Pasadena Plastic Surgeons

PIP Victim is Sub Muscular Implant AND Capsule Removal my Best Option?

I am 38 have had PIP submuscular implants I think 220 for 6 years I want them removed and not replaced I have read a lot about the capsule and would like advice. Should I insist on capsule removal because of the possible contamination through the faulty toxic implants that may have been absorbed into the protective capsule? I am concerned that even if I have the implants removed I will still be at risk from the industrial silicon.

It is very unfortunate that so many woman have suffered with the PIP industrial silicone debacle.  The good news is that assuming your implant are intact (the outer shell is not disrupted) there is little need for a complete capsulectomy.   Simple removal of the intact implants should completely eliminate any potential problem and should allow you to have some peace of mind.  If the implants have ruptured, however, it is best to remove the capsule along with any spilled silicone.  If you are considering removal and not replacing your implants, then there may also be an argument for removing a portion of the capsule to allow for the space that was created by the implants to collapse down.  Best of luck with your future surgery.  

Max Lehfeldt, MD, FACS

Pasadena Plastic Surgeon

Swimming After Breast Reduction?

Hi, I'm on a very competitive college swim team, and have very large breasts (DD). I'm 5'6 and very tiny and muscular elsewhere. I was wondering if I were to get a breast reduction, how soon I could resume swimming (at an intense level) Thank you

There are several surgical techniques associated with breast reduction surgery and most of them involve incisions on the breast.  You need to allow your body sufficient healing time following this surgery.  Assuming your post-operative course is uneventful and your healing is normal, I believe you could return to swimming and submerge the breasts after six weeks (but every patient heals differently).  Small areas of delayed healing may require a slightly longer period of recovery and may delay your return to swimming a bit longer.  Please be sure to have a board-certified plastic surgeon discuss your options regarding breast reduction surgery.   

Max Lehfeldt, MD, FACS

Pasadena Plastic Surgeon

Scheduled Tummy Tuck & Maybe Breast Implants. Which Implant Suits Me Better?

Im a african american female scheduled for a tummy tuck in 4 months and I am considering Breast implants because i loss breast mass after pregnancy. My question is whch is better saline or silicone? Im concerned with silcone leaking into my body but my doctor is straight smitten w/ the memory gel ones and wants me to consider those and tells me that they are safe One of my breast are smaleer than the other and the silicone comes pre-filled so im also concerned with dis proportioned breast.

When helping patients decide between Saline vs. Silicone implants I like to evaluate the pros and cons of each type of implant with the patient.   Ultimately the choice is up to you and you should feel comfortable with your decision.  You should find a board-certified plastic surgeon that can help you make an informed decision that satisfies your concerns and needs. In my practice I have also found that 3D imaging (vectra) and simulation can help patients make better decisions regarding the implant type and size. Below is a quick list of the pros and cons of Saline and Silicone gel implants that I review with my patients:

SILICONE GEL IMPLANT - PROS:

* More natural "feeling" -- better replicates the feeling of natural breast tissue

* Less likely to show "rippling" on the surface of the skin -- particularly in patients with little breast tissue 

SILICONE GEL IMPLANT - CONS:

* Requires a slightly larger incision for placement

* More difficult to determine if the implant is ruptured -- the breast will not deflate and you may need an ultrasound or MRI to determine if the implant is intact

* Silicone exposed to the breast tissue may create a local "inflammatory" reaction and therefore a ruptured silicone gel implant should be removed/replaced

* Higher cost -- roughly twice the cost of saline implants

SALINE IMPLANT - PROS:

* Filled with saline (salt water) that is totally safe and can be absorbed by your body if the implant breaks

* Can be placed with a slightly smaller incision compared to silicone gel implants

* Usually half the cost of silicone gel implants

* You will know if the implant is broken due to the obvious deflation of the breast -- you don't need special tests to determine if the implant is intact

* Can be differentially filled -- can fill one implant slightly more than the other to compensate for breast volume differences (Helpful in your case - since you think one of your breasts is smaller than the other)

SALINE IMPLANT - CONS:

* Less natural feeling -- saline implants tend to feel "firmer" and more like a "water balloon" compared to silicone gel implants (especially in patients that do not have a lot of breast tissue to cover the implant)

* More prone to rippling -- saline is less viscous/thick than silicone gel and therefore ripples on the skin surface are more likely with saline implants

I hope that this information will help you make a decision that is right for you. 

Max Lehfeldt, MD, FACS

Pasadena Plastic Surgeon