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They may feel unnatural.
Dallas plastic surgeon William P. Adams Jr., MD says patients need to understand that implants will cause their breasts to feel unnatural at first. As your implants settle and you get used to them, you will feel like they are a part of your body.
Bacteria are Bad and More Bacteria are Worse
This simple concept is critical to understand the nuances of device-associated infection, including capsular contracture and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
We are honored to discuss this paper on a topic that we have had a keen interest in for over 20 years.1 This topic has been important for all breast surgeons and has continued to be, especially with the recent confirmation of the role of bacteria in BIA-ALCL.2-9 The authors have done a nice analysis in this study, and I will attempt to highlight certain portions to emphasize and sometimes clarify.
The authors state, “Numerous studies and recommendations exist regarding the choice of intravenous antibiotics, timing, and duration of their administration. But the use of topical antibiotic prophylaxis agents in plastic surgery is not specified and nonstandardized.”1 We agree with this statement, but not because the details of standardization are not available. They have been readily avail-able for the past 15 to 20 years.10-13 The problem is with surgeons inaccurately implementing these practices. With the recent developments of BIA-ALCL and the role of bacteria, surgeons have a renewed interest in minimizing bacterial load, including breast pocket irrigations. This study brings up some salient aspects of breast pocket irrigation to which we hope surgeons will finally pay attention.
Body fat has gotten a bad rap over the years, especially from those who are trying to lose weight. What many people don’t realize is that there are several types of body fat – some that are good and others that aren’t so good.
We’re going to examine the various types of body fat, what creates it, where they are found in the body, as well as their purpose in regulating our health. By understanding how our bodies gain and lose fat, you’ll be better able to intelligently embark on a weight loss plan that is not only healthy but has the best chances of success.
Adipose tissue, also known as body fat, is a normal part of the human body that helps perform a wide range of life-giving duties including storing energy for metabolic functions. It can be divided into three different categories:
Essential – Our bodies require some fat to help regulate body hormones and body temperatures, protect our internal organs, and help absorb vitamins from the foods we eat. Without essential body fat we’d be very sick or close to death.
Reserve – Our bodies keep a “reserve” which provides an on-demand supply of extra energy. This reserve fat is not damaging to our health and provides additional energy throughout the day.
Excess – Excess body fat is considered to be any body fat that’s not being used for essential and reserve purposes. It’s stored in several places on our bodies, including our bellies. Excess body fat can lead to many health issues such as diabetes, heart attacks, strokes, poor health, and even some forms of cancer.
Body fat is created by both stress and the consumption of foods. Stress causes the hormone cortisol to be released and that in turn increases the visceral fat ratio in our bodies. This type of fat is most often found around our bellies, arms, legs, and other body parts and is responsible for obesity.
The fat contained in the food we eat is broken down and stored in fat cells for future usage. Our bodies are very good at capturing and storing fat. This means that the fat cells that aren’t used for regulating various bodily functions will quickly become excess visceral fat.
There are many different kinds of foods whose consumption can lead to excess body fat. Trans fats are one of the unhealthiest fats and are found in processed and fried foods. Meals and drinks (e.g., sodas) that contain high levels of sugars can also cause rapid weight gain.
A few years ago, an NBA basketball player gave an interview in which he said he quit drinking sodas cold turkey and lost 11lbs!
There are several different types of body fat. Some of which are vital to regulating our bodily functions and keeping us healthy, and others which are detrimental to our health.
Essential fat – As mentioned above, essential fat is good fat. It helps maintain proper body temperature, cell structure and protects our internal organs from harm. Essential fat cannot be lost without a detrimental effect to our health. For example, healthy women need around 10 to 13 percent of their total body weight to be comprised of essential fats.
White fat – White fat is the main form of fat in our bodies. It helps regulate hunger by producing certain hormones and has receptors for insulin and cortisol. White fat also serves as the biggest energy backup in our bodies. It can be found all over the body, including arms, shoulders, stomach, and legs.
Brown fat – While white fat stores energy, brown fat burns it. The main purpose of brown fat is to keep our body temperatures regulated at a comfy 98.6 degrees. It’s located on the back, upper half of the spine, and around the shoulder area. Brown fat was only recently “discovered” by science and some studies suggest that white fat can be turned into brown fat – thereby helping with weight loss.
Beige fat – Beige fat is not entirely understood by medical science, but it’s thought to be a combination of white and brown fat. Beige fat is found in the same areas as brown fat.
Subcutaneous fat – This layer of fat is found right underneath our skin and makes up around 90% of the fat found in our bodies. Subcutaneous body fat is most often used to measure body fat levels utilizing a skin-fold test.
Visceral fat – This type of body fat makes up our belly fat. It’s white fat that’s stored around various internal organs. Too much visceral fat can lead to several health issues such as dementia, certain cancers, Alzheimer’s, Type 2 diabetes, and even strokes.
When it comes to body fat, there are good types and not-so-good types. Far too many people think all fat is bad – and this can cause severe health problems when they try to lose weight. By understanding which body fats are essential to good health and which aren’t, we can remain healthy while we lose weight.
When it comes to breast implant surgeries, sometimes complications will develop.This has nothing to do with the talent or experience of the surgeon, but rather the patient’s own body and immune system.
A common side effect of breast implant surgery is a condition called “capsular contracture.” It can cause distortion, pain, shifting, and hardening of the breast.
We’re going to look at what a capsular contracture is, the reasons behind why it can happen, how it can be avoided, and the various options available to fix it.
The human body views saline and silicone breast implants as non-natural intruders. As you’re healing up from breast implant surgery, your body sees a foreign object and forms a thin membrane called a capsule around it. This is actually a benefit because it can prevent the implant from moving around the area it was initially placed.
Problems arise when the scar tissue becomes too thick and starts to contract and squeeze the implant. This is what causes pain, shifting of the implant, and hardening of the breast.
There are a few things that can cause capsular contracture to develop after breast implant surgery, and all are related to the bacterial load around the implant.
A pocket of blood serum within the surgical area can alsopotientiate bacterial growth and the formation of a capsular contracture.
Capsular contractures are graded on a scale called a Baker Scale. There are four levels, with the fourth being the most serious:
Grade 1 – The breast appears normal and soft. The overall capsule is flexible.
Grade 2 – The breast is somewhat hard to the touch, but overall looks normal.
Grade 3 – There is some distortion to the breast, and it’s hard. The breast can also become rounded in appearance and tilted upwards.
Grade 4 – Similar symptoms to Grade 3, but the capsule is much more hardened.
During your initial consultation, your surgeon will discuss several placement options. Implants that are placed within muscles are less prone to developing capsular contractures.
Many methods have been described but the only evidence based prevention is a refined surgical technique called the 14 point plan that Dr. Adams developed.
If you have developed a capsular contracture, there are several things your surgeon can do to help alleviate both the pain and the condition. A capsulectomy can be performed which removes the capsule completely. The surgeon might opt to replace the breast implant as well for best chances of success.
Another surgery called a capsulotomy can be performed. In this procedure the scar tissue is sliced open, thereby allowing expansion and decrease in pain and pressure. If surgery isn’t an option or the patient has no desire to undergo the knife, other treatment methods can potentially help.
Prescribed medications, massages, and even ultrasounds might help the stiff capsule relax a bit. If you suffer from capsular contracture or are in pain, it’s best to make an appointment with a surgeon as soon as possible to discuss your concerns and go over all available treatment options.
You can also help lessen the risk of a capsule from forming by keeping a few things in mind while recovering from surgery. For example, quitting smoking can help decrease overall healing times.
For the first few weeks after surgery, try to avoid any strenuous physical activities which could cause the implant to shift. It needs time to settle into its final resting place, so avoid any trauma to the breast area, including heavy exercise.
If you’re having chest wall radiation after your mastectomy, you might want to consider delaying implant surgery until after your treatments have completed.
If you’re suffering from a capsular contracture, experiencing pain or stiffness of the breasts after implant surgery, or think you might be at-risk of developing one, give the offices of Dr. Adams a call at (214) 965-9885 to schedule an appointment.
Dr. Adams is a world-renowned breast implant surgeon and can help fix your capsular contracture and get you on the road to recovery.
Plastic surgeons are usually one of the first to adopt new cutting-edge technologies. This is most often attributed to the importance of the end results of plastic surgery. People get work done because they want to look and feel better.
Advancements in technology have enabled surgeons to give their patients a more realistic expectation of how the final results will look. Virtual Reality (VR) is one of those new technologies that’s taking plastic surgery by storm.
Once relegated to the video game industry, VR has now gone mainstream with many different industries taking advantage of its benefits. We’re going to look at the various technologies such as VR, 3D modeling, and AR, and how they’re being used by surgeons.
Virtual Reality is most often associated with a headset connected to a high-powered computer. When people put on the VR headset, they are instantly taken to another reality. Everything they see on the headset appears in 3D.
Basically, a virtual world is instantly created. For example, someone could put on a VR headset and be immediately transported to a beach in Hawaii. As they turn their heads and look up and down, the images inside the VR headset would move as if they were there in real life.
While Virtual Reality has been around since the 1990s, it was often considered more science fiction than science fact. This is due to the technological limitations of the computers that ran VR in those days.
In the past 10 or so years, computers and the software/hardware that powers virtual reality have become powerful enough to create an image that looks extremely life-like.
Many video game manufacturers have taken advantage of this and released video games which completely immerse people inside their virtual worlds.
Medical science has benefited as well. Plastic surgeons will often give their patients a virtual reality headset that can show them what their new breast implants would look like.
This can be especially helpful in helping the patient decide what size implants to get. Patients can literally “try on” a new set of breasts by simply putting on the VR headset over their head.
Augmented Reality (AR) differs from virtual reality in that the headset worn by the person doesn’t cover their eyes completely. It merely augments what someone is seeing.
The “Google Glass” craze a few years ago is a good example of augmented reality. In it, a special pair of eyeglasses were worn, and selected images were shown on the screen which “augmented” what the person was seeing.
It’s been said that AR is much easier to use than VR in this day and age. This is because VR requires much more powerful software and hardware and it’s relatively new.
As time goes by, it stands to reason that VR will undergo a series of technological innovations which will make it the go-to technology for plastic surgeons.
Before the advent of 3D modeling, a patient would come into a plastic surgeon’s office for a consultation. They would bring with them a bunch of pictures clipped from magazines that show the shape of the nose, breasts, or other body parts they want to have worked on.
The problem with this method is that it was in 2D and didn’t give an accurate picture of what to expect. Surgeons nowadays are using powerful computers and 3D imaging software/printers to give prospective patients a clear understanding of what to expect.
3D modeling works by taking pictures of the patient from different angles. These pictures are then compiled into a special computer program that the surgeon can manipulate at will. It offers a real-life 3D image of what a certain breast size would look like.
If the surgeon has a 3D printer, he can print out a very life-like 3-dimensional image of what the patient’s face, breasts, or other body parts will look like after surgery.
This gives the patient more confidence to undergo the procedure because they will already have a good idea of the outcome.
Plastic surgeons are already using Virtual Reality in breast augmentation procedures. When they sit down for a consultation, patients are given a special wearable bra. They then put on the virtual reality headset and can instantly see what their new breasts would look and feel like.
The surgeon sits at a computer and can instantly change the shape and size of the breasts which will be reflected in real time on the headset that the patient is wearing. VR also gives the doctor and patient the ability to see the asymmetries of a proposed procedure and check if it’s possible or not.
Virtual reality augmented reality, and 3D modeling offers patients a way to see the results before they undergo the knife. This can help avoid any “buyer’s remorse” and give the patient a much clearer understanding of what they’re trying to achieve.
As time goes by, advancements in medical technology will get better and better. It stands to reason that one day, a patient will be able to walk into the office of a plastic surgeon and see a 100% life-like image of themselves on a virtual reality headset.
Dr. Adams reviews his practice philosophy of the renowned Breast and Body Contouring click here.
