Breast Implants: Over or Under the Muscle?

Implant placement relative to the pectoralis major muscle continues to be a source of controversy. Although the majority of plastic surgeons prefer submuscular placement, there is still a large group of plastic surgeons that feel strongly about subglanduler placement. Each group can make convincing arguments regarding their position of choice. It’s safe to say that both approaches have advantages and disadvantages.

In the context of these discussions, we feel that every patient needs to be considered individually. Each patient has unique anatomic findings that effect the decision to place the implant under or over the muscle. The aesthetic goals of the patient are equally important and have a significant impact on the decision as well. The vast majority of patients are striving for larger breasts with a natural look. They want balance, harmony, and proportion with the surrounding structures.

The majority of breast implants are placed in a submuscular position. There are several advantages to the approach. These include softer tissue coverage, which results in fewer visible folds, creases, and ripples in the implant. This is especially important in women who have thin skin and minimal breast tissue that want saline implants.

Plastic Surgery Financing

For many patients, cosmetic surgery would not be possible without some type of financing. For this reason, the vast majority of plastic surgeons offer some type of financing program.

In our practice, we almost exclusively utilize Care Credit. This is currently the most commonly used source of plastic surgery financing in the United States. Care Credit is run by GE Capital Financing. It’s reputable and you can apply for a loan online. It takes approximately thirty minutes to get a response. In some cases, you may be able to get a twelve-month interest free loan.

Mini Tummy Tuck vs. Full Tummy Tuck

Pregnancy has a significant impact on a woman’s body, and nowhere is this more noticeable then the abdomen. This area develops excess, saggy skin, weakened muscles, and stretch marks. Despite diet and exercise, most women are unable to reverse these changes and this ultimately affects their self-image and self-esteem. Treatment options are limited and in most cases involve either abdominoplasty or mini abdominoplasty.

Abdominoplasty is performed by making a lower abdominal skin incision and then lifting the skin and subcutaneous tissue to the level of the rib cage. This typically requires detaching the belly button, which allows more skin to be removed. The muscles are then tightened, excess skin removed, and the belly button re-attached in proper position.

Recovery Following Facelifts

Facelift recovery varies from patient to patient and depends on a large number of variables. Just as every patient is unique, the chosen procedure for he or she is unique as well. The differences in wound-healing characteristics and the type of procedure performed account for variations in facelift recovery.

Most patients feel pretty good in about four to five days, but their primary concerns are when they will look good enough to go out in public. Recovery following facelift surgery may last for months, but most patients feel they can go out in public in about two weeks. At this point, most of the bruising and swelling have resolved. Many patients adjust their hairstyle to hide their incisions and use make-up as well.

Breast Augmentation & Under Wire Bras

We generally avoid using under wire bras for six to eight weeks following breast augmentation. There are two reasons for this approach. First, when patients undergo sub muscular placement of breast implants, the pectoral major muscle may undergo spasm in the early post-operative period. This may force the implant in an upward direction and lead to malposition. When this situation arises, we utilize compression to force the implant in a downward direction. An under wire bra would have the opposite effect.

Another reason for avoiding under wire bras in the immediate post-operative period is the potential for the bra to irritate a fresh surgical incision.  An infamammary incision would be directly beneath the under wire bra and this might lead to irritation of the incision.

Signs of Breast Implant Leakage

In the majority of patients undergoing breast augmentation, implants last a lifetime. Occasionally, implants deflate and need to be replaced.

Current data suggests that implants deflate at a rate of 1% at one year and 3% at three years. Over time, this number can be expected to grow. Implants may deflate with no apparent cause or may deflate secondary to trauma.

When saline implants deflate, the diagnosis is relatively easy to make. These implants lose volume and flatten quickly. Silicone implants present a much more difficult problem when they deflate. Rupture of silicone implants may not be apparent for years.

Signs of deflation include soreness, redness, loss of volume, change in shape, and sometimes, capsular contracture. These signs may be subtle and a history of trauma may be the only early indicator.

Aesthetic Surgical Images Sees 100,000th Patient

When you’re considering cosmetic surgery, the experience of your surgeon is extremely important. In 1970, Aesthetic Surgical Images saw its first patient. We are proud to say that after 43 years, we have seen over 100,000 patients. This is not only a testimony to our longevity, but the support of the community as well.

One of the driving forces behind the achievement of our practice is the strength of our surgical team. Comprised of four, board-certified plastic surgeons, our team members were selected not only for their credentials, but also for how their skills would complement one another for the benefit of our patients. For these reasons, you can count on our surgeons to provide integrity, trust, and excellence from the consultation and surgery to each postoperative visit.

Drs. Heieck, Edney, Bruneteau, and Montag want to thank the community for your continued support and look forward to serving you well into the future. As always, our cosmetic consultations are complimentary. To schedule a day or evening appointment, please call 402.390.0100.

When is the Best Time to Get a Mommy Makeover?

Pregnancy causes significant changes in a woman’s body.  These changes vary from patient to patient and are permanent in most cases unless surgery is undertaken to reverse them. These changes can affect the breast, abdomen, and lead to fat accumulation in the hips and thighs. Many patients attempt diet and exercise, but this isn’t always helpful.  This problem can ultimately affect self-confidence, self-esteem, self-image, and the quality of day-to-day life. For these reasons, many patients request breast augmentation, tummy tuck, and liposuction.

The timing of surgery following pregnancy is important and several issues should be considered before proceeding with surgery. It takes time for a new post-pregnancy body to reach its new baseline following pregnancy. During this period, stretched skin may contract, a swollen uterus may shrink, and the weight gained during pregnancy may gradually disappear.

The breasts also undergo significant changes with pregnancy and breast-feeding. This results in breast enlargement, which continues with nursing. After nursing is stopped, it takes time for the breasts to return to their new baseline. At this point, the breasts may be smaller and have sag. This process takes three to six months to occur. All of these changes need to occur before a mommy makeover is considered.

What is an Endoscopic Browlift?

Brow descent occurs with normal aging and is typically treated with a browlift. The traditional open transcoronal approach and the endoscopic approach are the two most commonly used techniques. 
 
A transcoronal browlift is performed by making an incision across the top of the head from ear to ear. The forehead skin is lifted off the bone to the level of the orbital rims. The forehead muscles that are responsible for frown lines are then treated under direct vision. The brow is elevated by removing a strip of skin along the incision. 
 
In contrast, endoscopic browlift is performed through several small incisions placed behind the hairline. The operation is performed with a scope, ultimately accomplishing the same basic maneuvers as the open approach. 

Cool Deal! CoolSculpting Special!

Worried about how you look in your swimsuit? You can reduce inches and bust stubborn bulges with CoolSculpting, the amazing nonsurgical technology that literally freezes your fat cells.

At Aesthetic Surgical Images, we are now offering special pricing for all CoolSculpting treatments. Let this be our gift to you and our way of saying thanks for another year of continued support.

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Call 402.390.0100 for more information
or to schedule your FREE consultation today!

Tummy Tuck Scars

It’s safe to say that it’s impossible to perform a tummy tuck without scarring. This operation trades stretch marks, loose skin, and weakened muscles for a scar that is hopefully well positioned.  The patient’s particular anatomy will have a profound impact on scar placement. Factors such as the transverse width of the abdomen, the distance from the pubis to the rib cage, the position of the umbilicus, and the patient’s stretch marks are all extremely important variables.

Each patient is unique and it’s important to have good communication between the patient and surgeon. We find that it’s very helpful to perform pre-operative markings with the patient wearing her swimsuit. By utilizing this maneuver, confusion regarding incision placement is minimized.

How Long Do Breast Implants Last?

This is a commonly asked question and a frequent source of confusion amongst patients. There is a common misperception that breast implants should be replaced every ten years. The origin of this belief is unclear, but is probably secondary to misinterpretation of implant warranty terminology.

The manufacturers of breast implants clearly state that these devices are not intended to last a lifetime, despite this many patients can expect to have implants last their entire lifetime. Current studies suggest that implants deflate at a rate of 1% at one year and 3% at three years. Over time this number can be expected to grow.

Implants may deflate with no apparent cause or may deflate secondary to some type of trauma. Under these, the decision to replace implants is easy.

Father’s Day Botox Special!

Not sure what to get that special Dad for Father’s Day? How about some Bro-tox? Bro-tox is Botox for men! Bro-tox makes a great gift for all those hard working Dads! 

Does Dad always look stressed or angry? Does he have lines between his eyes? Are the lines on his forehead getting deeper? 

At Aesthetic Surgical Images, we can help get rid of those angry frown lines by performing a simple Botox injection. For the months of June & July, men will receive a 10% discount on Botox injections. Let this be our gift to you and our way of saying thank you for another year of continued support!

Call today and say you were referred by the Father’s Day Botox Special!

402.316.5739

Insurance Coverage for Breast Reduction

Breast reduction surgery is often covered by insurance carriers, but not all of them cover this procedure and significant restrictions may exist. Some insurance companies actually exclude breast reduction as a contract exclusion. When insurance carriers cover breast reduction, they may have specific criteria that must be met.

For instance, most insurance carriers require documentation of symptoms. Examples would include back pain, shoulder pain, breast pain, and headaches to name a few. They may also require documentation of attempted non-surgical management of symptoms. Examples might include physical therapy, support devices, and anti-inflammatory drugs. Some insurance carriers require a minimal amount of breast tissue removal from each breast. This is often based on calculations, which utilize the patient’s weight and height.

Is Breast Reduction Surgery Recommended if Overweight?

For many patients, breast reduction surgery is a life-changing experience.  Symptoms such as back, neck, and shoulder pain seem to improve almost overnight.  Patients note that clothes fit better and over time, their self-esteem and self-image improve as well.

Patients who are overweight do not differ from other patients in this regard.  They note similar improvement in quality of life and significant improvement in symptoms.

When patients who are overweight undergo breast reduction surgery they often experience additional benefits.  They note increased exercise tolerance and subsequently become more physically active as they adopt a healthier lifestyle.  In many cases, this results in significant amounts of weight loss.

Liposuction for Men

Liposuction is one of the most commonly performed cosmetic surgical procedures in men.  The flanks, abdomen, chest and neck appear to be the most commonly treated areas.  This procedure is associated with high satisfaction rates when patients are near their ideal body weight.

Liposuction in men has limitations because the fat tends to be more fibrous.  In addition, a large amount of the abdominal fat is located within the abdominal cavity where it can’t be reached by a liposuction canula.  These characteristics can limit the amount of fat that can be removed with this procedure.  Men generally have thicker skin than women and as a result, skin sag is less likely to occur in this group.

Plastic Surgery on the Rise for Those 55 and Over

It’s true you can feel good and look good at any age.  According to the American Society of Plastic Surgeons, more patients over the age of 55 are undergoing plastic surgery now than in years past.

The greatest number of surgeries which this demographic tends to opt for are "… surgical body contouring procedures (liposuction, tummy tuck), eyelid surgery and breast augmentations,” according to ASPS President Dr. Michael McGuire.  Men are showing an interest in body enhancements, while facelifts remain a popular choice.