Birmingham Breast Implants doctors

Michael S. Beckenstein, MD Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
800 St. Vincent's Drive Suite 610, Birmingham
44 answers
William J. Hedden, MD William J. Hedden, MD
Birmingham Plastic Surgeon
140 Village Street Greystone Cosmetic Center, Suite 100, Birmingham
19 answers
James C. Grotting, MD James C. Grotting, MD
Birmingham Plastic Surgeon
One Inverness Center Parkway Suite 100 , Birmingham
10 answers
Robert Oliver Jr., MD Robert Oliver Jr., MD
Birmingham Plastic Surgeon
2000 stonegate trail, Birmingham
8 answers
Christopher J. Schaffer, MD Christopher J. Schaffer, MD
Birmingham Plastic Surgeon
140 Village Street Suite 100, Birmingham
5 answers

Recent Answers

5 Wks Post Op, 400 Cc High Profile Implants, What Cup Size? (photo)

Hello, I am 5 weeks post op. I had 400 cc Mentor High Profile implants put in under the muscle (partially). I did not have a lift. Prior to surgery I was a 32A, I had shown my PS pictures and said I wanted to be a very full C. I am 5'2 and weigh 122 lbs. I measured my breasts yesterday and I am only measuring as a B cup. I am very disappointed. Also, although they appear round from some angles, from other angles they almost look flat. Did I go to small implant wise? Will they always appear flat?

A: Volume (cc s) and cup size

For where you started (A cup) considering your height and weight,  400 ccs seems a very appropriate choice for your implant volume, given your desire for a full C cup.  Round implants will give a more "artiifcial" look in general.  For 5 weeks I think your result is good and if given time, when measured will likely achieve your cup size goals.  Keep in mind if you wear a Victoria Secret bra count on a full cup size difference as their bras run smaller.  chris@heddenmd.com

Christopher J. Schaffer, MD
Birmingham Plastic Surgeon
What Are the Advantages and Disadvantages of Subfacial and Submuscular Placement? (photo)

Which would you recommend on a thin woman to get the most natural result?

A: subfascial breast implants preferred when possible

I'll disagree with my colleagues somewhat and point out that it's a matter of tradeoffs. It is the general thought by most plastic surgeons world wide that subfascial or subglandular implants offer a more natural result with less morbidity then submuscular implants.  When you listen to the most experienced surgeons in the world who have done this operation for 30-40 years and have literally "seen it all, twice" , they by and large describe a personal shift toward smooth, round subglandular or subfascial silicone devices as it is the most forgiving operation with the least morbidity.

Outside the USA, it's much,much more common to place implants over the muscle. The caveats to that are 1) you need to go smaller with the implant & 2) you've got to have enough tissue to camouflage the upper implant. The issue of hardening of the implants is a little more complex then submuscuar or saline have less capsular contracture with more recent long term follow up of patients with implants. It's more accurate to point out that early hardening  is more common but there is little difference between groups as you get further out. Very thin women with little tissue will require the coverage of the muscle and do well over time.  Women with more tissue frequently get the implant staying high with the tissue sliding off the muscle within a few years (the "snoopy deformity") when placed totally or partially beghind the pectoralis

If that photo attached to the thread is your preoperative picture, I'd suggest you'd be an excellent candidate for subfascial placement

Robert Oliver Jr., MD
Birmingham Plastic Surgeon
Should I Replace my Saline Implants with Silicone Through Nipples or Under the Breast?

I have saline implants for 7 years, through my nipples, and want to replace them with silicone. But one doctor wants to go under the breast instead of through the nipples. He says it's easier and better that way, and that the silicone won't fit through the nipples Another doctor wants to go through the nipples again. Please advice which way is best. The original way through the nipples or under the breast.

A: implant replacement thru the nipple or beneath the breast

As someone who gets referred a lot of revision breast surgery, I'm going to disagree slightly with my colleagues and suggest that revision thru the periareolar incision with gel devices can be significantly more difficult a procedure, particularly with larger devices.  Unless the patient is getting some kind of associated periareolar mastopexy, the precision of the IMF approach (particularly for retropectoral implants) is going to be superior for this and produce less potential step off by having to go thru and replicate the breast tissue disrupted by a periareolar disection.  I've seen a number of wierd contour problems on some of these redo's  from periareolar implants where the breast tissue closure creates an almost uncorrectable ripple or step off  that's made more me more circumspect in accepting a small second scar on the IMF.

Robert Oliver Jr., MD
Birmingham Plastic Surgeon
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