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Monthly Archives: February 2017

High-Profile Saline Breast Augmentation

The patient to the right is a 24-year-old female who was looking to have a primary breast augmentation. During her consultation, she explained that her desire was to increase the fullness and size of her breasts. After listening to her goals, primary breast augmentation before and afterwe agreed to use Allergan’s 350 cc high-profile saline breast implants. These implants give an increase anterior/posterior projection and have reduced lateral width or diameter.

During her breast augmentation surgery, we took the 350 cc implants and overfilled them to 370 cc to achieve the right fullness and size.

The postop photo is six weeks out, and she is happy with the size and AP projection.

To schedule your consultation with Dr. Linder or learn more about primary breast augmentation, call our office at 310-275-4513 or fill out our online contact form today.

 

 

 

 

 

 

TOTAL MOMMY MAKEOVER UNDER 35

Patients present to my office weekly requiring total mommy makeovers at a much earlier age. This is associated with pregnancy and history of breastfeeding. The case below is a patient who is only 25 years old, who presents with bilateral breast dysphoria, involutional upper pole atrophy, and loss of upper fullness of her breast. She is an excellent candidate for augmentation mammoplasty procedure using a high profile saline implant under the muscle in the dual plane technique in order to obtain upper pole fullness. Her lower abdominal area shows skin laxity with some lipodystrophy at the muffin-top regions.

The patient underwent bilateral augmentation using high profile saline 425 cc Natrelle Allergan implants through the periareolar approach, dual plane and a full abdominoplasty through a tightening of the rectus sheath and liposuctioning of the hips. The frontal view shows slight asymmetry with the right breast slightly smaller than the left and 10 cc more volume was added. It also shows rectus diastasis in the lower abdominal area with the muscles pulled out and a pouching of the lower abdominal region. The side view shows the skin laxity of the abdomen and nicely shows complete flattening of the upper pole of her breast. Her postoperative oblique view shows excellent upper pole fullness with tapering of the implant along the lateral inframammary fold. Her oblique view of the tummy tuck shows nice softening of the hips, well-healed scars around the lower abdominal area and the umbilicus and makes tightening of the rectus sheath in the midline.

Patients under 35, including this 25-year-old, do well with high profile saline implants to enhance the upper pole loss of fullness due to involutional atrophy associated with breastfeeding at a young age and full tummy tucks are excellent procedures for patients who no longer desire to have children in the future.

MOMMY MAKEOVER

SRX Silicone Gel Breast Augmentation

SRX, Full Profile Highly Cohesive Silicone Implant

SRX, Full Profile Highly Cohesive Silicone Implant

The patient below is a  35-year old female requesting a primary breast augmentation.  As you can see by the preop photo, both breast are small and nicely balanced. The patient was hoping to increase her size and fullness overall. After listening to her expectations, we selected to go with 225 cc Natrelle Inspira SRX breast implants. These SRX implants are silicone gel with a smooth shell surface and provides a nice fullest.

The postop photo is 12 weeks out, and she is happy with her upper pole fullness.

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

 

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SEVERE BREAST DEFORMITY

This patient presents from Missouri, having had three operations for her breast enhancement. She has consistently had problems, including right breast double-bubble breast deformity with superior retropositioning of the implant and skin laxity of the lower pole. Also, there is severe bottoming out of the left breast where the implant is placed too low. She underwent a vertical mastopexy; however, the skin inframammary fold was never addressed and the skin laxity remains. She now presents for her first surgery with us in order to have this reconstructed.

In her preoperative photograph, it is evident that the upper pole of the right breast is quite full. There is also skin laxity on the right nipple and is significantly lower than the left side. On the left breast the implant is positioned quite low and there is increased skin laxity along the inframammary fold. The operation included both scar tissue removed, an open capsulectomy of the right breast, as well as an inferior open capsulotomy, releasing the implant bringing it down, as well as repositioning of the nipple areolar complex by doing a complete lift, that is, a formal mastopexy using the inverted-T or the Wise-pattern technique.

breast deformity

 

Specimen of the capsule removed is shown. The formal mastopexy was performed on the right and on the left a vertical T mastopexy with the specimens now showing skin removed (specimen #2) with 6 cm of skin removed from the inframammary fold reducing her bottoming out from 13 cm down to 7 cm. The implants were also replaced to regain symmetry with slightly different implants. High profile saline implants, 320 cc filled to 330 cc on the right, and 350 cc filled to 380 cc on the left, allowed volume symmetry.

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Her postoperative Day 1 photographs are shown. With the bra open, note the upper pole fullness is even. The nipple positions are also the same level and that there is no longer bottoming out of the left breast. With the Linder Bra in place notice the cleavage is enhanced, there is great upper pole fullness with symmetry and the breasts are even. This is the case of a very difficult breast reconstruction where the patient actually presented with two problems, a double-bubble deformity (implant too high) and bottoming out (implant too low). By performing the correct surgery, i.e., a formal mastopexy rather than a vertical lift, it was quite easy to regain symmetry, narrow the breast with high profile saline implants and have upper pole fullness with symmetry as well.

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This is Everything: Gigi Gorgeous

Gigi Lazzarato better know as Gigi Gorgeous a model, actress and Internet personality has appeared on a number of television shows including Access Hollywood, Good Work and Project Runway is now starring as herself in the current documentary This is Everything: Gigi Gorgeous.

This is Everything: Gigi Gorgeous portrays the intimate journey of Gigi Lazzarato, a fearless young woman who began life as Gregory Lazzarato, posting beauty and fashion videos to YouTube from his bedroom, only to later come out as a transgender female to an audience of millions. Directed by two-time Oscar® award winner Barbara Kopple.

I had the privilege to be a small part of Gigi’s journey and included in this documentary. On February 3, 2017 Alexis (my daughter) and I attend the Hollywood World Wide premier for “This is Everything” and had the chance to congratulate Gigi at the event.

Gigi / Dr. Linder / Alexis

Gigi / Dr. Linder / Alexis

Capsular Contracture With Sling, Breast Revision

The patient to the left came into my Beverly Hills office looking to correct a previous augmentation. During her examination, it was apparent that she had capsular contracture (hardening of the breast) due to scar tissue around the implants. After listening to her goals, we scheduled a breast revision surgery.

Treatment of capsular contracture involves multiple steps to decrease the chance of recurrence. First, I remove the current implants and then perform a complete capsulectomy (removal of all the scar tissue). I then put a dermal mesh sling around the right implant to help prevent the risk of scarring again. I replaced the old implants with  560 cc SRX extra-full profile silicone implants, which have a smooth shell surface and will provide the patient with a fuller, rounder look.

The post-op photo to the right is now four weeks out. As you can see, her breasts are balanced (symmetrical), and she has a nice fullness.

For more information regarding breast revision surgery or a consultation with Dr. Linder, give us a call at (310) 275-4513 or feel free to contact us via email.

 

 

 

 

 

 

 

 

 

 

BREAST ASYMMETRY + TUBULAR BREAST CORRECTION

A young lady presented with severe tubular breast deformity with grade 2 ptosis of the left breast and severe breast asymmetry. The patient declined to have any scarring with breast lifts performed. In any case, the patient underwent augmentation mammoplasty with saline high profile smooth implants, 330 cc filled to 400 on the right, 330 cc filled to 380 cc on the left using the dual plane technique, periareolar approach and radial striation of the lower pole of the right breast. Her “before and after” photographs are shown for reference.

MaryanneFront

Interestingly, the left breast pocket was made very conservative, especially lateral to the areolar border, which allowed the implant to sufficiently tighten up the left breast skin without the necessity of a breast lift. Her cleavage is actually quite good as well. The most important part of this operation was releasing the right breast lower pole inferiorly in order to reduce the tubular shape of the breast (this can be seen nicely on the oblique view), also limiting the pocket dissection on the side of the breast and using high profile saline implants in the dual plane technique, two-thirds under, one-third over. This is an interesting case. Once again, the successful surgery on a patient presenting with tubular breast deformity, sagginess or grade 2 ptosis of the left breast and asymmetry without the use of breast lift scarring.

3 Months Post-Op Using Natrelle INSPIRA® SCX Implants

Three months ago, I evaluated a woman who was looking to have a breast augmentation. She had a condition called pectus excavatum, which is an abnormal formation in the chest or breast that gives it a caved-in appearance. During her primary augmentation, we used the Natrelle INSPIRA® SCX extra-full profile, highly cohesive silicone breast implants. These implants combine the benefits of the traditional gummy bear implants with an extra-high profile and upper pole fullness.

The patient below is now three months post-op, and, as you can see, she has a nice profile and fullness.

To schedule your consultation with Dr. Linder and learn more about breast augmentation surgery and breast implant options, call our office at 310-275-4513 or fill out our online contact form today.

 

PECTUS EXCAVATUM BREAST AUGMENTATION

Primary Augmentation 3 Month Post-Op

 

 

NY Times Article “After Mastectomies”

Nytimes article "After Mastectomies"A few days ago on January 29, 2017, New York Times posted an article by Roni Caryn Rabin titled After Mastectomies, an Unexpected Blow: Numb New Breasts. The article presents a few patients’ stories about having mastectomies and the subsequent loss of sensations in their breasts. As the article states, “While doctors agree on the need for a mastectomy procedure that spares nerves, they note that the goal of the surgery is to make sure the cancer is gone.”

As a board-certified plastic surgeon, I believe it is important to share these types of articles so patients can be better informed as they look toward breast reconstructive options.

To schedule your consultation with Dr. Linder or to learn more about breast reconstruction surgery, call our office at 310-275-4513 or fill out our online contact form today.

 

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