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Dr. Linder's Blog


Monthly Archives: December 2013



Happy Holidays and New Years from Dr. Linder and staff. Here’s to a Healthy and Beautiful 2014.

Saint Moritz, Switzerland

Saint Moritz, Switzerland


This case example is of a patient with a 42-year-old ruptured Heyer-Schulte silicone gel implant placed back in the late 1960s.  This is a 78-year-old White female who presents with severe capsulitis, mastitis, ruptured silicone implants and symptoms of possible rheumatoid arthritis.  She was referred by her rheumatologist for removal of her ruptured silicone implant, implant material with breast mastopexy lift, reconstruction and drainage.

 Intraoperative photo of the ruptured implant shows a posterior patch notable on a complete dissolved shell with loose, smooth silicone gelatinous material.  The Heyer-Schulte implants were the first United States manufactured saline implants back in 1968.  Heyer-Schulte implants initially manufactured the polyurethane silicone gel prosthesis with an internal Y-shape baffle called the Natural Y Prosthesis.  Heyer-Schulte later introduced multiple single lumen gel implants in the early 70s.  These implants notably had a thinner shell.  These implants were removed with complete dissolving of the majority of the shell with calcifications within the capsule and scar tissue formation throughout the breast.  The Heyer-Schulte implants have had data on shell thickness and gel characteristics that were not initially available by the company.  Dorne reported weights of average silicone gel molecular weight to be 83,500, significantly higher than the modern Silastic II silicone gels of 55,000 molecular weight.  It is very rare to find patients with Heyer-Schulte silicone implants.  These implants on most patients have been removed and replaced decades ago or the patients are now deceased.

These are the oldest silicone implants in my person practice of 16 years that I have had the chance to remove.  The patient is now postoperative three weeks and the implants have been removed with a full breast lift and drains removed.  Postoperative photos will be present in a following blog.

AskMD Launches App

As a a Member of Editorial Advisory Board for ShareCare I am excited to see the new app that AskMD launched that gets you from “what’s wrong?” to what you can do about it.

Today marks an important milestone for Sharecare as they announce the launch of AskMD, an iOS app that helps consumers collect information about their symptoms, learn more about common causes, and connect them to the doctors and specialists qualified to treat them. AskMD uses clinically-proven research to guide consumers through a personalized questionnaire that takes into account all their symptoms and other factors, like medications and known conditions, and matches their answers against the latest clinical research.

Below is the press release announcing AskMD:

ATLANTA, December 9, 2013 – Sharecare, the online health and wellness engagement platform founded by Dr. Mehmet Oz and Jeff Arnold, today launched AskMD, an app for iPhone and iPod touch to help you collect information about your symptoms, learn more about common causes, and connect you to the doctors and specialists qualified to treat them. This free, iOS-exclusive app helps you get organized around your health, enabling you to have a more productive doctor’s visit and ultimately get better.

“If we are going to transform our health care system from one that merely treats the sick to one that fosters comprehensive health and wellness, consumers need access to healthcare anytime, anywhere – and with AskMD, we wanted to find a way to put your doctor’s exam room right in the palm of your hand, on your mobile phone,” said Arnold, chairman and CEO of Sharecare. “While building the app, we focused as much on providing accurate clinical information as we did on creating a truly personalized experience to ensure people feel like AskMD was created just for them every time they use it – and iOS was best positioned for us to realize this critical element of our user experience.”

AskMD uses clinically-proven research to help you get from wondering what could be wrong to what you can do about it. By guiding you through a personalized questionnaire that takes into account all your symptoms and other factors, like medications and known conditions, and matching your answers against the latest clinical research, AskMD provides you with results that actually are relevant to you. AskMD’s clinical knowledge management system was developed through Sharecare’s acquisition of PKC Corporation, with the vision of bringing evidence-based medicine to patients and providers, and enabling clinically-informed communications.

“As a doctor, AskMD will make the time I spend with my patients more efficient because before they even walk into the exam room, the app collects and organizes important information I need to help them get better,” said Dr. Oz. “And as you use AskMD more regularly, you’ll start to notice patterns and gain insights into what triggers health issues for you – and that’s something that can benefit the entire health system.”

Beyond helping you find out what’s bothering you at the moment, AskMD has tools and information to help you understand more about your health day–to–day. From notes for a doctor’s appointment to locating a doctor covered by your insurance, from a list of all the prescriptions your mom is taking to a list of the doctors and specialists for your entire family, and animations showing the impact your blood pressure and cholesterol are having on your body, AskMD takes the guesswork out of getting better and being well.


Patient in her preoperative photograph shows severe weight loss leading so significant skin laxity of the breasts, abdomen and hips.  She lost approximately 120 pounds and underwent 10 months ago augmentation mammoplasty procedure using high profile saline implants over-filled; a formal mastopexy using the inferior pedicle Wise-pattern technique (breast lift anchor scar) and a full panniculectomy with muffin-top liposculpturing of the hips.  This patient is now 10 months postop.  Notice the positioning of the nipple areolar complex from preop to postop and that the size of the areolas which were approximately 10.5 cm preop now have remained constant at approximately 4.2 cm.  The positioning of the implants has settled nicely over the last 10 months and the symmetry of the breasts is excellent.

The abdominal area shows excellent tightening of the skin or lower abdominal area.  The scar can be notable just above the underwear line.  It is slightly pink and this will continue to improve over the next six months.  This patient has now been instructed to continue abdominal wall exercising, including crunches with the personal trainer.  The sides of the hips show nice softening and a great reduction in the lipodystrophy status post the muffin-top procedure.  This patient has undergone a total mommy makeover, which has included augmentation mammoplasty, formal breast lift as well as a full panniculectomy with liposuctioning and sculpting of the hips.  This holiday season is an excellent time to get your body back to its original pre-pregnancy or after massive weight loss status.

Board Certified Plastic and Reconstructive Surgeons have the capability to perform procedures to regain your body back to its excellent preoperative appearance which include breast implants, breast lifts and full tummy tucks.