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Dual-plane breast augmentation refers to the placement of a breast implant in a specific anatomic position — partly behind the pectoralis muscle, and partly behind breast tissue. The layers of the breast, from external to internal, are skin, breast tissue, pectoralis muscle and ribs. Plastic surgeons have debated the best plane for implant placement over many decades — some preferring placement between the breast tissue and the muscle (the “subglandular plane”), and others preferring placement between the muscle and the chest wall (the “submuscular plane”). There are advantages and disadvantages to each. The “dual plane” was first described by Dr. John Tebbets in 2001 as a way to combine the advantages of both.
In the dual plane approach, the lower origin of the pectoralis muscle is detached from the chest wall and separated from the lower part of the breast tissue. This allows the muscle to slide upward slightly. When the implant is placed, the upper portion is covered by muscle and breast tissue, while the lower portion is covered by breast tissue alone. The upper muscle coverage of the implant reduces the risk of rippling and implant visibility in the upper part of the breast, capsular contracture, and disruption of cleavage (synmastia), while improving mammography accuracy. At the same time, the lower part of the breast implant that is covered by breast tissue benefits from a smoother implant-breast transition, enhanced shape, and a more natural look and feel.
The dual plane technique comes in very handy in cases of breast deflation with ptosis (sagging), which occurs after having children, breastfeeding, losing weight, or naturally with time. In these cases, a dual plane allows the implant to be placed slightly lower to fill the lower pole of the breast and give a lifted appearance during breast augmentation. This does not replace the need for breast lifting (mastopexy) in moderate to severe cases, but it does occasionally prevent the need for lifting in more mild cases.
Drs. Donaldson and Sieffert prefer dual plane breast augmentation for all of the benefits mentioned here. At Donaldson Plastic Surgery, our patients consistently comment on how proportionate and natural their results look, and how quickly they recover with minimal pain. We’ve used the dual plane approach to help over a thousand patients achieve their goals — safely, predictably and beautifully!
For many women, the decision to get a breast augmentation is a process that requires several different factors before reaching the final decision. One such factor that is often quite difficult is choosing the right size — not too large, not too small — for the implants. We know that breast size affects many aspects of a woman’s life, including her relationships, social interactions and overall physical well-being. We want to make sure that patients have the resources and guidance to choose the perfect implant size!
Here are some of the most important factors to consider and discuss with your surgeon before settling on what implant size to choose for your breast augmentation.
We all know that bra cups are typically sized in A, B, C and up, but implants are measured in cubic centimeters — cc for short. For approximately every 150 to 200 ccs, the breasts will usually increase about one or one and a half cup sizes. That can vary a bit depending on your specific measurements and even the bra manufacturer, but it gives you an idea! You can always try on different sizes with specialized bras during your consultation to see how the implants look and feel on your body.
With such a large range of sizes, it’s important to realize that not every woman’s body type and breasts will be able to handle implants higher up on the scale. Your body type, including the width of your natural breasts and shape and size of the chest wall, will factor into the ideal size of implant to create the desired fullness, shape, and profile.
It should come as no surprise that larger breasts, whether natural or augmented, are heavy. This can take a toll on a woman’s entire body. Women with larger frames and/or stronger muscles are best equipped to handle large breast implants, but even they can be susceptible to issues. Choosing a too-large breast implant size can lead to fatigue, back and shoulder pain, and potentially even the need for a breast reduction.
Depending on your frame, a high, moderate, or low profile may work best. For those with a small frame, a high profile may be ideal because this option has a narrower width. While a low volume option may work for those with broad shoulders and a larger frame to create an even proportion.
Now that we have covered several body-related factors to consider, it’s time to talk about lifestyle. For active women, athletes, or women with more physically demanding jobs, larger breast implants may not be ideal. It’s simple: the larger the breasts, the more tiresome and potentially painful it will be to carry the extra weight while working, running, lifting weights or playing a sport.
It’s also important for you to think about what kinds of clothing you normally like to wear, and if those items will be compatible with larger breast implant sizes. Augmentation will certainly affect how shirts, bras, swimsuit tops, and dresses fit, and additional procedures like lifts or reconstructions will affect things even further.
There’s a lot to think about when deciding on breast implant sizes! If you’re considering breast augmentation surgery and wondering if it’s right for you, we would love to see you at Donaldson Plastic Surgery. Dr. Donaldson will perform a personalized consultation that takes into account your specific anatomy and the results you’re looking for. He and his surgical assistant, Bobbie, will work with you to determine the best option according to your body shape. Call today to schedule a consultation and we can help make sure that you get the best results from your breast augmentation surgery.
Tummy tuck, liposuction and breast lift (with or without breast augmentation) are all considered part of a mommy makeover.
Pregnancy and breastfeeding lead to very predictable physical changes for many women: abdominal bulging, belly button distortion, stretch marks, love handles and deflated breasts. The mommy makeover treats each of these problem areas. The tummy tuck flattens the abdominal bulge and allows the “six-pack” to emerge. It also refines the belly button into a more attractive shape and position, and it eliminates all stretch marks that occur between the belly button and the pubic area. Liposuction removes the love handles and provides a more feminine, curvy “hourglass” shape above the hips. The breast lift elevates sagging nipples and skin, and is often combined with breast augmentation using implants to create more fullness and cleavage.
You’ve put so much into your children that it’s often difficult to find time for yourself. Good nutrition and regular exercise are important, but they usually don’t fully correct the bulging, sagging and stretching — these corrections require plastic surgery. Mommy Makeover procedures are safe and very effective for restoring pre-pregnancy contours; they can be done separately, or at the same time in one operation. You should wait at least six months between your last pregnancy or breastfeeding and your surgery date, and if you become pregnant again after surgery, you might need a touch-up.
Columbus, Ohio women seek Dr. Donaldson’s advice about how to restore their bodies after having children. It is a team effort between patient and surgeon. Dr. Donaldson works one on one with you, listening to your goals and discussing your concerns. Together, you will develop a personalized plan to give you the body you’re ready to reclaim. Visit Donaldson Plastic Surgery, Columbus, OH, for the latest techniques and beautiful, natural results.
Most breast augmentations are straightforward procedures with beautiful results, but on occasion, a bothersome process known as capsular contracture develops. This occurs when the body tries to wall off an implant as a foreign object (like a splinter) with an abnormal amount of scar tissue. The scarring can be firm, and even painful when severe.
Experts are not convinced about what causes capsular contractures: some think it is bacteria or “biofilm,” while others believe it is trauma from surgery. Regardless, the reported incidence is anywhere from two to thirty percent depending upon the surgeon.
Dr. Donaldson takes many precautions to prevent capsular contractures in his own practice. First, he uses meticulous sterile technique and antibiotics to avoid bacteria and infection. He insists on “no touch” handling of implants so they go directly into position without delay. He operates with a soft touch — “gentle with tissue” — to minimize trauma. These simple principles have helped Dr. Donaldson achieve an extremely low rate of capsular contracture.
Columbus, Ohio patients also visit Dr. Donaldson for second opinions regarding capsular contracture treatment. For these individuals, he performs an operation including capsulotomy (scoring and release of capsules) or capsulectomy (removal of capsules), with removal of the old breast implants and placement of new breast implants.
Seen this morning on Columbus’ NBC4i, Dr. Donaldson explains breast augmentation procedure where the breast implants are positioned by going through the armpit leaving hidden surgical scars.
Reprinted from NBC4i:
COLUMBUS, Ohio —
When it comes to cosmetic surgery, breast augmentation is the number one procedure done in the US.
There were 289,000 done last year alone.
Doctors are always looking for better ways to perform the procedure — ways that give patients better results with less down time.
Plastic and reconstructive surgeon Dr. Jeffrey Donaldson, of Columbus, spoke about what he’s doing.
“We’re doing endoscopic, transaxilliary breast augmentation. It’s positioning the breast implants through the armpits and under the muscle,” Dr. Donaldson explained.
Typically surgeons cut just under or on the breast, leaving a scar, but Dr. Donaldson’s procedure creates only a tiny scar in the armpit, leaving no visible scar on the breast.
“These scars are really well hidden, way up high in the armpits, so this surgery is appealing because it leaves the scars off the breasts,” said Donaldson.
First a small incision, about a half-inch wide is made.
Then space is created for the implant, and then he deflates the implant. The doctor then fills the implant with saline once inside.
The procedure costs about $5,000 and isn’t for everyone.
Dr. Donaldson said the ideal patient is young and looking for a natural look.
Patients will experience a week of swelling and bruising.
(1) How would you define a fat transfer plastic surgery procedure to readers who don’t know what it is?
Fat transfer is a minimally-invasive surgical procedure during which a person’s own fat is harvested though needles, or cannulas, then purified outside the body and re-injected into areas that need more volume. In essence, fat is taken from wherever it is unwanted and transferred to wherever it is wanted.
(2) Are these types of procedures popular?
Very. Just in the last ten years, many advances have been made in the harvesting, purification and injection techniques. Many plastic surgical training programs have begun to incorporate fat transfer into their curricula, and it is routinely discussed at national and international plastic surgical
(3) What are the different kinds of fat transfer procedures? How are they performed?
Fat transfer procedures may be categorized as cosmetic procedures and reconstructive procedures. Cosmetic purposes primarily include facial rejuvenation (cheek augmentation, lip augmentation, lower eyelid treatment, nasal contouring, wrinkle/crease filling, acne scar treatment) and buttock augmentation; reconstructive purposes include filling of post-cancer defects, treatment of radiation damage and scar revision to name a few.
They are all performed using sterile technique in an operating room, and they all include various methods for (1) fat harvesting that is similar to liposuction, (2) fat purification using centrifuges, strainers and/or wicks, and (3) fat injection using syringes and specialized needles or cannulas. The fat must then be painstakingly placed in tiny particles throughout the surrounding tissues in a latticework, or honeycomb pattern, so that they take on blood supply and become part of the body once again.
(4) What types of fat transfer procedures to you perform in your practice?
Facial rejuvenation, buttock augmentation, filling of breast cancer defects and scar revision.
(5) What are the pros and cons of these different fat transfer surgeries?
Pros: Permanent, natural, safe, minimally-invasive, affordable. Cons: Variable results depending upon surgeon and patient.
(6) What are the side effects of fat transfer surgeries?
One side effect is favorable: stem cell activity. Fat is rich in stem cells, and current research is attempting to understand how fat transfer procedures may maximize their utility. Many patients describe improvements in skin tone, clarity, texture and pore density above areas of fat transfer, which may possibly be due to stem cell differentiation into skin cells. Negative side effects can include oil cysts, fat necrosis or granulomas.
(7) What should a patient consider before considering this type of plastic surgery? How are these considerations different from other plastic surgery procedures?
First, the results may be unpredictable. They are highly dependent upon the surgical technique and the surgeon’s experience, but also the patient’s own fat and blood supply. Second, the results change significantly over time. Most studies show that 50-70% of injected fat cells survive, which means that up to half of the immediate result may be lost. This leads most surgeons to “over-correct” during the procedure, knowing that the final outcome will be less. Finally, it is a permanent solution, unlike fillers such as Restylane or Juvéderm that fade away after a year. Some patients use temporary fillers to test their appearance before committing to fat transfer.
(8) What do you see as the future of fat transfer plastic surgery? Where is it headed?
One of the most exciting and controversial applications for fat transfer is in cosmetic breast augmentation. Many women (and surgeons) are thrilled by the idea of taking fat from the belly, or the hips and using it to enlarge the breasts. These techniques are being developed and refined, but many questions about long-term safety and the effect on breast cancer screening will need to be answered before this becomes mainstream. Also, more breakthroughs in the delivery of stem cells through fat transfer will likely be seen soon.
(9) Please add any additional information that you feel the readers would like to know that is not covered here.
Fat transfer may be done under local or general anesthesia, depending upon the extent of the procedure and the areas of treatment. Minor facial rejuvenation typically costs around $2000, major facial rejuvenation costs around $5000, and buttock augmentation costs around $10,000.
Quotes may attributed to Dr. Jeffrey Donaldson,
Some women want larger breasts, while others would prefer to simply improve their shape. The latter prioritize cleavage over cup size. For these women and others like them, getting small breast implants is a great way to finally have cleavage while also maintaining their current body type.
Small breast implants are not at all uncommon. In fact, many celebrities, businesswomen, models and moms have elected to get smaller implants in order to maintain a very natural look that is proportionate to their bodies.
When choosing breast implants, patients should try to think in terms of shape instead of volume. During consultation with a board-certified plastic surgeon, measurements such as breast width and height, nipple position and inframammary crease location will be considered. The surgeon will also assess the shoulder-chest-waist-hip proportions, as well as height and overall body type (e.g., athletic) to help determine the best implant size for achieving the desired look.
Ultimately, small breast implants are a great choice for people who would like to augment their busts while also maintaining a natural look. Through an analysis of body dimensions, surgeons can recommend implant sizes that will allow patients to accomplish this goal. So, if you are interested in breast implants, you can stop focusing on cup size, start imagining your ideal shape, and visit a plastic surgeon!
*Earned by Dr. Donaldson