Breast Augmentation with Lift

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Breast Augmentation - Dr. Terri HalperinAfter a pregnancy or after a significant weight loss are very popular times for Boston women to consider breast augmentation and a breast lift. These life events cause inevitable loss of volume in the breast that can leave behind droopy or saggy breasts. These side-effects of life may not be avoidable, but they are treatable with a breast augmentation paired with a breast lift. The most important factor when considering breast augmentation surgery is the qualification of your Boston plastic surgeon to perform this procedure.

Women who have experienced pregnancy often times complain that their breasts never seem as “full” as before pregnancy. Loss of breast volume leaves breasts looking deflated and flat. In this case, breast augmentation via breast implants would successfully refill “scooped- out” looking breasts to a more voluptuous appearance.

Boston plastic surgeons may also recommend a breast lift along with your breast augmentation if the nipple drops below the inframammary fold of the breast. The dropping of the nipple below the breast crease is also a result of aging and or significant weight loss. If your breasts are the exact size and shape you want them to be in the bra, you may only need a breast lift. If you are unhappy with the appearance of your breasts, even inside of the bra, you may want a breast augmentation accompanied by a breast lift.

Only a qualified board certified plastic surgeon can say what is right for you and your anatomy. Call the offices of Dr. Terri Halperin in Boston today to schedule a consultation for your breast augmentation surgery. Dr. Halperin will explain all of your options during your individualized consultation. Come prepared with any and all questions you may have about breast augmentation and ask Dr. Halperin if you can see before and after pictures of her work.

Breast Implant Incision Locations

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Breast Implants - Dr. Terri HalperinPlastic surgeons in Boston and around the globe will tell you that one of the first questions women have when considering breast implant surgery is the location of the incision. Although women are concerned about the form of anesthesia and the type of implant that will be used for their breast implant procedure, women are especially concerned with the placement, shape, and size of the scar that will be left behind. Your certified Boston plastic surgeon will help you decide best location for your incision, but here are the basic options for breast implant surgery:

  1. The inframammary technique: This is by far the most common technique practiced in plastic surgery today. The incision is made under the breast in the breast crease. The scar is completely out of the eye’s view when looking at your breast directly in the mirror, and from most angles. This incision location will not disturb milk production when lactating.
  2. The transaxillary technique: This incision option for your breast implants takes the scarring away from the breast completely and brings it to the upper/inner edge of the armpit. This incision may be visible when wearing a tank top.  Implant placement can be more difficult using this technique.
  3. The periareolar technique: Boston surgeons use this technique to efface the scar with the nipple. The incision is made around the circumference of the nipple and is nearly invisible.
  4. The tranumbilical technique: This approach leaves behind the smallest scar. However, Boston plastic surgeons avoid using this approach because of its distance from the breast, making breast implant placement difficult and increasing the likelihood of complications.

If you are considering breast implant surgery in Boston, call the offices of board certified plastic surgeon, Dr. Terri Halperin, today. Dr. Halperin can further explain all of the breast implant options for your specific anatomy.

What are shaped implants and what makes them different?

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I have just returned from the American Society of Plastic Surgeons meeting in San Diego.  This meeting brings together experts in plastic and reconstructive surgery across the world to discuss the latest advances in our field.  At this meeting, there was quite a bit of buzz regarding the FDA approval of shaped breast implants.  I wanted to hear what other surgeons thought about these new devices.

To this point in my practice, I have been quite happy with round, silicone gel implants.  I think that they give a nice result for the majority of patients, either for breast augmentation or for breast reconstruction.  What do these new shaped implants offer that the round implants do not?  What are the downsides?

Three companies in the U.S. offer these shaped implants: Sientra, Allergan and Mentor.  For the purposes of this discussion, I will be referring to shaped implants in general.  These implants are made of a more cohesive silicone gel than the round silicone implants.  What does that mean?  Well, these are the so called “gummy bear” devices.  They feel firmer than round implants.  Not firm as in hard but firm as in younger breast tissue.

The most obvious difference between these implants and the round implants is their shape.  These implants are shaped like tear drops with more of the volume being in the lower half of the implant.  This is useful for the patient who desires a more “natural-looking” breast, the patient who does not want that much upper pole fullness.  This can be useful in the breast reconstruction patient for whom we would like to try match her opposite, natural breast.  This implant is not for the patient who desires an “augmented” look, one with significant upper pole fullness.

There is a downside to “shape” and that is rotation.  There is the possibility that these implants can turnover in the breast, giving a full upper pole and an empty lower pole.  The numbers presented at this meeting showed that this only happens in a single digit percentage of patients but that still means another procedure to reposition the implant.

These shaped implants are textured while most surgeons are using round implants that are smooth walled.  The texturing is important to keep the implant in position and prevent that rotation.  This texturing does seem to increase the risk of developing a late fluid collection around the implant (months to years down the road).  Although again, the risk is relatively low, this is still something for surgeons and patients to discuss.

There has been some discussion about texturing of the implants decreasing the risk of capsular contracture (scar wall that forms around the implant).  This does seem to be the case when the implant is placed in the subglandular position (above the muscle) but it has yet to be shown when the implants are placed in the submuscular position (under the muscle).  Since most implants are placed under the muscle these days, we are not likely to see a huge decrease in capsular contracture rates due to these implants.

Implant choice is a discussion that needs to take place between the patient and the surgeon.  Both sides must feel comfortable with the choice of implant.  Shaped implants may not be right for every patient but it is a wonderful thing to have another choice in our armament.

If you would like to know more about breast augmentation or the different types of breast implants, don’t hesitate to schedule a consultation.

Being a plastic surgeon in Boston

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I love being a plastic surgeon here in Massachusetts, helping my patients to achieve their goals. I believe in offering the highest quality of care for anyone considering cosmetic surgery in Boston.  I offer a personal level of service that goes beyond what most people have come to expect from their physicians. I feel that patients deserve to have a conversation with their plastic surgeon and to feel that they are part of the decision making process.  Many people complain that their doctor lacks a good bedside manner.  My patients often comment that they felt at ease communicating with me from the beginning of our relationship.

I am not only a plastic surgeon in Boston, I am a mother, which makes me a teacher, counselor, advocate and friend. I am a student, learning how to better the results my patients receive by always increasing my knowledge and skills. I love knitting and skiing, traveling and hiking.  I am an avid reader. I have a very full life and a great plastic surgery practice here in Boston but when I take a break from everything I need to run.

I love the feeling of having pushed my body beyond what I thought was possible.  Now, from the way that I speak, you would have thought that I was always an athlete.  This is not so.

Terri-halperin-runnerI ran on and off in college to try to work off the “freshman ten.”  I had no love affair with running at that time though.  I thought of the activity as a chore, a necessary evil.  In medical school, I ran to relieve stress.  It was during this time, however, that I ran my first 5K race.  After this, I was hooked.  I’ve always had a competitive spirit and what better than to run to better your own race times.  I have run the Susan G. Komen Race for the Cure many times and I have tried to better my time with each race.

Since having my children, running has become a “me time” activity.  I use the solitude of running to think through challenging surgical cases in my Boston practice or to ponder the difficulties of motherhood.  Much of the time though, I just enjoy the quiet time that running affords me.  Every once and a while, I will run with someone else but, truthfully, it is a journey I prefer to take on my own.

Until last year, I hadn’t run much more than 4 miles at a time.  I wasn’t sure I was capable of much more than this.  Then, my husband signed up to run the Boston Marathon to celebrate his 40th birthday.  I joined him along the course and, because of the race day excitement, I was able to run 10 miles with him.  Since then, I have run several 10K races and I am now training for a half marathon.

I tell you about my passion for running because I think physical fitness is so important.  Not only is exercise a critical means of controlling weight but it also reduces the risk of cardiovascular disease (heart attack and stroke), Type II diabetes and some cancers.  Exercise has been shown to improve mood, brain function and memory, and it strengthens muscles and bones.

Running may not be for you but finding a physical activity that appeals to you is critical for good health.  Whether you are a biker or a swimmer, softball player or hiker, I wish you a fabulous summer filled with lots of outdoor fun.  Maybe I’ll see you at my next race!