• FREE Area of Lipo with Any Tummy Tuck
• $500 OFF Breast Augmentation with Silicone Implants
• $75 OFF Permanent Makeup (Eyebrows, Eyeliner, Lipliner, Full Lip)
• 3 FREE Laser Hair Removal Sessions (small area with purchase of select Laser Packages)
• Give Your Valentine a Gift Card from Inland Cosmetic!
• Gift Cards Available good towards products, injectables, Laser, or surgery
• see details below

Rancho Cucamonga, Chino Hills, Victorville

Dr. Samir Pancholi, a Las Vegas cosmetic surgeon, says that he often performs breast augmentation and breast lift surgery in the same session and liposuction with fat grafting techniques when performing the Brazilian butt lift.

Breast Surgeries

Patients who have lost the shape and fullness of their breasts, such as massive weight loss patients and postpartum women, are often good candidates for a combination of a breast lift and breast implants.

The breast lift, also known as mastopexy, results in a more ideal positioning of the nipple and breast, but it does not adequately address the lack of fullness of the breast in those patients, Dr. Pancholi says.

“In order to achieve a more voluptuous-looking breast…I often combine a mastopexy with breast implant surgery. The breasts are not only higher up but also have a fullness to them because of the implant,” he says.

Buttock Enhancements

By combining liposuction with fat grafting techniques when performing a Brazilian butt lift, the rounded shape of the buttocks can become more enhanced.

Dr. Pancholi says he typically performs liposuction to remove fat at the waist and upper and lower back, which causes a slight hollowing of the area and results in an accentuated curve of the buttocks. Then for a more enhanced curving effect, he takes the fat harvested during liposuction and injects it into the buttocks.

Benefits of Combination Procedures

In the past, patients might have had one breast surgery and then had the other six months later, but combining them can have benefits.

“Combining the two makes much more sense in terms of having one surgery, one recovery, reduced cost and achieving the final result without a second surgery,” according to Dr. Pancholi.

There are other areas of the body where surgeons are performing multiple procedures at one time. The New York Times recently reported that a California surgeon has combined eyelid surgery and a brow lift to create an “All-in-One Eye Lid and Brow.”

Allergan released a statement after France’s health minister recommended French women have their Poly Implant Prosthese (PIP) silicone gel implants removed.

PIP used cheaper industrial silicone instead of medical silicone for the implants to save money, according to investigators. The PIP implants were removed from the market last year and have never been used in the United States.

Estimates say that around 30,000 women in France have the PIP implants. Tens of thousands more women in Britain, Italy, Spain and other countries in Europe and South America also have had PIP implants.

Allergan’s breast implant devices, including Natrelle, were not part of the investigation. Just last year, the FDA reaffirmed the safety of silicone breast implants in the U.S.

“All Allergan implants are manufactured at our state-of-the-art facility using silicone and saline that is approved for use in medical devices and are designed to meet all relevant national and international Quality Control Standards and Current Good Manufacturing Practice (CGMP),” stated Allergan’s press release.

Allergan also offered specifics on the manufacturing of its implants: from start to finish, it can take up to 12 days to manufacture an Allergan breast implant, which undergoes almost 100 quality control tests.

Allergan’s breast implants have been used for almost 50 years. Their gel-filled breast implants have been available in Europe since 1997 and received U.S. FDA approval in 2006.

According to Allergan, silicone gel-filled breast implants are among the most studied medical devices, with more than 3,000 studies supporting their safe use.

In addition to Allergan, Johnson & Johnson’s Mentor also makes a silicone breast implant approved by the FDA.

Patients should recognize that while breast implants are safe, they are not lifetime devices. It’s possible that at some point a patient may need to have an implant removed or replaced.

Learn more about breast augmentation in Rancho Cucamonga.

The study found that overall the forums are a positive experience for women. “Through electronic postings, they cared for and nursed each others’ anxiety and feelings throughout the whole process,” wrote the researchers at Oslo University Hospital.

Online forums have made it easier for patients to connect and communicate with others interested in breast augmentation. The researchers suggested that for women who are looking for information on the procedure, the Internet “is one of the most important or perhaps the most important, source of knowledge on the topic.”

The women used forums and message boards to share information and experiences on breast augmentation and to examine their reasons for choosing the procedure.

The message boards are also a place for getting support and building relationships as well. “The most profound element of the forum culture was the provision of support to other women,” the researchers wrote. “By sharing and exchanging thoughts, the women nursed each other in terms of their doubts, bitterness, pain, sadness, excitement, elation, and happiness.”

The study found the forums offered women support throughout the process. For instance, before surgery women discussed how they were making decisions with regard to implant size, profile, shape, placement and material. After surgery, discussions included their experiences with soreness, swelling, pain and postoperative self-care.

Women on the message boards also discussed relationships with their self-image and their surgeons.

The researchers located the online forum they studied using Google. Here are a few popular breast augmentation forums:

• Just Breast Implants
• Implant Info
• Real Self
• Make Me Heal

Learn more about breast augmentation in Rancho Cucamonga.

In 2006, the FDA lifted a 14-year ban on silicone gel-filled breast implants and approved the implants made by Allergan and Mentor for breast reconstruction and breast augmentation in women 22 and older in the U.S.

The New York Times reported that after two days of discussion about the safety of silicone implants, Dr. William Maisel, of the FDA’s Center for Devices, said he had heard nothing to shake his faith in the safety of the popular implants.

The committee also felt that patients should no longer be told to get an MRI three years after getting their implants and every two years after that.

It’s currently recommended that women have MRI’s after getting silicone breast implants because the implants sometimes rupture, and an MRI can reveal this problem.

However, many patients don’t follow this requirement because MRI’s are expensive, and the risks associated with ruptured implants may not be greater than the risks of the operation needed to take them out.

“FDA continues to believe, as does the panel, that MRI is the gold standard for evaluating breast implants for silent rupture,” Dr. Maisel said. “But there was consensus among the panel that the requirements for ongoing MRI’s should be removed.” Whether to drop the MRI requirement will be evaluated in further studies about silicone implant safety.

Radiologist Leonard M. Glassman, MD, was among those in favor of dropping the MRI requirement.

“It’s an impossible thing to request patients to do. Nobody pays for it except the patient. It is expensive. If the patient is asymptomatic and we find a rupture, chances are nobody will do anything about it; therefore we shouldn’t have done the test in the first place,” he said. “I would drop that MRI recommendation from the labeling.”

In addition to ruptures, complications with silicone implants include hardening of the area around the implant, scarring, infection and the need for additional surgeries.

Sources:

• The New York Times
• USA Today
• Medscape (registration required)

Experts say that this trend is likely to continue as baby boomers begin to pass 65.

There are many reasons these older patients undergo cosmetic surgery. Many are living longer and staying healthy, so they want their bodies to reflect that. Others are dating and want to look their best, and some are still working and want to be seen as more youthful.

Mary Graham, a 77-year-old profiled in the Times article, recently had a facelift and breast implants. She said the only time she goes to the doctor is for cosmetic procedures.

Ms. Graham still works seven days a week and said, “I wanted to look as young as I feel.”

Cosmetic Surgery at an Older Age

There are concerns from some about the safety of performing elective surgery on older patients: it may take longer for these patients to heal, and the results may not last as long as in younger patients.

However, some studies have shown that properly screened older patients don’t have higher risks. For instance, researchers at the Cleveland Clinic found no significant difference in the instances of complications between a group of older facelift patients (average age 70) and a younger group (average age 57.6).

No matter what age you are at when considering cosmetic surgery, your surgeon will discuss potential risks at your consultation prior to surgery.

Johns Hopkins University researchers reviewed insurance claims of 2,403 obese patients and 5,597 normal weight patients who had breast procedures, including breast lifts, breast reductions and breast augmentations, between 2002 and 2006.

Just over 18 percent of the obese group had at least one complication within 30 days of surgery, compared to only 2.2 percent of non-obese patients.

The study found that obese patients were 22 times more likely to have inflammation; 13 times more likely to develop infection; and 11 times more likely to experience pain.

Breast reduction was the most common procedure for patients in the study, accounting for 80.7% of surgeries in the obese group and 63.8% in the non-obese group. Next was breast reconstruction, followed by breast augmentation and breast lift.

Individual breast procedures all had higher complication rates for obese patients, and complications were most common with breast augmentation among obese patients, with half of obese patients experiencing complications.

Complication rates for each breast surgery are as follows:

• Breast augmentation – 50.5% among obese and 4.4% among non-obese
• Breast lift – 24.1% among obese and 11.4% among non-obese
• Breast lift with augmentation – 38.9% among obese and 5.6% among non-obese
• Breast reconstruction – 29.4% among obese and 1.8% among non-obese
• Breast reduction – 14.6% among obese and 1.7% among non-obese

Based on their findings, the researchers recommended that patients should be informed about the risk of obesity prior to breast surgery procedures.

The reasons for the higher risk of complications with obesity, according to the authors, may be greater space for infection to set in from larger surgical wounds and slower healing due to poorer blood flow in fat tissue than in other types of tissue.

The first thing that is important for patients choosing a breast implant size to understand is that bra cup sizes vary wildly from retailer to retailer and are not an exact measurement of breast size. Breast implant sizes are measured by exact volume in cubic centimeters (cc’s), so while a cup size might give you a ballpark range of the overall breast size you are trying to achieve, they will not help you choose an exact breast implant size.

Try to put the idea of C cup and D cup out of your mind while you consider your options. Also, remember that your natural breast tissues will also contribute to the overall size of your breasts after implants have been placed provided your implants are not part of a breast reconstruction procedure.

Breast Implant Sizes

A great place to start your journey to understanding breast implant sizes is with the range of implant sizes or, rather, volumes available in the U.S. There is slight variation in size availability for saline and silicone breast implants, however in general, breast implant volumes range from about 120cc to 850cc.

Saline implants can be overfilled to achieve a slightly larger size, however most patients do not want breast implants that large. In fact, some states even dictate that plastic surgeons may not supply patients with breast implants larger than a certain size (usually 1000cc to 1200cc).

In choosing a breast implant size, it also helps to remember that your skin must stretch to accommodate the implants you choose, so if you have poor skin elasticity or are prone to stretch marks, your cosmetic results may be best if you choose implants that will not put undue stress on your skin.

Breast Implant Profiles

In addition to different volumes, breast implants also come in four different profiles: low, moderate, moderate plus and high profile. The implant profile affects the projection of your breast implants, and although they are not directly related to the implant size, they can affect how large or natural your breasts appear.

The greater the profile of your breast implant, the greater the height of your breast side wall. Many patients who desire more upper pole fullness, or cleavage, and are less concerned that their implants look natural choose high profile implants, as do patients with very narrow breasts.

Tools to Help You Choose a Breast Implant Size

There are many tools Dr. Haiavy can provide you with to help you visualize how different breast implant sizes would look after surgery. Although none of them offer an exact representation, they can still give you a general idea of the look and proportions implants would create.

Implant sizer bras are helpful to some patients as they struggle to imagine how they would look with larger breasts. Sizer bras have pockets in them designed to hold replica breast implants of different sizes, allowing you to contrast and compare the effect different breast implant volumes has on your contours. Try on sizer bras with a swimsuit, t-shirt and other tops to see a general approximation of the effect breast implants would have.

A measuring tape can also be a great help. Having your surgeon take measurements of your chest wall dimensions will help you get a better understanding of your existing body proportions and how they would change with different breast implants. Your surgeon will provide you with appropriate context and a brief anatomy lesson during this stage of the decision-making process.

Finally, arguably the best tool available to patients choosing a breast implant size is their surgeon’s gallery of breast augmentation before and after photos. Looking at before and after photos of other patients who share a similar build, existing breast size and desired breast size can provide some of the most useful direction to women considering implants. Review as many before and after photos as possible as you make your decision.

Input From Your Surgeon

Dr. Haiavy will certainly help guide you throughout the process of choosing your ideal breast implants. However, keep in mind that decisions about your implants, including their size, must ultimately rest with you.

Be sure to choose a surgeon who makes you feel comfortable asking questions and gathering all of the information you need to make an informed choice. While Dr. Haiavy has spent many years helping women in the Inland Empire area choose their breast implants and can offer you invaluable input, you must feel confident in your decision to ensure your expectations for breast augmentation are met.

Oftentimes choosing whether to have saline or silicone implants can be one of the most difficult decisions to make because the choice is very subjective, and science does not offer patients a definitive answer as to which type of implant is “better.”

Look and Feel

Both silicone and saline implants can give you a natural look, particularly if the implants are placed under the chest muscles, however silicone breast implants have a reputation for providing a more natural feel.

This makes sense, given that silicone implants today are made of a cohesive gel material that more closely mimics the weight and suppleness of natural breast tissue than liquid saline solution.

Patients who are very thin or have little natural breast tissue to cover their implants are often good candidates for silicone gel implants because the implants are softer and less prone to rippling, allowing for a more natural look and feel.

Patients with pronounced asymmetry in the size of their natural breasts may also be good candidates for saline implants, as the volume of saline solution in each implant can be adjusted to even out the breasts.

Scarring

Saline breast implants are composed of an outer silicone shell and a filling of liquid saline solution. Because the saline solution can be added after the implant shells have been placed in the chest wall, the incisions needed to place saline implants are slightly smaller.

There are also more options as to where incisions can be placed with saline implants. Unlike silicone implants, which can be inserted only through incisions in each breast fold (inframammary incisions) or along each armpit (transaxillary incisions), saline implants can also be inserted through incisions around the border of each areola (periareolar incisions) and even through the belly button (TUBA incision).

Thus, saline implants result in smaller scars (about half an inch smaller) than silicone implants and offer more options for patients in terms of where their breast augmentation scars are located.

Safety

In 2006, the FDA ended a 14-year moratorium on silicone breast implants that was instituted because lawmakers felt there was insufficient evidence to rule that the implants were safe.

After years of rigorous testing, the FDA allowed silicone implants to re-enter the market because no scientific data had been produced to link silicone implants to systemic diseases they were previously assumed to cause.

From a scientific standpoint, the safety of silicone implants and saline implants is identical. The only difference between the two from a legal standpoint is that patients must be 22 to have silicone implants, whereas they can be as young as 18 to have saline implants.

Patients who choose either option can rest assured that all FDA approved breast implants are safe and will not directly affect your health and wellness in any way, positively or negatively.

Breast Implant Cost

Breast implant manufacturers charge about $1,000 more for silicone breast implants than saline breast implants, so breast augmentation with silicone implants is slightly more expensive initially.

Also, consider that patients with silicone implants should have an MRI three years after surgery and every two years thereafter, as there is no other way to detect breast cancer or implant ruptures with silicone implants. Saline implants, on the other hand, do not require an MRI to detect cancer and will visibly deflate if they are ruptured.

Due to the cost of periodic MRIs, the cost of maintaining silicone implants can be slightly higher in the long run.

The Bottom Line

It is easy to get overwhelmed evaluating the pros and cons of each type of breast implant, but before you do, remember that you have a guiding light in this process: your cosmetic surgeon. Dr. Haiavy has a decade of experience and has helped hundreds of Inland Empire breast enhancement patients choose the best breast implants to meet their unique needs.

Trust Dr. Haiavy to help you make this important decision, and feel free to ask questions, talk to other breast augmentation patients and look at plenty of breast augmentation before and after photos before you decide on silicone or saline breast implants.

For a breast augmentation, the incision techniques include:

• the crease of the lower part of the breast
• along the lower half of the areola
• in the armpit
• through the belly button

A transumbilical breast augmentation (TUBA) is one in which the incision is made through the belly button, and because the incisions are hidden in the navel, it is sometimes referred to as scarless breast augmentation.

According to Cosmetic Surgery Times, a review of 3,300 charts of TUBA cases emphasizes the assertion of Dr. Robert Shumway that it is a “faster, safer and better procedure than other breast augmentation approaches.”

Dr. Shumway, who reported on his own TUBA procedures at the 27th annual American Academy of Cosmetic Surgery scientific meeting, said that “TUBA is about as safe as breast augmentation can get.”

At the meeting he reported on complications, complaints and patient satisfaction ratings from the TUBA procedures he did between 1994 and 2010.

The most common complication Dr. Shumway saw was capsular contracture (69 cases, 2.09 percent), and he said the rate is lower than the published national average for augmentations performed via other techniques.

He also found that there was one possible infection (0.03 percent) and only several other types of complications, all with rates equal to or less than 0.18 percent.

On a scale of one to 10, patient satisfaction ratings at two and six months after surgery were eight or higher, with a mean of 9.7, he said.

Dr. Haiavy was one of the first cosmetic surgeons in the United States and Southern California to perform transumbilical breast augmentation, which results in no visible scars, reduced loss of sensation and reduced risk of infection.