Breast Augmentation

Breast Implants: Looking Real, Part 1: Size

Wed, 10/13/2010 - 13:55 -- caketeam

Breast augmentation is the most frequent procedure I perform, doing well over one hundred augmentations a year. In my practice in Denver, breast augmentation is frequently discussed with women who uniformly express the concern that they do not want results that look “fake.” In this blog, I’ll talk about what goes into avoiding the “fake look.”

The causes of a fake appearance after breast augmentation relate to size, shape, position and motion.

If the implant size is too big for a woman’s frame, she will have a result that will look disproportionately large and distort a woman’s figure, rather than enhance it. This can cause too much fullness in the upper and lateral chest and create an unnatural appearance, as well as difficulty in getting clothes to fit and drape attractively.

Too larger a breast augmentation can draw too much attention to a woman’s breasts and leave a woman feeling self-conscious rather than attractive.

How, then, to avoid the costly mistake of too large an augmentation, but still get the results you want?

Fitting the implant to the person is a key part of a breast augmentation consultation with an experienced breast implant specialist. Careful consideration of each woman’s goals, as well as her particular physique, are critical to achieving successful results.

In my practice in Denver, breast augmentation consultations begin by discussing your goals: understanding your vision is basic to getting you the result you seek. Each woman’s sense of self, sense of aesthetic balance is personal and unique, particularly in her sense of her own body.

Next we perform an examination which includes measurements that inform us what will fit your particular body, taking into account the size and shape of your breasts and your chest, as well as other important factors like skin tone and elasticity.

Then in our imaging studio, we use our state of the art Axis Three Dimensional Breast Simulator. We’ll digitally capture your own image to simulate images of you with implants of different size (and shape) so you can see what your results can look like, and together we can fine-tune your surgery plan to optimize your results.

Your best assurance for getting great results from breast augmentation come form good communication with your plastic surgeon, careful planning and choosing an experienced breast implant specialist with a reputation for producing natural results.

Your Implants Still Want You to Take Antibiotics Before You Get Your Teeth Cleaned!

Thu, 06/03/2010 - 06:58 -- caketeam

Previously, I wrote a post on my Denver plastic surgery blog, "5 Really Important Things to Do to Prevent Capsule Contracture,"  explaining the importance for women with breast implants to be sure to take a single dose of amoxicillin (or another antibiotic if you have penicillin allergy) before having a surgical procedure or having your teeth cleaned by the dentist or hygienist.

For decades, antibiotic prophylaxis was standard for people with heart murmurs to prevent developing an infection of the heart valves. Recently, The American Heart Association and the American Dental Association concluded that taking an antibiotic (antibiotic prophylaxis) was unnecessary for patients with heart murmurs.

So why should women with breast implants still take antibiotic prophylaxis?

Because there is a big difference from what was studied by the American Heart Association. The likelihood that bacteria getting into the bloodstream could actually cause an infection of a heart valve was found to be insignificant. However, the stimulation of a capsule contracture is believed to be an effect of the immune system’s reaction to the presence of those bacteria.

Although we do not have absolute scientific proof that antibiotic prophylaxis will prevent capsule contracture, there have been many clinical reports of women developing contractures after a dental cleaning, even many years after having soft breast implants without capsule contractures. Because a single dose of amoxicillin (in the absence of penicillin allergy) is innocuous and very cheap, it is certainly a cost effective and prudent measure to preventing a potentially costly complication and protecting your excellent results from a Denver breast augmentation!

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5 Really Important Things to Do to Prevent Capsule Contracture!

Tue, 05/25/2010 - 06:59 -- caketeam

All women considering Denver plastic surgery will want to be well informed about the procedures they are considering. In my blog on capsule formation, I talked about good capsules and bad capsules. Every woman who gets implants must know how to get the good capsule and avoid the bad one!

1. No High Impact Activities for 6 Weeks: The body takes about 6 weeks to make the capsule, after breast implant surgery. During that 6 week time period, the tissue around the implant is still a raw surface and is easily irritated by excessive implant motion, which will cause tissue irritation, inflammation and cause thickening of the capsule.  So during this time, you must avoid high impact activities like jumping or jogging, or big arm swinging activities (tennis, golf).

2. No Heavy Lifting or Repetitive Arm Motion for 6 Weeks: For the same reason noted above, the tissues need to be protected from intense or repetitive contraction of the pectoralis muscle (don’t lift more than 20 pounds), or do things like vacuuming (repetitive motion) or raking the lawn.

3. No Blood Thinners for 14 Days Before Surgery: The presence of even a small amount of blood in the implant pocket irritates the tissue. We must avoid post-operative oozing, so it is critical to avoid foods, supplements and drugs that thin the blood for a FULL 14 DAYS before your Denver breast augmentation surgery: aspirin, ibuprofen, herbal supplements, vitamins are blood thinners important to avoid. Even one baby aspirin 10 days before surgery can make a big difference!

4. Implant Manipulation Forever!: The body will naturally want to scar down the space we create at the time of surgery, so moving the implant to keep the full dimensions of the pocket is very important. I recommend a specific manipulation that takes only 10 seconds twice a day, that should be done every day starting right after surgery, and continue as long as you have implants.

5. Dental Prophylaxis: When you get your teeth cleaned by the dentist, there is a possibility that the scraping of the plaque can force some bacteria into the tiny blood vessels in the gingival (gums). The presence of bacteria in the blood stream (“bacteremia”) can stimulate the body’s defenses, the immune system to react in a way that can cause capsule contracture.  Clinical studies have shown this can happen even many years after a breast augmentation!  For this reason 40% of plastic surgeons routinely recommend antibiotic prophylaxis: a single dose of amoxicillin ½-1 hour before having your teeth cleaned or any surgical procedure.

Do these 5 really important things to help avoid capsule contracture!

Capsule Formation

Thu, 05/20/2010 - 16:36 -- caketeam

If you’ve read about breast augmentation, you’ve heard about avoiding “capsule contracture,” the term we use to describe the development of firmness of the breast after breast implants. Denver women should always take the time to understand all aspects of the breast augmentation process.

What is a “capsule” and why is it so important to a successful result to breast augmentation? Is there a “good capsule”? How do you avoid a “bad capsule”? The answers are ones that every women having breast implant should know!

The Pocket: When we perform a Denver breast augmentation, we create a space (also called the “pocket”) for the implant behind the natural breast, oftentimes behind the chest (pectoral) muscle. After surgery, the body recognizes that there is a foreign object, the implant, and that it needs to move. To protect the surrounding raw tissue surfaces of the breast, muscle and ribs, the body creates a lining around the implant. Because the implant is moving in the pocket, the body creates a smooth slick lining that allows motion. This lining is very smooth and white and looks exactly like the lining of a joint called the joint capsule, which helps the motion of the joint. That’s why we also call the lining around the implant a capsule, because it looks just like the joint capsule and it helps with motion.

The Good Capsule: The ideal breast capsule is a thin delicate and supple lining with a pocket large enough to allow the motion of the implant to mimic the motion of the natural breast. The result is a natural flowing breast that moves naturally and feels naturally soft.

The Bad Capsule: If the capsule gets thick or stiff, or if it tightens down around the implant, the result is an implant that feels firm, doesn’t move with the breast, and may have an unnatural shape or position. If there has been inflammation, scarring can add to the stiffness of the capsule (“scar capsule contracture”).

How do you get a “good capsule” and avoid a “bad capsule?”  The answers are in my blog: 5 Really Important Things to Do to Prevent Capsule Contracture!

 

Get The Facts

Fri, 03/26/2010 - 07:09 -- caketeam

We are posting some guest physician blogs that we feel are compatible with the way that Dr. Zwiebel practices. This blog from Dr. Paul M. Parker provides some valuable insight on how patients can educate themselves on the surgical procedures they are interested in.

Get The Facts About Breast Augmentation From Our Site

Whether you’re thinking about boosting your breasts, trimming your belly, reshaping your facial features or full body contouring, plastic surgery has something to offer. A simple surgical procedure can get you the New You that you’ve always dreamed of. The first step is to do your homework and get educated.

The Internet is a valuable tool. New Jersey plastic surgeon Dr. Paul Parker has created a website full of all the information you need. His clinic, Parker Center, specializes on New Jersey breast augmentation, but their site is full of articles, pictures and videos about every operation imaginable. Like Parker Center, we strive to give you all the information you need before you even start your consultation.

How will you look afterwards? What can this procedure achieve for you? Is there pain? Are there risks? How will the doctor carry out the procedure? What’s the latest technology available? How long will you need to recover? What do former patients say? All of this and more is available at just the click of a mouse.

Unlike other medical procedures, plastic surgery is all about the visual. You need to see what it can do. The Internet offers you a way to visualize your results without even leaving your living room.

Skim the site and shop for your new looks. If you like what you see, make the call and set up your free consultation. This site is your first step in creating the New You.

Parker Center for Plastic Surgery, New Jersey
122 East Ridgewood Avenue
Paramus, New Jersey 07652
Phone: (201) 967-1212

No Pain IS a Big Gain for Plastic Surgery in Denver

Fri, 07/17/2009 - 16:09 -- caketeam

Pain-free Denver plastic surgery is within reach.

New technology has made it possible to control postoperative discomfort more effectively. The Pain Pump (anesthetic pump) is a breakthrough technology that has dramatically improved the comfort of my patients during the post-op period. The Pain Pump is a simple device that connects a reservoir of local anesthetic (“novacaine”) to a very fine tubing (catheter) that drips the local anesthetic right into the surgery site to keep it numb for days after surgery. The result is much greater comfort for our patients.

For over 6 years, we’ve been using the Pain Pump routinely in Denver breast augmentation (breast implant surgery) and abdominoplasty (tummy tuck) procedures with great success and safety in over 700 patients. The results have been so excellent that we are submitting our results to plastic surgery journals for publication.

We carefully recorded the number of pain pills used by our patients with Pain Pumps and compared that with the number of pain pills used by our patients without pain pumps. We also asked those same two groups of patients to score the amount of pain they experienced on a scale of 1-10.

The patients with Pain Pumps used half as many pain pills and rated their pain 50% lower than the patients without Pain Pumps!

 

Using fewer pain pills also means less nausea.

Less pain and nausea mean greater postoperative comfort and faster recovery.

 

So if you are thinking about breast augmentation or abdominoplasty, come see me for a consultation and find that when it comes to your procedure, no pain can be a big gain.

 

 

Post operative pain is one of the biggest concerns of people thinking about undergoing elective plastic surgery.

Denver Tubular Breast Reconstruction

Thu, 07/09/2009 - 15:54 -- caketeam

The tubular breast shape is more common than may be appreciated and treated frequently by me in my Littleton, Colorado plastic surgery practice.

The Tubular Breast deformity is one where the breast shape is more cylindrical than tear-dropped. The nipple and areola protrude excessively and the circumference of the breast appears very narrow and tight. The distance from the edge of the areola to the breast crease is shortened and the skin of the lower part of the breast is tight and appears constricted. The breast crease loses its definition.

For women with tubular breast deformity, there is often a great deal of self-consciousness which can lead to diminished self-image, embarrassment, and sexual inhibition. This can be mitigated with a Denver breast augmentation.

Breast asymmetry is very common with tubular breasts: the shapes of the two breasts are most commonly significantly different, requiring correction to get the left and right breasts to be a closer match.

 

The aesthetic reconstruction of the tubular breast is performed with saline breast implants or silicone breast implants. In my practice, I normally use subpectoral (submuscular) implantation.

Key to the repair of the tubular breast is the reshaping and redraping of the breast tissue. This is usually done through a circumareolar incision, which allows reduction of the protuberance of the breast tissue in the areola and resizing of the areola, if needed. Then, surgical reshaping of the breast tissue is done, and the tissues are released to allow for redraping of the breast and muscle around the implant.

The result is better symmetry with a very pleasing and beautiful breast shape that enhances a woman’s self image.

If you have - or someone you know has - a tubular breast, call to arrange a consultation to learn how you can transform the shape of your breast and feel better about your appearance.

 

 

Dr. Paul Zwiebel of the Zwiebel Center for Plastic Surgery is a Board Certified by the American Board of Plastic Surgery, and a Cosmetic Surgery specialist in Denver, Colorado.

Denver Mommy Makeover

Mon, 05/11/2009 - 19:52 -- caketeam

Mother’s Day seems a good time to discuss one of the most popular requests in my practice: the combination of breast and tummy enhancement procedures known as the Mommy Makeover. In Denver, Mommy Makeover procedures are becoming increasingly popular.

We all celebrate and appreciate the great personal sacrifices made by Moms. For most Moms, the great joy and fulfillment of pregnancy and childbirth can come at the cost of some undesirable physical changes.

The changes to the breasts and tummy can include loss of skin elasticity and loss of shape. The physical changes that persist after pregnancy can mean self-consciousness and diminished self image. Many women tell me they feel so self conscious, they avoid looking in the mirror, do not allow their husbands to see them undressed, and even experience sexual inhibitions.

Commonly women complain of breasts becoming droopy or saggy, and with loss of volume and shape. Denver breast augmentation or breast implant surgery restores volume and shape. For drooping or sagging, breast lift (mastopexy) will improve the shape and position of the breasts. Combining augmentation with breast lift (Augmentation Mastopexy) is common solution to correct the deflation and drooping of the breast after pregnancy and nursing.

Tummy tuck (Abdominoplasty) includes many different techniques customized to the individual and can include different combinations of procedures to repair the muscle of the abdomen, as well as removing excess skin and fat.

Call to schedule a consultation with me,  Dr. Paul Zwiebel, if you (or a “Mommy” dear to your heart) would like to learn more about how we can help to repair some of the body changes left after pregnancy.

Check out this Mommy Makeover's Story on Dr. Zwiebel's website.

Denver Breast Augmentation and the Economy

Wed, 04/08/2009 - 22:14 -- caketeam

The current state of the economy is daily news: it’s impossible to ignore.

Yet, my schedule for consultations and elective cosmetic procedures are filling at a rapid pace.

Why?

The current economic climate in Denver has resulted in the lowest prices for Denver breast augmentation in years. Special incentives from breast implant manufacturers have helped to lower the costs for breast enhancement surgery.

Many people are taking advantage of this opportunity to do something important for themselves. An enhanced self-image is priceless, and the rewards enduring.

For a limited time, we have waived our fee for consultation. During our consultation, we’ll use your photographic image in our state of the art simulation studio to let you see your own body with different size implants. What better way to help you decide if breast implants are right for you and what size helps you find just the right proportion and look you seek?

This may be an excellent time to do something wonderful for your self. If you live in the Denver area and a Denver breast augmentation surgery has been something you’ve considered, call today and come in for your consultation to see if breast augmentation is right for you.

Denver Plastic Surgeon talks Saline or Silicone

Fri, 03/27/2009 - 19:08 -- caketeam

Now that you have decided to have a Denver breast augmentation, it’s important to decide whether to use saline- or silicone gel-filled implants.

Which is Best? The decision is always individual and personal, best determined in a dialogue between you and me during your  consultation.

Breast Implant Safety: Breast implants have had a great record of safety. The fallout of the breast implant“crisis” of the mid 1990’s and the focus of the FDA has led to hundreds of scientific and clinical studies, as well as technologic advances.

Currently, gel implants are highly cohesive: this means that the gel sticks to itself, like jello. If the shell of the implant develops a leak, the gel does not flow out of the implant, and remains well contained.
Still, some prefer saline (balanced salt water solution), because it is a normal intravenous solution and a normal fluid component of the body. If a saline implant develops a leak, the saline is rapidly absorbed and removed into the urine by the kidneys.

Imaging: Normal breast diagnostic studies like ultrasound and mammograms can and should be done with either silicone or saline implants. After your Denver breast augmentation, your mammographer may choose to take 3 views of each breast, rather than just two in order to see adequately around the implant.

Radiographic tests are not necessary to detect leaks in saline implants, because saline implants deflate if they leak, and the change in breast size indicates the diagnosis. With silicone gel-filled implants, mammograms, ultrasounds, and scans are less reliable for diagnosing leaks: now that the silicone gel is so cohesive, it’s hard to see any gel outside the implant shell.

Incisions: Normally, I make a 2cm (~1/2inch) incision in the crease below the breast. Because saline implants are inflated after they are inserted into the breast, we do not need a larger incision. Because silicone implants are pre-filled, a larger incision may be necessary. Depending on the size of silicone implant chosen, incision size varies from 2cm (~1/2inch) to 3-1/2cm(1-1/4inch).

Aesthetics: If you have enough breast tissue to cover the implant, saline implants can feel quite soft and natural. However, the flow and feel of silicone gel is much more like natural breast tissue and it’s much harder to tell an implant is present. It’s also harder to see or feel the edge of a silicone implant. The very natural feel of the silicone gel implant is the reason more than 70% of my patients choose silicone implants.

I look forward to meeting you, answering your questions and assisting you in your deciding which implant is best for you.

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