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Breast implant types and abbreviations

Our newest team-member, Hannah, wrote some notes after a discussion about breast implant types, different manufacturers and abbreviations regarding the different breast implants.

Here are her excellent notes:

 

Today Karla hosted a meeting where she encouraged us to ask any questions so we could have an open discussion. We ended up spending the majority of the time talking about the different types of implants and their abbreviations.

Here are the Breast Implant notes that I took:

In 2006 Mentor and Allergan both came out with a gel implant. This implant was commonly referred to as the “gummy bear” implant. Before these implants got approved, only patients who were participating in a study could get gel implants, and only saline implants were readily available. These same gel implants are still widely used today. Even if this implant is cut open, the gel will stay together, which is why they are referred to as cohesive silicone gel implants. Textured teardrop shaped implants were released that were highly cohesive and offered by both Natrelle and Mentor. Allergan called their version of the highly cohesive anatomically shaped implants “Style 410.” Highly Cohesive Silicone Gel Matrix holds its shape whether you are standing or sitting. Many patients referred to the highly cohesive implants as “gummy bear implants” as well. These will hold shape while standing, but because they are anatomically shaped, they will have less fullness at the top and the implant pocket must be very tight to minimize risk of rotation. Specifically the Allergan Style 410 have been linked to late forming seroma.

Allergan Inspira Responsive

  • Low Profile- SRL
  • Low Plus Profile-SRLP
  • Moderate Profile- SRM
  • Full Profile- SRF
  • Extra Full Profile- SRX

Allergan Inspira Cohesive

  • Low Profile- SCL
  • Low Plus Profile- SCLP
  • Moderate Profile- SCM
  • Full Profile- SCF
  • Extra Full Profile- SCX

Mentor Breast Implants

  • Moderate Classic- MC
  • Moderate Plus Profile- M+ or MPP
    High Profile- HP
  • Ultra High Profile- UHP

Silicone Gel Implant History

Silicone gel implants were available way back in 1960s, and they are pretty much the same gel as the ones that were approved in November 2006.

They’d been used for decades and were taken off the market because of lack of safety profile studies. When the studies showed that the silicone gel implants were safe, they were brought back on the market in Nov 2006.

Takeaway from Breast Implant Types Meeting

The biggest takeaway from this meeting is that there is so much information about these implants online. The patients often have a hard time keeping the information straight, so the guidance from a very experienced plastic surgeon is invaluable. This is why the consultation is such an important aspect of the surgical process for patients. Many times, patients think that they can get the same look as their friend, but their body affects the final outcome just as much as the implants do.

Thank you Karla for this very educational lunch meeting!

 

 

Above are notes from Hannah, our newest team-member to Surgical Artistry. We specialize in Breast Augmentation in Modesto.

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Plastic Surgery Demystified

By Tammy Wu, MD

Plastic surgery is such a common term that when one hears it, one knows what someone is talking about. But more likely than not, people will equate the term “plastic surgery” with “cosmetic surgery”. Due to the recent popularity of media coverage as well as shows portraying lives of plastic surgeons and some plastic surgeries (ie. Nip Tuck, Dr. 90210, etc), and shows that “give away” plastic surgery, such as The Swan, plastic surgery is no longer “hush hush”, as it was in the past, but is in the very forefront of everyone’s television and/or internet.

But what IS Plastic Surgery? What does it entail? Who performs them? How is it different from Cosmetic Surgery, or is it?

These are the questions that I will address in this article.

The word “plastic” in plastic surgery came from the Greek word, “plastikos”, which means “to give form or to mold”. Hence the specialty of plastic surgery encompasses the field of Cosmetic Surgery, but also Reconstructive Surgery. As a plastic surgeon, I was trained on doing both reconstructive as well as cosmetic surgeries. In fact, if one were to read the history on cosmetic surgery, one will find that many cosmetic surgeries have their origins in reconstructive surgery. Many discoveries for either new ways or methods for cosmetic surgery came from the field of reconstructive surgery. Therefore, it makes sense then that a surgeon who is well versed in reconstructive surgery would also be well-trained in the field of cosmetic surgery.

What then is Reconstructive Surgery? How is it different from Cosmetic Surgery?

Reconstructive Surgery, in general, is surgery that is performed on abnormal structures to improve function or appearance. The abnormal structure may have been a structure that someone was born with, termed “congenital”, or due to acquired causes or external events, such as trauma, infection, tumor, or other disease processes.  Some examples of congenital structures that plastic surgeons perform to reconstruct, or correct the deformity, include cleft lip and palate, hemangioma formation or other blood vessel malformations, or limb abnormalities, such as absence of a thumb.

Some examples of trauma reconstruction would be soft tissue or bony injuries from car accidents or boating accidents, falls, dog bites, as well as burn care and burn reconstructions. Then there are also the reconstructive surgeries that are performed to restore a structure either deformed or taken away by cancer, such as breast reconstruction for breast cancer, facial reconstruction due to cancers of the head and neck, or limb reconstruction due to limb cancers such as sarcomas. Many of these reconstructive surgeries sometimes will involve microsurgery, which is the usage of a microscope, in order to perform very fine detailed work to optimize the outcome of the surgery.

As you can see, just the field of Reconstructive Surgery is quite extensive.

What is Cosmetic Surgery then?  Cosmetic surgery is surgery that is performed to reshape normal structures to improve appearance.  Therefore, most if not all cosmetic surgeries are elective in nature, meaning that one does not have to have the surgery, because the structure or body part that one does not like, is not necessarily abnormal or nonfunctional; but one wishes to improve upon its appearance. That is also why when a surgery is considered “cosmetic” in nature, insurance companies do not cover or pay for them. The range of cosmetic procedures is extensive as well. They include areas of non-invasive topical treatments to less invasive treatments such as Botox ®, fillers, medium-level chemical peels, to invasive procedures that require anesthesia in order for the procedure or surgery to be performed comfortably for the patient.  The cosmetic surgeries may involve any body part from head to toe. From the head (hair transplantation), to the face (eyelid lift and face/neck lifts), to the chest (breast augmentation /lift in women and gynecomastia treatment in men), to the abdomen (tummy tuck, liposuction), to the thighs (thigh lift, liposuction, etc.), and shaping of calves with contouring liposuction or other modalities of treatment. Thus, it does seem that the possibilities are almost endless.

So, is it true then, that when one starts down the road of plastic surgery, one can’t stop? This is an issue which shoulders the responsibility on both the patient and the surgeon, to ensure that  the patient does not become a cosmetic surgery “junkie”. However, there are certainly situations in which multiple surgeries are planned for the safety of the patient. For example, when one has lost a massive amount of weight (, ie, > 100 lbs), one may be left with a lot of loose skin all over. Due to the extensiveness of some of these body contouring procedures to remove the excess skin, it is necessary to divide up the surgeries and do them in multiple stages, so that we can minimize the perioperative risks and optimize the patient’s safety.

In the next article on Plastic Surgery, De-mystified, I will discuss in more detail some of these reconstructive and cosmetic surgeries.

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What is Plastic Surgery? Why the word Plastic?

I frequently get asked about why plastic surgery has the word “plastic” in it. Dr. Wu had written an article about the noble medical profession of Plastic Surgery. I think it was earmarked for Contentment Health Magazine – which it never got published to my knowledge, but I can’t seem to find it at the moment. So here’s my definition.

I love this quote about plastic surgery written by Gaspare Tagliacozzi in 1597:
“We restore, repair, and make whole those parts…which fortune has taken away, not so much that they may delight the eye, but that they may buoy up the spirit and help the mind of the afflicted.”

I work at Surgical Artistry because it is my passion to lift up the spirit, confidence, and health of my patients. And I like to do it one person at a time. Patients come to me with a spark of motivation to use Botox to erase a wrinkle (or Botox for a painful muscle trigger / migraine), then the interest evolves into skin health and then ultimately total body health which includes a whole food plant based diet.

The term plastic means to mold, and is from the Greek word “plastikos”. It was first used to describe a specialty of surgery in 1837 – this was over 75 years before the invention of plastic bottles. Thus Plastic Surgery came before the material called “plastic.” I can see how the public gets confused and think that plastic surgery is all about putting in plastic materials into patients. But it’s not that simple. Both Plastic Surgery and Plastic Bottles got the word “plastic” for the meaning “to be mold-able.”

Today plastic surgery encompasses cosmetic surgery, reconstructive surgery after cancer surgeries and traumatic accidents, HAND surgery, microsurgery, BURN intensive care, craniofacial surgery to fix birth defects like cleft lips, and branches of transplant surgery.

And I love this picture of my wife and I working together. This is what we do everyday at Surgical Artistry.

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Steroids and Keloids

How do steroids shrink keloids?  Including keloids from surgeries such as breast augmentation.

The science behind the treatment is that keloids are an abnormal form of healing. This healing process has a prolonged INFLAMMATORY phase, which is the main cause of the keloid formation.

What steroids do, is that they DECREASE inflammation, thereby shrinking keloids – works every time! J

I hope I answered your question adequately. If you want to know more, please let me know!

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any specific limitations for patients who want multiple surgeries performed at once

This is a really good question, so I am going to share my response to this question with the rest of the office.

Are there any specific limitations for patients who want multiple surgeries performed at once including Breast Augmentation? I know one is if the patient has ever had gastric bypass, due to the fact that the minimal amount of nutrients consumed adds a certain caveat to healing.

 

The main limitations to having multiple surgeries at once are:

 

  1. Patient’s health – can they withstand the stress of having multiple surgeries at once?
  2. Length/Duration of surgery when multiple surgeries are combined – I generally try not to do surgeries under general anesthesia that last more than 6 hours – having said that, I have done some surgeries that are about 7 hours or  more, but it is not my preference to do such long surgeries because the longer the surgery duration, the more potential perioperative complications such as infection, wound healing issues, etc. can happen.
  3. Surgeries requiring different types of anesthesia– I usually do not combine surgeries that usually are done with different types of anesthesia, ie, general vs. local or local with IV sedation. There are some physiologic differences for these different types of anesthesia; and some surgeries are better done under one vs. another.
  4. Gastric bypass status – you mentioned this issue. And indeed this is one of the factors that I take into consideration. Reason: Gastric bypass patients are immunocompromised and they have a surgically altered gut system that purposefully creates malnutrition for them. Therefore, they generally do not heal as well. The malnutrition is not because they eat very little; whatever they eat, the nutrients generally don’t get absorbed, because they get a big portion of their gut cut out and the portion of the gut that gets cut out is the main area for nutrient absorption. And that’s how they lose weight; it’s not because of the amount they eat; its’ the decrease in absorption surface area. Because of that, most of them are not as healthy as someone who’s never had such a surgery. And gastric bypass truly should be reserved for treating medical conditions that are resistant and nonresponsive to non-operative treatments.

 

I hope that answers your question. If anyone has any questions about above, please let me know. J

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Breast Consultation Six measurements

We had a new employee start with us recently and this question was asked which I thought was good and we can share with the rest of the world interested in Breast Augmentation:

What are the six measurement taken during breast consultation? And what impact do they have on choosing implant size and placement?

 

Breast Consultation Measurements which I record:

The six measurements taken when people come in for augmentation consultation consist of the following:

Sternal notch to nipple distance (2)

Sternal notch to inframammary fold (2)

Base width of the breasts (2).

These measurements help me decide which implants are best for the patients, both in size as well as style. I generally let the patients choose the volume of the implants, and I use the measurements to ensure that we pick the proper style or profile for them, so that the implants are not too big or too small for the patient.

I hope this makes sense. Good question!

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Nice review from a physician from Los Angeles

Thank you so much for this amazing review.  Dr. Tammy Wu and Dr. Calvin Lee pledge to work hard to live up to these wonderful words.  We work day and night perfecting our results and experiences for our breast augmentation, tummy tuck, and other plastic surgery patients.  We also work hard on our Botox, Kybella, Fillers (ie. Juvederm) and Acupuncture patients.  We love being in Modesto and we hope that Modesto would be proud to have us.

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Keller Funnel For Breast Augmentations

For Breast Augmentations, Dr. Tammy Wu uses the Keller Funnel. This is a special device that allows for a “no-touch” technique which protects the breast implant from possible problems such as infection and possibly capsular contraction. And it also allows potentially for a smaller incision on the skin.

Dr. Tammy Wu has known about the Keller Funnel for many years, but it was at the Plastic Surgery Meeting (The Meeting in Los Angeles) in 2016 where she was able to talk to the representatives of the company and set up several subsequent breast surgeries with representative support from the Keller Funnel Company.  She has been using the Keller Funnel since and she is extremely happy with this product, as are her Modesto breast augmentation patients.

Dr. Tammy Wu has been operating every single work day since she came back from her Sacramento meditation retreat.

Dr. Tammy Wu founded Surgical Artistry in Modesto along with her surgeon-husband, Dr. Calvin Lee in 2006.  She focuses her work on Breast Augmentations and Tummy Tucks.  Her husband specializes in Acupuncture and Cosmetic Injections (Botox, Kybella, Fillers, Veins).  The Keller Funnel is one example of how they strive for the best results for their patients every single day.

More information regarding the Keller Funnel for Breast Implants