This unfortunate woman had breast augmentation by a board certified plastic surgeon in Denver. After an in-office procedure, she developed infection and capsular contracture of the left breast resulting in the loss of a large amount of tissue of the left breast. Reconstruction was done with removal of the left breast capsule, use of acellular dermis to rebuild the left breast and bilateral implant exchange. A right nipple lift was done to improve symmetry. Results are shown at one year. Choose your Plastic Surgeon carefully. #SquiresPlasticSurgery#BreastAugmentation #Denver#JohnSquiresMD
If you want to enhance your curves, breast augmentation surgery with saline or silicone implants is a great option to consider. Breast enlargement can increase breast size, enhance breast shape, and give you much more prominent bustline.
Dr. John Squires has helped many patients in the greater Denver, Colorado achieve their cosmetic goals thanks to breast augmentation.
Patients who are overweight or obese sometimes ask if there are any health concerns or special considerations when it comes to breast augmentation surgery. Let’s consider a few of the basics on this topic so you know what to expect.
Can overweight patients undergo breast augmentation?
In short, the answer is yes.
A number of patients who are overweight or obese have undergone cosmetic surgery and other elective surgical procedures and achieved good results. However, this can vary from patient to patient, and it is important that obese patients in particular consider the risks involved with breast augmentation surgery.
Higher Risk of Surgery Complications for Obese Patients
People who are obese or morbidly obese tend to be at a higher risk for surgical complications than people who are overweight or of a normal weight. According to a 2011 study published in the journal Plastic and Reconstructive Surgery, women of normal weight had a 2.2 percent complication rate when undergoing breast surgery.
Obese women, by comparison, had a 18.3 percent complication rate when it came to breast surgery. This is a 12-fold increase in potential complication risks.
The report noted that breast reduction surgery was the most common surgery performed on women who were obese, accounting for 80.7 percent of breast surgeries for the obese women in the study. This makes sense since woman who are obese tend to have breasts that are large breasts that droop and sag.
Breast Augmentation Risk Was Highest Among Obese Patients
The Plastic and Reconstructive Surgery report found that breast augmentation surgeries comprised just 4 percent of the procedures in the obese women in the study. Yet the complication rate among obese breast augmentation patients was 50.5 percent.
This was the highest complication rate of all breast surgery procedures performed on obese women in the study. In non-obese women, the complication rate for breast augmentation surgery was just 4.4 percent.
Given the much higher rate of complications for obese women undergoing breast augmentation surgery, it’s important to consider how the risks from surgery may be far greater than the aesthetic benefits.
Discussing Surgery with Your General Practitioner
If you are obese or morbidly obese, be sure to discuss your eligibility for breast augmentation with your general practitioner. They may dissuade you from undergoing breast augmentation given the risks involved, or may make recommendations that limit the potential risks to wellness should you undergo surgery.
If you are overweight and suffer from health issues such as hypertension or diabetes, it’s also a good idea to discuss breast augmentation with your general practitioner. He or she will let you know if it is safe to proceed with breast augmentation or if there are major risks that would make the procedure a poor idea.
Does it sound to good to be true to increase your breast size and slim down your tummy or thighs at the same time?
For years, saline and silicone implants have served as the most effective method for breast augmentation, and many studies and FDA approval declare both saline and silicone implants to be safe. Breast augmentation has been the most commonly performed cosmetic surgical procedure in recent years.
The relatively uncommon fat transfer breast augmentation procedure has women everywhere buzzing about the ‘benefits” of this seemingly more natural breast enhancement option. Present clinical evidence does not conclude that fat grafting is safer or better than saline or silicone implants, but the idea of taking one’s own fat and repositioning it to augment the breasts is rapidly capturing the attention of medicine, consumers, and the media.
Breast enhancement using fat grafts (lipoaugmentation) rather than silicone or saline implants employs fat suctioned from the patient’s buttocks, thighs or other fatty areas. This type of breast surgery can be used to increase the size of the breast or to fill in defects or abnormalities in existing breasts, including enhancing the appearance after breast reconstruction and softening the look of existing implants. Fat injections of the breasts may offer patients augmentation with a natural look and feel and the benefit of body contouring through liposuction—without the requirement for incisions or implants.
However, long-term safety and efficacy data as well as the effect of the procedure on breast cancer screening using mammography is still being evaluated in clinical studies. Concerns about fat grafting for breast enhancement include unpredictable or low survival rates of the transferred cells (which are frequently absorbed by the body), development of cysts, calcification and tissue scarring. Another major concern is long-term problems with breast cancer detection due to difficulties in telling the difference on mammograms between calcifications associated with breast cancer and calcifications associated with fat transfer.
This procedure does offer a modest opportunity for enhancement— specifically, about one cup size increase and the degree of enlargement will depend on the amount of spare fat that the patient has. But, numerous questions remain about this new technique: How much of the fat survives? Does the procedure have to be repeated? Are the breasts hard and uncomfortable for long periods after the procedure? And most importantly, what are the cancer implications of this technique? Research projects, funded by the Aesthetic Surgery Education and Research Foundation (ASERF) of the American Society for Aesthetic Plastic Surgery are being conducted to determine the safety and efficacy of breast enhancement with fat.
In the meantime, plastic surgeons will continue to study the intricate details of the procedure for the safety of our patients– namely, the techniques of harvesting, preparation, and placement of the fat tissue, who should receive fat transfer, when it is appropriate, and whether it is safe for the long term. Results of clinical studies this far seem promising—so maybe going up a cup size with the benefit of a little liposuction elsewhere will be common practice at some point. Anyone reading this should be aware that this procedure is very technique dependent and to avoid complications it must to be done correctly by a properly trained, board-certified plastic surgeon. Methods for tissue harvest and tissue injection have been refined, as fat cells are carefully removed by a specialized liposuction procedure using numerous syringes and transferred to the breast via dozens of minutely small injections. This technique results in increased survival of the fat cells.
Autologous fat grafting is currently used for touching up reconstructed breasts which it is safe and effective for given that the breast tissue has already been removed and these patients are getting routine surveillance imaging. The procedure can also soften the appearance of existing implants and hide visible rippling which is particularly apparent in very thin women with a bony chest wall and little skin or fat with which to work. The amount of fat injected with these procedures is usually a lot less than that used in breast augmentation as well. So, the take home message here is the more long-term clinical trials involving multiple centers as well as radiologist and oncologists need to be done before a blanket endorsement of the procedure can be made. It also serves to mention that this would not be the method of choice for breast augmentation in women who have had or have a family history of breast cancer.
We learned that surgical techniques and implants have improved so much—even in just the past 3–5 years—that some women who had breast reconstruction just few years earlier are opting for revision reconstruction, and they’re genuinely happier with their results.
Here’s why Dr. Squires is more optimistic than ever about the care women facing cancer and reconstruction are getting, and what the future holds.
What do women facing breast cancer need to know about reconstruction, that they may not know yet?
Dr. Squires: One of the things women tend to be surprised by is that breast reconstruction is a covered insurance benefit, by law. It’s covered for both women who’ve just had breast surgery, and for women who, for whatever reason, had breast surgery in the past and didn’t have reconstruction at the time. They don’t always know it’s an option even 15 or 20 years down the road, and their options are better now.
The spectrum of breast reconstruction is bigger than most women realize. One of the things I try to talk a lot about is lumpectomy reconstruction. The majority of women with breast cancer in this country are having lumpectomies for their breast cancer surgery, but they don’t know there are good reconstruction options for lumpectomies too—everything from filling in a divet, so they aren’t reminded that they had cancer, to making your breasts look better than before. Even a breast reduction or lift falls into that reconstruction category, in this context. Sometimes women think they want to have mastectomies, but when they hear that they could have a lumpectomy combined with a breast lift, they realize that might be a better choice for them.
I always recommend that women try to go, if they can, to a place with a dedicated breast team, with a fellowship-trained or specialized breast surgeon, who either does their own breast reconstruction or has a plastic surgeon there who does it. So women can make sure they’re getting access to and information about all their options.
Sometimes, surgeons don’t do certain kinds of reconstruction, don’t have them in their toolbox, so they might not even present them as an option.
How much have you seen technology and techniques change, just over the past five years?
Dr. Squires: The last five years have been huge. We have microsurgery for autologous (flap) reconstructions, which can allow for muscle-saving reconstructions like DIEPs (a type of flap surgery that uses your lower stomach skin and fat to reconstruct your breast.) We’ve been doing DIEPs for longer than five years, but now surgeons are doing DIEPs more aesthetically. We’re making the abdominal contour better, shaping the breast better. A lot of people are combining flaps with implants. Sometimes DIEP flaps can’t always give you the best projection alone, so it’s a nice combo.
Also, our fat grafting has gotten so much better. So sometimes if I’m doing flap reconstruction, I will fat graft my flaps to help with upper pole or central breast fullness, or help make them look more natural in matching the other side. I use fat grafting in most of my implant reconstructions too, and sometimes after lumpectomy. All of that has gotten better.
I now feel more comfortable offering women revisions, because I actually know I can do better. I feel very confident.
How have you seen nipple reconstruction evolving?
Dr. Squires: The biggest change is that many women are able to keep their nipples now with nipple-sparing mastectomies. We’ve seen major changes in the breast surgery world over recent years and most of us are really expanding the indications for nipple-sparing mastectomies. At this point, nearly 100 percent of my patients have nipple-sparing mastectomies.
We all know that we don’t have great nipple reconstruction options yet. The projection doesn’t stay very well. So for women who don’t keep their nipples, I’ve been so happy with 3D nipple tattooing. They look beautiful. I sometimes cannot get over the results.
Saggy breasts — whether from breastfeeding or gravity — is a top concern among women. There seems to be a new exercise or supplement announced all the time claiming to restore perky breasts, but we wanted to know for real: Is it possible to lift breasts without surgery?
Dr. John Squires recently held a Q&A to debunk common myths about treating saggy breasts. Here’s what you need to know. A breast lift is the only tried-and-true method for beating the sag. Here are the five most common myths about saggy breasts — and the breakdown of the only surgery that really works.
Myth No. 1: Bench presses and push-ups will prevent drooping.
Unfortunately, exercise working your pecs won’t give you a breast lift. Breasts sag due to lost volume and retained breast skin, and working your muscles won’t fix that, though you will probably get more awesome arms, so there’s that for a win.
“Most of my patients want to know what they can do to tighten loose breasts and abdominal skin after childbearing,” said Dr. Squires
“After childbearing, the skin of the breast, as well as the abdomen, lose their elasticity,” he continues. “Diet and exercise, unfortunately, cannot regain that lost skin tension. The paradox of exercising, which I strongly encourage, is that it will lead to less body fat, which will ultimately further loosen the skin of the breast as well as the abdomen. So paradoxically, patients who do everything right often wind up getting even looser.”
Myth No. 2: Breasts sag because of too much bouncing around.
The supporting ligaments and skin stretch out over time, no matter how much you’re killing your workout.
“Current research highlights the following as risk factors for sagging: greater age, history of significant weight loss (more than 50 pounds), higher BMI, large bra cup size, pregnancy and smoking,” he said. “As women age, the Cooper’s ligaments — the connective tissue that helps breasts keep their shape — stretches out.”
“Aging also causes breasts to transform into having more fat rather than breast tissue, making them less perky and appear deflated,” he continues. “Although you cannot control the natural aging and sagging effects or a genetic link, factors such as weight fluctuation, BMI and smoking are in your control.”
Myth No. 3: Breast size doesn’t change.
Breast size fluctuates with life changes, especially pregnancy, breastfeeding, hormonal and weight changes.
“After breastfeeding, the fat and ligaments of the breasts may change, therefore, your breasts may not go back to their previous size or shape. Some women will remain larger and others will become smaller. Whether you will become ptotic [droop] or remain full will be more of a direct result of your genetic predisposition, weight gain or loss during pregnancy and the age at which you breastfeed.”
Myth No. 4: You can skip the lift if you get implants.
It’s a common misconception that breast implants will give you the lift you want. Typically, that isn’t the case.
“Some patients who are interested in having a breast augmentation may receive the suggestion of pairing the surgery with a breast lift,” says Dr. Squires. “This is because you may have sagging breasts that will not be completely filled by the implant. Rather than just having an implant, the skin can be retracted around the new implant, which will create a much more attractive rest mound with a small breast lift.”
Myth No. 5: Creams and supplements will increase perkiness.
Regardless of what you’ve heard, there’s no OTC product or natural solution for saggy breasts.
Unfortunately, there is no reliable and feasible way of achieving a natural breast lift without surgical intervention. Your breasts may appear higher and lifted with certain styles of bras, but to have a true, natural breast-lift effect with optimization of shape, size and symmetry, some form of a surgical breast-lift procedure will be required.
A Brazilian butt lift (BBL) is one of the most popular procedures for enhancing your backside. It also has the highest mortality rate of any cosmetic surgery, an estimated 1 in every 3,000 procedures.
But there is some good news on the horizon: a new task force set to tackle this complex issue just issued a major warning to plastic surgeons.
What is a Brazilian butt lift?
A BBL is a surgical procedure where fat is liposuctioned from one area of your body and transferred to your butt for a rounder shape (a procedure also known as fat grafting).
There are two main BBL techniques. The safest involves injecting fat into the subcutaneous tissue, the area closest to the surface of your skin. The riskier technique injects fat into the deeper muscular plane, producing more dramatic results — at a much greater risk, especially in unskilled hands.
What’s the risk?
Autopsies from Brazilian Butt Lift patients have shown the number one cause of death as fat embolism.
A fat embolism happens when a vein is injured during fat transfer, causing fat to enter the blood vessel. The veins in question are located in the deeper muscular plane, which is why injecting into the muscle is a riskier technique even though results might look better.
What’s being done?
This week, all plastic surgeons received an urgent warning that fat should no longer be injected into the muscle, only the subcutaneous tissue. This is an unprecedented announcement.
“Never before has a plastic surgery society come out with such a strong warning about a procedure,” says Denver-based plastic surgeon, Dr Squires. “But never before has there been a procedure associated with such a high death rate.”
The newly formed multi-organization* task force that issued this statement will continue to conduct studies to help develop technical safety guidelines for BBLs.
How to be safe
While the death rate is alarming, many board-certified plastic surgeons have a lot of success with Brazilian butt lifts. So why all the complications? “The majority of this year’s deaths to date have been from ‘unaffiliated,’ renegade doctors, practicing outside of their training,” says Dr. Squires.
He recommends finding a “board-certified plastic surgeon who expresses familiarity with this risk, brings it up in a forthright way with the patient, and demonstrates that they understand what they need to do — most notably to never inject into the muscle.” It’s also important that you and your doctor go over any questions you have during your consultation. RealSelf put together a list of the best questions to ask before a BBL to help you prepare.
Setting the right expectations is also key. Your aesthetic goal may not happen in one surgery. It’s best to listen to your surgeon and not push for more volume than they recommend as safe.
“We are very confident that these complications only occur if very large veins deep in the buttock are injured,” says Dr. Squires. “If surgeons avoid them, the risk of death should approach zero.”
*The following organizations make up the task force: The American Society for Aesthetic Plastic Surgery (ASAPS), American Society of Plastic Surgeons (ASPS), The International Society of Aesthetic Plastic Surgery (ISAPS), International Federation for Adipose Therapeutics and Science (IFATS) and International Society of Plastic Regenerative Surgery (ISPRES).
October in National Breast Cancer Awareness month. It’s an important time to spread awareness and educate women about breast health. For a little over a decade, it was suspected that breast implants may be directly linked to causing breast cancer. Technology and research proved that breast implants are not directly linked to causing breast cancer, however, it is important that women with breast implants practice the same caution as women with natural breasts. Early detection of breast cancer greatly increases the likelihood of survival. Early detection methods such as self-exams, breast screenings and mammograms are proven to save lives. To follow are a few facts about mammograms that every woman should know.
- Since 1990, the use of mammography has helped reduce fatalities by 1/3 in the United States.
- After age 40, the likelihood that a woman will develop breast cancer in the next 10 years in 1 out of 69.
- Alarmingly, 3/4 of the women diagnosed with breast cancer have no family history of the disease and are not considered high risk individuals.
- For everyone 1,000 women who have a mammogram, 100 of them are called back for more imaging tests, 20 women are recommended to under go biopsy to test irregular tissue, and 5 are diagnosed with breast cancer.
- Women with breast implants should have mammograms at the same rate that women with natural breast tissue do, when age appropriate.Breast implants can hide part of the breast tissue during a mammogram, it is imperative that women with breast implants notify their technician so that necessary measures can be taken to ensure that the most amount of breast tissue is visible in the exam as possible. Technicians use a special technique called implant displacement that will not damage your breast implants, but it will benefit your mammogram outcome.
BUTT IMPLANTS VS BRAZILIAN BUTT LIFT
There is no doubt that the butt is one of the most admired parts of the body for many people. However, not everybody is born with those gorgeous curves. One of the most popular cosmetic procedures today is the buttocks augmentation. As the American Society of Plastic Surgeons explains, buttock augmentation procedures like Brazilian butt lifts can be a great choice for anyone who wants to improve the fullness and projection of their butt. It is also a good option for people who want to balance out their figure while they improve their self-confidence.
There are two options if you want a more curvaceous butt: The Brazilian butt lift and butt implants. Many people assume that the two procedures are similar, but in fact they could not be more different. Butt implant surgery can have some major drawbacks, but Brazilian butt lift surgery has major benefits. If you are trying to decide which is the best option for you, read on to find out the information you need.
- Implants are made from artificial materials and carry risk of infection, extrusion (popping out through the skin), malposition (shifting from proper placement), and scarring
Fat is your body’s own tissue and does not carry the risks associated with artificial implants
- If there is a complication from the implants, the treatment usually requires an additional surgery and removal of the implants
Complications that may arise after fat transfers can usually be treated without an additional surgery or invasive procedure
- Implants may need to be replaced over time
Fat is a living cell and doesn’t need to be replaced. It is part of your body.
- Placement of implants require a longer incision within the butt crack and this scar may become thick, raised, or painful
Fat placement is done through small punctures in the buttock and hips. These scars are short and easily hidden.
- Implants can only increase the projection of the buttock, and do not increase the hips.
Fat transfer can be placed in any area of the body, including the buttock AND hips. Fat can be placed in the buttock to increase projection AND/OR placed in the hips to improve the curves. Placement of fat is customized to what each person needs or wants.
- Implants only change the size of the buttock, and do very little to reshape the buttock – they cannot make a square butt look round, or a long butt look shorter.
Fat can be placed in a way to reshape the buttock and hips, meaning that it can change an unattractive square butt into a more aesthetically pleasing round or heart-shaped butt. Fat transfer can accomplish much more than an implant.
- Implants will remain the same size and shape for as long as they are in place, even if your body changes
Fat is a living cell and will change as your body changes. This means that as you gain weight, your butt and hips will increase in size, and if you lose weight, the butt and hips will shrink. This ensures that the butt and hips will remain a similar proportion as it relates to the rest of your body, even as the rest of the body changes with aging and weight fluctuations.
- Implants do not change the rest of the body
To perform a fat transfer, fat needs to be harvested through liposuction. This means that the harvesting of fat from certain areas will make those areas smaller. For example, when someone gets fat transfer to the butt and hips, they also get the abdomen, back, flanks, arms, thighs (or any other area) made smaller. It is essentially two procedures in one – liposuction AND fat transfer.
- Implants can feel firm, and can at times be painful during sitting if the implants are placing pressure on the main sensory nerve to the leg (sciatic nerve)
Fat is soft and adds additional cushioning to the buttocks.
As butt lift before and afters typically show, this type of procedure is ideal for the person who wants to improve their confidence level, or people who simply want a more curvy look for their backside. The butt lift can define and increase the attractive slope going from the waist to the butt, making both the rear and side views much more attractive.
At a consultation with Dr. John Squires, you’ll first talk about what you hope to achieve with a Brazilian butt lift. It is important to understand that the results will not be extreme, but will rather be more natural. The goal of a Brazilian butt lift is to achieve a more rounded look that will help you look better in jeans, skirts, and everything else. During the consultation, Dr. Squires will also show you a wide range of photos of different results.
Since clients are so diverse, you’ll clearly be able to see that a Brazilian butt lift is truly customized for each unique individual. Whether the woman is super curvy or stick thin, Dr. Squires can create a beautiful and natural looking result for her.
There are a number of significant dangers associated with the butt implant surgery, as explained above. However, Brazilian butt lifts carry far less risk while still giving you the beautifully enhanced butt that you’re looking for. In the “Butt implants versus Brazilian butt lift” battle, there is little doubt that the Brazilian butt lift emerges as the best option when the two procedures are compared point by point. If you’re interested in a Brazilian butt lift, call for a consultation appointment to learn more today!
Breast augmentation is one of the most-performed plastic surgery procedures today. While most women go into the surgery with thoughts of their fuller, perkier breasts, recovery is a necessary predecessor to enjoying those positive results. To make your recovery go as smoothly and comfortably as possible, the staff at Squires Plastic Surgery has a few tips to keep in mind.
The best time to ensure a healthy recovery process is before you even undergo your surgery. Plan ahead by stocking up on supplies like soft foods and quiet activities. Fill prescriptions prior to your procedure as well, so they are ready for you when you get home. Stop all medications as recommended by your surgeon prior to your procedure to prevent any potential complications and kick the smoking habit a few weeks before surgery for the same reason.
Most surgeons will require you to have someone with you for the first 24 hours after breast augmentation surgery. You will likely need that person to help you get to and from the bathroom and to bring you food and other necessities during that first day so you can rest and heal. If you have small children, it is a good idea to line up someone to care for them for the first few days after surgery, since you will not likely feel up to fulfilling your “mommy” duties during that time.
In addition to pre-operative instructions, you will also receive post-operative instructions that will likely involve three basic steps:
Medication – Most women do take some prescription medication in the early days following breast augmentation. Your pain level will depend on many different factors, including the location of your incisions and the placement of your implants. Your surgeon will provide you with the resources necessary to minimize discomfort during those early days.
Compression – Compression garments are generally worn in the days after breast augmentation to encourage healing of the breasts and ensure good
positioning while they heal. The gauze dressing is likely the first type of compression you will have, followed by a sport or surgical bra that will be worn 24 hours at first.
Massage – Massaging the breasts after surgery will help to settle the implants into proper position and soften the surgical area. A member of our team will instruct you on proper massage techniques, which you will be expected to perform at home. The exception is women that have had augmentation and lift surgery at the same time – massage is not recommended for these patients.
Take Ample Time
There are no shortcuts to recovering after breast augmentation surgery. Patients that give themselves ample time to heal tend to fare much better than those that try to rush back to activities too soon. Most patients are back to regular activities within 1-2 weeks. However, if you have a job that involves heavy lifting or strenuous activity, you may need to take even more time off to ensure your body heals fully.
Develop Healthy Habits
Ideally, the best time to develop healthy habits is before your surgery. However, it’s never too late to switch up your diet and adopt a regular exercise program to keep your body in top condition. If you stopped smoking before your breast surgery, stick with that plan for a healthier body for life.
Breast Augmentation is a surgical procedure that offers significant benefits to women today. By following these tips, you can rest assured your recovery from breast surgery will be as comfortable and successful as possible. To learn more, contact Squires Plastic Surgery at 303-321-3210.
Abdominoplasty, also known as a Tummy Tuck, is a procedure designed to remove excess skin and fat from the abdomen, as well as tighten abdominal muscles which may have been loosened or separated. There are various versions of the Tummy Tuck procedure, each designed to benefit each individual patients unique needs and goals. Often times other body contouring procedures are also done in conjunction with the Tummy Tuck procedure, such as Liposuction, Breast Lift, or Thigh Lift.
Talking to Dr. Squires is the first step in evaluating what the right plan is for you. Contact our office today to schedule your confidential consultation and find out if Abdominoplasty may be the best way to achieve the mid-section you desire.