There has been some discussion in the press recently concerning the safety of PIP breast implants. In particular, PIP breast implants and those manufactured by ROFIL Medr do not meet medical safety standards.

The following is an excerpt from a statement released by the American Society of Plastic Surgeons. “During a recent French governmental inspection of breast implants manufactured by PIP and ROFIL Medro since 2001, health authorities have discovered that most are filled with industrial grade silicone that does not meet the same stringent quality requirements as medical grade silicone. The rupture rate of these implants appears to be five times higher as compared to other implants. This means that they do not meet legal requirements or industry standards. Due to the high risk of rupture and subsequent release and distribution of silicone gel, PIP breast implants have been prohibited in Europe since April 2010 where more than 1,000 cases of ruptured PIP breast implants have been reported already. The total number of patients with PIP breast implants is estimated at 30,000.”

It is important for all of our patients to know that we have NEVER USED PIP or ROFIL Medro implants in any of our patients at any time. Further, for women who have breast implants but are not patients of ours, please be aware that although PIP did sell breast implants in the U.S., the implants that are of concern were never sold or implanted in the U.S.

We only use breast implants manufactured by Mentor or Allergan (formerly McGhan). These are the two largest and best breast implant manufactures in the world. Both of them are American companies and make extremely good, safe breast implants. These implants are manufactured in the U.S. under strict FDA quality control. You may rest assured that if you received breast implants through our practice or if you have either of these implants from elsewhere, that you have breast implants of the highest quality.

Any product that we use in our practice is of the highest quality, from reliable sources (industry leading manufacturers) manufactured in the U.S. We never use any product that has not been fully scrutinized and approved by the FDA.

If you have any questions concerning this issue or breast augmentation in general please do not hesitate to call us at 615-327-0201 or e-mail at info@drnein.com

I’m thinking of going with the 339 on silicone implants but tossing the idea of a 371 i’m 5’9, 140lbs…I want to look natural and not big boobs I’m currently a 34a. Is there that much of a difference between the two?

There is a relatively small difference between the sizes of these two implants. It is actually 32cc which is about 1 oz out of your measuring cup in the kitchen. Consider that amount distributed over the entire volume of your breast and I doubt you’d perceive any real difference. Ideally, implant size is chosen according to breast dimensions, skin conditions, patient build etc. But in this case the implant dimensions between these two are also quite similar. You’ll do very well with either of these implants but my personal observation over the past 16 years of doing this procedure is that nearly all women at six months after breast augmentation wish they had chosen a slightly larger implant than what they actually did choose.

Hello, I had my first breast augmentation on July 7th this year with smooth silicone implants under the muscle. My left breast started contracting in week 7 and now at my 3 month post-op my surgeon recommending replacing the implant and using Strattice this time. I am only wondering if my breast is now inflamed and contracting, would it be better to wait a few more months for the inflammation to go down before doing the surgery, so that the current inflammation doesn’t affect the outcome?

Fortunately with modern surgical techniques for breast augmentation, the likelihood of capsular contracture has diminished significantly. The current risk is less than 10% for implants placed submuscularly. Statistically about 80% of women who get capsular contracture will develop it in the first two years and in my personal experience the vast majority of those will develop contracture in the first 2 to 6 months. There is no exact science as to when is the optimal time to perform a capsulectomy but I would probably wait until the process has stopped for about a month. In other words once the contracture is no longer getting worse or changing, then wait 4 to 6 weeks before having the capsulectomy performed. I personally wouldn’t use Strattice for the first episode of capsular contracture. I’ve only had one capsulectomy redevelop contracture; so the odds of getting a resolution to the capsular contracture without the use of ADM (acellular dermal matrix) are quite good. I would avoid the extra expense for something that probably is not necessary and that doesn’t guarantee that contracture won’t recur. If someone has had multiple recurrent contractures then ADM would be a very reasonable option.

I have seen my ps two times now and can’t decide on the implant. I am already a 34c but compete nationally in bikini fitness comps and loose my boobs. I’m scared of being too big but would love to be a dd. I want the fullness on top but not fake round and to have cleavage again. I’m 5″6 120 pounds and very athletic. I know it’s hard to recommend an implant when you haven’t seen me but if you could what would you recommend, 371 moderate plus silicone or 450 high profile silicone? Thank you!

There is no right or wrong answer to what size you should pick. The final choice is of course entirely up to you and your preferences and tastes. Having said that, there are some considerations that you should be aware of. The larger the implant the more like an implant and the less natural the appearance becomes. By definition the most natural looking breast is one that has no implant. If you have an adequate amount of breast tissue over the implant then you can increase the implant size without looking “fake”. In my opinion, the silicone implants give a more natural appearance even at slightly larger sizes. Since you become very thin/lean at the time of a competition then you may consider placing the implant under the pectoralis major muscle. This will provide additional “padding” or coverage over the implant and lessen the implant look. Long term you also have to consider the implications of the size and weight of the implant. The larger the implant, the more the tissues are stretched to cover the implant and the more weight that those tissue have to support. Thinner tissues have a lessened ability to support weight than thicker tissues have. Consequently, a larger implant is more likely to stretch the tissues of the breast, increase the likelihood of sag and increase the likelihood of a poorer cosmetic result as time goes on. Unfortunately, no one can determine exactly at what size these problems may occur for any particular individual. That depends upon implant size/weight, individual tissue characteristics, tissue thickness, previous stretching of breast tissues either from pregnancy and/or weight gain and also how conscientious a woman is about wearing a bra for support. All these factors and other play a role in determining what the long term results will be for any particular individual.

Watch NBC’s the today show on Thursday of this week (10/20/2011) where they will feature one of our favorite skin care products from Neocutis. Lumiere, a bio-restorative anti-aging eye cream with PSP from Neocutis has been clinically shown to restore the appearance of stressed and puffy skin thereby reducing dark circles. It contains a mixture of essential skin nutrients, growth factors, interleukins and antioxidants.

Liposuction linked to lower triglycerides
Sep 29, 2011
By: Bill Gillette
Cosmetic Surgery Times E-News

Denver — Liposuction patients may experience a reduction in triglyceride levels and white blood cell counts, possibly decreasing their risk for heart disease, stroke and diabetes, Globe Newswire reports.

A new study, results of which were presented here last week at the American Society of Plastic Surgeons (ASPS) annual conference, measured triglyceride and cholesterol levels in 322 patients undergoing liposuction and/or a tummy tuck. Most of the patients, 71 percent, had liposuction only. Triglyceride levels in patients with normal preoperative levels were unchanged. However, patients with at-risk levels, defined as greater than or equal to 150 mg/dl, experienced an average postsurgery reduction of 43 percent — about twice the effect achieved with a commonly prescribed drug.

The study also found that white blood cell counts decrease an average of 11 percent after the procedure.

Globe Newswire quotes Eric Swanson, M.D., ASPS Member Surgeon and study author, as saying, “For years, it has been assumed that ‘visceral fat’ surrounding the internal organs has greater metabolic importance and is more directly linked to cardiovascular disease and diabetes risk than ‘subcutaneous fat’ that lies under the skin. These new findings support recent studies suggesting subcutaneous fat, which can be reduced by liposuction, is just as metabolically important.”

Dr. Swanson noted that the study’s findings do not mean liposuction can replace medications in patients with very high triglyceride levels. The study emphasizes the need for further research to determine whether these favorable changes in triglyceride and white blood cell levels translate to reduced health risk.

After two days of discussion and testimony about how to improve silicone breast implant study compliance, agency officials said silicone breast implants were safe and the studies would continue. “Women should feel assured that the F.D.A. continues to believe that currently marketed silicone breast implants are safe,” said William Maisel, MD, MPH, chief scientist in the FDA’s Center for Devices and Radiological Health, in remarks after the meeting. “The current post-approval studies will continue. The FDA is committed to seeing them completed and making sure the follow-up rates improve.”

Many experts at the hearings sighted the current labeling for MRI screening as unrealistic for healthy, asymptomatic patients. The panel agreed that patients should no longer be told that they should get an MRI three years after getting implants and every two years following. “F.D.A. continues to believe, as does the panel, that M.R.I. is the gold standard for evaluating breast implants for silent rupture,” Dr. Maisel said. “But there was consensus among the panel that the requirements for ongoing M.R.I.’s should be removed.”

Towards the end of the final day of the hearings, the FDA panel commented that they were impressed by the organization of the two plastic surgery societies, our message and our efforts to generate data and address important issues such as international registries, labeling compliance, patient confidentiality, and informed consent.

Michael O’Riordan

August 29, 2011 (Paris, France) — In a city renowned for its love of food, it is only fitting that researchers presented the results of a new study in Paris, France, showing that chocolate is good for the heart and brain. In a presentation at the European Society of Cardiology (ESC) 2011 Congress, British investigators are reporting that individuals who ate the most chocolate had a 37% lower risk of cardiovascular disease and a 29% lower risk of stroke compared with individuals who ate the least amount of chocolate.

In the study, published online August 29, 2011 in BMJ to coincide with the ESC presentation, Dr Adriana Buitrago-Lopez (University of Cambridge, UK) and colleagues state: “Although overconsumption can have harmful effects, the existing studies generally agree on a potential beneficial association of chocolate consumption with a lower risk of cardiometabolic disorders. Our findings confirm this, and we found that higher levels of chocolate consumption might be associated with a one-third reduction in the risk of developing cardiovascular disease.”

In this meta-analysis of six cohort studies and one cross-sectional study, overall chocolate consumption was reported, with investigators not differentiating between dark, milk, or white chocolate. Chocolate in any form was included, such as chocolate bars, chocolate drinks, and chocolate snacks, such as confectionary, biscuits, desserts, and nutritional supplements. Chocolate consumption was reported differently in the trials but ranged from never to more than once per day. Most patients included in the trials were white, although one study included Hispanic and African Americans and one study included Asian patients.

Of the seven studies, five trials reported a significant inverse association between chocolate intake and cardiometabolic disorders. For example, individual studies showed reductions in the risk of coronary heart disease (odds ratio 0.43; 95% CI 0.27–0.68), the risk of cardiovascular disease mortality (relative risk [RR] 0.50; 95% CI 0.32–0.78), and the risk of incident diabetes in men (hazard ratio 0.65; 95% CI 0.43–0.97).

Overall, the pooled meta-analysis results showed that high levels of chocolate consumption compared with the lowest levels of chocolate consumption reduced the risk of any cardiovascular disease 37% (RR 0.63; 0.44–0.90) and stroke 29% (RR 0.71; 0.52–0.98). There was no association between chocolate consumption and the risk of heart failure, and no association on the incidence of diabetes in women.

The researchers note that the findings corroborate the results of previous meta-analyses of experimental and observational studies in different populations showing a similar relationship between chocolate and cocoa consumption and cardiometabolic disorders.

“These favorable effects seem mainly mediated by the high content of polyphenols present in cocoa products and are probably accrued through the increasing bioavailability of nitric oxide, which subsequently might lead to improvements in endothelial function, reductions in platelet function, and additional beneficial effects on blood pressure, insulin resistance, and blood lipids,” conclude Buitrago-Lopez and colleagues.

On June 22, the FDA issued an updated white paper on the safety of silicone gel-filled breast implants, stating that “silicone gel-filled breast implants have a reasonable assurance of safety and effectiveness when used as labeled.”

The American Society of Plastic Surgery reports that aaproximately 1.8 million procedures using soft tissue fillers (collagen, Juvederm, Sculptra, Radiessee, etc.) were performed in 2010 to enhance the aesthetic appearance of patient faces.
Facial enhancement with soft tissue fillers is an in-office outpatient procedure done with local anesthesia. The procedures take only a few minutes, last for many months to years and are inexpensive. They area great way to enhance your beauty!