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Dr. Linder's Blog


Monthly Archives: June 2015

Top Doctor Status

I received an email the other day from Realself.com letting me know that I had reached there Top Doctor Status. I have been contributing to there site by answering questions from there customers regarding plastic surgery. I enjoy doing this and I hope it helps future patients make good choices in  cosmetic surgery decisions.

Dr. Linder, “Congratulations! You have achieved RealSelf’s “TOP Doctor” status.  Less than 10% of the doctors on our site have this designation.  We really appreciate your valuable contribution to the community to help educate consumers.”

NOTE:  RealSelf Top Doctor (TOP) status is awarded to less than 10% of the RealSelf doctor community.  This status is earned by achieving high patient satisfaction (as reported in RealSelf reviews), getting favorable feedback on their expert answers, and after investing significant time in Q&A and other doctor activity.

High Or Moderate Plus Profile Implants

Profile Breast Implants

Both high profile and moderate plus profile implants come in silicone and saline. When it comes to anterior/posterior projection the high profile have a increased projection and the moderate plus profile have a mid range projection.

The majority of the implants used in our practice are high profile implants because they leave a more tapered appearance, have a less visibility and rippling, and more enhanced AP projection. However,  the moderate plus profile is especially useful for patients who are somewhat narrow along the thoracic cavity and for those who do want a slightly less upper pole fullness. Below are two examples of high profile and moderate plus profile before and after photos.

During a consultation it is important to express your expectations and then based on your shape options of what type of implant can be best determined.

For a consultation regarding breast augmentation surgery give us a call at (310) 275-4513 or feel free to contact us via email for more information.

Moderate Plus Profile

Moderate Plus Profile

High Profile Saline Implants

High Profile Saline Implants

Pigeon Chest Deformity

The preoperative photo to the left indicate the patient has Pectus Carinatum Deformity. Pectus Carinatum is a congenital anomaly of the sternum (anomaly congenitally is often referred to as a pigeon chest). 

I performed a breast augmentation to this 27 years old patient by placing subpectoral implants in the dual plane technique using 306cc moderate plus silicone gel implants. I encourage all patients to use a compression bra (Linder Bra)  for six weeks postoperative in order to maintain the medial breast pocket shape.

The patient has done extraordinarily well as you can see by the before and after photo below. 




Reasons for Breast Augmentation Revision

Reasons for Breast Augmentation Revision

Breast augmentation surgery involves the insertion of implants to enhance the size, shape, and projection of a woman’s breasts. This procedure generally leaves patients feeling beautiful, confident, and comfortable in their new bodies. However, complications or concerns may arise that need to be corrected by a secondary surgery.

Breast Size

Even with today’s technology, surgeons can only use there experience as to how an implant will look once it is placed. Sometimes, it is hard to vocalize what you wish your results to be. You can do your best and your surgeon can do his or her best to meet the image in your head. Since deciding implant size can be a gray area, some women find that their breasts aren’t the size they were hoping for after the procedure. In some cases, the implant chosen is too small and they are disappointed. In other cases, the implant is far too large and they feel disproportionate in a way different from before. In these cases, breast revision surgery may be needed to change implant size.

Capsular Contracture

When an implant is inserted into the breast, a tissue capsule forms around it. For unknown reasons this tissue can begin to shrink and squeeze the implant. The tighter the implant is compressed, the firmer it begins to feel. This complication is known as capsular contracture. There are four grades of capsular contracture:

  • Grade I: the breast looks and feels soft inside the natural tissue capsule.

  • Grade II: the breast looks normal but feels firm.

  • Grade III: the breast has become distorted by the contracture and feels firm.

  • Grade IV: the breast looks distorted, feels firm, and is painful.


Either an open capsulotomy or an open capsulectomy is performed to correct capsular contracture. During a capsulotomy the capsule is cut in order to release its hold on the implant. A capsulectomy involves completely removing the current capsule so the body can form a new one.



A Ruptured or Leaking Implant  

In a small percentage of patients, their implants rupture. When this occurs with a saline implant, the saltwater will harmlessly leak into the body and the implant will deflate. When a silicone implant ruptures, the gel leaks into the capsule that has formed around it. Ruptures to silicone implants are harder to detect. To correct a ruptured implant, the broken one is removed and a new implant is inserted. In cases involving silicone implants, the scar tissue is removed to ensure that all traces of the gel have been excised from the body.

Double Bubble Deformity

“Double bubble” refers to the image created when the breast tissue falls under the implant. This typically occurs when the implant settles high on the chest either because of implant placement or capsular contracture. The surrounding breast tissue then sags, creating the appearance of two bubbles. Double bubble doesn’t always occur right after the primary breast augmentation; it can form after the breasts begin to droop due to age or pregnancy. Correcting double bubble deformity may involve a breast lift or repositioning of the breast implant.

If you are interested in breast revision surgery, please call (310) 275-4513 or fill out our online contact form today. Dr. Stuart A. Linder is a breast surgery specialist and is ABPS Board Certified in Plastic Surgery. He looks forward to helping you attain the breasts and confidence you deserve.