A common question I am asked by patients considering plastic surgery in Chicago is whether using their own body tissue during breast reconstruction is safer or more natural-looking than an implant. The answer is that one technique is not necessarily better than the other; the two are simply different. I’ve found that both of these procedures are chosen by patients in my practice for different reasons, depending on their individual circumstances. A few general pros and cons to each technique are as follows:

Autologous Reconstruction

Benefits:

• Because autologous breast reconstruction uses existing body fat to rebuild the breast, the results often feel more natural.
• Your new breast will adapt accordingly during normal weight fluctuations.

Possible Disadvantages:

• Recovery may be longer and more difficult.
• Some women may not be candidates for the procedure, particularly very thin or overly obese women.

Implant Reconstruction

Benefits:

• Implant reconstruction is typically a shorter procedure than autologous reconstruction.
• Recovery time is often faster with implant reconstructions.

Possible Disadvantages:

• Implant-related concerns may arise, such as capsular contracture and the need for replacement.
• Implant reconstruction can sometimes require multiple surgeries to achieve the desired results.

There are many factors to consider when deciding between autologous or implant breast reconstruction. It is best to discuss your personal needs with a qualified surgeon in order to better understand which procedure is best for you.

The issue of breast reconstruction after mastectomy is one that I find particularly important. It can be extremely valuable for the mastectomy patient and extremely rewarding for the reconstructive surgeon. However, surprisingly few women actually choose to undergo reconstruction, even though legislation requires all insurance policies to cover it. According to a study performed by Alicia Holt, MD, Surgical Fellow at City of Hope Medical Center in Duarte, California, only about 20% of eligible women opted for this procedure in 2007.

Why is this? As an Alabama plastic surgeon with years of experience performing breast reconstruction procedures, I have some ideas. I believe the main reason for the low percentage of women pursuing the procedure is lack of information. There are plenty of resources out there, but evaluating the information and understanding the options can be difficult. Here, the guidance of a qualified and caring doctor is absolutely essential.

Physicians should be clearly articulating the benefits of the procedure, which are substantial. First, there’s the obvious aesthetic improvement – breasts regain their shape, looking better both in and out of clothes. Then, there are the emotional and psychological benefits. After breast reconstruction, women report improved self-confidence. They also explain that breast reconstruction helped them feel “whole” again – so that they weren’t reminded of the trauma of their illness every time they looked in the mirror. Reconstruction can be an important stepping stone on the road to emotional, psychological and spiritual recovery.

At the end of the day, despite all the benefits, breast reduction is optional – and a woman’s informed choice not to pursue the procedure should be respected. However, women should actually be informed so that they can make the decision for themselves. They should know their options for reconstruction, even before mastectomy has been performed.

If you are a woman who has had a mastectomy, or if you have been told that you will need one, talk to your doctor about breast reconstruction. Don’t be afraid to ask questions and obtain more information about the different types of procedures offered, the benefits/drawbacks of reconstruction, and the various procedural options before making a final decision. It is important that you take the time to assess if this surgery is right for you, because every woman deserves a choice.

I’ve been asked if I have a “favorite” liposuction technique for specific areas of the body, and today I want to share two of my favorite approaches for dealing with “belly flab.”

Why This Area is Different:

The lower (and even the upper) abdomen can be one of the easier areas in the body for fat removal, since adipose tissue here tends to rest in a dense patch without a lot of other tissue intruding. However, in some cases, this area can be a bit challenging because:

1. Without techniques to help keep the procedure as gentle as possible, the repeated movement of the liposuction wand can bruise surrounding tissues

2. Fat removal can result in loose, sagging skin that will not tighten after the procedure

My Favorite Techniques:

Here are some methods I personally use to address the challenges of abdominal liposuction in Michigan:

1. Loosen or “melt” fat for gentler removal – These days, most liposuction surgeons loosen fat before surgery by infusing the treatment area with some kind of sterile saltwater and anesthetic solution. Technologically advanced methods can also make this process faster and gentler by “melting” or “breaking down” fat cells using laser energy or ultrasonic waves.

My personal favorite: Smartlipo™ laser liposuction, because it makes fat removal much easier.

2. Stimulate skin contraction using heat – No matter which technique you use, skin contraction won’t happen immediately, but a few techniques can stimulate the skin and provide some tightening.

My personal favorites: Ultrasonic and Smartlipo liposuction, depending on the patient.

My Advice: I like Smartlipo particularly for belly fat, but, for certain patients, ultrasonic or tumescent liposuction will be a better fit. When you talk to your plastic surgeon, he or she may recommend a different approach, but be sure to find out how that technique will deal with bruising and skin tightening.

By: Andrew Smith, MD

It used to be commonplace for women to wait about a year after their mastectomy before undergoing reconstructive breast augmentation. These days, more Irvine, California breast reconstruction surgeons are offering immediate reconstruction procedures, where mastectomy is followed directly by a second procedure using either breast implants or the patient’s own tissue to reconstruct the look and feel of the natural breast. Even so, many breast reconstruction patients in Irvine still choose to delay reconstruction.

If you are not sure which approach is right for you, you need to talk with your mastectomy surgeon and your plastic surgeon. Research your options so you can assess the emotional and physical pros and cons for yourself. Here are some quick facts to help you get started.

The Big Picture

Women undergo breast reconstruction surgery in Irvine for a variety of reasons. Many women link breast reconstruction with feeling “whole” again after their procedure, and other factors like a better sex life can add extra benefits for many patients after breast reconstruction. Ultimately, choosing breast reconstruction is a very personal decision and each woman needs to decide for herself what is best.

What the Research Tells Us

As more plastic surgeons have begun to offer immediate and combined mastectomy / breast reconstruction procedures, more researchers are comparing the experiences of patients who underwent immediate vs. delayed breast reconstruction. What we know:

• Advantages of Immediate Reconstruction:

In one study, 76% of women who delayed reconstruction said they wished they had undergone their reconstructive procedure immediately, and there are good reasons for this perspective. Immediate reconstruction can cut surgical costs by as much as half and, more importantly, women who have immediate reconstruction tend to experience significantly much less emotional distress over their mastectomy than those who wait. They also tend to benefit most from the typical, positive impact of breast reconstruction on a woman’s self-image, confidence, sexuality, and general happiness.

• Advantages of Waiting:

While studies suggest certain advantages to immediate breast reconstruction, it is not right for everyone. Big-picture factors like your personal life, as well as the type and treatment of your breast cancer, can mean that delayed reconstruction offers more benefits for you personally. Post-mastectomy radiation therapy, for example, can negatively affect the results of certain types of immediate, “flap”-type breast reconstruction procedures. While implant-type reconstruction is still a valid, safe option for most of these women, some will choose to wait a bit before moving ahead with surgery.

Things to Keep in Mind

Breast reconstruction in California is not something a plastic surgeon or family member should decide for you. You need to discuss this decision carefully with your doctors and with the people who matter to you in your daily life. Talk to different surgeons and get in touch with a variety of women who have had this procedure so you can compare the experiences of those who had immediate reconstruction vs. delayed procedures. Most of all, take the time to understand your options clearly and find a surgeon who you feel understands you.

With good preparation and a clear understanding of your options, you will be much better equipped to make healthy, positive decisions that make sense for you medically – and personally.

By: Andrew Smith, MD

Breast cancer affects the self-confidence of every woman it touches, but breast reconstruction in California is about regaining your life and your confidence. If you are facing mastectomy, you will need to process a lot of new information and make many important decisions in a short period of time. Like most of the breast cancer survivors I meet with, you probably understand from your own experience how important it is to have a strong support group that will help you stay grounded and focused through all of these difficult choices.

As an Orange County breast reconstruction surgeon, I have found that the benefits of a positive support system don’t end with mastectomy. Breast reconstruction is one part of your journey toward healing, but women who are planning this procedure can still benefit from the same kind of active, constructive support that was so important before mastectomy.

California Breast Reconstruction Support: Before Surgery

Plastic surgery can have a positive, even life-changing influence on how you look and how you see your body, so a good surgeon will take time to help you formulate a clear idea of your desires, and encourage you to take the time to clarify your goals. Sometimes, just having a friend or family member with you at your consultation can help both you and your surgeon understand your goals and expectations in ways that connect much more realistically with your day-to-day life.

Group consultations with a breast reconstruction surgeon are not right for everyone (or offered by every surgeon), but if you feel that you would benefit from having a friend present, you should make sure that this person is part of your everyday life and can offer constructive perspective. This person should:

• Make you feel relaxed, comfortable, and positive
• Understand your motivations for considering reconstruction
• Be trustworthy to support you in whatever decision you make, without pressuring you toward a specific choice

California Breast Reconstruction Support: After Surgery

Your surgeon will give you specific instructions to follow after you leave his or her surgery center in Orange County. Breast reconstruction recovery takes time, so family or support group involvement can be very important for recovery both physically and emotionally. A caring and resourceful support group can often help out in these areas:

• Household tasks: You will have to avoid activities like childcare or household tasks until you are farther along in the healing process, so a little help in this area often goes a long way.
• Safe healing: A conscientious friend can help make sure you take your medication and follow all post-surgical guidelines so you can focus on recovery.
• Driving: You will not be able to drive for a few weeks, but for many patients a little mobility and change of scenery early on can accomplish a lot to help them recover more comfortably.

Emotionally, family support also can be a huge asset to your recovery from breast augmentation in Orange County, California. Rest is extremely important to help ensure healthy healing and prevent complications, but at the same time, interaction and entertainment are almost equally as vital to help you anchor your emotions and focus on your goals rather than on your surgical site and the healing process itself.

By: Thomas McNemar, MD

Men tend to build muscle quickly, so after significant weight loss, many men enjoy a better physique to match their healthy new lifestyle. However, after weight loss surgery in San Francisco, areas of loose, sagging skin can be very frustrating for men in particular. This is why I perform post weight loss cosmetic surgery – to help men achieve a body contour that more accurately reflects their hard work.

Some of the top goals and procedures options for male body cosmetic surgery after weight loss include:

Firmer Upper Body: Pectoral-Area Liposuction

Most men want a firmer, flatter chest area, but unfortunately weight loss often leaves loose skin or fat. A surgeon may need to remove excess skin and tissue through a series of incisions, but in many cases liposuction surgery tightens up this area very well, giving a firmer and more defined appearance to the pectoral muscles.

Flatter Mid Body: Abdominoplasty and Body Lift

Ideally, the midsection will look flatter and firmer after weight loss surgery, but in reality weight loss surgery often leaves San Francisco area men with a large amount of excess abdominal tissue. Abdominoplasty (tummy tucks) are used to correct this problem by tightening stretched-out abdominal muscles and trimming away loose skin from the lower belly. For very large amounts of excess skin, a body lift may be necessary to retighten the hips, upper and lower abdomen, flanks, belly, and thighs.

Tighter Lower Body: Inner Thigh Lift, Liposuction

The hips and thighs are typically less of a problem for men than for the women who need post weight loss surgery in Walnut Creek, but depending on your physiology these areas can still pose problems. Loose, wrinkled skin on the lower thighs and small, isolated patches of fat on the flanks and lower belly can look and feel awkward, so many men choose to correct these areas with liposuction or lift procedures. Typically, I will perform these as a combination procedure that may integrate abdominoplasty or body lift, but they can also be performed as single procedures.

By: Wandra Miles, M.D.

The latest clinical research shows that breast reconstruction after mastectomy has many benefits, but the fact remains that only about 20% of women who lose their breasts to mastectomy choose to undergo breast reconstruction. Why aren’t more women choosing reconstruction?

I’d like to explain the benefits of breast reconstruction, and address a number of misconceptions that in my experience cause many women to discount the potential benefits of this procedure.

Common Misconceptions

As a Seattle breast reconstruction surgeon, I see many women opt out of reconstruction because:

• Their mastectomy surgeon neglected to discuss the option at all, and/or failed to mention that the cost is generally covered by insurance
• The patient thinks she is too old for surgery
• The patient initially delayed reconstruction, and thinks that after years without breasts, reconstruction would have minimal benefits
• They dislike the idea of breast enhancement using implants

Over the years, I’ve seen better awareness of the benefits of reconstruction among mastectomy surgeons like the ones I work with. Some are even developing enhanced techniques to preserve more of the original breast curve by using more vertical mastectomy incisions.

While some patients have other health concerns that make them less eligible for surgery, in my experience most women who forego reconstruction because of age, time since mastectomy, or aversion to implants do not have accurate information about the procedure.

Seattle Breast Reconstruction: Options and Impact

There are actually two main options for breast reconstruction:

• Expander and Implant (typically more appropriate for larger-breasted women): The surgeon uses a tissue expander to stretch the chest skin gradually before replacing the expander with a breast implant.
• Flap Method: The surgeon reconstructs the breast mound using your own tissues from your abdomen or back.

While immediate reconstruction patients tend to experience greater benefits to their mood, both immediate- and delayed-reconstruction patients generally see significant positive effects on their:

• Self esteem and mood; specifically, incidence of depression and anxiety can be reduced
• Body image and how feminine a woman feels
• Sexuality, including both how attractive a woman feels and her degree of sexual satisfaction

Self-image is complex, so these benefits will be different for each woman. However, in general, women who choose not to undergo reconstruction tend to experience higher levels of depression and anxiety than women who do. Many patients find breast loss hampers personal relationships and everyday activities like clothes shopping.

In the end, many of my patients see their reconstructive plastic surgery in Seattle as part of the healing and recovery process. Better self-confidence and feelings of normalcy can accomplish a great deal to help a patient regain a sense of physical and emotional wholeness, and alleviate some of the fears that persistent after a cancer diagnosis. Many psychologists see breast reconstruction as “positive coping” because it requires a patient to initiate a decision about her body and assume control of her own wellbeing.

Plenty of people think about plastic surgery according to one rule: “Either it’s necessary, or it isn’t.”

These black-and-white perspectives are unreasonable, unsupported, and damaging, but media and insurance companies make money by perpetuating this myth, which has too many people believing that surgery is only necessary when it’s about life and death.

As a board-certified plastic surgeon performing reconstructive and “cosmetic” procedures like breast augmentation in New Jersey, I’ve seen the reality: plastic surgery can play a much greater role in a person’s life than simply enhancing their visual appeal.

Clinical Research

Too often, people who have had no interaction with the real world of cosmetic surgery think that a patient would only receive procedures like breast augmentation in Philadelphia and New Jersey to stay trendy and increase sex appeal.

These misconceptions are part of the reason insurance companies see the line between necessary and “elective” surgery as a matter of measurement. Breast reduction, for example, becomes “necessary” if it removes a certain number of cc’s of breast tissue. This is so regardless of the frame of the patient or health concerns that change the ways a woman’s breasts affect her wellbeing, and regardless of research showing that even women who undergo less-intensive breast reduction procedures can experience significant improvement to their health and comfort.

Some of the most important research studies into the impact of “cosmetic” surgeries have found that cosmetic surgery significantly impacts quality of life in the long term, increasing not only body image satisfaction, but also tendencies to engage in social support and capabilities to cope with stress.

The Root of the Problem

Essentially, the controversy here is over what types of surgery are “necessary.” Social engagement, reliance on those we care about, ability to handle our fears and fully enjoy our bodies – these are the qualities that take life beyond the livable, and without them most of us would consider ourselves much less than alive. If cosmetic surgery can help enhance these aspects of daily living, what is the argument for it not being necessary?

Cosmetic surgery can’t promise to change lives in predictable ways, but I’ve seen through my own experience how inextricably these factors tie into who we are and how we live. Think about it: your body is the way you communicate with the world, and if it determines the kinds of messages you give and get, that can dramatically impact all aspects of life, including:

• Health
• Career
• Relationships with friends and family

When people feel more confident with their bodies, they tend to feel more complete in all areas of their life. People recognize and respect the importance of body shape and body image when they see the positive effects of breast reconstruction after cancer or physical trauma. For many patients receiving breast implants in New Jersey for breast augmentation, the need is just as strong, and the procedure is a necessary part of them feeling their very best.