Denver Cosmetic Surgery Blog.com

Capsular Contraction: New solution

Dr. Steven Vath — Tue, 31 Jan 2012 23:53:55 +0000

Today, I saw a woman who has had multiple capsular contractions. This is a tough problem that only happens to a few percent of people that undergo breast augmentation. But when it does, it’s very frustrating for both the patient and for me. I genuinely want every patient with whom I interact to be happy and have no problems. But this just isn’t reality. Although I feel that I can keep complications to a minimum, capsular contraction is one that I just can not completely control. No plastic surgeon can. That’s why capsular contraction is one of the most prevalent topics discussed at national and international Plastic Surgery conferences.

After breast implant placement, the body forms a capsule (scar tissue) around the implant. It’s normally very soft and pliable, but in some people it hardens, thickens, and contracts. This is called capsular contraction. The prevailing theory behind this is based upon bacteria that incite the thickening; however, antibiotics provide no reduction in it’s incidence. The standard treatment is to surgically remove the capsule. There is no “scraping” involved. The scar tissue is meticulously dissected away from the surrounding breast tissue and removed. Then, the implant is replaced and generally, the contraction doesn’t redevelop. But in some people, it does. When someone gets recurrent capsular contraction, the management options are limited. In the past, completely removing the implants was the only definitive solution.

But now, there is another option. Strattice (TM) is a matrix of acellular, cadaveric, porcine, dermal graft. Basically, it’s re-engineered pig skin that can safely be used to drape around the implant and prevent capsular contraction. By placing it next to the lower portion of the implant, it does not allow the body to form the linear capsular scar that can tighten, lift the implant, and distort the breast. This is an exciting development. Although recurrent capsular contraction is the worst case scenario associated with breast augmentation surgery, it is no longer untreatable and the hope of implant preservation exists.

Dr. Steven D. Vath

3-D breast imaging is here

Dr. Steven Vath — Wed, 18 Jan 2012 00:31:37 +0000

The Center for Cosmetic Surgery recently purchased the Vectra 3-D imaging system. Our new web page all about it will be live soon. We’ve been using this new technology in consultations for several weeks now and it has made a remarkable difference in the educational process. This system captures multiple pictures of a person’s body and reconstructs a three dimensional image which can be rotated on the computer screen. Then, a virtual augmented preview of the breasts can be displayed, using any size implants. Primarily, it serves as a tool to enhance the discussion, gather valuable feedback from patients, and provide a better idea of the expectations from surgery. Mostly, people find it comforting to preview their after-surgery result from breast augmentation before the surgery even happens.

The world of plastic surgery is not as technologically driven as many may think. But this is one advancement that I am embracing. It fills a void in the consultative process around breast augmentation: it answers the frequently asked question, “What will I look like after breast augmentation surgery?”Although there was no way to answer this before, now there is. And patients are loving it.

Dr. Steven Vath

Black Diamond

Dr. Steven Vath — Sat, 14 Jan 2012 00:09:19 +0000

It’s not necessarily true that a surgeon who does a high volume of a certain procedure is very good at it. But it is true that a surgeon can’t be very good at a procedure unless he or she does a high volume. In line with this but at the risk of sounding as if I’m bragging about Dr. Wolfe and myself, I think it’s important that people searching for breast augmentation surgeons know that we are a Black Diamond account with the major and dominant breast implant manufacturer in America, Allergan. This means that we have been recognized for the large number of implants that we purchase from the company. And, I should add that we are their #1 account in their Northwest region, meaning we order more breast implants than any practice, center, or hospital in this large geographic area.

So, while this does not prove that you’ll receive the best care and the finest breast augmentation surgery at the Center for Cosmetic Surgery, our Black Diamond status with Allergan is one important factor that allows for us to be the best and may also be a result of the same.

Humbly,

Dr. Steven Vath

Buttock fat injections

Dr. Steven Vath — Tue, 10 Jan 2012 23:13:19 +0000

My practice manager and I were noticing that inquiries coming into the Center for Cosmetic Surgery regarding fat injections to the buttocks seem to be increasing. I’ll admit, fat injection sounds really cool: the ability to take your own natural fat and move it to another area of the body seems enticing. Furthermore, the plastic surgery studies largely support this treatment method to enhance the butt…. but, I’m not a supporter. The technique to properly inject fat into a body area is not rocket science. In fact, I did this procedure in the past with relative frequency and it’s easy to perform, but the results just weren’t good. So I stopped. I believe that the fat either gets absorbed by the body so that the benefits are temporary, or it leaves an unattractive lumpy contour. So, on issues like this, where I find myself disagreeing with some of the plastic surgery community, I go back to my common recommendation to prospective patients; search for pictures on the web. If something works well and doesn’t just produce the occasionial good outcome, plastic surgeons will post before and after pictures of the results all over the web in an effort to educate, and yes, sell what they do. And certainly for a procedure that has such huge and growing demand, if it’s successful, there should be ample proof. But I can’t find a wealth of impressive pictures. Case closed. Despite positive claims from many surgeons, and sporadic support in the plastic surgery literature, I do not believe that fat injection to the buttocks is a reliably good operation and do not recommend it to patients.

If anyone out there has had great results from this procedure, please share your experience with me. I’d love to hear from you. But for now, I still have to accept that plastic surgery does not have solution to every concern, no matter how enticing it sounds.

Dr. Steven Vath

Breast Implant “re-do”- helpful?

Dr. Steven Vath — Sat, 07 Jan 2012 00:29:14 +0000

I saw two consults today who had previous breast implant surgery and came to me wanting new, bigger implants. During our discussion, it became evident that both women thought that changing their implants (”re-doing” their augmentation surgery) would improve their breast shape. It doesn’t. Changing implants, called an implant exchange, simply removes the old set and replaces them with a new pair of implants, possibly of a different size or material. Going with bigger implants makes you bigger and adds more upper fullness, but doesn’t improve breast shape, doesn’t increase cleavage, doesn’t manage sagging, and, as a general rule, does not make breasts look better. What I commonly see are women wanting the look achieved with a breast lift, but hoping that an implant exchange alone will accomplish this. It just doesn’t. After some nice discussion with pictures to assist in the explanantion, both women realized that a lift, or mastopexy, was the procedure that would really make them happy and that a breast augmentation ”re-do” surgery wouldn’t suffice alone. It was a lot of fun getting on the same page as these women. Many days like today, I really enjoy the process of a consultation with some very thoughtful, nice people.

Dr. Steven Vath