On this blog, Dr. Gregory T. Fisher, MD, FACS, provides useful intormation to his patients. Please contact us with your inquiries. You may also make an appointment by calling Dr.Fisher's office at 562-865-9600.
Before bras, there were corsets, whose function was to lift and shape breasts upward. In the past, women did not move as much, did not jog, did not commute, and consequently there was little need for this type of undergarment. The modern bra with its two separate cups was gradually developed from the corset in the early 20th century.
Generally, the bigger the breasts, the more support you need. Women with small-to-medium size breasts, if they are used to wearing bras, probably feel a little uncomfortable without them. However, this is more a psychological issue and a question of habit: women tend to feel awkward or less self-conscious without bras if they are used to wearing them. In fact, you become used to automatically wearing bras, it is possible to not even notice or pay any attention to the slight discomfort from bras. So much the more important it is to ascertain the correct size and make certain it fits.
Although credible studies have not been conducted in this field, for obvious difficulties of arriving at objective statistical results, it is a common knowledge that tighter bras may have some link to breast cancer… In the field of plastic surgery, the surgeon is actually the best person to consult on the size, shape and aperture of the bra, because he knows your anatomy better than you. Dr.Fisher will provide you not only with advice, but also with the correct bra you should wear for 3-6 months after the operation.
2. Lean forward into the cups and rest your breasts into the supports.
3. Reach behind to hook the bra on the middle hooks of the closure.
4. Put the straps on your shoulders.
5. Position your breast in the cup by slipping a hand into the cup and lifting the breast while aligning the underwire on your ribcage along the natural crease of your breast to prevent pinching of the breast tissue.
6. Tighten the straps so that they support the breasts lightly without cutting into the skin or putting too much strain on the shoulders.
7. Adjust the straps every time you put on a bra.
Further, while bras do give breasts support, they do not ultimately prevent sagging. Gravity will eventually take its effect. However, fortunately, you can visit Dr.Fisher – the Expert in combating this type of gravity!
Historically, nipple-areolacomplex reconstruction has been considered a secondary procedure to the more important breastmound reconstruction. To optimize positioning of the nipple, surgeons generally recommend waiting until complete settling of the reconstructed breast before performing nipple reconstruction. However, when nipple reconstruction is delayed for months to years, final reconstruction is often never completed, as patients often opt to minimize their exposure to further surgical procedures. Most recently, some have advocated immediate nipple reconstruction in free TRAM flap reconstructions to minimize operative procedures and to achieve earlier completion of the breast reconstruction.
Nipple reconstruction techniques have evolved significantly over the years. From simple tattooing to the more technologically advanced, although rarely available, tissue engineering. Dr.Fisher uses techniques, which provide long-lasting, satisfactory reconstruction with minimal morbidity. While not recommended in breast augmentation, this procedure is inevitable in certain types of reconstructive surgery. (viz. our previous article)
Nipple-areola reconstruction represents the completion of the breast restorative process and has significant psychological implications for women who undergo mastectomy. Nipple size, position, projection, and color are determining factors in the aesthetic symmetry of the reconstruction, qualifying an otherwise nondescript flesh mound as the new breast. Complete nipple-areola reconstruction with tattoo can visually draw attention away from the scars on the reconstructed breast mound. In addition, autologous flap breast reconstruction following skin-sparing mastectomy can usually be designed so that the entire flap skin paddle, along with the scar, is tattooed as an areola.
The benefit of nipple-areola reconstruction is supported by the findings of a retrospective psychological survey comparing the level of satisfaction of women who underwent breast reconstruction with or without nipple-areola reconstruction; a highly significant correlation was seen between level of satisfaction and presence of the nipple-areola complex. Artists and anatomists consider the nipple-areola complex an essential and defining component of the breast aesthetic unit, and the physical characteristics of the nipple gain importance as the breast mound decreases in size. Reconstruction of position, size, shape, and color of the native nipple-areola complex currently are attainable goals; functional restoration of erectile ability and erogenous sensation can be restored by Dr.Fisher.
Many women fail to do their homework and throw themselves hopelessly after the Hollywood glitz and sparkle. It is the unique understanding of how the body works with the experience wedded in the hands of an artist, which provides Dr.Fisher with such acumen and wise distance when assessing his would-like-to-be competition.
A recent study showed that almost 15% of plastic surgeons in the United States are misleading their patients about saline implants. In some geographic locations, this number can be much larger.
Saline implants are little more than round bags of salt water. As any skilled environmentalist would tell you, such a round bag can last for centuries in the harshest weather conditions without significantly decomposing or malfunctioning. In the safe environment of the human body? “Well, it will last you a lifetime,” as Dr.Fisher says.
Compared to cohesive siliconegel implants, saline implants are somewhat more prominent and sturdy. That is why the popular sex symbols you often seen on magazine covers and the T.V. screens have opted for saline, not silicone. In the latter, the filler material is silicone gel, which is adapted to mimic the consistency of natural breast tissue, and retain its natural shape.
Silicone gel implants cost $1000-$1,500 more than their saline counterparts. This may be the reason for their lasting popularity. However, you should not think of your wallet but your welfare when you come and see Dr.Fisher in Cerritos Towne Center.
“I am very comfortable with all varieties of silicone as well as saline. I mostly use saline implants though, because there is a higher demand for them,” states Dr.Fisher. “I make a tiny incission, not more than an inch-and-a-half, which is completely imperceptible when healed… True, some of the proponents of the saline implants,” says Dr.Fisher, “argue that the silicone gel implant is too complicated. Too complicated? They mean the operation… Nothing is too complicated if you know what you are doing!” responds Dr.Fisher with a smile. “There have also been those who voiced objections based on their bad memories of the flawed liquid-silicone implants popular in the ‘80s… These have long since been made illegal in this country. Of course, you can go to Mexico or Venezuela or wherever these hopeless souls go, trying to save. You never know what you are getting there…”
There are many more types of implants. Do not listen to your girlfriend, because your body may not well accommodate to – or may even reject – the type she has. Modern implants, both saline and gel, are safe, but only a board certified plastic surgeon with experience and unsurpassed artistic acumen, such as Dr.Fisher, can determine which type is best-suited for a you, based on a number of factors.
Therefore, come to us with an open mind and never hesitate to ask; for Dr.Fisher will never experiment with your health. Your safety comes first. He may even postpone your operation or even ask you for a secondary medical exam. Do not be surprised.
Dr.Fisher will never let you down. Your Happiness is His Goal!
In the 1980s, Replicon implants were the most popular. Replicon is an anatomically shaped, polyurethane coated, silicone gel-filled implant. Many surgeons felt that the initial results were very beautiful, but short-lived, because the polyurethane, which was bonded to the surface of the shell helped to maintain the anatomic shape of the implant, eventually deteriorated, and once it was absorbed off of the shell, the remaining thin and pliable shell could not hold the silicone gel in place, and so its shape was lost. Further, gravity forced the gel to the bottom of the shell, collapsing the upper breast, and expanding the lower breast. Folds developed in the collapsed upper pole. The shell was very thin, and with time, the shell weakened along those folds, and eventually could break, allowing the relatively liquid-like contents of the implant to leak outside of the shell. In addition to the effects of gravity, the forces of the breast acted upon the implant, deforming its initial anatomical shape. The implant accommodated to the shape of the breast, rather than the breast taking on the shape of the implant.
Dr.Fisher was directly involved in a long and tedious process – far beyond the scope of this article, or this site, to describe in detail – which involved experimentation with diverse silicone gel fillers. Silicone can be made in virtually any firmness, from a liquid lubricant to almost a rock-hard solid. The aim was achieved in making the filler more stable and avoiding collapse of the shell. Further, the modern cohesive shell can be formed into a particular shape and maintain it.
In the past, shape was of only moderate importance, because the forces of the body and of gravity would shape the implant. However, the modern cohesive filler allows for various ratios of width, height, and projection.
The FDA moratorium on silicone gel filled breast implants in 1992 also contributed to increase in competitiveness and invention in this area. The type of implants that were available before the ban are available today as part of an “adjunct study,” which is open to patients with congenital deformities or having a revision for particular reasons.
What distinguishes the modern cohesive implants is that the silicone gel is firmer, essentially a soft solid. If a cohesive implant is cut in half, there is no gross movement of gel, and the implant maintains its shape. The way these are made is that the company uses more “crosslinker” in the making of the implant. The ingredients are the same, but with more crosslinker added, it makes the gel firmer.
Cohesive breast implants implies form stability, or form retention. That means that in any position, the implant maintains its shape. That is an important distinction, because it means that the shell should not fold, and that it will maintain a particular shape. All breast implants are “cohesive” to a different extent. More cohesive are not necessarily better. The bottom line here is the desirability of shape and firmness, which must be in proportion to the body’s natural qualities.