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Dr. Linder's Blog


Monthly Archives: September 2013

BioCorneum Ultimate Surgical Scar Treatment

We have included bioCorneum in the Back-to-Work Makeover as it is the ultimate scar treatment for patients worldwide.  I have used bioCorneum for several years, even in its prior form of Kelo-cote, a similar product with silicone liquid, but now bioCorneum has added SPF30.  Our co-surgeon on the Back-to-Work Makeover Project with Entertainment Tonight, Dr. Kristi Funk of the Pink Lotus Breast Center has used bioCorneum in the majority of her breast cancer reconstructive mastectomy patients, including Angelina Jolie.  I am proud to be an advocate and to be found on both the Kelo-cote and bioCorneum websites.  These websites are now linked to the Back-to-Work Makeover, which will be featured on Entertainment Tonight in the near future.

The bioCorneum product is a silicone fluid liquid with an SPF30 sun block.  The bioCorneum works over several months to greatly reduce scarring and also reducing the effects of keloid formation as well as hypertrophic scarring.  There is a significant measure of improvement in the scar appearance over time.  On the bioCorneum website, you can mark your scar, determine the redness pigmentation and elevations scores that will help track the healing.

Once again, we are thankful and pleased to be advocates of the use of bioCorneum, as it is now a significant component of the Back-to-Work Makeover Project.

65th Annual Prime Time Emmys

Yesterday, my wife, Crystal, and I had the opportunity to attend the 65th Annual Emmy Awards.  We first walked the Red Carpet which allowed me to firsthand examine, as a plastic surgeon of sculpting women’s bodies, the type of dresses that give women the most flattering figures.  The dresses in general were shorter and showed greater tapering along the upper chest area.  Many of the women wore lace and colors were definitely “on the in” on the Red Carpet.  Sofia Vegara wore Vera Wang with a form-fitting top, tapered, hip-hugging with a long trail.  Cat Deeley wore a black Romani gown that was tapered along the lateral breast to slim down her upper body appearance.  Heidi Klum wore a skin tight Versace with a long trail, showing upper shoulder and chest area.  Kerry Washington wore Marchesa, a creation in white which accented her bust line down to the hips.  Carrie Underwood, who performed an amazing Beatles tribute, looked elegant wearing purple color side-swept with a shoulder back trail.  This was a very form-fitting dress which proportioned her body and matched her beautifully.

As we had the opportunity to walk the Red Carpet, my wife and I greatly enjoyed seeing Michael J. Fox.  Michael looks fantastic. IMG_9435 I think we both had the same clothier.  I wore Ralph Lauren with a similar black long tie.  Check out Michael J. Fox’s new show this fall on NBC.

It was a pleasure seeing Michael Douglas as he won his next Best Actor Emmy last night.  Matt LeBlanc was fantastic at the Governor’s Ball, wearing all black, a black shirt on black tie.  It was great seeing Jimmy Kimmel and his cousin Sal, who always hilarious and a pleasure.

Then there is my wife and me on the Red Carpet.  Crystal wore a long white and black Lela Rose dress with a long trail.  The upper shoulders of the dress accented her upper arms and lateral chest beautifully.

It was great seeing Nancy O’Dell at the Entertainment Tonight booth on the Red Carpet; she looked elegant as always in long green attire.

Neil Patrick Harris did a wonderful job this year both in announcement, choreography, dancing and comedy.  He is a truly gifted actor and dancer and would do a wonderful in the future re-hosting the Emmy Awards if given the chance.


Biocel Silicone Textured Silimed Ruptured Implant

Patient presents recently with a 25-year-old ruptured Silimed silicone implant notable on MRI is extravasation of both intra and extracapsular rupture.  Patient presents clinically with painful breast deformity, Baker IV capsular contracture, double-bubble breast deformity with ruptured silicone mastitis.

The video shows the patient’s implant being removed with the silicone material as loose globular amounts of small droplets of silicone rather than a smooth viscous silicone liquid.  These implants are 25 years old and are no longer available in America.  The Silimed Biocel textured implants in my experience have a high rupture rate.  Notice the textured coating of the silicone shell with the calcifications and white plaque shown throughout the shell.  Notice half of the implant has lost its integrity and that the free silicone is identifiable throughout the breast.  Patients who present with ruptured Biocel silicone textured implants should have them removed.  Notice open capsulectomy silicone material exenteration is required and reconstruction with either silicone or saline implants can be performed.  These Allied Biocel Silimed textured implants are rare and I only see these a few times a year in my busy revision reconstructive practice due to its rarity.


Multiple Breast Deformities Requiring Revision Reconstruction

The patient’s preop photo shows a patient with multiple problems associated with her breast augmentation procedure.  On the right it is notable that she has a double-bubble breast deformity with a severe Baker IV capsular contracture.  Notice the implant is raised superiorly and the skin is over-laying inferiorly.  This will require an open capsulectomy, removal and replacement with a high profile saline implant, inferior open capsulotomy and at this time an areolar Benelli lift reduction was performed as the patient was quite adverse to the inferior pedicle scar of the inverted T.  The left shows a ruptured saline implant which required obviously explantation of the saline implant with a complete open capsulectomy due to complete constriction of the pocket and entrapment.

Subsequently, high profile salines were replaced bilaterally and an areolar reduction periareolar lift was performed on the left as well.  Final results will be available in six weeks in a further blog.  This is an excellent example on how patients can develop multiple problems from previous breast augmentation surgery and in this case double-bubble Baker IV capsular contracture and ruptured saline implants all included.

Tubular Breast Deformity, Severe

The patient presents with severe tubular breast deformity.  Notice her preoperative photographs showing conical appearance to the breast, poorly defined inframammary folds, flattening to the bottom of her breast (left greater than right) and pseudo-herniation of the nipple areolar complex.  The patient is an exceptionally good candidate for tubular breast augmentation/reconstruction with high profile saline implants placed in the dual plane technique with radial striation of the lower poles of her breast.

The second photograph shows the markings that have been placed with 490 cc of high profile saline on the right and 505 cc on the left to regain symmetry.  She had partial resection of the retroareolar tissue with dual plane augmentation mammoplasty procedure as well as formal radial striation of the breast without any form of breast lift.  Her postoperative photograph shows a one-year postoperative result.  She has good symmetry, softening of the breast, excellent cleavage, inframammary folds are quite even and the nipple areolar complexes are quite symmetric.  Patient is extremely happy with the results of her tubular breast reconstruction.

Patients present to my practice with tubular breasts weekly.  I enjoy fixing this difficult problem, as only Board Certified Plastic and Reconstructive Surgeons specializing in breast augmentation and revisions should.