breast surgery
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The TUBA, or, transumbilical breast augmentation, procedure is favored by some because the only scar sits within a wrinkle in the patient’s belly button.
But just how does a plastic surgeon insert breast implants through a belly button?
First, the patient is placed under a general anesthesia; the whole procedure goes better if she lies still like a statue. Local anesthetics are injected into the umbilicus (the belly button) and breast.
Then, the plastic surgeon makes an inch and one-half long incision in the umbilicus and creates two tunnels just under the skin, one apiece leading to a breast. The surgeon has the choice of ending the tunnels above or below the chest muscle to make an implant pocket.
A tiny light and camera inside the tunnels then checks the pockets’ position.
After that, empty breast implants are rolled up like a cigar, inserted through the tunnels and placed in the pockets. They are then filled with saline to expand the pockets. (The expander filler tubes hang out of the belly button incision.)
After removing the expander, yet another long instrument checks the position of the pockets to make sure the new, enhanced breasts will be balanced and symmetrical.
The next-to-last step is placing the permanent breast implant through the tunnels and filling them to the size the patient wants.
Only saline breast implants are used; silicone implants are already, permanently filled and won’t fit through the tunnels.
Last item? Closing the incision and applying a dressing.
While recovering, the patient will notice some pain in her stomach near the tunnels and more discomfort if the implant has been placed below the chest muscle. However, adherents say there is less bleeding during a TUBA procedure and a quicker recovery with less risk to breast and nipple nerves.
As in all plastic surgery procedures, a practitioner who does the procedure often – once or twice weekly – is more likely to produce the best results.
Despite all that, many plastic surgeons writing in RealSelf.com don’t recommend TUBA because the procedure is difficult unless the surgeon is highly skilled and experienced.
One way to check: the surgeon should have many, many breast augmentation before and after pictures of his past TUBA patients.
July 28, 2010
Techniques
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Silicone breast implant doctors aren’t sure what causes a complication known as capsular contraction, a in which the body’s scarring mechanism reaches out and painfully surrounds one or both breast implants with scar tissue, making the breasts feel hard to the touch.
But a good guess is that the implant picks up a stray germ or three from the skin of the patient as the implant is worked through the incision and down into a previously prepared pocket, usually under the chest muscles.
Now, a plastic surgeon has come up with a way to place an implant through the skin, down and under the breast without the implant touching the patient’s skin.
It works like this: the tip of a nylon funnel is placed through the incision into the breast pocket. The surgeon puts the implant into the funnel and squeezes the implant into place.
The device (pictured) looks like a pastry bag used by bakers and chiefs.
Known as the Keller Funnel, somewhere around 400 U.S. plastic surgeons are said to be using it in breast enlargements. The funnel can be used when incisions are made in the:
- Armpit, an area known to surgeons as the axilla
- Areola, the brown area surrounding the nipple
- Inframammary fold, the area under the breast where the chest wall meets the breast
Normally, a surgeon uses his fingers to squeeze, poke and prod the implant into place. It’s harder to put a silicone implant into place because it is already filled. Saline implants, however, can be inserted empty and then filled after placement.
More women and their partners often report they prefer the soft, natural feel of silicone.
The funnel’s makers say placement is easier — and more sterile — because the nylon funnel has a slippery coating which allows the implant to slide easily along the length of the funnel.
Without the device, some plastic surgeons say their fingers have become fatigued while pushing and prodding the implants into place.
One expert even did a study and found a 95 percent reduction in force surgeons must apply to get the implant into the breast pocket!
Other benefits claimed include:
- Smaller scars
- Faster and more gentle surgery
- Quicker healing
- Easier on the patients’ breasts
According to the manufacturer, about 1000 breast enhancement procedures have a used the funnel.
July 7, 2010
Weird and Wacky News
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The economy seems to be improving and more plastic surgeons are reporting more people inquiring about, and actually, having cosmetic surgery.
So your bff goes in for breast augmentation or your other gf has a nose job. Of course, you notice, but exactly what do you say? A proper response can be awkward so why not let the professionals say it for you and send a plastic surgery greeting card?
Leading the way several years ago was the aptly named Lift Me Up Cards with greetings for gal pals who had:
- Breast augmentation (Congratulations on the Twins!)
- Breast lift (“I Thought You Needed a Little Lift. But it looks like your plastic surgeon already took care of you!”
- Rhinoplasty (“Your Nose Looks Great! You picked a great one!)
- Liposuction (“I Thought We Could Sit Around and Chew the Fat. But since you had liposuction, that’s not a good idea!”)
- Tummy Tuck (“Congratulations on Your Tuck! Now, no more Roll!)
- Face lifts (“You Look like a Million Bucks! I hope it did not cost that much to look so great!”)
- Sclerotherapy (“You’re So Vein. You probably think this card is about you!”)
And because imitation is the most sincere form of flattery, other plastic surgery greeting cards have entered the fray. Greeting Card Universe, for instance, offers congratulation cards for:
- Cosmetic Surgery
- Your Boob Job
- Your Breast Reduction
- Your Face Lift.
One card for breast augmentation patients shows a puzzled youngster on the front saying, “Gee whiz…I always heard of people making mountains out of molehills.” When you open the card, it says: “I just never knew anybody could really make it happen!”
Yet another card obviously intended only for woman-to-woman mailings says on the cover: “So you got some new Boobies, eh?”
Open the card and it says inside: “Can I have your old ones? Wait, I already have old ones!”
(Browse other plastic surgery greeting cards.)
June 17, 2010
Weird and Wacky News
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Most people already know that breast reduction by a plastic surgeon can prevent a lot of pain in the back and the shoulders of women who have huge, heavy breasts.
But save a life?
It actually happened when a mother of four little children was trapped under her massive N-size cup breasts for half a year.
The strange case happened in a remote area of Northern Peru when a five-foot tall woman, Julia Manihuari, 29, found her breasts continued growing after the birth of her third son.
According to news reports, Julia’s breasts caused her to faint if she tried to get out of bed; Julia, who admitted to having always had a small body build, said the stress of the breasts caused her absolute agony.
“My breasts were growing daily,” said Julia Peru. “My skin had sores and I had trouble breathing.”
By comparison, the Guinness world record holder for largest breasts ever belongs to a Florida exotic dancer who claims to have triple M breasts.
In Peru, Julia’s doctors at the Loayza Archbishop Hospital in Iquitos – in the Peruvian rain forest — had more serious concerns. First, they announced that the diagnosis was an extreme form of bilateral gynecomastia. But that was probably an error in translation because gynecomastia only occurs in males.
Julia’s doctors probably meant gigantomastia, which is the rapid growth of the breasts usually concurrent with pregnancy, according to Dorland’s Medical Dictionary.
Naturally the doctors were worried that the huge weight would crush her lungs.
Such a condition is VERY rare and only happens in about one in every 28,000 women.
After six months of being bed bound, word about Julia’s plight eventually got out, donations poured in and a trip to the nearest hospital was organized.
During a six-hour operation, doctors found the breast reduction was more complex than most because they had to work around many extra blood vessels which had sprouted in the breasts.
(Learn more about the unusual breast surgery.)
Eventually, they removed 35 pounds of flesh, fat and tissue, leaving Julia with much more manageable 34B breasts and freeing her from entrapment in her bed.
May 25, 2010
Doctors/Surgeons
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Your next trip to see a surgeon for breast implants, a breast augmentation or breast reduction consultation may be able to save you a stop or two at other doctors’ offices and the inevitable wait to see doctors, struggle for parking and other time consuming irritations.
It started with a study of 10,000 mammograms taken at a surgeon-run breast health center in South Africa.
Both South Africa and the United States have known shortages of radiologists who are trained to interpret the breast images so that a diagnosis is spot-on.
To test just how well breast surgeons could analyze a mammogram, Justus Apffelstaedt, MD, an associate professor of surgery and head of the University of Stellenbosch’s Breast Clinic and colleagues, created a database of mammograms done between January, 2003 and June, 2009.
A separate data base contained the patients’ vital data, including:
- Age
- Previous breast surgery
- Confirmed cancer cases
- Therapy records
Each mammogram was then read by two breast surgeons and his answers jotted down.
Results: The surgeons’ readings were equivalent to the results of screening programs run by specialized breast radiologists in Europe and in Australia.
But the breast surgeons scored even higher than dedicated radiologists in the United States.
The finding could be useful because valuable time can be saved.
One important measurement of the skill of the person reading and interpreting mammograms is known as the “recall rate.”
That means the patient must go back for another mammogram because the first was inconclusive. Physicians who needlessly send patients back for another mammogram waste precious time if indeed a case of cancer is present.
But the breast surgeons “bounce back” rate was about the same as European and Aussie radiologists and a little better than American radiologist.
Adds Dr. Apffelstaedt: “Breast surgeons are a highly qualified source for second opinions….women should take advantage of this.”
(Read more about the breast surgeon study.)
Added Deanna Attai, M.D., chair for the Communications Committee for the American Society of Breast Surgeons (ABBrS), and director of the Center for Breast Care in Burbank, California: “There are countless examples of a surgeon finding something on a mammogram that might have been missed by their radiologist.”
What does all this mean for you, the patient? Just ask your breast surgeon what experience he or she had reading mammograms.
May 21, 2010
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