Both saline and silicone implants have a silicone shell. The difference is in what fills the implants. A saline implant is filled with saline solution, the same that is used for IV’s. Thus, if the implant ruptures, the body absorbs the saline and the breast shrinks or deflates. A silicone implant is filled with a silicone gel. The silicone has improved with time. The current silicone is called “cohesive” meaning it holds to itself. An implant outside the body can be cut in half without the silicone going anywhere. If a silicone implant ruptures, you would likely not know as it would stay in the scar tissue that forms around the implant.
Both implants have advantages and disadvantages. Saline implants are less expensive and empty when we put them into position so they can be placed through smaller incision. However, saline implants ripple more and do not feel as natural. Silicone implants are filled when we put them in place and therefore need a larger incision. However, silicone implants ripple less and feel more natural. Both implants will give you a natural appearance although if you have little natural breast tissue, rippling is sometimes visible.
A breast lift, known as a mastopexy, is necessary if your nipple is at or below the crease below your breast. The lower the nipple is in relation to the crease, the more aggressive the lift that is necessary. Minor lifts result in a scar around the areola. Major lifts result in a scar around the areola and a vertical incision from the areola to the crease below the breast. Sometimes a short horizontal scar in the crease below the breast is also necessary.
When a breast lift is performed, a small amount of skin around the areola and on the central lower portion of the breast is removed. The nipple and areola are not detached. The tissue is folded to move the nipple up higher on the breast and the sides under the breast are brought together leaving a vertical incision line.
The majority of women can breast feed after having implants. The ability to breast feed is affected by the choice of incision site. An incision in the crease under the breasts doesn’t go through any breast tissue. The tissue is lifted up and the implant is placed underneath. A peri-areolar incision (next to the areola) does go through the breast tissue, which can affect breast feeding more. Just having implants makes it difficult for one in five to breast-feed even if the tissue is left intact.
Breast implants do not have to be changed every 10 years. You are free to keep a breast implant until you are unhappy with the shape of the breast, the implant ruptures or you have some problem with the implant. Implants carry a lifetime warranty. For the first 10 years the implant companies are so confident in their implants that they will even pay part of the surgeon’s replacement fees if an implant deflates. Patients should expect to change their implants at some point during their life. Usually patients elect to change their implants because they become unhappy with the shape. As a breast ages it typically loses natural tissue and droops leading to the desire to get a repeat augmentation.
Wrinkles around the mouth are a challenging problem. Options include injectable fillers such as Juvederm and Radiesse, chemical peels such as TCA (trichloro acetic acid), or surgical dermabrasion which may help with fine and moderate wrinkles but has the longest recovery time.
Botox works by stopping the muscles from moving. It will not make your wrinkles go away immediately. Skin has memory and thus, even though the muscles which create the wrinkles are no longer moving, the wrinkles persist. Over time the skin memory decreases and wrinklesl fade.
Botox lasts about 3-6 months. Everybody overcomes the effects at a different rate. In addition, every facility injects varying amounts of Botox which affects how long it lasts as well. The average duration of effect is 4 months.
A unit is simply a standardized amount designed to be readily reproducible. Every area treated takes a certain number of units to effectively stop or decrease the muscle movement. Usually around 6 units is used on each side to treat the eyes and about 20 units are used to treat the forehead.
Smartlipo is the brand name developed by Cynosure for their laser liposuction system. Traditional liposuction is a two-step procedure. First, fluid containing two medications, lidocaine and epinephrine, is injected into the area where the liposuction will be performed. Second, the fat is removed by suctioning. The removal is traumatic but effective. Laser assisted liposuction or Smartlipo adds an additional step. First, the fluid is injected into the tissue. Second, the laser is inserted into the same tissues, melting the fat and cauterizing blood vessels. Third, the fat is removed by suctioning. The removal is less traumatic with laser-assisted liposuction, which results in less pain, faster recovery, less bruising and less swelling. In addition to these benefits, the heat generated by the laser may improve skin contracture over traditional liposuction.
Five to eight treatments are usually necessary to get an area essentially hair free. Hair grows in cycles. The laser only works on active hair follicles. Not all follicles are active at any one time. The average hair follicle cycle is six weeks which is why your treatments will be spaced out about that far apart.
A mini tummy tuck removes a small amount of skin below the belly button. During the procedure two vertical muscles called the rectus abdominus muscles are exposed and sewn back together in the midline from the belly button to the incision line. The belly button is not affected other than getting a slight downward pull.
A standard tummy tuck removes all the skin between the pubic hair and the belly button. An incision is made around the belly button and it is left attached to the muscle layer. The skin above the belly button is elevated up to the ribs. While the skin is free, the rectus abdominus muscles are sewn together from the ribs to the pubic area. The skin is pulled down to the pubic area resulting in a low incision that spans from hip to hip. A new opening is created for the belly button and it is sewn into place. The belly button isn’t really “moved” but it will look different and have an incision all the way around it. A standard tummy tuck allows much more skin to be removed and more shaping and tightening of the abdomen. A mini tummy tuck is appropriate for a select few people. Any amount of hanging skin disqualifies one for a mini tummy tuck.
You can get pregnant after having a tummy tuck and have a safe pregnancy. Pregnancy can undo some of the improvements made to the stomach when the tummy tuck was performed. For example, during a tummy tuck the rectus abdominus muscles (two vertical muscles in the central abdomen) are cinched back together in the midline. When you are pregnant these can be stretched apart again and never return to the tightened position after pregnancy.
Returning to work depends on how physically demanding your job is and how extensive your surgery. If you work at a desk and had a simple surgery like breast augmentation, five days may suffice. If you have a tummy tuck and walk a lot on your job, you may need two weeks. At two to three weeks after a big surgery, most patients can do 80% of their normal activities but will still need help with the strenuous activities.