Revolutionary Single-stage Breast Reconstruction Procedure

This new procedure preserves the nipple, areola and surrounding skin by using a vertical mastectomy incision, a dermal flap for coverage, and a definitive adjustable smooth saline implant.

breast reconstruction

Hilton Becker, M.D., a local plastic and reconstructive surgeon and an affiliate professor in FAU's Charles E. Schmidt College of Medicine, studied and developed this procedure as an alternative to radical mastectomy. His findings were published in the Plastic and Reconstructive Surgery Journal, co-authored by Jeffrey Lind II, M.D.

According to Dr. Becker,

There are numerous advantages to using a vertical incision over a horizontal incision. From the surgical perspective, it allows for ease of access, and from an aesthetic perspective this incision leads to a better cosmetic result with a scar that resembles that of a breast lift procedure. The procedure is minimally invasive as no new tissue planes are opened after the general surgeon has completed the mastectomy.

Procedures that spare the nipple and skin have been shown to be oncologically safe and allow for much more flexibility in implant-based breast reconstruction. Single-stage breast reconstruction will become more important as there continues to be increasing financial strains on our healthcare system.

Elizabeth Hopkins is an aspiring physician and pre-med student who has been mentored by Dr. Becker. She is also a patient of his and shared her personal feedback after undergoing this new procedure.

This blessing in disguise introduced me to a brilliant surgeon whose unique procedure enabled me to have a skin and nipple sparing mastectomy free from animation deformity, which happens when implants are placed beneath the pectoral muscle – mine were placed over the muscle. Being his patient and working side-by-side with Dr. Becker has changed my life and will hopefully change the lives of many others.”

During the preliminary stage of the study, 31 patients with a median age of 51 underwent the single-stage breast reconstruction procedure. They were followed over the course of four and a half years.

Both a low complication rate and implant loss were shown and reported as part of the results of the procedure. Other benefits according to the authors of the study include: elimination of animation deformities or movement of the implants, elimination of asymmetry, less postoperative pain and discomfort, and a faster recovery.

In addition, the natural position of the implant above the muscle leads to a more natural feel.

Currently, both a one-stage and a two-stage reconstruction are available for patients.

In an immediate breast reconstruction, the plastic surgeon places the implant beneath the muscle of the patient's chest after the removal of the breast tissue. A special type of graft or an absorbable mesh is used to hold the implant in place, much like a hammock or sling.

In a two-stage reconstruction (also called delayed-immediate reconstruction), a short-term tissue expander is used wherein a saline-water solution is injected by the surgeon over a period of 2 to 3 months. When the skin over the breast has stretched enough, a permanent implant will be surgically done to replace the expander. This kind of reconstruction allows time for other treatment options such as radiation therapy to be done when it is needed by the patients.

For more info, you may visit:

http://www.fau.edu/newsdesk/articles/Mastectomy%20Alternative-study.php

FDA Approved Saline-filled Breast Implants

Ideal Implant Incorporated has recently announced the FDA approval of its Structured Breast Implant for use in the United States and Canada.

The breast implant was designed by a plastic surgeon and it is the first to provide women with the feel of silicone gel-filled implants combined with the safety of only saline inside. The natural feel of the breast implant is attributed to its patented unique design and internal structure which was a product of more than 10 years of research and clinical studies.

As to its design, the company's website provides the following:

Years of research and testing led to this innovative design, with a series of implant shells nested together and two separate chambers, which hold the saline filler. The internal structure controls movement of the saline, and is designed to reduce folding and wrinkling, thought to be the main cause of implant rupture and deflation. On the outside, the edges have been lowered for better contouring to the chest wall.

According to Robert Hamas, MD, a Dallas plastic surgeon:

Now, for the first time, women can have a breast implant that offers them a natural feel without silicone gel. It has only saline inside for their safety and peace of mind. Unlike silicone gel implants that have a high incidence of silent rupture that requires an MRI scan for detection, with the Ideal Implant, a women can look in the mirror each day and have the confidence of knowing her implants are intact.

In a study, patient satisfaction for those who received their first breast implants were at 94.3% while those who had replacements for their previous implants was at 90.6%. The high satisfaction rating among women were attributed to the natural feel of the implants coupled with ease of mind because of its saline-filled components. The surgeon satisfaction was also high at 95.9% for primary implants and 91.7% for replacements.

 

For more info,

you may visit www.idealimplant.com

or contact Adeena Fried, 917-633-4380, idealimplant@evolvemkd.com

Thoughts On The "Ideal" Breast Implant

Thoughts On The "Ideal" Breast Implant

Guest Post: Aaron Stone MD

Thoughs on the Ideal silicone / saline breast implant.

The 2 main types of breast implants available for decades have been the saline filled an silicone gel filled breast implants. Each has its pros and cons.

Silicone gel implants have a more natural feel and look. Unlike silicone gel, implants containing only saline do not blend well with surrounding tissues at the edges of the implants. This is due to the chemical properties of salt water which is chemically charged as positive and negative charges that attract each other as opposed to silicone gel which does not carry a charge. Thus saline is more cohesive than silicone. What this means in clinical terms is that saline implant margins are more visible than silicone gel implant margins, especially when the soft tissue (breast gland and fat) between the outside world and the implant is thinner. Thus, in those patients with smaller breasts (less glandular tissue and/or fat) it is preferable to place saline implants under the chest muscle.

Saline implants may look very good when lying flat on a table. However, when upright the upper portion of the implant collapses (wrinkles or ripples) as the cohesive saline falls

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Toronto Plastic Surgeon, Wayne Carman, MD, FRCSC

Dr. Wayne Carman opens up about his thoughts on Canada's medical health system and his own cosmetic surgery clinic.

Name: Dr. Wayne Carman, MD, FRCSC
Clinic: Cosmetic Surgery Institute
Location: Toronto, Canada
Website: drcarmanplasticsurgery.com

That's interesting: Dr. Wayne Carman is Past President of the Canadian Society for Aesthetic Plastic Surgery and is the Secretary-treasurer of the Canadian Society for the Accreditation of Ambulatory Surgical Facilities. Other prestigious positions include membership on both the editorial board of the Aesthetic Surgery Journal and also the Premises Inspection Committee of the College of Physicians and Surgeons of Ontario.

Your practice is relatively close to the US border. Do you have patients coming from the US? Is this increasing or decreasing? Do you see this as 'medical tourism'?

In the past, I have had the opportunity to treat many American patients and have enjoyed the opportunity to contribute to their care. More recent restrictions on our professional insurance have curtailed the ability of plastic surgeons to see foreign patients. Those of my colleagues in border cities have sometimes chosen to make individual arrangements to allow treatment of Canadian non-residents, but most plastic surgeons have...

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Dr. Michael J. Brown, Plastic Surgeon In Virginia & Maryland

Dr. Michael Brown's practice includes three offices across Virginia and Maryland.

Name: Michael J. Brown MD
Clinic: The Loudoun Center for Plastic Surgery
Locations: Ashburn & Richmond VA, Bethesda MD
Website: rejuven8u.com

About: Dr. Michael J. Brown has been voted a Top Plastic Surgeon in Virginia and Top Doctors in Virginia by Northern Virginia Magazine and Best Cosmetic Surgeon in Virginia by Virginia Living Magazine in 2012. Dr. Brown has also served on the editorial board of a cosmetic surgery magazine. He is an active committee member for the The American Society for Aesthetic Plastic Surgery.

As a clinic that is primarily focused on plastic surgery but offers nonsurgical treatments, how is your clinic organized?

The Center is organized with 4 components. There is the medical office that's devoted to plastic surgery. The Center has a nurse who is trained and provides assistance with injectable treatments like Botox, Restylane, Juvederm, Dysport

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Italian Plastic Surgeon, Dr. Egidio Riggio's "Zenith System" For Breast Augmentation

Dr. Egidio Riggio focuses on innovation and research related to plastic surgery, both aesthetic and reconstructive. 

Name: Egidio Riggio, M.D.
Location: Milan, Italy
Website: chirurgiaplastica.mi.it/it/home/

That's interesting: Dr. Egidio Riggio is the creator of an innovative philosophy and aesthetics of an original surgical approach to breast augmentation he calls the "Zenith System" which he claims lead to more natural breast augmentation results. He has performed mor than 100 cases and published this proceedure in the international journal of cosmetic surgery most authoritative, Aesthetic Plastic Surgery August 2012.

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Dr. John S. Silverton, An English Plastic Surgeon In Stockton, CA

Dr. John S. Silverton, An English Plastic Surgeon In Stockton, CA

With his UK medical education and US credentials, Dr. John Silverton brings his artistic sensibilities to his plastic surgery practice in California.

Name: John S. Silverton, MD, FRCS
(England and Edinburgh)
Clinic: Stockton Plastic Surgery
Location: Stockton, CA
Website: silvertonmd.com

That's interesting: Born and educated in the UK but practicing in Stockton, California, Dr. Silverton is a fellow of the Royal College of Surgeons in England and the Royal College of Surgeons in Edinburgh as well as the American Society of Plastic Surgeons.

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Dr. Robert Cohen, Breast Enhancement Specialist In Scottsdale, AZ

Dr. Robert Cohen

As a plastic surgeon in Scottsdale, Dr. Rober Cohen specializes in cosmetic surgery of the breast.

Name:Robert Cohen, MD, FACS
Clinic: Scottsdale Center For Plastic Surgery
Location: Scottsdale, AZ
Websites: robertcohenmd.com, cohenbreastsurgery.com

That's interesting: Dr. Cohen published a textbook chapter on technology and robotics in plastic surgery while at Dartmouth.

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Perky Boobs + Nipple surgery?

Who’s your nipple role model?

Have no idea what I'm talking about? (Nipple surgery to change the shape, color or size of your areolae.)

According to the Daily Mail, a cosmetic surgery clinic called the Harley Medical Group in London has reported a 30 percent rise on nipple surgeries in the past year, including more from women who haven’t recently undergone mastectomies.

With a price tag of roughly $3,200: ‘padding’ the areola with extra skin as to push the nipple out, ‘popping out’ inverted nipples, and even getting tattoos to change the areolae’s pigmentation. 

One doctor from the clinic thinks celeb nipple slips are the cause. “Until now celebrities didn’t expose their nipples so they were no ‘nipple role models,’” explained Dr. Riccardo Frati, a plastic surgeon with the Harley Medical Group.

Young Medical Spa: Further Developing the Breasts

When the first laser lipolysis device was approved by the FDA it started a whole new revolution in the medical spa industry.

Many physicians who invested in the technology believe it saved their practices from succumbing to the downfall of the economy. Soon after the approval, an array of new lipolysis technologies began to develop over time. Wavelengths were altered to find the optimal "melting point", ultrasound technology was applied, high-powered water jets were developed - all in the name of technological advancement. At that time I wondered, "What the industry could possibly develop to top this?".

It wasn't long until I received my answer! Enter, the Natural Breast Augmentation procedure utilizing fat transfer under local anesthesia! Hard to believe this procedure wasn't perfected sooner! Take the fat from one body area and put it in another - perfect! Up until this point, there was a lot of controversy regarding fat transfer. In fact, for 20 years it was denounced by U.S. plastic surgery societies as being a "dangerous" procedure. Unfortunately, this declaration was based on the technology and techniques utilized over 20 years ago. Heck, even our laptops are obsolete after 3 years!

Dr. Todd K. Malan of the Innovative Cosmetic Surgery Center in Scottsdale, AZ developed new techniques which resulted in the lifting of this "ban" in March of 2009. Many dispute the success rate for the survival of the fat after the transfer. However, with the latest technological advancements in fat harvesting, adipocyte survival rates have proven to be 85% to 90%. With the addition of adult stem cells to enhance the fat transfer and breast splinting technology, adipocyte survival rates have shown to be even higher. In fact, Dr. Malan states that when the fat transfer is concentrated with adult stem cells harvested from the patient's own fat, and is injected into the fat that is already within the breast, the result can equal a permanent increase of 250cc to 500cc in overall breast size equating to a 1 to 2 cup size increase.

Of course there are many facets to this procedure not covered in this post. I just applaud innovative technology when I see it for my own eyes. So much so, that Young medical spa (our medspa) is now performing this procedure after being trained by Dr. Malan himself and others like Dr. Jeffrey Caruth of Plano Aesthetics in Plano, TX. Technology is wonderful, isn't it?

I wonder what the industry could possibly develop to top this?

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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