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Monthly Archives: February 2011

Extra High Profile Breast Implants

STYLE 45 Silicone Implants
45 implants photoExtra high profile text style 45 Allergan silicone implants. The extra high profile, Style 45 Allergen silicone implants are the fullest and roundest implants available on the market today. These implants are quite narrow based, but have the greatest AP projection for a silicone implant. These implants may reduce visibility and rippling in patients who have thin walls or minimal amounts of breast tissue. Ectomorphic women with minimal amounts of breast tissue have increased visibility and rippling, especially along the medial breast as well as the outer lateral breast.

 The extra high profile gel implants are very round implants. They are narrow based and they are not for everyone. They are, however, useful for women who desire increased fullness on the upper pole of the breast as well as increased projection and the narrowest base. The extra high profile silicone implants give a much more tapered appearance, have less visibility and rippling and greatly enhance upper pole fullness and AP projection.

International Plastic Surgery

Having the opportunity to reconstruct and revise patients internationally is both a privilege and a humbling experience !

Dear Dr. Linder,

Further to my very recent breast revision surgery carried out by yourself, I would very much like to express my greatest satisfaction and gratification, on the excellent works carried out to convert the horrendous work from another surgeon on two previous occasions, into the perfect pair of breasts, which is all that I have ever wanted. Previously I had been told that my breasts were as good as they were ever going to get, due to my bodies way of healing after surgery, and now after seeing what you have been able to do to them I simply can’t put into words how happy and emotional I feel with the results from your operation. You and your team Adriana and Beverly the nurse who held my hand as I became very emotional before going into theatre, have been excellent, professional, courteous and very informative, you all have made our stay here in Los Angeles a credit to the state.

I can only hope that no one has ever to go through the journey that I have endured only to find the most skilled surgeon on the third attempt, I would have no doubt in recommending your surgery for any form of plastic surgery on future occasions, I simply cannot express my satisfaction enough to you for the perfect finish, you really are a MIRACLE worker!!

Yours Ever So Gratefully,

C.R.
England

Muffin Bottom Procedure With Liposuction

Recently I performed the muffin bottom procedure for national television. It included tumescent liposuction of three zones 1-infragluteal folds 2-lateral saddlebags 3-posterior medial thighs!
Over 1.6 liters of fat was removed with small fine tip cannulaes ! Notice the sharp buttock crease afterwards and and smoothing out of the thighs.

Pre-op and Post-op 1_edited-1

 

 

 

 

 

 

Pre-op and Post-op 2_edited-1

High Profile Breast Implants

High profile saline and silicone implants are used weekly in Dr. Linder’s practice. The favorable advantages of the high profile Allergan and Mentor saline and silicone implants include:

  1. The base diameter is more narrow, thereby patients have a sleek, thinner, tapered appearance than the moderate plus or moderate profile saline implant or silicone implants
  2. These implants are fuller and rounder, especially with the saline, which may lead to less visibility and rippling, especially along the medial breast cleavage area
  3. Patients can have larger breast implants placed without looking matronly and wide along the sides.

The example below shows a patient with a high profile saline implant placed using the dual plane technique. The dual plane technique includes placing the implant under the subpectoral muscle two-thirds medially and in a subglandular retromammary plane along the lateral one-third to one-quarter portion of the pocket. This is the universal approach and is a safe approach which allows for good tissue coverage along the inner medial portion of the breast, reducing visibility and rippling. Also, the muscle allows an effacement or smoothing of the upper pole of the implant preventing that rounded out appearance which is not favorable with most patients.

High Profile Breast Implants

High profile implants have a significantly narrowed base diameter in comparison with moderate profile implants of the past and this will allow for a more beautiful tapered and thinner appearance to the upper chest wall compared to the old moderate profile implants of the past. In comparison, for an example, the style 68 low profile 350 cc Natrelle implant as a base diameter of 13.3 cm with a 350 cc high profile style 68 Natrelle implant as a base diameter of 11.6 cm. Though these are the same volume, the volume distribution is more of an increased AP projection and decrease in lateral width.

- See more at: http://www.drlinder.com/psarticles-high-profile-implants.html#sthash.9HMq1OnT.dpuf

Changing Treatments For Early Stage Breast Cancer

Recently in the Journal of American Medical Association (JAMMA), new studies indicate that approximately 20% of breast cancer patients who have either one or only two lymph node involvement or Sentinel nodes in the axilla may do well without a total lymph node resection or removal.  Removing all of those lymph nodes does have increased risk in patients, including severe lymphedema, swelling of the arm as well as nerve sensitivity, loss and numbness.  Most importantly, studies have indicated that the women who have not undergone lymphadenectomy, but rather lumpectomy with the single or two nodes removal, radiation therapy and possible chemotherapy, have actually done as well with recurrence being similar to those who have had total lymph node removal.  The paper was based out of Sloan-Kettering Cancer Center, which has now changed its own guidelines based on this study to reduce the side-effects of total lymphadenectomies associated with severe lymphedema on patients with early stage tumors with only one or two lymph nodes in the armpit.  Further research needs to be done and larger numbers of women need to be researched and reviewed as to the recurrence rate when only two versus total lymphadenectomies are performed on women with early stage breast tumors or cancers.

Beverly Hills Lipo Sculpture

Liposuctioning is a surgical procedure that should be done by experienced and qualified Board Certified Plastic Surgeons.  Liposuctioning requires skill and talent.  Understanding the different tissue planes of the abdomen, thighs, chest area and facial region is essential in order to perform accurate, precise and safe liposuctioning.  I perform tumescent liposuctioning weekly in our Beverly Hills Surgery Center.  Tumescent liposculpture includes infiltration of tumescent fluid with three components.  The first component is the wetting solution known as sodium chloride or lactated Ringer’s solution.  This solution will hydrate the fat cells and allow the fat to be suctioned in a confluent, smooth manner.  The second component is epinephrine.  The epinephrine causes vasoconstriction, reducing bruising and bleeding, as well as decreasing total blood loss.  The last component is Lidocaine.  This is a numbing agent.  It is a local anesthetic that allows for up to 24 hours of pain relief in the specific area that is being lipo sculptured.  We perform our liposuction surgeries under general anesthesia with Board Certified Anesthesiologists.  This allows for complete control of the patients so they do not move on the operating table which could cause inadvertent cannula perforation of intraabdominal viscus or other important vital structures of the extremities.  No more than five liters of fat should be removed at one time in order to prevent undue blood loss which may require a blood transfusion.  In my practice, we usually stop at 3 liters of total fat removal at one operative setting.  Staged surgeries can be performed if necessary.  Three months minimum should be required before staging. 

Finally, compressive garments are absolutely essential in postoperative liposuction management in order to allow for reduction of swelling, edema and allow confluence and smoothing of the tissue, especially the abdomen as well as the thighs.  In other words, girdles and abdominal binders can be combined, as well as the Dr. Linder Band which can now be worn for six to eight weeks post-surgical for abdominal lipo sculpture.

DR. LINDERBRA™ Now Available Worldwide

Linder BraInitial shipment of the Dr. LinderBra™  has arrived here in the mainland.  It is now available for distribution allocation worldwide.  The Dr. LinderBra™ comes in three colors, black with hot pink inner lining, tan or nude and snow white.  The unique features of the Dr. LinderBra™ include the patent-pending triple clip adjustable side straps which allows up to two inches or adjust ability during pregnancy, swelling, post-surgery or during a woman’s time of the month.  It also has the strongest reinforced No. 3 zipper as well as a double clip and zip frontal mechanism to allow for easy placement.  The bi-directional stretch fabric of 95% cotton, 5% spandex, allows for compression, support and breath ability during strenuous workouts and training exercises.  It is also fabulous as a sleep and beauty bra to be worn at night to prevent gravitational descent, skin laxity and sagginess of the breast.

Commercials are also now seen and played throughout cable television, including Bravo, E, Woman Entertainment the Oprah Winfrey Network.

This is a bra that Dr. Linder devised after years of complaints by his patients being unable to find a tight compression sports bra, training bra or post-pregnancy bra that allows for all the features that the Dr. LinderBra™ has.

Severe Double-Bubble Breast Deformity with Combined Capsular Contracture, Baker IV

Below is an excellent case of a patient who has undergone bilateral breast reconstruction for breast cancer mastectomy.  The left implant had ruptured and the right implant shows a severe double-bubble breast deformity with superior retropositioning of the implant.  Her surgery was done by a different surgeon approximately 12 years ago.  She has had increasing scar tissue on both breasts leading to complete rupture of the left implant.  The right implant has taken on a very odd shape, deformed and shows a severe Baker IV capsular contracture.  Postoperative photograph shows bilateral open periprosthetic capsulectomy, circumferential open capsulotomy and removal and replacement with high profile saline implants.  After three and a half months, the patient’s implants have fallen to a reasonable level and she is very happy with the final appearance. linder

 

 

 

Scar tissue contracture is one of the most common complications we see postoperative on breast enhancement surgery.  Double-bubble deformities can occur when the implant rises superiorly and the skin over-drapes it.

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