Archive for May, 2012:

Transaxillary Breast Augmentation

One of the biggest concerns of women in my practice undergoing breast augmentation surgery, besides safety and choosing the best size and type of implant, is whether or not they will have a scar on their breast following the procedure, and if so, how large of a scar.

For many years I have been specializing in a transaxillary approach to breast augmentation which leaves no scar on the breast. A very small incision is made beneath the arm near the armpit through which the implant is inserted, resulting in a very small, well-concealed scar. Typically, within several months following surgery, the scar is no longer visible. This “scarless” technique may be used for all types of implants, both saline and silicone gel and allows for a very nice, natural result without any scar at all on the breasts themselves. Additionally, when using the transaxillary technique, there tends to be less swelling and bruising than with some other approaches, and this allows patients to follow our “rapid recovery” protocol successfully.

Although in typical breast augmentation surgery scars are somewhat masked underneath the crease of the breast, many women in my practice prefer not to have a scar on their breasts. Depending upon the size of the implant and the woman’s anatomy, the breast scar may still be visible when the implant incision is made underneath the breast. The transxillary approach to breast augmentation takes about an hour to perform and requires an experienced plastic surgeon familiar with this technique. I have been surprised, at times, when discussing this technique with colleagues they inform me that women in their practice don’t seem to mind having the scar on their breast. I question whether or not the women have been asked or given other options.

For more information about transaxillary “scarless” breast augmentation surgery or to schedule a consultation, please call Grand Rapids Plastic Surgeon, Dr. Steven Ringler at 616.328.8800

Archive for May, 2012:

Transaxillary Breast Augmentation

Patients often ask me if there is something that they can do to speed up healing after surgery. Although there is no magic bullet when it comes to recovery after surgery or a sports injury, there are certain types of foods that may aid in the recovery process. It is a good idea to focus on whole foods as much as possible and to avoid processed foods, as they will contain the highest levels vitamins or amino acids your body will need for a speedy recovery. Amino acids appear to help wounds heal faster. These can be found in foods such as chicken, egg whites, fish, brown rice, healthy nuts like walnuts and almonds or sunflower seeds.

Some studies also indicate that boosting Vitamin C in your diet as well as increasing your zinc level can be helpful. Strawberries are not only tasty but full of vitamin C. Strawberries have the added benefit of being high in fiber and full of antioxidants. Most citrus fruits are also great sources of vitamin C, which you can get by drinking orange juice or eating an orange or grapefruit. When available, papayas are another great way to maximize your vitamin C intake. By putting some papaya in your morning smoothie or protein shake, you will get 100% of your daily requirements of this vitamin.

Eating a fortified breakfast cereal is a good way to get zinc in your diet, but you can also find it in foods like oysters, which have one the highest zinc levels found in any food. Taking a zinc supplement is another option, but you don’t normally want to take it excessively as it can disrupt the absorption of copper and iron. Check with your doctor if you plan to take a supplement to aid wound healing. For healthy individuals 15mg of zinc daily is the recommended amount
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The other amino acid that has been shown to speed wound healing is glutamine. In study out of Harvard, glutamine was shown to shorten wound healing by about four days. Foods rich in glutamine include; beef, chicken and all types of fish. Animal based dairy products such as milk, cheese, yogurt and eggs contain glutamine with ricotta and cottage cheese being two of the best sources. If you’re a vegetarian, you can get glutamine in beans and and lentils. Glutamine may also be taken as a supplement, but it is important to check with your own doctor to find the level that is right for you. Following a healthy diet filled with lean fish and meat, fresh fruits and vegetables should have you back in the game quickly.

For more information about reducing recovery time after surgery or to schedule a consultation, please call Grand Rapids Plastic Surgeon, Dr. Steven Ringler at 616.328.8800

Archive for May, 2012:

Transaxillary Breast Augmentation

In my plastic surgery practice we all become so accustomed to talking aboutBotox and dermal facial fillers on a daily basis, that we may incorrectly assume that everyone knows all about these procedures and their uses. But it occurred to me that there are probably many people who may not know the difference between how Botox and facial fillers work to reduce facial wrinkles. So here are the basics.

According to the American Society of Aesthetic Plastic Surgeons (ASAPS) Botox® Cosmetic is currently the number one non-surgical procedure in the country and has been since it was FDA approved in 2002. Botox is a Botulinum Toxin Type A product, as are Dysport®, and Xeomin®. This is a family of neurotoxins that block nerve signals that cause muscles to contract. The toxin works directly where it is placed, and thus can be artistically used to alter facial expressions. These products are appropriate for active lines or age associated wrinkles that are just starting to appear, and they act by temporarily weakening or paralyzing the muscle that is causing the wrinkle. Although FDA approved to treat the glabellar lines or “elevens” that form between the eyebrows, it is also often used on crow’s feet and those “bunny lines” that we get at the intersection of the eyes and nose. Most of these products require repeat treatment every 3-4 months to maintain results.

Dermal facial fillers, which contain hyaluronic acid go by the name of, Juvederm®, Restylane® and Perlane® as well as others, are more useful for treatment of firmly established wrinkles or larger lines of facial aging (such as the nasolabial folds) which are those lines between your nose and corners of your mouth that tend to become more defined as we age. They are all variations of hyaluronic acid, which is a naturally occurring substance that is present throughout the body. For example, HA provides support and hydration of the skin and it lubricates joint spaces. These dermal fillers restore volume to the face and can add structure as well. They are a good choice for adding volume to the lips. Depending on the type of filler and the depth at which it is injected, you can smooth out fine lines on the surface of the skin and fill out deeper lines. Most of these products last for about 6 months, sometimes longer depending on the area treated.

The newest products on the market, such as Radiesse®, contain microsphere technology, Microspheres are tiny round particles of solid material that are relatively uniform in size. These products are used for volume replacement and for deep facial wrinkles (such as the nasolabial folds.) These products provide more volume than the HA products. It is important that your provider is very experienced with Radiesse® as it is less forgiving than some of the other facial fillers if not injected properly. These products are great for helping to sculpt a jawline that has some laxity and creating cheek volume. Radiesse® results last for about one year. Using a combination of these approaches is often called a “liquid facelift.” Results, of course, will not be as dramatic as a surgical facelift but can definitely give significant improvement for the right patient in the right hands.

These are the basics of facial fillers, but the game is changing all the time, and there are new products gaining FDA approval as this blog is being written. The best approach to finding out which products are best for you, is to speak with a board certified plastic surgeon or dermatologist who offers many options and one with significant expertise in injectables. They will be able to help guide you on the best products to help you achieve your goals for non-surgical facial rejuvenation.

For more information about Botox and dermal facial fillers or to schedule a consultation, please call Grand Rapids Plastic Surgeon, Dr. Steven Ringler at 616.328.8800

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