Get the 411 to a Fabulous New You!
Question 1: How Does Liposuction Differ from a “Tummy Tuck” (Abdominoplasty)?
In liposuction, small openings in the abdomen are used for access to suction and remove fat from the abdomen and this may extend to the flank area. This is best for removal of isolated areas of fat deposition, and this will often result in a contouring of the abdomen and waist. In our youthful years, the abdominal skin is better at regaining the shape and integrity. The elasticity of the skin often has better contraction and will regain the original shape and appearance. As we mature, the skin may not regain shape and integrity like it did in our youth. This is an aspect to consider about liposuction, as it may result in excess skin after the liposuction or some redundancy in the skin.
A “tummy tuck” (abdominoplasty) is often used to tighten the abdominal wall muscles and remove the excess skin of the abdomen. Most often this is done with an incision along the lower bikini area and it may include an incision around the umbilicus. The “tummy tuck” often is combined with some liposuction to achieve a more balanced appearance. Most commonly this is in someone with previous pregnancy and excess skin in the lower abdomen after delivery and in patients after losing a significant amount of weight and the skin does not contract with the weight loss. Each has a place in reshaping and recontouring; and a discussion with your surgeon may help to determine what is best for you.
Question 2: What is the Difference Between Silicone and Saline Breast Implants? How Do I Know Which is Best for Me?
Breast implants have two different substances used for filling, one is silicone – a substance used for many items around and in the human body. It is used because of its low reactivity with the human body and is tolerated well. It is used in syringes for diabetics and orthopedic implants for joints among other things. It has been used for years with a long track record of safety. The breast implants have been studied extensively and are currently approved by the FDA for cosmetic and reconstructive purposes.
Saline implants are breast implants with a silicone shell like the silicone implants, but the filler is saline, a dilute saltwater mixture. One difference is the way the implant feels due to the implant filling. The saline has a more water-like feel and the silicone has a thicker consistency due to the silicone and a little more tissue-like in feel. If there is a break in the shell of the implant, the saline will be absorbed by the body whereas the silicone will remain in place. Most of the implants used today have a thick viscosity and the silicone is a gel which will remain in the capsule around the implant. In both cases, the implant can be removed and replaced.
Which implant is best for nay one patient is dependent on many factors. Both types of implants come in a variety of shapes and sizes. This decision is best determined after a full exam and discussion with your surgeon on your goals, with the development of a customized plan.
Question 3: When Do I Need Breast Implants and When Do I Need a Lift, and Sometimes Do I Need Both?
This is a very interesting and complex question with the answer varying from person to person depending on the body shape, breast shape, and skin type. Generally speaking, breast implants are used to enhance the appearance of the breast with enlargement and increase in volume. Ideally, this is a breast with mild to no excess skin and no sagging of the breast. In this situation the implant can result in good breast appearance and position of the nipple areola. All of our current knowledge indicates no contraindications for breastfeeding after breast implants is desired.
Often in the postpartum breast, there is an excess of skin after loss of volume at the completion of lactation. This may be accompanied by some sagging of this excess skin and change in the position of the nipple areola. If the volume of breast tissue present is satisfactory, a “lift” (mastopexy) may be all that is necessary to remove the excess skin and reshape the breast. This involves scars around the areola and a vertical component extending to the lower breast crease. Often a transverse aspect of this scar along the breast crease is necessary to achieve the shape desired.
The next area to address is the patient who desires an increase in volume and has an excess of skin present. This will require an implant and a “lift.” This is a procedure which can be done as two separate procedures or as one procedure; however even when done as one, a second procedure may be necessary to achieve a good result. Each situation requires a full exam and discussion of your goals and discussion with the surgeon about weather these can realistically be achieved and what the risks are.
Question 4: I Have Very Large Breasts and Have Been Told to Have a Breast Reduction. When Should I Consider This Option?
The most common reasons for a having a breast reduction are back pain, neck pain, and breakdown of the skin under the breast – which may include chronic yeast infections. This is one of the most common procedures performed by plastic surgeons, and can be a radical change in the day-to-day life of a person. Many times, every day when coming home, the patient will have pain in the back and neck, which impairs the patient from many of the usual activities of daily living due to pain. It can affect the ability to exercise and perform some jobs. In a reduction, tissue is removed and the breast is reshaped after removal. The breast has scars around the areola the a vertical scar down to the breast crease and a transverse scar in the breast in most cases. In most cases, over a pound of tissue is removed from each breast. This may or may not be covered by insurance. It may impair the ability to breastfeed and sensation in the nipple areola may be lost. Most patients feel this risk is well worth it to resume many activities they were unable to enjoy and are very satisfied.
Question 5: What Credentials Should I Look for When Finding a Qualified Plastic Surgeon?
A qualified plastic surgeon will have had training in an approved plastic surgery graduate medical program – which leads to certification by the American Board of Plastic Surgery. This is a rigorous training of at least six years after medical school. Other qualifications to look for include membership in the American Society of Plastic Surgery and/or American Society of Aesthetic Plastic Surgery. These all indicate a level of training to deal with the complexities of plastic surgery. In addition, a consultation with the surgeon and discussion about their approach to surgery in your case may demonstrate an approach with which you are comfortable. Ask to see pictures of previous patients with a similar surgery as you plan to have. It is important for you to be able to discuss with your surgeon your desires if you are to achieve a good outcome. A relationship of trust and communication will be in your best interest.