The Biggest Issue in Breast Implants Part 3: Breast Implantation Issues

Judy in Trinidad

How is capsular contracture or hardening of the breast implants treated?

First, as mentioned in the past essay, we attempt to prevent this by encouraging the consumption of fish oil and Vitamin E. These home remedies are not clearly established to prevent capsules, but there is a lot of circumstantial evidence suggesting that they do.

Second, if you have a capsule, there are various remedies, and one of the things that has been thought to work is a medicine for lung disease called Accolate, or another related medicine called Singulair. These brand-name medicines are commonly used by lung doctors to improve lung functioning in certain kinds of asthmatic and other conditions. They have a very small statistical rate of some serious problem, so be sure to talk to your doctor about these before taking the medicines. In any case, they're expensive and they need to be taken for four to six months in order to be effective. The earlier you catch your capsule, in other words, the softer the breast is before starting the medicine, the better chance you have of correcting the problem with a medication.

We also increase the fish oil to a higher dose, although as stated before, this is not clearly known to be effective. We have seen interesting cases in which a person who stops taking their Vitamin E or fish oil and develops a capsule within a month, but of course, this doesn't prove anything for sure.

Surgery for capsular contracture is problematic, because the chances of the problem coming back are very, very high after most any surgery. The traditional approaches include removal of the capsule, which sometimes is difficult, especially under the muscle, and replacement of the implant in a different plane. This means that if the implant was above the muscle, you put it below the muscle; and if it was below the muscle, you put it above the muscle in the secondary operation. The chances of a return of the hardening of the breast after these surgeries is a disappointing nearly 50 percent.

Unfortunately, the Allergan study, which encompassed many, many thousands of women with breast implants and silicone gel implants, had a secondary operation rate of about one in three after seven years. This means that you must not view these things as a permanent solution to small breasts unless you're lucky.

Judy, my wife, has had her implants for about 15 years and has never had any problem except for a slight firming on one side, so she might be the exception rather than the rule.

Best of luck, and if you get breast implants, be sure you have a good surgeon who will be happy to follow you for any problems afterwards.

The Biggest Issue in Breast Implants: A 3-Part Series

Pasadena's Natural Beauty

 Part 1: By far the most important choice you will make in your pursuit of bigger breasts is whether to put the implant above or below the muscle. The muscle is a wildcard that produces many effects, not all of them good. Understanding all of these options and possibilities is very important. 

We recently took the Sports Illustrated swimwear, swimsuit model edition, and analyzed the problems with the women's breast implants. Many of the under-the-muscle placements had resulted in the implant being pushed out toward the side and down. The girls in the Sports Illustrated photographs were often holding their breasts toward the middle, and many times the implant had dropped or been forced down lower than it might naturally have done so by the muscle action. 

Under-the-muscle implants are supposed to produce a more natural curve in the upper part of the breast area, and perhaps they do for a while. However, eventually most "under the muscle" implants get pushed down so the muscle is no longer really covering them. 

Of course, it's possible and even likely that over-the-muscle implants droop also, unless they're protected by a good-quality bra most of the time. These implants, however, tend to sag straight down. 

Efforts to repair problems like these are relatively hazardous compared to the initial implant surgery. The medical journals are full of reports of nipple areolar area death and a higher infection rate and other problems due to attempts to improve breast implants. 

One particular article I show the patients who want surgery because their breasts have stretched out, and this article shows in living color nipple areolar complex or nipple areolar area skin death and loss of the nipple and areola. 

Even though breast implants have problems, they are still the most popular and the highest satisfaction cosmetic surgery we have. Women who improve their bustline often feel much more confident and are able to perform at a higher level in many ways. 

Am I A Surgical Candidate?

Dr. Yoho and friends in Argentina.

You are a surgical candidate if a number of things come together. First of all, you have to be psychologically ready for a surgery. Sometimes these things are stressful and sometimes they’re not, but you have to be willing to undergo the stresses of the possible complications for any of these given surgeries, however unlikely they are. Most cosmetic surgeries are comfortable and their post-operative recovery for most people is very modest, however. 

Second, you need to have good physical characteristics for the surgery that you desire. The doctor will help you understand just what kind of result you are likely to expect. For example, a woman with medium-sized breasts and a lot of breast tissue can get spectacular results with breast implants in most cases. A woman with long, skinny breasts sometimes needs reconstructive surgery and some of these surgeries come out better than others. Liposuction works very well for people with a lot of fat just under the skin surface, but doesn’t work at all for people with fat underneath the muscle wall. 

Of course, you need to be able to afford the procedure, and you need to be able to take the time off. If you are too busy to take the time off, many of the noninvasive procedures we do can, over time, make improvements that are as significant or nearly as significant as the invasive procedures. For example, our fractionated laser repeated several times can produce a fantastic result, and if you stay out of the sun and use Fallene sunscreen from drugstore.com (for example) and Retin-A over a year or two, you can get a fantastic result that rids you of wrinkles and really in many ways is as good as the invasive procedure which requires the two-week recovery and the possibility of more complications. 

Fillers can approximate a facelift for the right individual, replacing the fat and restoring the contours and form of the aging face to a younger contour, and when performed in conjunction with Botox and the resurfacing modalities, can be spectacular indeed. But the noninvasive procedures, remember, can be easily as expensive as the invasive procedures and require coming back to the office a lot.

Perfection and Cosmetic Surgery

The above photo is of another surgeon's breast implant which was coming out through the incision that it was placed through. This implant had to be removed a week later after watching and waiting for the hole to close by itself. The lady was to wait for 4 months then have the implant replaced when the healing was complete. Many such problems occur in cosmetic surgery, and this is nothing unusual.

Nothing is perfect! Every face and body is different. Every result depends on the preexisting state of the patient’s skin and underlying structures, and their nutrition as well as the skill of the surgeon. We see imperfections and complications all the time. If we were just to operate on people who looked great and were in perfect health, our results would be nearly perfect too. The following is one “Evaluation” from one of our patients at just a week after the liposuction surgery. Everyone isn’t this happy however. Perfection just doesn’t exist in life or cosmetic surgery…

“Dr. Yoho’s staff is wonderful. They were on top of things. I got a call from his staff every day after my surgery to ensure I was doing well. I felt very comfortable and important. Both Dr. Yoho and Jeremy were wonderful as well. They made me feel relaxed and worry free. I already can see results from my surgery and can’t wait till all the healing process is over to see everything. Thanks you Dr. Yoho and staff for making me feel great and helping me bring my sexy back!!!”

Clint Eastwood is said to have stated, “If you want a guarantee, get a toaster.” We always say there are no guarantees. Our reputation is our guarantee. We promise to do our absolute best to give you the nicest cosmetic result in the safest way we can. For a more definitive article about cosmetic surgery expectations and complications see link. There's a photo here of skin death after liposuction.