BREAST IMPLANT DIMENSIONS AND SIZES
4 July 2018
If you’ve been researching breast augmentation, the chances are you’ve seen sizes mentioned like 250cc or 330cc. Maybe you expected implants to be sized in cup sizes like bras, so what does ‘cc’ actually mean?
Well, to be more accurate than bra cup sizes, which vary between brands, breast implants are measured in ‘cc’ or ‘cubic centimetres’ of liquid volume. This way it’s a fixed measurement and we all know exactly what size, or volume implant we’re dealing with.
I’d always advise coming in to try real implants in a bra and using our Crisalix system in the clinic. Before you try them on, I will ask you all a host of questions to determine the look you want to achieve. Whether it’s natural, or a more accentuated ‘glamour’ look. I’ll also take some precise measurements to identify the size of your breast pocket. This is unique to you and is related to both your height and frame size. It’s what I use to make sure you keep the right proportions. I’ll also discuss the positioning and help you decide between over the muscle, under or partial. This is where my expertise and years of experience really makes the difference.
How to convince a doubting family that Breast Augmentation is a good idea
1 July 2018
So, you’ve made the decision to have breast augmentation. Now you’ve got to break it to the family…and you’re not sure of their response!
Well the full support of your family, no matter who it is, your mum, your husband, your sister, or even your children, to most women, their approval is incredibly important. It’s the permission to go ahead. It’s the confirmation that ‘Yes, I will be there for you…I understand and I’ll help you through it.’ Great if that’s their response. But what if you suspect they might take some convincing? Or maybe they’ll never come round to your way of thinking.
Picking your moment can mean the difference between a great listening ear that’s willing to take on board your ideas and your feelings, as opposed to a negative, dismissive attitude. Dismissive is unhelpful and probably means you’re going to have to attempt this conversation again.
So, choose a time when everyone is relaxed, when there’s not another family crisis in the wings. You need their full attention to give yourself an uninterrupted chance to explain. Decide whether to speak to people individually, and a have a real heart to heart, or whether you’re going to get everyone together as a group.
Husbands worry that a new fresh faced wife, or bigger boobed partner may suddenly decide to leave them. It’s up to you to prepare for this reaction and put their mind at rest. Sisters can also step into the same arena, not liking the idea that the new you might look younger or more attractive. Helping them understand your reasons can sometimes be the clincher. You may also have to consider going ahead without their support, but be careful, it can disrupt some relationships beyond repair.
BEFORE YOUR BREAST AUGMENTATION CONSULTATION – WHAT TO DO
Breast Augmentation Dubai | 28 June 2018
With an abundance of information on breast augmentation available and easily accessible opinions, it is easier than ever to do your research online about all the different types of implants. Some tips for things to do before you meet with Dr Vigo are:
Make sure that, as you research online or talk to friends, you take notes on what you like and don’t like or want and don’t want. Bring in breast augmentation before and after photos as a reference. Write down any questions that you think of and have them ready to ask.
Don’t get too caught up in someone else’s experience. Because everyone’s bodies and experiences are so unique, it is most beneficial to discuss your personal needs one on one with your trusted surgeon. Remember that Dr Vigo is here to help you and you can’t ask too many questions or anything he hasn’t heard before.
Once you know your “why,” and you select a surgeon you know you can trust, deciding on “what” will be easier. Breast augmentation has come a long way and with highly experienced specialist surgeons like Dr Vigo can offer the best experience to their patients without compromise. Women can feel confident knowing that their “why” is understood and they will be receiving an incredible experience and even better results.
WHAT IS THE FAVOURITE BREAST SIZE AND SHAPE?
23 June 2018
Breast size and shape is a common concern for many women, who often worry their breasts aren’t big or round enough. Now the favourite cup size has been revealed. Breast size is a topic of contention, and some men and women are very specific about what is the right size for them. However, a C cup is the perfect size, according to a recent survey. A C cup is also the most frequently asked for size among patients with the prevailing tendency for breast augmentation today being for a smaller, more natural augmentation. It is not just size that comes into consideration when it comes to the preferred breast size. Shape is also a consideration. Round breasts are the preferred shape generally. Bell shape breasts, fuller at the bottom with less volume on top are also popular.
GETTING THE BEST RESULTS FROM BREAST AUGMENTATION
20 June 2018
When it comes to breast augmentation, patients are typically looking to increase their breast size, but there are a few other key factors to keep in mind when choosing the right breast implants that will both achieve the desired results and highlight your natural figure.
When considering breast implants, it is important to distinguish between cup size and implant size. Bra sizes are not uniform and can vary from brand to brand and by style, whereas implant sizes are uniform and are measured in cubic centimeters of volume. Discussing the difference with your surgeon can help find the right match for you.
It’s similarly vital to know what you are looking for as a result of the surgery. Some patients seek subtle improvements while others hope for dramatic changes. Visually, patients may be looking to increase cleavage, lift sagging breasts, or alter breast position.
Another aspect to consider is your lifestyle. If you work out, play a lot of sports, or have a physically demanding job, this could affect the size of breast implants you choose. Of course, women who lead an active life can still enjoy implants, just in some cases a smaller increase in volume may be a better choice.
Perhaps most importantly for those having breast augmentation is to have good rapport with your surgeon. Be sure to clearly communicate your goals and discuss them with your doctor. He or she will be able to help you choose the right size for implants as well as possibly suggesting a breast lift to go with the augmentation. In the office you will also have the opportunity to look at before and after photos to find pictures of women with similar body types and see how their augmentation improved their appearance.
WHAT TO ASK YOUR SURGEON BEFORE BREAST AUGMENTATION
15 June 2018
Before making a final decision on considering breast augmentation it’s essential to be able to ask your surgeon the right questions during your consultation.
The first thing to do is ask your surgeon if breast augmentation is right for you. This will entail letting him or her know your ultimate goals which will provide the information needed to let you know if breast augmentation will help you achieve those goals. Next, ask for advice on choosing the right implant size. Generally, those getting breast implants a part of their cosmetic surgery want to choose a size that complements their figure and still maintains a natural look. You should also talk to your doctor about the difference between your options for the type of implants. The final look and feel of your augmentation could be affected by this decision and your doctor will be able to help you choose according to your individual plan. When consulting with your surgeon about breast augmentation, get to know the surgical techniques that are available. Submuscular and subglandular implants offer different advantages for different body types and lifestyles. Bringing this up during your consultation will help you get the best results.
Finally, it is important to ask what the recovery will be like. Your surgeon should be able to give you a good idea of how long it will take to return to work, your normal exercise routine, and more. With this knowledge you will be able to prepare your home to make your recovery more comfortable and stock up on supplies you will need. Many women can return to work in a week or two and resume exercise in four to six weeks, but it depends on other personal factors.
As with any other procedure, the more knowledge and understanding of the breast augmentation process you have, the better chances of success you will have. Having an experienced, trustworthy, and friendly surgeon is important in getting the results you want.
CUTTING EDGE TECHNOLOGY ALLOWS WOMEN TO VISUALISE THEIR NEW BODIES BEFORE BREAST AUGMENTATION
10 June 2018
The 4D Crisalix scanning device projects images of your potential figure to help you choose your implant size. After undressing and getting the distances between your nipples measured, the distances between your sternum and nipples measured and the distance from each nipple to your ribcage recorded, you simply need to stand as still as you can while you are scanned from every angle possible – which is where the 4D visualisation begins.
The iPad I use has the Crisalix camera scan device attached to it, it scans in real time, in 4D and the imaging software recreates your body on the iPad screen – every contour precisely rendered in front of you! A tap of a button and your body appears on screen in the consultation room. In addition to scanning every curve, roll, wrinkle and mole on your top half, it’s also scanned your skin tone, which is replicated exactly on the screen.
One second and a tap of my screen later and you have the breasts you’ve always wished you had. Fuller, natural, it is likely your silhouette is completely different and you’ve been able to see what you’d look like with implants without having to go under the knife – even the moles you have are recreated with the precision scanner.
The amazing thing about the Crisalix technology is that I can make sure – as a surgeon – that I am on the same aesthetic page as the patient that I’ll be operating on. I’ve had women in consultation tell me adamantly they want a 400cc implant but no two bodies are the same and until this imaging software there wasn’t an accurate way to show patients what their implants would look like in their bodies.
My Crisalix technology puts the power in the hands of the patient which can only be a good thing.
HOW FAT TRANSFER BREAST AUGMENTATION WORKS
06 June 2018
Breast augmentation is one of the most popular plastic surgeries for women but breast enhancement doesn’t always involve breast implants. Fat transfer breast augmentation is also a safe, effective and natural way to increase breast size, and the procedure is even scarless.
Here are the steps to the fat grafting process.
Fatty tissue is the best material to use for breast augmentation because it eradicates the common concerns with breast implants such as capsular contracture, loss of sensation in your nipples, implant deflation and visible rippling.
The three main steps of fat transfer breast augmentation include:
– The fat cells are removed from a donor location on your body via liposuction.
– The fat is separated from the anesthetic liquid used in liposuction, condensed and readied for the breast augmentation procedure.
– The fat is injected into the breasts to increase breast size.
How Does Fat Transfer Breast Augmentation Work?
In the most simplistic terms, a fat transfer is accomplished by a procedure called liposuction. Fat from one part of your body especially the thighs or stomach or buttocks is removed and then injected into the desired area of the body – not just the breasts. The collected fat naturally contains stem cells which are preserved through the use of very fine, needle-like harvesting cannulas. Between the liposuctioning and the injection, the fat is cleaned and filtered in a sterile closed system. This method improves the chances of fat cell survival and prevents contamination prior to reinjection.
The Pros and Cons of Fat Transfer Breast Augmentation
Unlike the breast implant whose size is fixed, a fat transfer augmentation cannot guarantee a specific size outcome.
Pros: Improves self-esteem, It’s all natural, Reduces risk and has a natural feel
Cons: Outcomes can be hard to determine because the volume injected is not always equal to the final, stable size. May require multiple treatments – because of unanticipated fat absorption, the treatment may need to be repeated to create the desired outcome.
SMALLER IMPLANTS CAN OFFER A MORE FIT AND ATHLETIC LOOK
01 June 2018
Many of my patients come to me thinking bigger is always better, even when their body type could benefit from smaller implants.
With the breast augmentation gaining momentum a few years back, women were opting for large breast implants. However, the scenario has changed and women are looking for more natural results with breasts that look less obviously enhanced. This is leading to the trend of 3D imaging for breast augmentation. 3D imaging provides a higher chance of offering results as per the plan. This is also helping women to choose the implant size that results in the natural looking breast augmentation. Lifestyle is the most important factor in a decision to undergo a cosmetic surgery. Hence, women are seeking breast implants to balance the figure than to dominate their appearance.
To balance an active lifestyle, many women prefer smaller implants that can offer a more fit and athletic look. Advancement in breast augmentation technology is resulting in improved design, fill volumes and construction, accelerating the development of new devices that leads to less wrinkling and rippling.
Fillers in Dubai: Tips to Achieve Successful Outcomes
Fillers in Dubai
INTRODUCTION
Dermal fillers have revolutionized the field of cosmetic dermatology. With the aging of baby boomers, dermal fillers have become a sought-after rejuvenation procedure as they offer a youthful, three-dimensional look with minimal downtime. Dermal fillers are gaining popularity because of the increased attention by the media and the availability of a wide array of filler materials available at prices more affordable than before. The use of fillers for soft tissue augmentation with the synergistic use of botulinum toxin and a variety of complementary procedures has become the mantra for rejuvenation.
Presently, the fillers available in India vary in source, longevity, site of deposition, and cost. The focus of this article is to analyse the fillers available in the market and to provide practical tips that would enable the dermatologist derive optimal results for the patient.
CLASSIFICATION OF FILLERS
Fillers can be classified either on the basis of longevity in tissues, or based on their source.
Based on longevity
Fillers are classified as temporary, semipermanent, or permanent. Temporary fillers stay in the tissue for less than a year, semipermanent fillers for up to 1–2 years, whereas permanent fillers are substances that remain in the tissue more than two years. However, there is some confusion in the classification of semipermanent and permanent status of some fillers, with some sources classifying any filler that lasts more than one year as permanent.
Based on the origin
Fillers may be classified depending on their source as:
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Human
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Animal
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Synthetic
Knowing the source of the filler is important as it helps the dermatologist to take decisions about the need for preskin testing and to know the patient’s preference. Many patients may not wish to use animal products for religious or personal reasons.
Temporary fillers
Temporary fillers are also referred to as nonpermanent fillers. Their stay in the tissue is for less than 12 months and hence, they have the advantage of spontaneously disappearing if the patient is not satisfied with the results. Similarly, an adverse event with such fillers is also a temporary one, as seen in the majority of the cases. However, rare permanent side effects have been reported even with temporary fillers.
Some of the common temporary fillers available in India are described here:
Bovine collagen-based products
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Zyderm 1
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Zyderm 2
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Zyplast
Human tissue-derived collagen
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Cosmoderm
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Cosmoplast
Synthetic fillers: Hyaluronic acid-based fillers
A wide range of hyaluronic acid products is available with varying hyaluronic acid concentrations and cross-linking structure and hence, also in their indications
Fillers in Dubai Table 1
Temporary fillers, their indications, and sites of placement
Semipermanent fillers
Semipermanent fillers undergo slow degradation with time over a period of 1–2 years. Side effects with semipermanent fillers are more common and longer lasting than temporary fillers.
Fillers in Dubai Table 2
Semipermanent fillers, their indications, and sites of placement
Permanent fillers
Permanent fillers are fillers that remain for longer than two years in the tissyue. Side effects with permanent fillers tend to be more permanent, and complication is the main issue with any permanent filler.
Fillers in Dubai Table 3
Permanent fillers, their indications, and sites of placement
Other materials, which are less commonly used, include Artefill and Silicone.
INDICATIONS OF DERMAL FILLERS
Fillers are mainly used in the rejuvenation of facial areas. However, dermal fillers may also be used in nonfacial areas and for cutaneous defects.
Facial areas
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Wrinkles and folds
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Lip Augmentation
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Depressed scars – postsurgical, traumatic, postacne, chickenpox, and other diseases
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Enhancement of facial contour
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Periocular melanoses and sunken eyes
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Dermatological diseases – angular cheilitis, dermal atrophy, AIDS lipodystrophy
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Earring ptosis, atrophic earlobes
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Nasal depressions
Nonfacial areas
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Neck
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Décolleté } Rejuvenation
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Hands
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Corns and calluses – to reduce contact points, pain, and risk of ulcer formation
CONTRAINDICATIONS
Complications of fillers are generally rare; they include:
Absolute
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Hypersensitivity to products
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Unrealistic expectations
Relative
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Keloidal tendency
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Patients with autoimmune disease
PATIENT EDUCATION AND ASSESSMENT
Patients should be counseled about the nature of the filler, what to expect, longevity, any possible side effects, and the cost. An assessment of both the physical and psychological states of the patient is necessary for a successful outcome. Written informed consent ensures compliance with regulatory and legal requirements as well as the management of the patient’s expectations. Pre- and post- photographs are important to critically analyse the results of the treatment and also, to prepare for medico-legal situations.
PROCEDURE OF FILLER INJECTION
The aesthetic benefit for the patient with temporary fillers can be attributed to 90% technique and 10% substance, whereas it is usually 99% technique with permanent fillers.[3]
Preparation and anaesthesia
The area of injection and also the surrounding skin should be cleaned properly with antiseptics. Anaesthesia is important for technical benefit and the patient’s comfort. Anaesthesia can be ensured by:
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Application of ice
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Topical EMLA cream application
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Regional nerve blocks – infraorbital, mental, maxillary, submucosal – as applicable, depending on the area
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Distraction Techniques such as massage, application of vibration
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Talking in a soothing and comforting manner – Talkesthesia
Injection technique
The choice of the injection technique depends on the indication, its location, the filler substance, size of the needle, and the experience of the injector. The techniques include:
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Linear threading technique
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Serial puncture
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Fanning
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Cross-hatching
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Depot
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Fern
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Cone
The first four techniques are used commonly, whereas the last three are only used in special situations. It is important to place the filler in the right place and the bevel orientation is not a significant issue at any site.
Postinjection management
Patients should be asked to avoid extreme cold or heat for 48 hours. Massaging of the treated area and strenuous physical activity should be avoided for six hours. Patients are asked to sleep with their heads elevated for one night; skin care routine may be followed after 24 hours.
Measures to achieve successful outcomes
A comprehensive treatment plan should be devised to suit the needs of each patient. Choosing the right filler for the right indication is vital. Where essential, combinations of fillers with botulinum toxin should be used to optimize the results. In such cases, it is advisable to inject the botulinum toxin first, wait for a week to see the improvement, and then, inject the filler to achieve best results.
FACIAL ANATOMIC AREAS: SPECIAL CONSIDERATIONS
Glabella area
Always choose patients with a positive glabella test. Inject small boluses relatively superficially, using only moderate pressure while injecting. Always watch for erythema and stop injecting when you see blanching as this will reduce the incidence of ischaemic necrosis which is common in this area. Techniques used in this area are usually a combination of linear threading and serial puncture techniques.
Nasolabial fold
This is the ideal indication to start with for a novice injector. Stretch and compress the skin to visualize the fold. Inject into a site medial to the fold to avoid further cheek ptosis. Overcorrection is common here and this leads to change in animation, lumpiness, and bumpiness. Remember that nasolabial folds always display a degree of natural asymmetry which should be discussed with the patient prior to injection. Usually a linear threading or a fern technique is chosen to treat this area.
Lips
The lips are the focal centre of the lower face. It is always important to consider antiviral prophylaxis in a patient with a history of herpes simplex episodes.
The height of the lips and the proportion of the upper to lower lip should be considered. The lower lip should protrude slightly beyond the upper lip. The upper lip should be 2/3 of the volume of the lower lip. Usually lip augmentation is done with a larger particle-sized filler in contrast to lip line augmentation which is done with a smaller gel particle-sized filler. Overcorrection of the upper lip can lead to a “duck bill” appearance. As lips swell immediately following the injection of the filler, steroid prophylaxis needs to be considered.[7]
A linear threading technique is done for volume augmentation and a microdroplet technique is used very rarely when one has to inject near the submucosal area.
Periocular area
The best candidates are younger patients with thicker skin and minimal to moderate volume loss. A depot injection at the level of the periosteum essentially traps the gel implant creating a long-lasting effect. Edema and ecchymosis are quite common in this area. Too superficial placement or thin skin in this area can lead to visibly pale nodules or Tyndall effect. Injection of filler into the periocular area is a difficult procedure and only a person with good training and experience should attempt it. One should also be aware of serious side effects such as blindness (see under complications).
COMPLICATIONS OF FILLERS
Temporary fillers have fewer complications and transient adverse effects when compared to semipermanent and permanent fillers. Adverse effects could be injection-related or filler material-related and may appear either immediately or later.
Early complications
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Hypersensitivity reactions
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Haematomas and ecchymoses
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Infections – reactivation of herpes simplex
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Nonhypersensitivity-related swelling
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Acneiform eruptions
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Erythema – transient or permanent
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Skin necrosis
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Embolism (blindness)
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Tyndall effect
Late complications
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Implant migration
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Telangiectasia
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Granulomas
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Lipoatrophy
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Hypertrophic scarring
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Sterile abscess
The treatment of complications should be aggressive and initiated as soon as possible after occurrence. Effective treatment of complications and assuring patients in the interim are the keys to successful practice.
NOVEL THERAPEUTIC AGENTS AS DERMAL FILLERS
Stem cells
Adipose tissue is easily obtained through liposuction and it provides a good source of stem cells which serve as a useful agent for soft tissue regeneration or repair. It has been found that fatty tissue has the highest percentage of adult stem cells of any tissue in the body with about 5000 adipose-derived stem cells per gram of fat vs 100–1000 stem cells per milliliter of bone marrow.
Autologous vein transplantation
Autologous vein transplantation can be performed with the unwanted veins of the patient. The procedure involves extracting varicose or other unwanted leg or hand veins of the patient, soaking the vein in hypertonic saline to destroy endothelial cells, and then, implanting portions of the remaining material (containing collagen, elastin, and muscle) into the dermal defect. The endothelium is destroyed to prevent newer angiogenesis in the implanted area. So far the results have been long-lasting with no complications. Although results are encouraging, this procedure is laborious at present, and is restricted to patients with unwanted veins.
CONCLUSION
With a variety of fillers flooding the market and with the aging of baby boomers aspiring to retain their youthfulness, careful selection of the patient, the dermal filler, and the technique can maximise patient satisfaction and lead to a successful outcome