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Breast Implant Malposition Explored

Coming out of Breast Augmentation, there is much care taken for you to have the best results possible. A lot of complications can be avoided by putting yourself in expert hands. I’m triple board certified and specialize in Breast Augmentation, revision and reconstruction. You have the best chances for the best outcome with us.

One of the complications of Breast Augmentation that we strive to avoid is breast implant malposition. This is when the implants move out of their correct position, either immediately or over time. It isn’t extremely common, but when it does happen, there are usually a few reasons and options for correction. If you’re aware of them, you can help avoid or identify them as early as possible for correction with Breast Revision surgery.

Here is a guide for the possible reasons for implant malposition:

  1. Not allowing yourself to properly heal. With the pressures to return to work and daily activities, especially for mothers, you’re faced with the difficulty of allowing your body enough time to heal. Everyone heals at different rates. This can take from 3 to 6 months, up to a year to completely recover. Taking proper care of yourself during healing and wearing the correct bra support is crucial. Usually breast implants are positioned high with the intention of them dropping, or “settling” into the proper place as they heal. Wearing underwire or push up bras during this time can prevent them from doing this properly and they could stay unnaturally high. This “riding high” malposition is usually a tell tale sign of Breast Augmentation and can also cause nipples to appear irregularly low or pointed downward.
  2. Your body shape, particularly if the ribs are more prominent or uneven, they could push the implant into a different position even if the implant pocket is positioned correctly. Ribcage prominence and scoliosis are some things surgeon should take note of and make accommodations for in surgery.
  3. If breast tissue is not strong, implant size can sometimes contribute to a low malposition where the implant seems to be falling out of the breast pocket. This isn’t the only reason low malposition occurs, but there is a higher risk of this with larger implants because the extra pressure can thin out the bottom of the breast pocket. The inferior position or “bottoming out” of an implant empties out the top of the breast of any fullness and often points the nipple too high.
  4. Capsular contracture is the most common reason for implant malposition. This occurs when the tissue surrounding the pocket containing the breast implant hardens. This constricts the implant and pushes it into a variety of ways that can look abnormal and be uncomfortable:
    1. This could be one of the reasons the implant would be pushed upward.
    2. Implants squeezed laterally into the armpits will look unusually far apart.
    3. When implants are pushed inwardly toward the center of the body this is called synmastia. The breast could be positioned inward or the implant could slide out of the pocket and bubble under the skin to look like a “uniboob.”
    4. Capsular contracture could also squeeze the implant into an irregular shape with unnatural curves or indentions.

If you are experiencing any of these unfortunate malpositions, in the correct expert hands, Breast Revision surgery can restore your hope, confidence and your breasts to a beautiful, natural appearance. Let’s talk about how I can help you. Visit www.davinciplastic.com to schedule a consultation.

Steven Davison M.D.

Board Certified Plastic Surgeon

Reasons for Breast Revision Surgery

These days my patients are quite informed about the procedures they are requesting from me. They’re reliant on my professional advice on the details and implementation of their goals, but most Breast Augmentation patients have an idea about what the procedure entails. The lesser known sister of Breast Augmentation is Breast Revision surgery. There are a variety of reasons someone might need this “surgery after the surgery,” and I’ll cover those here.

Breast Revision surgery is for someone who’s already had a Breast Augmentation and needs a change that requires another surgery to the breast area at any point in time near or distant from the original Breast Augmentation. The majority of women love their new breasts with no complications and often experience satisfaction for many years.

However, a Breast Revision surgery is a great option for a variety of reasons, such as:

  1. Address the natural effects of aging and gravity on the breasts. The breasts with the implant still will sag over time and so a Breast Lift could help restore perkiness and placement.
  2. Breasts change as a result of pregnancy, weight loss or gain. If the Breast Augmentation occurred before these events, a Revision can be intended to restore your breasts to their former stature.
  3. Change the implant size with a Breast Implant Exchange to go smaller or larger. Fortunately, the Breast Implant Exchange is less intense of a surgery than the original augmentation. The space or pocket for the implant has already been created so there’s not the stretching discomfort experienced during the initial surgery. Also, the recovery time is usually shorter.
  4. Repair breast implant malposition. The implant didn’t settle where it should be and has caused the breasts to look unnatural.
  5. Correct capsular contracture where the tissue surrounding the implant contracts and squeezes the implant into an awkward and uncomfortable position. In this case, the constricting tissue would be removed and the implant replaced.
  6. Change the implant type. Some women who got saline implants and experience rippling or wrinkling, prefer to exchange them for the consistency of a silicone gel. This is particularly common for women who got a Breast Augmentation when the silicone option was off the market from 1993 to 2006.
  7. Breast Implant Exchange for prevention or in the case of leakage. Implants do not have a lifetime guarantee to not leak. It is recommended to exchange for a new implant every 10 years. If a saline implant is leaking, it’s easy to detect because the breast will appear deflated. However, in most cases, a silicone implant leak would require an MRI to detect leakage, so regular checks are recommended.
  8. Breast cancer treatments may require the implant to be removed. This is a decision that should be made along with your medical support team.

In conjunction with considering the need for a Breast Revision surgery, I can’t emphasize enough the importance of choosing an experienced plastic surgeon to perform it. Maintaining aesthetics of the breasts while navigating prior surgery effects is an art that requires much technical skill and expertise. To discuss the possibility of putting yourself in the hands of a triple board certified surgeon, such as myself, you can schedule a consultation at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic Surgeon

 

Before and After Virtual Reality for Breast Augmentation

Everyone wants to have an idea of what they’ll look like after their cosmetic procedure. It used to be all conjecture, but fortunately now with 3D technology, you can get a really good idea of your results. I’m pleased to offer Vectra Breast Imaging as a state of the art imaging program to help in the process of creating the best Breast Augmentation results achievable.

See What Can Be… This state of the art computer program, along with our trained implementation of it, can give you realistic images to explore your options in a hypothetical visual sense of what your body could look like. This can better help you set your goals while allowing for the benefits and conditions of your options to sink in. This significantly improves your decision making ability by allowing you to get the best possible idea of what you could look like after your Breast Augmentation. We can also be sure to manage expectations and be on the same page for the best possible treatment plan.

Customized to You… Vectra Breast Imaging takes exact measurements of the current body contours and proportions, and uses this to adjust volume with just one click. The degree of change is highlighted with a color distance map. It offers 3D views from any angle of your body with superimposed images to see “before and after” views before the actual possible reality of it. This means you can seamlessly rotate from front, side and back views to get a complete picture. Also, the “before and after” views can be formatted in side by side or as a faded overlay.

Easy Consideration of Choices… This tool also allows you to compare multiple scenarios with different size and implant types. It uses the implant shape, size, placement and factors in gravity. Vectra Breast Imaging’s dynamic capabilities allow for the correction of ptosis (sagging) and breast asymmetry.

Visualize in Office and at Home… These images are not only available in our office consultation, but through the ViewMyConsult portal. You can visually soak in the different options and review treatment recommendations in the comfort of home. While I strive to offer a compassionate, complete, relaxed office consultation, these types of decisions have multiple levels of consideration and having all the information and images at your finger tips is so reassuring.

Vectra Breast Imaging empowers our patients with confidence, manages expectations, and improves our communication to get your Breast Augmentation journey off to a great start. But to make sure the actual outcomes are the best possible, you need to be in the best hands… our hands. To begin your successful Breast Augmentation journey with me, visit www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

All About The Breasts: Surprising Facts, part 2

The more you learn about your breasts the better you can care for them and appreciate them. Here are some more fun facts to help you know more about your girls.

Side sleeping is best for breast shape. They even could use some pillow support while you sleep. This is just another reason that belly sleeping isn’t best for your body.

Breasts can be a breeding ground for bacteria. This happens because sweat can collect and the abundant oil glands above and between your breasts to make the area vulnerable to clogged pores and pimples. Prevent problems by wiping the area right after workouts or if you’ve been outside sweating a lot, and never staying long in sweaty bras because they can harbor bacteria that love dark, damp places.

They have growth potential through your early to mid 20s. This is especially important for younger women when considering breast augmentation. Though most breast growth does happen through the puberty years, they do continue to grow into early adulthood. How big they do get is actually determined by genetics from both parents. After the mid 20s, it’s unlikely for them to grow unless you gain weight, get pregnant, breastfeed (however they will go back down afterwards) or sometimes with birth control.

Nipples usually get darker during pregnancy. The body does this because it is anticipating breastfeeding the baby, which can better see darker colors. The darker nipple makes it a more visible target. No reason to freak out though, most women’s nipples lighten back to normal a little while after baby is born, while some may stay just slightly darker.

The creation of cleavage isn’t just based on breast size. While the larger ladies do have a cleavage creating advantage, breast shape and location on the torso also come into play. This means that the same cup size can vary in their ability to create cleavage. If the breasts are fuller in the outer breast or positioned wider apart, cleavage may not come as readily. A narrow torso, breasts set closer together or fuller in the center have an easier time creating cleavage.

Exercise can’t increase breast size, but the right ones can help their appearance. Breasts aren’t made of muscle, but they’re resting on top of muscle. These exercises can help firm up the pectoral muscles, which can slightly perk up the breasts: pushups, bench presses, dumb bell flies, medicine ball slams or pullovers. If this doesn’t provide enough of the lift and firmness you’re looking for, a Breast Lift can definitely enhance the positioning and perkiness of the breast.

If you’re considering any cosmetic surgery related to the breasts, it’s worthwhile to talk to an expert in this area. As a triple board certified plastic surgeon, I’ve had extensive training and expertise in all areas of Breast Augmentation and Reconstruction. Schedule a consultation to see how I can help you enjoy your desired breasts, by visiting www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

All About The Breasts: Surprising Facts, part 1

Your precious pair can surely be assets of enjoyment and wonder. Hopefully, you’ll have your set for life, so it’s a great idea to get to know them more. Here are some facts about your bosom buddies that may be surprising.

Breasts have their own monthly cycle so there is a better time of the month to schedule your breast exam. Fluctuating hormones cause changes in breast tissue. Level hormones in the week after your period help even out any lumpiness or swelling, which makes it easier to diagnose any abnormalities. They’re also less sensitive, making the exam more comfortable.

You should be using anti aging cream on your breasts. Breasts consist of fat, milk glands and firm, connective tissue called collagen. As we age the glands shrink, collagen decreases and fat may increase. Along with gravity, this results in the drooping over time. It doesn’t help that the skin of the breasts is quite thin. This means that you shouldn’t neglect to moisturize your breasts and nipples and event can use collagen building creams to help keep the skin supple.

They weigh less than you think, but still need support. Surprisingly, with an A cup size, you’ve got about a half pound of weight all together in your breasts, a pound total for B cups, C cups add up to about a pound and a half, and about 2 pounds total for D. Even though it doesn’t sound like a lot of weight, the thin skin and loss of collagen with age, mean that it’s best to help your girls with supporting them with a bra, especially during exercise.

Nipple hair is completely normal. It’s very common to have 2 to 20 nipple hairs on each breast. Heritage, skin and hair darkness, and hormonal stages play a big part in how much hair each woman deals with. Generally, darker skin and hair on the head means more nipple hair. To remove them, waxing and plucking is completely fine, just be sure to clean the area before and after to prevent infection.

They come in different sizes, shapes and directions even on the same person. No one is completely symmetrical with any part of their body. Most women actually have their left breast with a little more tissue so it’s slightly larger. Also, nipples point in different directions and come in varying shapes and sizes.

Breast implants are more common than you may think because they can look more natural than you may realize. The statistics say that about 250,000 women get them every year and estimates are that currently 2 million women have them. While the extreme makeover cases get the most attention, most women simply wanting to go back to their before children breasts or just making slight improvements, with just a 2 cup size increase on average.

Learn more about your breasts and if you’d like to talk about improving them, schedule a consultation at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

Touch Up on Breast Reconstruction Techniques

When considering Breast Reconstruction after cancer, I will guide you through the possibilities for creating the most natural, beautiful breasts. There are a couple of different types of surgery that you may want to familiarize yourself with beforehand. These are the kinds of Breast Reconstruction surgeries available through my office. Some options utilize the body’s own tissue taken from areas with a little extra, such as the abdomen or thighs, and the others use silicone or saline implants.

DIEP Flap Breast Reconstruction

DIEP stands for Deep Inferior Epigastric Perforator. This technique uses excess skin and fat from the lower abdominal area. The incision is similar to the one used for a Tummy Tuck and can be easily hidden by clothing or bathing suit. Another benefit to this surgery is that it flattens the abdomen for an overall beautiful body contour. It spares the abdominal muscle and there is significantly less pain in the shorter recovery process. Since the muscles are in tact, the abdominal wall strength is not affected.

Tram Flap Breast Reconstruction

This is another technique that uses the abdominal tissue to rebuild the breasts, however the difference from the DIEP is that it does use abdominal muscle in addition to the skin and fat. The incision will still be discreet and hidden by the clothing or bathing suit, but recovery will take longer due to harvesting muscle. I am skilled in offering options within this surgery, which are to take the tissue connected to a blood supply, which is called pedicled, or not attached to the original blood supply and requires connection to a new one, which is called free flap. Both of these methods require immense skill and unique challenges. For example the pedicled technique is to avoid muscle rotation, which can create an abdominal bulge, and the free flap technique is even more intricate of a surgery as it requires successful reconnection of arteries using microsurgery.

Gracilis Flap Breast Reconstruction

This surgical technique uses excess skin and fat from the inner thigh to reconstruct a natural appearing breast. This can be done without taking any muscle, which it would then be called the Transverse Upper Thigh Flap surgery. Sometimes the inner thigh flap requires a small amount of muscle in order to assure an adequate blood supply to the flap. The muscle that’s used to do this is the gracilis muscle, which is what the surgery is named after. Unlike missing a part of the abdomen muscle, the gracilis muscle is often not missed unless you do a lot of exercises or sports mostly depending on quick changes of going side to side. A side benefit of taking tissue from the inner thigh is that it often can reduce inner thigh friction.

Latissmus Flap Breast Reconstruction

This surgery reconstructs the breasts using a flap of skin and muscle from the back of the same side as the operated breast. This living tissue is used to recreate the breast mound. It is mostly used for women who don’t have enough abdominal tissue or have had previous abdominal incisions. There are usually no complications and the blood supply is highly dependable. The use of the latissmus flap can be combined with implants.

Breast Reconstruction with Implants

Because of the familiarity with implants for Breast Augmentation, this is an option chosen by thousands of women each year who undergo a mastectomy. It is also commonly used for women who are thin and don’t have extra tissue to use. A major benefit is that this can be done sequentially under the same anesthesia as the mastectomy surgery, called immediate reconstruction. This process still usually requires 2 or more surgeries, as we will have to navigate unique issues with the skin stretching (possible loss of elasticity due to radiation treatments) and addressing scar tissue.

You can rest assured that I am using the most cutting edge and advanced techniques along with my immense experience to help guide you to the right surgical options for your Breast Reconstruction. Please schedule a consultation to discuss what might be the best option for you, www.davinciplastic.com.

Sincerely,

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

 

Choosing the Best for Your Breast Reconstruction After Cancer

One of the many considerations of breast cancer that requires a mastectomy is Breast Reconstruction surgery. This can be a time of overwhelming choices and so my goal with each Breast Reconstruction patient is to provide compassionate care and the best natural looking results possible. This is a specialty I give the utmost attention to and have developed knowledge and skills that have provided beautiful results that have been very healing and satisfying to many clients.

Why Reconstruction?

While considering being in surgery again most certainly is not appealing after going through cancer treatments, I have found that it does help empower women to regain their feelings of femininity and sense of normalcy. Most times I’m helping to rebuild a breast mound after lumpectomy or mastectomy surgery, however I can also correct previous breast surgeries and nipple replacement.

Deciding on the Surgeon

Through my many years of experience and artistry, as well as using the most sophisticated and cutting edge techniques, I can help to create natural looking breasts to enhance body shape. Breast reconstruction surgery requires a thorough understanding of the intricacies of the human anatomy, as this is not the same process as the standard Breast Augmentation. I have extensive experience and years of specialized training in Breast Reconstruction surgeries to provide my patients with the most beautiful, natural looking results possible.

Making Decisions

Working alongside your oncologist, we will patiently and thoroughly discuss your options regarding Breast Reconstruction surgery. We will cover many topics, such as the possibility of performing Breast Reconstruction at the same time as the cancer removal under the same anesthetic, or if we should wait until after other treatments.

You also have options as to what you’d like to replace the breast tissue with, including your own living tissue from an area with some extra to spare, such as your inner thigh, or implants made of silicone or saline. All of these can be used to create beautiful, natural looking breasts. The best choice differs for each individual based on many factors so we will discuss this extensively. Some of these factors are (but not limited to):

  • cancer type
  • stage of breast cancer
  • your personal preferences
  • overall health

If you’re considering Breast Reconstruction after cancer, and you’re looking for compassionate and expert care for the best results possible, please visit our website to schedule a consultation at www.davinciplastic.com.

Sincerely,

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

 

 

Plan Your Procedures

While you may initially come into my office to address an immediate beauty need, we will take the time in our consultation to talk about your long term beauty goals and to help you with a plan. This plan may start off with some non invasive treatments, such as a Liquid Facelift using a variety of injectables to touch up and rejuvenate some crows feet, furrowed brows or mouth parenthesis creases. Then it might build into a 5 to 10 year plan for a mini facelift to address slightly sagging jowls and neck or Blepharoplasty to open up drooping eyelids for a brighter, more rested looking eye area. Either way, this plan should not only focus on immediate needs, but incorporate treatments for future youth restoration goals and maintenance.

Cosmetic surgery and non invasive treatments can easily be performed all year long, however, there are certain times of year that lend themselves to easily incorporate the rest and recovery that make it more convenient. Also, there are also certain issues you may want to address before a special event (think: high school reunion or holiday party) or time of year (think: bikini season).

Here is a seasonal surgery guide with suggestions for planning your procedure:

Fall

After the activity of summer and before the flurry of winter festivities, the fall season offers a perfect break in the social calendar for most people. This means that recovery time away is easy to schedule. Also, the cooler weather means clothes with more coverage and comfort. After getting any kids and grandkids settled into school, the scheduled routine or empty nest would allow for effortless predictability and rest for scheduling a surgery. It also will allow plenty of healing time for you to approach the holidays recovered and looking great. This is a good time for anything from Liposuction, Blepharoplasty, Facelift to Breast Augmentation. Fall is my first choice for cosmetic procedures.

Winter

This season offers some good opportunities for cosmetic surgeries. Before the new year, the injectables are the best because you can’t afford downtime between Thanksgiving and New Years, but January is the perfect month to kick off the New Year with a big step towards your beauty and healthy body goals. Winter scarves and turtlenecks easily cover the bruising or swelling from Kybella or a Facelift. Also the bulkier clothes will conceal any over night changes to the body from a Tummy Tuck or Liposuction. The Martin Luther King and Presidents Day holidays allow for long weekends and time off work without the usual holiday social schedule.

Spring

These are the months to rejuvenate and refresh yourself along with the start of a new season, and to prepare for the summer season. Body image procedures such as Liposuction, Brazilian Butt Lift, and Breast Augmentation are popular this time of year. Also, by this time, some of the results from New Years resolutions for weight loss have a chance to kick in and become a habit so that body contouring can have optimal results.

Summer

Surgery can be a success in the summer, but it’s crucial to stay out of the sun. The heat and sweat can be irritating during recovery. It’s always a great time for injectables like Botox, Juvederm, Radiesse, Sculptra since these injectables are in and out so you’re on your way to looking fabulous for your vacation. Another fabulous non invasive, body contouring rpocedure to trim away small puches of stubborn fat is SculpSure. Popular summer break surgical procedures are Rhinoplasty and Otoplasty between the school years.

Let me help you make your procedure plan for your ideal image by scheduling a consultation today at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

2016: Year of the Ideal Implant

One of the 2016 predictions I feel strongly about is that the Ideal Implant will grow to be the primary and most requested implant for breast augmentation. After many years of trials and testing, to prove safety and patient satisfaction, the Ideal Implant is now available to my patients and those of other plastic surgeons around the country.

Not the Same Saline Implant
The Ideal Implant improves upon the saline implants of years past… but still offers the benefit of peace of mind by being a natural, harmless substance. It is called a Structured Breast Implant because the design has inner compartments to control the flow of saline, giving the implant a more natural look and feel and making it more resistant to leakage.

Now that a natural feeling saline implant is available, the greatest downside of saline implants, from the past, is eliminated. In older models, all the saline would pool in the bottom to give a sagging feel. Another downside was  folding at the edges so the implant outline would be detectable. Now, with the inner layered structure inside the Ideal Implant, neither of these is an issue.

Designed for an Aesthetically Natural Look and Feel
The innovative design of the Ideal Implant includes a series of implant shells nested together inside two separate chambers. This holds the saline filler in place and controls the movement of the saline within the implant. This maintains an aesthetically appealing position and shape that also feels natural. This internal structure is designed to reduce folding, rippling and wrinkling, which is a common complaint for traditional saline implants. With no folding and a lowered outer edge, the Ideal Implant achieves an improved seamless contour with the chest wall.

Materials with Well Being in Mind
Ideal Implant is filled with saline, a safe sterile salt water solution that is used in many medical capacities and, unlike silicone, poses no harm if it leaks. Even so, Ideal Implants internal structure is designed to reduce folding and wrinkling, which is thought to be the main cause of implant rupture and deflation. The outer shell is made with similar time tested silicone material as other implants, including the silicone. Even though no implant offers a lifetime warranty and requires regular checks, you can have the peace of mind that if there was a leak, you wouldn’t be exposed to a toxic material.

Experience to Demonstrate Reliability and Safety
A multi-center US clinical trial that began in 2009 with 502 women resulted in the Ideal Implant being approved by the FDA and Health Canada in 2014. Ideal Implant is made in the United States at an FDA-inspected facility with more than 30 years experience.

Feel Beautiful and Secure with Ideal Implants
I believe Ideal Implant provides what women are looking for in a safe implant….. peace of mind with a natural look and feel. To schedule a consultation to find out if Ideal Implants are a good fit for you, visit www.davinciplastic.com.

Steven Davison M.D.
Plastic/Reconstructive Surgeon

Schedule Your Consultation With Dr. Davison

The initial consultation with your surgeon is critical! It should always be face to face with your surgeon during which time he/she listens closely to your concerns. Dr. Davison believes this time spent with you is critical to both you and to him. It is during the consultation that he comes to fully understand your concerns, evaluates them correctly and is then able to make the recommendations and develop the treatment plan thats right for you. Dr. Davison invests the time to sit down and talk to you face-to-face.

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3301 New Mexico Ave. Suite 236

Washington D.C.