19495 Biscayne Blvd.
# 204
Aventura, Florida 33180 (Miami Metro)
Phone: 305.931.3338
Fax: 305.931.3324
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BREAST AUGMENTATION
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Breast Augmentation increases the size of a woman's breast. You can easily go from an A-cup to a full C-cup or more. Breast Augmentation can also yield firmer, fuller breasts.
By looking at the position of the nipple, you can tell if Breast Augmentation is right for you. The crease under the breast is called the infra mammary crease. If the nipple is above this crease you are a good candidate for breast augmentation. If your nipple is level with this crease you are not an ideal candidate, however, a large implant can increase the size and may lift the breast so there is less droopiness. If your nipple is below the crease, you may want to consider a breast lifting procedure with augmentation.
Just as Breast Augmentation is your decision, so is the type of implant you wish to use. It is important to discuss your implant options with Dr. Hochstein. Saline is a silicone shell filled with saline and is the most common implant used. Silicone gel implants have an identical shell but are filled with silicone.
The texture of the implant can also make a difference. Textured implants have less results of hardening breasts and tend to stay in position better. Though, there can be evidence of rippling. Smooth texture has less risk of rippling but can be displaced more.
The placement of the implant is also important to consider. Miami breast augmentation surgeon, Dr. Hochstein places the implants under the muscle for a softer, more natural and long lasting result.
There are also a variety of incision sites that can be used by the doctor. The incision site is the access point for the doctor to perform the surgery. The incision can be placed at the edge of the nipple, under the breast, under the armpit, or through the belly button. In choosing the incision site it is important to take into account your lifestyle and visibility of scars.
The common risks with breast augmentation include firming of the breasts, loss of nipple sensation, implant displacement, implant deflation, or breast rippling.
During your consultation, it is important to ask questions. Be sure to go over the surgery in detail. Dr. Hochstein is there to ensure you receive the best possible outcome and that you are happy with your Breast Augmentation.
BREAST IMPLANTS
There are various types of breast implants available for breast augmentation. During your consultation with Miami breast implants specialist, Dr. Hochstein, you will learn which implant is most suitable for your body. The decision about which breast implant type to use is based upon numerous factors, and should be agreed upon between you and your surgeon. This includes the type of breast implant, method of insertion, and placement.
Types of Breast Implants: Saline and Silicone
SALINE IMPLANTS
Saline implants are the predominantly-used implant for breast augmentation. The implants are essentially empty prior to placement, with the silicone shell filled once they are underneath the skin and in place. Most methods of insertion allow for very short incisions to be used during this procedure. The two main advantages of saline breast implants are the fact that they carry little controversy and should they rupture or leak, a patient can easily detect the problem. Saline is a saltwater solution and generally considered safer than silicone; the body should absorb the fluid should it enter the bloodstream. The major disadvantages of saline implants is their appearance and quality; they tend to look and feel less natural than silicone implants.
SILICONE IMPLANTS
In the early 1990's it was reported that silicone breast implants were possibly responsible for connective tissue diseases in some women. Since the controversy began over the potential risks of silicone breast implants, researchers have been conducting scientific studies to investigate the safety of silicone implants. In 1999, a landmark report, undertaken by the Institute of Medicine (IOM) concluded that silicone implants do not cause major health problems such lupus or rheumatoid arthritis. In fact, there have been a number of major studies failing to find an association between implants and autoimmune diseases or cancer. And while no one can ignore the fact that silicone - and saline - breast implants may cause localized problems for some patients, numerous scientific studies over the years have shown that silicone gel-filled implants are both safe and effective for breast augmentation and reconstruction.
SILICONE (COHESIVE-GEL)
The word cohesive is a new term being used today to describe the nature of the fill compared to the more liquid fill that may have been used in silicone implants in the early 1970's. This is not a new science, this is not new technology - cohesive is simply a word that's being used today to describe the "sticking together" nature of the gel. The gel acts as a unit rather then a liquid - it holds together uniformly and retains the natural give that resembles actual breast tissue. Because the gel is thicker than traditional silicone, these implants are less likely to leak, rupture, or tear.
A great advantage of Cohesive breast implants is their natural feel, which may be especially noticeable when compared to saline-filled implants. Both implants have a possibility of rupturing, although some plastic surgeons will state that silicone implants are less likely to produce rippling and have a more natural feel then saline implants.
The Gummy Bear is used in Europe and other parts of the world put still has restrictions here is the US. Cohesive gel implants, or "Gummy Bear" implants, were developed to help reduce the rupture rate and prevent the rippling effect. They are the latest types of silicone implants available on a restricted basis.
They are textured, anatomically shaped, with a firm feel that has lead to their "gummy bear" nickname. Gummy bear implants typically create a firmer feel than traditional silicone. Yet they are still a relatively new breast implant on the market, with restrictions similar to traditional silicone. There are advantages and disadvantages to any silicone implant, it is import to talk with the doctor to find out what works best for you.
During an initial consultation with Dr. HOCHstein, you can learn if you qualify for the use of silicone breast implants.
IMPLANT SHAPE
Breast implants come in more than one shape, depending on the patient's goals and Dr. Hochstein's suggestion. Each patient considering breast augmentation should be individually evaluated regarding which implant shape is best for them - round or anatomic.
Anatomic breast implants, which are also known as "teardrop" breast implants, are fuller in the lower half. They are designed to look as natural as possible. Yet while this shape may work well for a select group of patients undergoing breast augmentation surgery, the anatomic implant is used sparingly. Because this design has a distinct vertical orientation, should the implant rotate, the appearance may become distorted.
Round breast implants are the leading style used for breast enhancement today. They are known to create a fuller look throughout the breast. An advantage of this design as compared to anatomic breast implants is that there is generally no adverse consequence should the implant rotates. Because it is round, there is no vertical or horizontal orientation. Due to gravity alone, the bottom portion of the breast will look fuller once the filler settles in. This creates contour similar to that of the anatomic breast implant, but avoids the risk of possible distortion.
SELECTION OF IMPLANT SIZE
Determining the appropriate implant size is one of the critically important steps in breast augmentation. An implant that is too small or too large produces an unsatisfactory result. Dr. Hochstein believes that the best and most natural results are achieved by selecting an implant that is proportional to a woman's anatomic features. During each consultation, Dr. Hochstein devotes much time to this process and together with his patients finds an appropriately sized implant to help them achieve their desired results.
LOCATION OF INCISION
There are several places where an incision can be placed for breast augmentation: in the axilla (armpit), under the areolas, or under the breasts. (Although Dr. Hochstein usually reserves using an incision under the breast for patients who have a preexisting scar in this location). Dr. Hochstein is fluent in the use of all of these approaches, during your consultation you can decide what works best for you.
LOCATION OF IMPLANT PLACEMENT
Breast implants can be placed either under the breast tissue and over the pectoralis muscle, or under both the breast tissue and the pectoralis muscle. The vast majority of patients who undergo breast augmentation today have implants placed under the muscle. The reasons for this include a more natural result by having more tissue cover the implant and a lower rate of complications.
RECOVERY
Recovering from breast augmentation, as with any surgery, is a gradual process. Some patients recover more quickly while others may be a bit slower. In general, the recovery following these procedures is not difficult. The typical patient will experience some pain and discomfort and use pain medication for 2 to 3 days following surgery. Depending upon the patient's occupation, most patients will return to work 4 to 5 days after surgery. After 1 to 2 weeks patients can resume non-impact lower body exercise. Four weeks after surgery they can resume impact exercises and 6 weeks following surgery they can resume upper body exercise.
Visit our Before Surgery Care for more information on pre and post operative care.
RESULTS
While patients will of course see results immediately after surgery, there is always swelling that develops. During the first week after surgery, the breasts and surrounding area are swollen, the implants appear high and your nipples point downwards, (this is all very normal). Over the course of several weeks the swelling subsides and the tissues stretch to accommodate the implant creating a more natural appearance.
COMPLICATIONS
As with any surgery, complications can develop following breast augmentation. Fortunately complications are unusual. Some of the complications which can occur following augmentation are: bleeding; infection; capsular contracture; and deflation. Dr. Hochstein will discuss these with you in detail.
FOLLOW UP
Dr. Hochstein and his staff are committed to his patients' care and well-being. Dr. Hochstein follows his patients progress for an extended period and is always willing to ease any concerns and answer an question that may arise.
BREAST AUGMENTATION / LIFT
As time passes, pregnancy, nursing, excessive weight loss and gravity have adverse effects on women's breasts causing them to lose their elasticity, firmness, and shape and begin to sag. A breast lift is a procedure that corrects this condition using a combination of removing excess breast skin. If desired, implants may be used to restore breasts to their natural shape and size.
The best candidates for a breast lift (Mastopexy) are healthy, women who are realistic about the result they would like to achieve. A breast lift can enhance your appearance and your self-confidence. The best results are achieved on women with small, sagging breasts due to loss of skin elasticity secondary to pregnancy and / or nursing, or weight loss.
Possible complications of the surgery include bleeding and infection following surgery, which may cause scars to widen, (poor healing and wider scars are common in smokers). The procedure can also leave you with different positioned nipples, or a change in feeling in the nipple or breast.
MASTOPEXY VS. BENELLI LIFT
A breast lift, also called a "mastopexy," may be perfect for women whose breasts have lost their shape and firmness. If factors like pregnancy, nursing, and the force of gravity have caused your breasts to lose elasticity, you may be left with stretched skin and less volume. To learn which type of mastopexy technique is best for your condition, make an appointment with Dr. Hochstein for a consultation visit. During this time, he may suggest a crescent-shaped, anchor-shaped, or a Benelli lift variation to help bring your breasts to a more youthful appearance. (A lift is not considered permanent, considering that weight fluctuation and aging may naturally take a toll on its shape; however, it is still successful toward improving the condition of sagging breasts.)
Mastopexy can take up to four hours to complete. It is usually performed with general anesthesia, although it depends on the technique used. For women who show only mild signs of sagging, or what is called "ptosis," partial mastopexy may be all that is needed. This technique involves a crescent-shaped, or "S-shaped," incision above the areola; moving the nipple upward into a new location. But for Miami breast lift patients who possess severe signs of sagging, an anchor-shaped lift, or a mastopexy, may be the best bet. It is designed to actually create a new breast envelope through the repositioning of the nipple and the reshaping of the breast. Although a full mastopexy leaves patients with heavy scarring, it is the most-commonly performed procedure for women needing a dramatic lift. The anchor-shaped incision starts at the base of the areola and vertically descends to where the breast meets the rib cage; a horizontal crescent-shaped incision is then created where the breasts meets the rib cage, before it is sutured.
Similar to the crescent-shaped incision, the Benelli lift involves making an incision solely along the areola. It entails the removal of a donut-shaped piece of tissue around the areola border. Sometimes a little more tissue is removed above the areola to compensate for a lifting effect when it is sutured; comparable to the crescent. This may result in flatter and rounder breasts in the end. The Benelli-Lollipop lift is similar to the Benelli lift; however this technique may be more effective on women who have medium ptosis. With straight incisions that run from under the areolae to the breast crease, the lollipop is a good option for patients who may have too much sagging for the Benelli and not enough for a full mastopexy. In general, scars around the areola fade faster than in other areas like the breast crease.
Please feel free to contact our office if you have any questions about the benefits of breast lift surgery, or if you would like to make an appointment with Dr. Hochstein for a consultation visit.
REVISIONAL BREAST SURGERY
In qualified hands breast augmentation surgery is very safe and reliable in achieving spectacular results. Sometimes, though, bad results occur.
Miami breast revision specialist, Dr. Hochstein has made his reputation in changing what is otherwise unattractive breasts and transformed them into soft, natural appearing results.
There are many causes for bad outcomes. The implants may have been placed over the muscle, they may have been placed too low, too far apart, too high, or so close together that it appears as if there is only one breast on your chest. All of these situations can be corrected. Let Dr. Hochstein show you how your breast implants should look like.
BREAST REDUCTION / LIFT
Many women with larger breasts often choose to have Breast Reduction surgery. Such surgery can alleviate back problems, avoid loss of sensation from stretched nerves, and look more attractive.
Often larger breasts are the result of excess skin. This skin has stretched and can cause the breast to droop. Techniques can be used to remove this excess skin with undetectable scars or with liposuction. The T-incision technique involves making a T-shaped cut on the breast which raises the nipple. The incisions can be short with only subtle scarring. The Vertical-incision lift works well with smaller or droopy breasts. The Doughnut Lift involves cutting around the nipple and removing extra skin or sometime breast tissue. Other techniques may be able to give Miami breast reduction patients better results without this risk of scarring.
With any breast reduction surgery there is a risk of skin or nipple loss, change or loss of sensation and the loss of an ability to produce milk. However, these risks are greatly reduced by choosing a well qualified doctor.
In order to achieve a lift as well as a breast reduction, the excess skin can be trimmed away. However, this is not as long term a solution. In time the breast skin will stretch again. Often extra breast tissue is removed and an implant added to provide a more permanent lift to the breast. Better cleavage often results.
If you are considering benefiting from a breast reduction surgery, be sure to discuss the surgery in detail with Dr. Hochstein.
GYNECOMASTIA
Due to various reasons, some men develop female-like breasts ("gynecomastia") as a result of excess tissue and fat in the chest area. This is oftentimes first noticed during the adolescent years when young men go through puberty. These individuals may feel insecure and/or embarrassed of this problem and refuse to remove their shirt when in public, such as at the beach or poolside.
Some of the common causes of gynecomastia include hormone imbalance, drug abuse, use of steroids, and certain prescription drugs. Also, it is important to note that gynecomastia is not only present in overweight men; it can also affect those who are otherwise in good physical shape.
Typically, men who experience gynecomastia attempt to reduce its appearance through diet and exercise; however, most of the time they end up making the appearance more evident due to the enlarged pectoralis muscle. In order to reduce the chest size, men opt to undergo a surgical procedure, "gynecomastia surgery" (male breast reduction surgery). This can involve liposuction to remove stubborn fatty tissue and/or excision of the tissue and skin.
During an initial consultation, Dr. Hochstein can thoroughly examine the patient and determine the most appropriate treatment.
What to Expect After Surgery
There is a moderate amount of discomfort associated with the liposuction and excision of gynecomastia in men. It should be well controlled by oral pain medications and should be expcted to last 2-3 days. It is always a good idea to have someone drive you home and stay with you at least for he first night of surgery.
There is some bruising and swelling associated with this surgery. In fact early on you are likely to see no difference at all as the swelling more than makes up for the amounts removed. It is helpful to apply cooling packs for the first 48 hours and to avoid salt intake while drinking plenty of water. I usually instruct my patients not to see much of a change for the first 2 months and that the final result is not known until 6 months. This is a surgery with an extremely low complication rate but should be monitored for any fluid accumulation afterwards.
Resumption of Physical Activities
I like for my patients to resume normal activities as soon as they feel up to it. Resuming work can be done as early as the next day or the day after as the discomfort from this operation tends to be short lived. The stitches are all under the skin and dissolving so that within 3 weeks my patients are able to begin going to the gym to work out. You should also avoid exposing the scars to the sun for at least six months. Sunlight can permanently affect the skin's pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sun block. A good rule of thumb is that if the scars have not lost their pink color yet the sun should be avoided.