Jana, a former two-time world champ in the 2003 and 2007 400 meter hurdles, only had the implants for 14 months before, in her own words, “I’m  back to being as flat as a pancake.”

Dancers are another group of athletes that feel large breasts only get in their way.

Other celebrities have opted to go through explant surgery, the procedure to remove or replace breast implants.

For instance, former Spice girl, Victoria Beckham, had her large implants downsized during the summer of 2009. Victoria has a tiny frame and her implants just did not compliment her body.

O.C. Real Housewife Tamara Barney found she was having back pains due to her large implants so she had them replaced with a smaller set which also proved to be a pain in the back. At one point, Tamara was thinking she would lose the implants altogether.

New York City Real Housewife Jill Zarin reduced her implants from a 32 G to a 32D.

Some women having explant surgery, the procedure to remove implants, opt to have a breast lift (or mastopexy) at the same time.

According to the American Society of Plastic Surgeons (ASPS), the average cost of implant removal in the U.S. is $2435. With 20,967 breast augmentation patients having explant surgery in 2008, about $51,044,485 was spent.

 (2008 is the most recent year for which statistics have been compiled. 2009 statistics will be released in March, 2010.)

The three most common reasons for breast implant removal include:

• A change in size or shape
• Implant leak
• Capsular contracture, a type of internal scarring that hardens the implant and breast

Other famous women who had their breast implants removed or had a considerable reduction in implant size include:

• Britney Spears
• Demi Moore
• Jenny McCartney
• Courtney Love
• Jenna Jameson
• MTV’s Kacey Long
• Denise Richards

(Read our previous post about how Denise Richards first got uncomfortably large breast implants, and then received even larger implants – due to bad communication with the plastic surgeon — before going just right for her size.)

(We call it “viral” because one website copies material from another and the information multiples as quickly as virus cells in a Petri dish.)

Here are most frequently reported top five myths about breast implants:

Myth 1: Silicone is dangerous

 Silicone implants were removed from the market in 1992 when medical sleuths searched for the link between cancer and silicone. Results: nothing found so silicone became available again in 2006.  But rest easy – even after 14 years of study, they are still studying the question.

Myth 2: You must change your implants every ten years.

Implants are subject to wear and tear but there is no way of predicting a failure point. The implants may last ten years, a lifetime or a year, depending on medical factors and the activity type and level of the patient.

Myth 3: You can’t have mammograms with breast implants.

Only if your silicone or saline implants are above the chest muscle will the results of your mammogram be clouded. But if the same implants are placed under the chest muscle, results will be excellent.

Regardless which position your implants occupy, tell your radiologist about your breast surgery. Many technicians like to take side and other views to insure they have fully examined the breast.

Myth 4: The TUBA (transumbilical breast augmentation) incision and approach is best.

Actually, many plastic surgeons get great results using any one of four surgical approaches to breast enhancement. Some surgeons skilled with the endoscope get good results entering through the armpit, the transaxillary approach.

The important factor is, after surgically opening the skin, the surgeons must create an excellent pocket for the implant. So while one surgeon may quickly do his work by making an incision under the breast, (the inframammary approach) another surgeon may be adept at incisions in the areola, the dark area surrounding the nipple.

Besides, whatever incision scar you have usually lightens to virtually nothing in about 18 months.

Myth 5: Women have boob jobs just to catch mens’ eyes.

Nope. Most women have breast enhancement to please themselves and to feel more feminine and attractive. While a few breast surgery procedures are obvious and over the top, the vast majority of women want only a natural look and feel.

· Saline

· Silicone

Now, a third generation of breast implants is coming down the pike. The new kid on the block – or maybe the next breast thing – is known as the Ideal Implant and is undergoing FDA clinical trials in California, Texas and Florida.

The new model purports to offer the best features found in the existing saline and silicone implants.

When a woman opts for a silicone implant, she must sign a statement saying she has been counseled to get an expensive MRI every three or four years.

Why?

Because if a silicone implant leaks, it may not be immediately noticeable. Compare that to saline. A leak there and the whole breast goes flat. Score one for saline implants.

But….most women and their significant others opt for silicone due to the softer, more natural feel. Score one for silicone.

However, if a woman gets saline implants above the chest muscle, the edges may show through the skin. Also, some saline implants slosh when the owner reclines. And if the implant envelope wrinkles, a rip can later develop.

So a Texas plastic surgeon and professor asked for ideas, thoughts and suggestions from both implant patients as well as board certified plastic surgeons who work with the implants and listen to patient comments – the good, the bad and the ugly — for years.

The result is a saline filled implant with an inner and outer shell separated by two more unattached, perforated shells. The idea is to better control the movement of the saline. (Read more about the new breast implant.)

The new implant is more curved to rest more naturally against the chest wall. Its inventor and other plastic surgeons think the new model offers the natural look of silicone gel and the safety of saline.

They can be put above or under the chest muscle.

So far, only about 100 pairs have been implanted in the U.S.

But don’t rush out and to buy one!

The F.D.A. test period is for a decade on 500 women. And because the test period is so long, each test subject expects to receive anywhere between $8,000 and $12,000 when the test is concluded after 12 follow- up visits.

The breast implant maker is springing for the payments.

When a woman thinks about having breast augmentation with implants, she has three choices where the implant is positioned:

• Over the chest muscle
• Under the chest muscle
• Under the thin, tough sheet of tissue, the fascia, covering the chest muscle

All three have their advantages and disadvantages so no one position is right for every patient. 

The basic drawbacks to the subglandular position over the chest muscle are: 

• Any rippling in the implant can be seen and felt through the skin
• Mammography is more difficult
• Capsular contracture, a painful scarring and hardening of the breast is more common
• Implants are more likely to fall down into the breast pocket, or, “bottom out”

But the procedure, also known as the submammary placement, is quicker for the surgeon to do, involves less recovery time and, most likely, less expense. If something goes wrong with the implant later, it’s easier for the surgeon to reach. 

When a plastic surgeon puts an implant under the chest, or, Pectoralis muscle, he or she usually cuts the muscles in half, creates pockets, places the implants and sutures the chest muscles back. That creates more recovery time and expense because the technique is more difficult to master. (Note: muscle cutting can be avoided by entering the breasts through the armpits.) 

But a larger implant may be required because the chest muscle presses down on the implant. 

However, the technique also offers: 

• Low risk of capsular contracture
• A softer and more natural feel
• Rarely seen bottoming out

The third option, placing implants under the fascia, also has many advantages, according to an article in the October, Aesthetic Plastic Surgery, a publication for cosmetic plastic surgeons. 

Three plastic surgeons in Nuevo Leon, Mexico, reviewed the records of 1000 breast enhancement patients over 10 years who had soft gel breast implants placed under the fascia covering the chest muscle.  

The surgeons entered 95 percent of the breasts through an incision in the inframammary fold, the area under the breast at the chest wall. 

The surgeons/authors found: 

• Less post-op pain
• A shorter operation
• Quicker return to daily activities
• Better projection (how far out in front the breast projects)
• Reduction of capsular contracture
• Less morbidity than subglandular and submuscular methods

(Read the fascia breast augmentation article.)

Among hotel stays, vacation, car rentals, luggage and free flights, you can now add breast augmentation.

If that doesn’t float your boat, how about a face lift or hair replacement for the follicle-challenged man in your life? Other cosmetic surgery procedures are available, too.

Finnair Oyj, billed as Finland’s largest airline, is offering cosmetic surgery in return for your frequently flyer points.

For instance, wing your way from New York City to Helsinki (and back) only 120 times and the breast augmentation is yours!

You may already know that cosmetic plastic surgery to reduce the size of very large breast usually will also:

• Stop back, shoulder and pain
• Take away the grooves in the shoulder bones
• Clear the dark marks under the breasts
• Allow sports without massive breast bouncing

You can now add to the list of beneficial results: make sure you are 100 percent cancer free!

A recent study shows you could have the dreaded disease and not know it.

Susan E. MacLennan, M.D., an assistant professor of plastic surgery at the University of Vermont Medical College and colleagues evaluated the breast reduction cases of 202 women over 20 months.

The purpose: to evaluate the incidence of hidden carcinoma and the excessive growth of normal cells in samples of breast tissue removed in breast reduction procedures.

According to Dr. MacLennan, breast reduction and correction of unequal breasts is done 100,000 times yearly in the United States. So Dr. MacLennan and her study colleagues were thinking that, as the sampling of breast tissue increased, so would detection of heretofore unknown cases of breast cancer.

After crunching all the data, the researchers found that significant pathologic findings like carcinomas and abnormal cell growth were found in 12.4 percent of the study patients.

Once the lab had done all its detective work, the rate of proven cancer was found to be four percent over all patients.

But as women get older, the need for increased screenings grows.

For breast reduction study patients over age 40, 6.2 percent of the group was shown to be cancerous.

For  patients in the study over 50 or older, the rate was 7.2 percent.

Nonetheless, none of the lesions had been identified on the patients’ mammograms taken before surgery.

 If you’re over 40 and you have breast reduction, the study authors suggest telling your surgeon you would like the skin and fat removed from your breasts to be checked for pathologic findings.

 The earlier the condition is found, the better your final results will be!

The Duchess of York (pictured) made news when she appeared in public in a low cut dress that revealed a sun damaged, aged cleavage.

The fault lies not in the 50-year-old’s stars but in the sun.

Being a redhead also means having the most sensitive skin known. But for any woman, why go to the trouble of having breast implants if the girls are covered in wrinkled, sun damaged skin?

What is a girl to do? Wear a turtle neck every day?

More plastic surgeons are stepping forward to provide treatments for the aged, sun spot splotched décolletage. It appears to be more of a problem as a woman approaches age 40.

Actually, there are some habits, beyond lying out under the sun, that contribute to cleavage wrinkling. For one, the skin in the cleavage and lower neck is very thin so it damages easily.

First, the no-no’s for keeping smooth skin just below the neckline:

• Tanning booths count as sun damage. Stay away!
• When you put sun block on your face, apply some to the cleavage
• Sleeping on your side wrinkles the cleavage. Special pillows and neck rests can help.

Some plastic surgeons who are good with injectables are using the newly approved Sculptra to plump up cleavage skin and drive the wrinkles away over time. Botox will also work, according to some practitioners.

 While most Retin A is applied to facial skin, the substance – which must be prescribed by a plastic or dermatologic surgeon – can also help aging and sun damaged skin on the lower neck and cleavage.

Ditto microdermabrasion. While that is another procedure that is often used on facial skin, it can also work nicely on the décolletage. However, lasers are intended to work on deeper layers and are not a good treatment that thin-skinned area.

But, that’s not the case with Intense Pulsed Light (IPL) or a treatment that is often called a Photo Facial.

IPL is a non-laser light that seeks out brown pigment – resulting from sun damage – and pesky blood vessels. The light breaks up the pigment that gives the brown spots and blood vessels their very noticeable color.

The smooth, unmarked results usually become apparent in three to four weeks.

And that allows admiring eyes to concentrate more on the new breast enhancement!

Want a tummy tuck with that?

Until now, patients were concerned about being under anesthesia too long. Or at least the time required for breast surgery and a tummy tuck, the popular procedures often referred to as a ‘mommy makeover.’

The procedure got that name because, as you may already know, pregnancy and nursing can be very hard on the mother’s body.

As a fetus grows into full term, the mother’s stomach muscles are often stretched beyond the point of rebound.

After birth, those loosened muscles allow the abdomen to bulge in a small – but nonetheless bothersome – pot belly.

Breasts don’t fare much better. After being filled with extra fluids and tissue they are then emptied, resulting in sagging.

Many of these women often say to cosmetic surgeons and plastic surgeons: “I just want my pre-baby body back!”

And have it they shall. In safety and at a rate less pricey than undergoing separate breast augmentation and tummy tuck proceudures. Plus, you can imagine the benefits of going through only one recovery period!

Reported in the Aesthetic Surgery Journal, one practice studied the health records of 268 women who had a mommy makeover from 1997 to 2007.

The breast surgeries included:

• Breast enhancements only
• Breast lifts only
• Augmentation and breast lifts
• Breast reduction
• Removal and replacement of breast implants

The procedures were all performed by highly experienced, Los Angeles board-certified plastic surgeons in a certified surgery center. While the patients had no additional risk from the combined surgery, it does not mean all practices, everywhere will deliver the same results.

You still must do your plastic surgery homework and check on certification of the surgeons and surgery center.

Tummy tucks included:

• Mini tummy tucks
• Full tummy tucks
• Circumferential tummy tucks, or, lower body lift
• Reverse tummy tuck (for excess skin above the belly button).

(Read more about the breast enlargement and tummy tuck study.)

Study results showed no life threatening conditions. Thirteen percent of the patients asked for revisions, meaning they wanted some part, or the entire, procedure done over again. Most of those requests involved tummy tuck scars or seromas, pockets of clear fluid.

Complications for the combined procedure was close to the rates for doing each surgery by itself.

You read it here first!

Back in July, 2009, readers of the California Breast Augmentation Institute Blog learned how your own fat can be used to enhance your bust line. (Read our post about natural breast augmentation.)

Now, plastic surgeons at the annual American Society of Plastic Surgery meeting in Seattle have released a study showing that fat — taken by liposuction — is a viable alternative to breast implants.

The study is noteworthy because breast augmentation saw 307,000 procedures in 2008; it was the leading plastic surgery performed in ‘08, the most recent year for which statistics exist.

However, breast implants present rare — but possible — risks including:

• Breakage and leaking
• Infections
• Attracting painful scar tissue
• Causing a replacement operation

The basic concern about fat transplantation to the breast was that the fat could die, form calcium cysts and block mammograms.

Other cosmetic plastic surgeons feared the fat might be reabsorbed by the body.

Plastic surgeon Roger K. Khouri, M.D. and colleagues studied 50 women, aged 17 to 63 for five years; all had breast enhancement with almost nine ounces of fat taken from each thigh.

Results included:

• Fat transfer to the breast did not obscure mammography
• Fat survival averaged 85 percent
• Patients said they were pleased with the natural breast feel
• The average increase was one bra cup size

New techniques included having patients wear a bra-like tissue expander device 10 hours daily before and after plastic surgery to make room for the transferred fat.

The researchers used a tiny liposuction tube only 2.7 mm (about 1/16^th of an inch) wide.

The fat was cleaned by sedimentation and re-injected into each breast through 10 to 14

needle puncture sites in three-dimensions.

Many fat transfer experts have found that injecting a pool of fat does not work because such a large glob does not easily find a blood supply. However, tiny pearls of fat do if they are spread out.

The researchers also took a series of MRIs and mammograms before and after surgery.

The operation required an average one and one-half hours while the patients returned to their normal activities within three to four days.

• Saved long and hard
• Compared board-certified plastic surgeons
• Studied before and after breast augmentation pictures
• Arranged the rest of the financing
• Had breast enhancement surgery and the healing process

And now, “the girls” look like the ones you’ve always dreamed of having.

Virtually all plastic surgeons would advise wearing a well-constructed brassiere to protect your investment.

Well, O.K., to protect and perhaps showcase it, too. After all, a little pride and confidence in one’s appearance is part of what cosmetic surgery is all about, right?

Entering that delicate space and bringing a very special bra to the attention of the world is the annual parade of the 2009 Ig Nobel Prizes.

The Ig Nobel Prizes usually feature real, but off-the-wall, scientific studies like:

• A study inquiring if more damage to the skull is done with empty or full beer bottles
• An academic finding that cows with names give more milk than nameless cows

Not too many Ig Nobel Prizes apply to plastic surgery, but for the first time ever, a dual-use bra has captured a prize.

Announced on October 1st at Harvard University, the winner of the Public Health Prize category Elena Bodnar, M.D., demonstrated her winning invention, a regular bra that performs its intended normal support function along with a gas mask application.

Yes, you read that right – this bra doubles as a gas mask.

If things should go seriously South and a threat to breathing crops up, the bra can almost instantly be converted into two gas masks.

Dr. Bodnar is entirely serious and told a Discovery Channel interviewer: “The bra makes you laugh at first and then think.”

She wants you to think about being prepared. Not only for the sagging that eventually goes along with advanced aging (long after your breast enlargement, of course) but for emergencies too.

The beauty of the concept is that, in any crowd, at least 50 percent of the people present are wearing bras.

(Attention shy women: the bra is designed to come off under your clothing; there’s no need to undress in public.)

And if some untoward event, oh, like a gas leak or a huge dust storm crops up, more people would be able to escape to safety

That is, if all the women at the scene were wearing one of Dr. Bodnar’s bras.

(Attention skeptics: Dr. Bodnar is a real doctor and highly respected scientist who researches electricity’s effect on the human mind. Here is her latest scientific research.)