Dr. Linder's Blog
Monthly Archives: November 2014
Introducing Our New Website www.ImplantRemoval.net
I am very excited to announce the launch of our new website, www.ImplantRemoval.
My goal of this new site was to address why women may consider implant removal and explain the two surgical approaches available: implant removal with lift and implant removal without lift.
Patients often present for nipple reduction. This is a procedure where the patients present with nipple hypertrophy. Symptoms of nipple hypertrophy can include pain, excoriation, rash, embarrassment, psychological and self-esteem issues. It can also be difficult to wear clothing due to enlargement of the nipple with exposure. Excoriation, rashes and irritation of enlarged nipples also have been seen in our patients.
The operation is a procedure usually performed in combination with breast augmentation or breast lifting in which I perform a superior pedicle flap. Resection of the inferior half of the nipple is performed down to the base with a 15-blade. Subsequently, the superior pedicle is inferiorly rotated, fits down with simple 5-0 Prolene sutures. The 3 and 9 o’clock position of redundant skin is then trimmed carefully and those edges are sutured as well. Stitches usually remain in for approximately 14 days. Scarring is minimal to none in that the scars feel extraordinarily well. I have never experienced a hypertrophic keloid or widespread scar of the superior pedicle nipple reduction. The key to nipple reduction surgery is proportionality of the nipple to the areolar size.
Notice in the preoperative photographs this patient has an extremely large nipple in proportion to the areola. It is approximately 65% in diameter to that of the areola. Her postoperative view shows this has been reduced to approximately 45%. The vertical height and the base have also been reduced, allowing for more proportionality with the actual implant as well as the areola.
The following patient is 18 years of age, who presented with her mother for severe tubular breast deformity. Components include decreased distance from the inferior areolar of the inframammary fold, hypoplastic lower breast, poorly defined inframammary fold and obvious herniation of breast tissue into the nipple areolar complex. She is an excellent candidate for a breast augmentation procedure using high profile implants in the dual plane technique. She wanted a very natural and simple result and therefore we took her from a 32A to a small C. A 280 cc high profile implant was filled to 315 cc. Using the dual plane technique, radial striation of the lower portion of the breast was accomplished of the pectoral major fascia and lower breast tissue in order to round out the breast. On both frontal and oblique views, it shows that the implant has been positioned precisely with good symmetry, good cleavage and symmetry of the inframammary fold.
Tubular breast reconstruction requires an approach that is safe and predictable. I believe the periareolar approach is easy in order to maintain the inframammary fold and release the lower pole of the breast in order to round out the breast, which is something lacking in tubular breast patients.
This patient presents from Korea with severe scar tissue contracture with ruptured silicone implants causing constriction and malposition of the right nipple areolar complex. She has complete loss of medial cleavage. See her preoperative photographs showing severe encapsulation and painful breast deformity.
The patient underwent bilateral open periprosthetic capsulectomy, circumferential open capsulotomy,removal of all ruptured silicone implant material and calcified granulomas through the inframammary approach. Notably, the scar tissue is completely exenterated and a 9-month postoperative photograph shows softening of her breast with the nipple areolar complex now in a more natural position and lowered appropriately. Her cleavage is excellent. There is softness to the breast with reconstruction with 320 cc silicone gel high profile implants. The patient is an excellent example of repositioning of the nipple without a breast lift by simply maintaining the implant in a normal position in a pocket with correct open capsulectomies and capsulotomies. A high profile silicone was excellent. The patient is happy with the results. Her cleavage is exceptional and she has had no recurrent scar tissue formation.
EXPLANTATION IS A CONSIDERATION
Here in my Beverly Hills plastic surgery practice I see patient everyday who choose to enhance their breast for a variety of personal reasons; likewise, there are women who decide to remove their breast implants. Over the years women have explained why they have been considering this option and I thought I would share there thoughts.
If you wish to have your implants removed rather than undergo breast implant revision, feel free to give us a call so we can review your options. (310) 275-4513)
Wants to Feel Healthier
Uncomfortable and Heavy
Breasts Begin to Sag
Stay Implant Free
Much Too Large
Feel Normal Again
It’s Just Time.
Never Looked or Felt Right
Finally Want to be Myself
Looking so Unnatural.
No Longer Needed for Appearance in Clothing
Implants Have Become Deformed