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Mini vs. Traditional: Which Tummy Tuck is Right for Me?

The tummy tuck, also called abdominoplasty, has many different benefits and is known as one of the best ways to rejuvenate the stomach using surgical techniques. However, when considering your tummy tuck options, it’s important to know that you have a choice in which tummy tuck will benefit you best. Although Dr. Weider will discuss the right tummy tuck for you during a consultation, here are some things to keep in mind as you plan your consultation.

The Traditional Tummy Tuck

Sometimes called the Full Tummy Tuck, this technique is the standard tummy tuck that produces excellent results. This method is best for patients that have recently undergone major weight loss or pregnancy, since this method includes tightening of the underlying muscles. This can have many benefits, including greater support of the abdomen which can reduce symptoms like back pain or urinary incontinence. This tummy tuck, however, can be more invasive than the mini tummy tuck and require greater downtime and recovery.

The Mini Tummy Tuck

This tummy tuck is best for patients looking for improvement in fatty deposits and excess skin below the belly button. This method is less invasive and doesn’t require extensive downtime, but also doesn’t include muscle tightening. This means the mini tummy tuck is best for patients looking for rejuvenation of the lower abdomen and improved contours. Many patients prefer it because it can be a quick and easy way to correct slight sagging before beach weather.

Which is best for me?

During a consultation with Dr. Weider, you’ll discuss your goals for a tummy tuck procedure and which option will achieve your results. Generally, however, patients experiencing looseness and sagging because of abdominal stretching can greatly benefit from a traditional tummy tuck. Patients that want improvement of the lower abdomen without extensive surgical techniques and recovery can greatly benefit from a mini tummy tuck. In many cases, liposuction can be combined with either method for additional contouring and rejuvenation.

Schedule a Consultation

Your first step in your tummy tuck journey is scheduling a consultation with Dr. Weider who can discuss your best options and make a professional recommendation. To schedule a consultation at our Dallas office, contact us by calling or filling out our online form.

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BIA-ALCL (Breast Implant Associated Acute Large Cell Lymphoma): dispelling the myths

BIA-ALCL (Breast Implant Associated Acute Large Cell Lymphoma): dispelling the myths

In the last few years a concern has surfaced over the possible risk of cancer after breast implant surgery. Many of the reports have presented startling statistics that are not at all accurate. I would like to use this opportunity to provide some accurate statistics in order that potential breast implant patients have a more realistic understanding of the connection between the implants and the risks.

What is BIA-ALCL?

BIA-ALCL is a rare and highly treatable form of lymphoma that can occur in the tissues surrounding breast implants.

Who is at risk?

Although it is rare, ALCL can occur in patients who had textured surface implants placed at least one year and typically several years earlier.

How common is it?

The lifetime risk of the development of ALCL in women with textured surface implants is estimated to be somewhere between 1 in 3800 to 1 in 30,000.

What are the usual symptoms?

Typically, ALCL presents with enlargement of a breast, pain, breast hardening, a lump in the breast or armpit or a large fluid collection around the implant. It occurs in someone who had an implant place at least one year and usually several years earlier. Only textured surface implants have been confirmed to put a woman at risk of the development of ALCL.

What should I do if I develop one or more of those symptoms?

You should contact your surgeon who will arrange for biopsy with drainage of any associated fluid for testing. If the testing shows evidence of ALCL, a scan such as a CT scan will be performed to help determine if there has been any spread of the disease.

What type of treatment is necessary.

In many patients, removing the implant and the scar capsule around it are curative. However, if the ALCL has spread, chemotherapy may be needed.

Does Dr. Weider use textured implants?

Very rarely. I almost always use smooth surface breast implants, and there is no clear association between smooth surface breast implants and ALCL.

How many implants are placed per year in the United States?

Approximately 550,000 breast implants are placed per year in the United States. This includes implants placed for both cosmetic and reconstructive reasons. About 70,000 of these are textured surface implants.

How many cases of BIA-ALCL are reported per year.

Less than 100 cases of BIA-ALCL are reported per year.

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Breast augmentation: What to Expect FAQs

Here is a primer for some of the most frequently asked questions regarding breast augmentation recovery.

Will the procedure be painful?

While everyone is unique, most of the women who undergo breast augmentation are pleasantly surprised that they don’t have much pain after surgery. Most describe tightness and some discomfort, however. We usually prescribe a painkiller and a muscle relaxer, but after 3-7 days most women can switch to over-the-counter pain medication. Some factors such as implant size and skin tightness will influence the level of pain and the duration of the discomfort and tightness. If the individual’s skin is tight, which is more common in younger women who have not had children, it will take longer for the breasts to soften up. By about three weeks, most women feel like they are back to “feeling like themselves.”

When can I go back to work, back to school and/or take care of my kids?

Typically, within three to five days, non-strenuous activities can be resumed. So, in the case of an individual who has a job that does not require strenuous activity such as heavy lifting, most women can go back to work after five days. If you have a toddler, then it would be a good idea to have help for the first seven to ten days. Again, everyone’s experience is a little different, but these are time frames based on the typical patient.

How should I sleep after breast augmentation?

For the first few nights, I recommend that you sleep on you back with your head elevated. This can be achieved with pillows or by sleeping in a recliner.  After about three days, you don’t need to sleep with your head elevated any more, but I would still recommend sleeping on your back for the first week. After that, if it feels comfortable, you can sleep on your side. I wouldn’t recommend sleeping on your stomach for several weeks.

When can I resume exercise?

We have many athletic patients, and this is a common question. This is the schedule I recommend, but it depends on how you are feeling during your recovery as well. For the first few days after surgery, I ask patients to take it easy. By that I mean they should be getting up and walking around but not doing any exercise. After about 4-5 days, it is ok to go on a long walk (10-20 minutes) if you feel like it. Alternatively, if you would rather walk on a treadmill, that is fine as well.   About 2-3 weeks after surgery, you can resume some light exercise. For example, riding a stationary bicycle or a spinning bike or using an elliptical trainer should be fine. In addition, doing lower body weight training is ok. The key is not to do any impact sports such as running as well as avoiding use of your pectoralis (chest) muscles. After six weeks you can resume running if you wish to.  We recommend that runners wear two sports bras for three months or even longer. This protocol is a general guideline and will need to be modified somewhat for some people. In addition, it is important to see how you feel when doing an activity. If it hurts, it is best to give it some more time before resuming that activity.

What about lifting? When can I lift my baby?

I recommend that women don’t lift more about 5-6 pounds for the first few days. By comparison, a gallon of water weighs just over 8 pounds. Then you can gradually increase how much you lift as the days and weeks go by. It will be about one to two weeks before you can lift your child up depending on what he or she weighs. However, it is ok to have someone else place your child onto your lap after a few days. Once you do resume lifting your child up, it is best to bend down low using your knees and not your back. Then hold your child against your hip to help support his or her weight as you stand up.

Will the procedure result in breast numbness (loss of feeling)?

Most women have some numbness after breast implant surgery.  However, this is usually temporary.  The numbness is due to the stretching of the nerves in the breasts.  However, normal feeling typically returns after six to eight weeks.  Many patients will note hypersensitivity in the first few weeks after breast augmentation.  This sensitivity will also go away after about three to six weeks.  It should be noted that the risk of any permanent numbness increases if very large implants are chosen.

Breast Feeding

Most women who undergo breast implant surgery can breastfeed in the future if they wish to.  I typically use an incision in the fold below the breasts (Inframammary fold) in order to place implants.  One of the benefits of this incision is that there are no incisions near the nipple that could potentially disrupt milk ducts or nerves near the nipples.  The inframammary incision means that almost no breast tissue needs to be cut in order to place the breast implants.

What are these weird sounds I hear coming from my chest?

That is a fairly common question. Many women hear odd sounds such as sloshing, squeaking or creaking coming from their chests. This is nothing to worry about. The sounds are due to the fact that there is some air and fluid in the pocket but outside the implant.  It sloshes around and makes some odd noises that can be alarming. You can rest assured that by about six weeks, that air and fluid will be safely absorbed by the body and the odd sounds will go away.

Implant replacement after 10 years

It is a commonly held belief that breast implants should be replaced every ten years.  However, with current implants, that isn’t the case. I advise my patients that if their implants are intact and they are still happy with their appearance, there is no need to change out the implants after ten years. That being said, silicone gel filled implants should be monitored periodically for leaks.  This is usually done with an MRI, but mammograms or ultrasound may also detect implant rupture.

Scarring and treatment

At the time of surgery, we take all measures we can to minimize scarring.  This includes inconspicuous incision placement and meticulous incision closure,  In addition, sterl strips or skin adhesive are placed after the incisions are closed. Two weeks after surgery, the experienced staff at Weider Plastic Surgery will explain the best methods and products to use to get the least visible scars.

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Saline vs Silicone Gel Filled Implants, Part #1

One of the most frequently asked questions in my practice relates to the choice between saline and silicone gel filled breast implants. Over the next two blogs I will review the pros and cons of each type of implant. Once a woman is considering having a breast augmentation in Dallas, she needs to decide whether to choose saline or silicone gel filled breast implants. In my practice in Dallas, my patients are about evenly split between those choosing silicone and those opting for saline. During the first installment, I will highlight the advantages of saline implants. The second installment will focus on the advantages of silicone gel filled implants.

Both types of implants have a silicone elastomer shell. The current generation of implants has a thicker shell than earlier generation implants. The thicker shell makes them stronger, more durable and less susceptible to leakage.

It is the fill material of the implants that varies. Saline filled implants are quite simply filled with sterile salt water. Because they are filled in the operating room, the surgeon is able to vary the amount of fill in each implant to correct small discrepancies in breast size. The silicone gel filled implants, on the other hand, are prefilled during the manufacturing process, so their fill volume cannot be adjusted.

Another key difference between the two types of implants is leakage detection. While both types of implants have low leakage rates, the saline filled implants will deflate when they leak, typically making the leakage easy to detect for the patient and the surgeon. The saline is absorbed by the body and is harmless. If a silicone implant leaks, it is likely that the patient won’t be aware of it. This is because the gel will typically stay in the implant or in the pocket around the implant. Because of this, the FDA has recommended that women with silicone gel filled implants undergo an MRI three years after surgery and every two years after that in order to detect asymptomatic implant leakage. It is concern about a silicone leakage that could go undetected that many women site as the reason they chose saline implants instead of silicone gel filled implants.

Cost is another key factor that differentiates these two types of implants. A pair of silicone implants costs about $1000 more than a pair of saline filled implants. The price difference reflects the additional cost charged by the implant manufacturer. In my next blog, I will focus on the advantages of silicone gel filled implants.

 

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Abdominoplasty (Tummy Tuck) vs Panniculectomy

Abdominoplasty (Tummy Tuck) vs Panniculectomy

I often find that the difference between a tummy tuck (abdominoplasty) and a panniculectomy is confusing to patients. It is understandable because the two procedures have some aspects in common but they are not the same. This distinction has become even more relevant because of the growing popularity of weight loss surgery.

The word panniculectomy means removal of the pannus. The pannus is the overhanging skin of the lower abdomen that typically occurs after major weight loss, pregnancy or both. A panniculectomy is a functional and not a cosmetic procedure. By this I mean that it is designed to relieve problems associated with the overhanging skin (pannus) that often occurs after a large amount of weight loss. The most common problems that may lead to insurance approval for a panniculectomy are skin irritation or skin erosion under the pannus and interference with typical daily activities.

A tummy tuck, which is also known as an abdominoplasty, is a cosmetic procedure designed primarily to improve the appearance of the torso. It often also involves tightening of the abdominal muscles that are typically stretched out during pregnancy. Since a tummy tuck is a cosmetic procedure, it is not covered by insurance.

From a surgical standpoint, a panniculectomy involves removal of the excess skin and fat under the skin (subcutaneous fat) and closure of the wound. While a tummy tuck also involves removal of the excess skin and fat of the lower abdomen, it usually is much more extensive and also entails the following procedures:
– release of the excess skin and fat all the way to the bottom of the ribs to maximize the tightening and contouring that can be achieved
– tightening of the rectus (abdominal) muscles as well as the fascia (fibrous tissue) that surrounds the muscles
– reconstruction of the navel
– liposuction of the flanks

Should you wish to discuss a tummy tuck or any other procedure, please give Weider Plastic Surgery a call at (972) 566-8444.

To Your Health,

Dr. Weider

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Chin Augmentation: A growing trend in Plastic Surgery

Data recently published by the American Society of Plastic Surgeons revealed that the number of chin augmentations experienced a 71% increase in 2011. This made it by far the plastic surgery procedure with the greatest growth last year. While no one knows exactly why chin augmentation has become so popular, there is speculation that the growth of video chatting is responsible for at least a portion of this phenomenon. People see themselves on services such as Skype and FaceTime and are self conscious of a weak chin. There is no doubt that a strong chin is associated with self-confidence and leadership. A chin implant can have a positive effect upon one’s profile just as a rhinoplasty (nose job) can. In fact, these two procedures are often done simultaneously.

Placement of a chin implant is usually a fairly straightforward procedure. During your consultation with Dr. Weider at his office in Medical City Dallas, he will discuss your goals and assess your face, jaw and chin. The appropriate implant size and shape will be chosen in preparation for surgery. During the procedure, an incision will be made inside the lower lip or under the chin. The implant will then be inserted below the soft tissue covering the chin to create a pleasing jawline in harmony with the patient’s face. The procedure can at times be performed under local anesthesia and is relatively affordable.

The recovery is usually quick as well with very little down time.

As with any procedure, there are occasional complications, though they are uncommon. The risks include infection, numbness and scarring. These will all be discussed with you in detail at the time of your consultation.

Should you wish to discuss chin augmentation or any other procedure please give Weider Plastic Surgery a call at (972) 566-8444 or contact us via email.