In general one should never underfill a saline implant because there is a higher chance of having a deflation or rupture. However if you want the fake, round porn star look overfilling is the answer. Optimally should fill the implant for the designed volume so that it will get less scalping and no rippling and the breast implant is associated with less implant rupture.
The prevention of rippling is optimally discussed per-operatively:
1) What type of implant you need. Silicone gel filled breast implant is better than normal saline filled breast implant
2) The breast implants should be placed below the muscle. The optimal way to prevent rippling and minimize rippling, is to place the implant below the
muscle. The muscle acts like additional padding and more likely cover up any breast implant wrinkling. However there is no muscle coverage in the lower
outer quadrant of the breast. Fortunately bathing suits and bras cover this area.
3) Make sure there is adequate breast tissue. The more breast tissue you begin with the greater the the amount of padding to cover a breast implant.
4) If you choose a normal saline breast implant make sure not over or underinflate an implant. muscle. If you are using saline implants make sure you
maximally fill it and not overfill or underfill, as that can cause more scalping or rippling. If you underfill, it has a increased rate of deflation in saline breast
implants.
5) If you are using
silicone implants do not oversize. Sometimes the use of silicone implants may be better, especially in patients with no breast tissue as well as placement below the pectoralis major muscle. If you are using saline implants make sure you maximally fill it and not overfill or underfill, as that can cause more scalping or rippling. If muscle. If you are using saline implants make sure you maximally fill it and not overfill or underfill, as that can cause more scalping or rippling. If you underfill, it can cause more deflation in saline implants.
When there is radiographic evidence or an MRI the breast implant is ruptured, it should be replaced:
1) Because long-term the silicone may cause reactions within the breast tissue causing benign granulomas or small masses in the breast which can mimic breast malignant breast tumors that may be.
2) Leaking silicone implants especially “non gummy” may stimulate internal scar tissue referred to as a capsule. It is optimal to remove the implant with the capsule. If breast implant on top of the muscle I recommend replacing with a new gummy bear implant below the muscle. All implants are now guaranteed for life. Thus if no evidence of rupture there is no need considered for removal after 10-15 years (as previous recommended).
There is significant medical evidence demonstrating that breast implants have less chance for internal scarring (capsular contracture), look more natural and feel better if placed below the muscle. Most plastic surgeons feel that the breasts have a higher likelihood of staying softer longer when placed below the muscle. Likewise implants are separated from the milk producing glands, easier to examine the breasts and when mammograms are done the muscle is a natural separation plane between the muscle, the implant and breast tissue allowing the radiologist a better view of the breast tissue.
Nothing substitutes for a personal evaluation, a review of your medical history/medications and a face to face discussion of your options.
Unfortunately with out a exam of your tissues I can can only comment based solely your photos. However, hopefully you will find them helpful.
The timing of when to perform a mastopexy is entirely dependant on the patients needs, wants and desires. Having a breast augmentation does preclude a a future mastopexy.
Mastopexy following a breast augmentation is often done following:
1. massive weight loss
2. Pregnancy
3. Borderline pre augmentation need for a mastopexy
4. Large implant placement and normal resulting sag (ptosis)
I recommend that you schedule several consultative appointments with Plastic Surgeons who are experienced and Certified by the American Board of Plastic Surgery. In addition ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
Hello, Asumming gentle surgical techniques here are several intraoperative procedures to reduce postoperative pain.
LOCAL INJECTION OF MEDICATION:
1) Bupivcacaine
2) Exparel is along acting injectable Bupivacaine .
Price difference is significant.
Both can be injected locally.
NON NARCOTIC PAIN PUMP
A pain pump us a mechanical device where there is a external “pump” through which thin catheters are inserted into the surgical site. For the next several days the local anesthestic agent (usually Bupivacaine) is release at constant flow. The thin catheters need to be removed in 3-4 days .
CONTRASTING THE TWO:
Exparel
1)one time local injection
2) works only where injected
3)longer 1/2 life of Bupivacaine (effects last longer)
NON NARCOTIC PAIN PUMP
1) a external delivery system through small catheters
2) can diffuse throughout the surgical site: in breast augmentation or abdominoplasty the anesthestic (Marcaine) fluid can disperse throughout the entire surgical pocket and theoretically cover more area in contrast to direct injection of the Exaparel or Bupivacaine in certain ares thus is only effective where locally injected.
3) Some pumps have a “on demand” function where additional local anesthetic volume can be intermittently delivered (with a corresponding lock out period so as not overdose).
I personally perfer the pain pump for long term pain relief (3-4 days) and perform local injection of local anesthestic on almost every surgical case. I provide a pain pump to all my abdominaloplasty patients. The pain pump is optional for all other procedures.
I trust you have chosen a experienced Plastic Surgeon who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
