From the Desk of Dr. Farzad R. Nahai: The Latest in Breast Implants

The last 12 months has seen a lot of exciting developments in the field of breast implants.  In fact, we have seen changes and advances in the last 12 months that have outpaced the previous 10 years.

First, the duopoly enjoyed by the two principle breast implant manufactures in the United States was broken up by the introduction of the Sientra implants in early 2012.  Now there are three companies from which surgeons can choose implants which means patients and surgeons benefit from a wider array of choices.  Second, two more advanced types of implants have been FDA approved for use in the United States, the Allergan 410 and the Sientra anatomic gel implants.  These are unique in that they represent a 5th generation of gel technology that is more cohesive and form stable, meaning that they are shaped more like a breast and keep their shape.  Furthermore there is early evidence that these anatomic shaped form stable gel implants have lower complication rates, but the data is premature at this time.

There is still no one perfect implant that is a solution for every patient, but now there are more choices available for patients and surgeons that can further improve aesthetic and reconstructive breast surgery outcomes.

Dr. Nahai’s approach to his patients is based on each individual’s needs and goals. He keeps up with the latest advancements in his field. He looks for and studies innovative surgical techniques and aesthetic treatments and works with his patients to find the safest and most effective solutions for their aesthetic needs. Dr. Nahai is a true artist who enjoys helping his patients feel and look their best.

Schedule a free consultation today with Dr. Nahai at The Center for Plastic Surgery at MetroDerm, P.C. The center serves patients around the metro Atlanta, GA area including Dunwoody, Sandy Springs, Roswell, and Buckhead.

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The short answer to this question is that it depends … what follows are some of the factors that go in to making an informed decision on breast implant placement, specifically, whether it should be placed over or under the muscle.
For starters, the muscle being discussed if the pectoralis major muscle; put yours hands together and press and that is the muscle we are talking about (it is the same muscle used for planking or push ups).  If you decide upon a saline implant, the recommendation is to place the saline implant under the muscle the vast majority of the time.  Because the saline implant is easier to detect by sight and feel and the muscle offers additional coverage of the upper half or two thirds of the implant, saline implants are generally placed under the muscle.  Gel implants, because they are harder to detect, can go over or under the muscle.  With enough breast tissue of your own, for example about 2 centimeters thickness when pinching, the implant will be hard to detect.  So the question arrises, why go above the muscle?  There are several advantages in breast implant placement above the muscle; less pain, quicker recovery, a tendency to a more natural appearing result, an absence of implant distortion with muscle contraction in the short term and implant bottoming out in the long term.  Breast implant placement above the muscle does have its cons though; increased chance of seeing ripples and the possible need for additional imaging during mammography.  See below for a quick reference.

Above muscle

more risk of ripples
less pain
less recovery
implant does not move with muscle contraction
less risk of bottoming out
tends to more natural appearance
may need more views on mammogram
tendency to narrower cleavage

Below muscle

less risk of ripples
more pain
more recovery
implant moves with muscle contraction
more risk of bottoming out
tends to less natural appearance
less effect on mammogram
tendency to wider cleavage

The bottom line is that for the best recommendation schedule a consultation with board-certified plastic surgeon Dr. Nahai, and review the pros and cons in detail and help you make the best and most-informed decision.

Dr. Farzad R. Nahai’s approach to his patients is based on each individual’s needs and goals. He keeps up with the latest advancements in his field. He looks for and studies innovative surgical techniques and aesthetic treatments and works with his patients to find the safest and most effective solutions for their aesthetic needs. Dr. Nahai is a true artist who enjoys helping his patients feel and look their best.

Schedule a free consultation today with Dr. Nahai at The Center for Plastic Surgery at MetroDerm, P.C.. The center serves patients around the metro Atlanta, GA area including Dunwoody, Sandy Springs, Roswell, and Buckhead.

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Q&A with Dr. Farzad R. Nahai: Breast Implants and cancer surveillance

“Do breast implants make it harder to detect breast cancer lumps? I have breast cancer in my family and am considering getting breast implants.” – Anonymous Patient

Hello. Not necessarily. You can still have mammograms, ultrasounds, and MRI’s as a method of screening and detection for breast cancer with implants in place. There are some reports that detecting new masses is actually easier because the implant pushes and compresses the breast tissue from below to some degree. Depending on the implant type and location, above or below the muscle, you may need more views on a mammogram but early detection of suspicious lesions in the breast is still very feasible. –FRN

Dr. Nahai’s approach to his patients is based on each individual’s needs and goals. He keeps up with the latest advancements in his field. He looks for and studies innovative surgical techniques and aesthetic treatments and works with his patients to find the safest and most effective solutions for their aesthetic needs. Dr. Nahai is a true artist who enjoys helping his patients feel and look their best.

Schedule a free consultation today with Dr. Nahai at The Center for Plastic Surgery at MetroDerm, P.C.. The center serves patients around the metro Atlanta, GA area including Dunwoody, Sandy Springs, Roswell, and Buckhead.

 

From the Desk of Dr. Farzad R. Nahai: breast lift incision pattern options

When it comes to a breast lift, or mastopexy, there are three principle ways and breast lift incision patterns used to achieve the lift; a circle around the areola (the donut), and circle on a stick (the lollipop), and the circle on a stick with a long incision in the crease of the breast (the anchor).  The choice of which incision is used is based on the degree of the droop in the breast, whether or not an implant is going to be used at the same time, the amount of excess skin, the quality of the breast tissue, and the comfort level and experience of the surgeon with the procedure type.

The goal of the lift is to center the nipple and areola on the breast while at the same time tightening and lifting the breast tissue.  In my practice the most common incision pattern used is the lollipop, a circle around the areola then a straight line down the middle of the breast that stops at the fold.  For very minor lifts the donut incision can be used and for very droopy breasts with a lot of excess skin the anchor pattern incision tends to be best.

There is a misconception that the nipple and areola are actually detached from the breast during the procedure when in fact this is not done very often.  The majority of the time the nipple and areola are kept attached to the breast tissue during the lift. In rare cases of severe breast droop the nipple and areola are detached and re-attached as a graft.

If you are considering a breast lift schedule a free consultation today with Dr. Nahai at The Center for Plastic Surgery at MetroDerm, P.C.. The center serves patients around the metro Atlanta, GA area including Dunwoody, Sandy Springs, Roswell, and Buckhead.