ask your doctor first but I recommend that my patients get in the shower the night following their surgery and let soap and water run over the incisions. This keeps them clean. However, do NOT soak underwater in a bathtub, swimming pool, lake or other body of water because you could be bathing in your own, and someone else’s, filth.

4. Tummy tucks and/or a breast lift – Myth: The scars will disappear eventually

Fact: You had an operation, and the only way to get rid of excess skin from the abdomen or breasts is to cut it out. That means incisions. You will always have those scars. Sure they may fade to the extent you’re happy with the scars but they will not disappear. This is also why incisions are often placed in areas that will be covered by clothing or under garments.

5. Breast augmentation – Myth: I have to get the implants exchanged every 10 years

Fact: Nope. There was a study years ago that showed about 20% of women who had breast implants had to get them exchanged after 10 years for one reason or another. Leaking implant, capsular contracture, malposition, etc. But that also means that 80% of women were just fine.

The study involved older generation implants. So if the study was done today with newer implants, the percentage could be even lower. Bottom line: if you’re happy with your implants and you know it, clap your hands…because you don’t have to change them out!

So that’s the truth on the matter. All 5 myths debunked. So tell your friends so we can put these 5 myths about aesthetic medicine to bed!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post 5 myths about aesthetic medicine first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Do you have droopy breasts? Do you need a breast lift or implants? Maybe both? Keep reading to understand your options. And keep in mind, you don’t have to have implants…but you may want them!

Breast lift or implants?

When a patient has droop to their breasts, they know it because the nipple has dropped below the IMF or inframammary fold. This is the fold under the breast. Typically, a nipple areolar complex positioned at or above the IMF is in an aesthetically pleasing position.

If however, the nipple and surrounding areola have dropped below that fold, most would consider that to be droopy. By performing a “donut” lift or “lollipop” lift or “anchor” lift, excess skin is removed from the breast. This essentially tightens the skin envelope and lifts the breast. If you’re happy with the fullness of the breast at that point, you don’t need implants.

But if the correct position of the nipple leaves you wanting because the breasts still have a deflated appearance, then you can add implants to the mix. In this scenario, implants provide fullness and size, whereas the lift improves shape. Size without shape isn’t a good look. But shape without size may be totally appropriate.

Many women have a large amount of breast tissue, even if they’re drooping. So if there’s enough breast tissue, this will provide a full, perky appearance after the lift. No implant required.

You can check pricing for either procedure from Dr. Kaplan, here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Breast lift or implants or both [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The smaller the better

With bigger implants, the patient may get stretch marks. Bigger implants also stretch out the breast pocket, meaning it can extend into the armpit area or go across the breast bone, forming a uni-boob!

Bigger implants also don’t look very natural. That may be what some patients are looking for but later in life, bigger implants can lead to a need for reduction.

Smaller implants look more natural, less likely to stretch skin and less likely to end up in the armpit. When you go in for your consult, consider this!

Video: Breast augmentation with smallish implants!

To check pricing on breast augmentation from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Breast implants: the smaller the better! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Textured breast implants

First, this doesn’t apply to all implants. It doesn’t apply to saline or silicone implants with a  smooth surface. This doesn’t apply to textured implants by Mentor or Sientra. This is only in regards to textured breast implants specifically made by Allergan.

So what’s the problem?

Allergan textured breast implants are associated with anaplastic large cell lymphoma (ALCL). It’s not your typical breast cancer. In fact, ALCL can occur anywhere in the body. But when it comes to textured implants, the scar tissue around the implant can turn into ALCL.

A patient would be suspicious if one breast all of a sudden grew larger because of an accumulation of fluid around the implant. If that happens, tell your doctor. They’ll remove some of that fluid and send it to the lab for diagnosis. The treatment is to remove the scar tissue that contains the lymphoma from around the breast.

With quick diagnosis, the patient can be cured with removal of this scar tissue.

Why texturing in the first place?

Textured implants help keep an implant in position within the breast. This is less important with a textured round implant because if it spins in the breast pocket, it’s still a round implant and is still in a good position. But a shaped or tear drop implant that spins can create a “sideways” boob. Texturing helps the implant from spinning. To completely avoid the issue, your best bet is to get a round smooth implant since you can’t get shaped or tear drop implants that are smooth.

What if I have textured implants?

If you’re not having symptoms, you don’t have to do anything. Even the FDA is not recommending patients remove their textured implants without symptoms. But again, if you do have symptoms, a cure is likely with removal of the implant and the surrounding scar tissue.

Video regarding textured breast implants and the risk of ALCL

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Allergan removes textured breast implants from market [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

1. They cause cancer

Breast implants don’t cause the typical type of breast cancer that the vast majority of women have. A very rare form of cancer known as lymphoma, which is more of an overgrowth of lymphatic tissue like lymph nodes that can occur anywhere in the body, can also appear, under certain circumstances, around a breast implant.

Specifically, implants with a textured surface, as seen in shaped or tear drop implants, may result in a very small risk of anaplastic large cell lymphoma (ALCL). This arises in the scar tissue that naturally forms around all breast implants. And within that subset of patients with textured implants, there are patients that have a certain brand of implants (Allergan), that may get ALCL. It can been seen in other brands of textured implants but they’re most commonly seen in that brand.

A patient may notice months or even years after surgery that they suddenly get a fluid collection around their implants. That fluid can be sent to a pathology lab that can diagnose ALCL because of specific proteins found in the fluid. The treatment is to go in and remove the scar tissue around the implant and the implant itself and this usually leads to a cure. So while breast implants can cause a type of cancer, it’s not “breast cancer.”

2. You have to change them out every 10 years

Simply not true.

There are multiple studies that review implants over the course of 10 years and find that a follow up surgery is necessary in about 20% of patients at 10 years. But that means 80% of patients are fine. So if you’re not having any issues with your breast implants, you don’t have to change them out after 10 years, or maybe ever.

3. You have to get shaped/teardrop for them to look natural

Here’s a little secret. Yes, teardrop or shaped implants have less fullness at the top portion of the breast to make them look more natural. But if you don’t get huge implants (round or shaped), they’ll look natural either way!

Go big or go home isn’t true when it comes to breast implants!

4. You can’t breast feed afterwards

Not every woman can breast feed but this has nothing to do with breast implants. So if you’re theoretically or actually able to breast feed before breast implants, you’ll be able to breast feed after breast implants.

5. The silicone can leak into the body

It’s important to make the distinction between older and new implants on this point. Older generation implants that ruptured have been shown to leak silicone molecules to the armpit region and even the liver. But newer implants, as discussed in this document submitted to the FDA, don’t leak into the body. They may leak out of the implant’s silicone shell but they stay contained within the scar tissue around the implant.

To reiterate, scar tissue naturally forms around any foreign object in the body – knee replacements, pacemakers and even breast implants. And this means all breast implants – saline or silicone. So when an implant ruptures and the silicone gel leaks out of the implant, the document above reports that none of that silicone leaked out of the scar tissue surrounding the implant.

Video: The 5 myths about breast augmentation debunked!

Click here to check pricing on breast augmentation from Dr.  Kaplan (aka Dr. Bae)!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post 5 myths about breast augmentation debunked [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Breast asymmetry correction is one of the most complex breast procedures around. The complexity is due to the myriad of ways to fix the asymmetry. It’s not just a matter of size, but also of shape. And then you have to get the nipple in a symmetrical position!

Video of breast asymmetry correction

As the video shows, there are many steps to correcting breast asymmetry. First you must identify the problem. Is it only a size discrepancy or a ptotic (droop) issue. Based on the discrepancy, the surgical plan will proceed from there.

The key to success is ensuring a cohesive plan preoperatively. Having a range of breast implants available to improve size symmetry is important. But you may also need to use different techniques for the breast lift to improve symmetry between the nipple position.

This means a “donut” lift to reduce the size of one areola to match the other. It may mean a “lollipop” lift to shift the areola northward. Or it may mean a more extensive “anchor” lift to shorten the distance between the nipple to the inframammary fold. Again, there are many variables and steps to achieving success. Experience matters.

And while experience is key, obviously cost is a realistic matter to take into account. To check pricing on this procedure from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Breast asymmetry correction with implants and lift [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.