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Check out the below video in regards to information about Private Health Insurance
October 24, 2016
Breast Implants and Breast Cancers – Guest post by Dr Justin Perron
July 8, 2016

Breast cancer is the most common type of cancer in women. The statistics speak for themselves when it comes to incidence and detection (Cancer Australia). While the incidence appears to be increasing over the years, the survival has also been increasing, due to advanced research, improvements in detection, and improved and focused treatment protocols.

Some patients I see when requesting a breast augmentation, have specific questions regarding implants and breast cancer. The most common questions are:

  • Do breast implants cause cancer?
  • Will my implant cause problems with a mammogram?
  • If I get breast implants, will they prevent my radiologist from detecting any new breast cancers?

The first question is a controversial question and issue. And unfortunately the answer is complex.

Not all breast implants are the same. They are manufactured in different ways, come in many, many shapes and sizes, and have various textures and coatings. Generally speaking, implants come as either round or anatomical, with smooth or a texturing on the surface. Various types of texturing methods have been created, depending on the manufacturing process. Some of these texturing methods have been implicated in the findings of ALCL (anaplastic large cell lymphoma) FDA ALCLBAPRAS ALCL.

Most implant manufacturers appear to have various incidences of ALCL. Originally it was thought that the ALCL was caused by the method of implant texturing (the salt reduction, or ‘lost salt’ technique vs mechanical texturing). However, new research suggests that certain bacteria around the implant that cause capsular contracture, may also contribute to the formation of ALCL. In a paper that has just been released (Plastic & Reconstructive Surgery, Volume 137(6), pg. 1659-1669).

At present, the jury is still out as to whether the implant texturing is the problem, or whether the bacteria causing the capsular contracture is the problem.

ALCL in these cases is treated by removing both the implant and the capsule (total capsulectomy). By doing so, that is usually the definitive treatment. But in some cases, further chemotherapy has been required to eliminate residual ALCL.

Another area of issue in the past has been the use of polyurethane coating around implants. Polyurethane implants have been around since the 70’s. Originally introduced in the US to counteract capsular contracture, it was discovered that 2,4-toluenediamine (TDA), a carcinogenic by-product of the chemical breakdown of the polyurethane foam coating of the breast implant, was discovered in the urine of women with these implants. This was later proven to not be a significant contributor to new breast cancer cases, but the implants were removed from the market, and never reintroduced in the US. However, polyurethane is attributed to neural tube birth defects in children (neural tube defects).

The last 2 questions deal with implants causing problems with mammograms. I’ve discussed this with a few different radiologists who regularly perform mammograms, and the answer is, yes implants do get in the way of a normal mammogram. However, there is a way around this problem.

A normal mammogram consists of an x-ray, and an ultrasound scan(USS) of the breast to screen for suspicious changes that may suggest cancer. Anything that gets in the way of the x-ray or the USS, will prevent the radiologist from seeing all the breast. If implants are above the muscle, more breast tissue is obstructed and is not seen by the radiologist. They estimate approximately 40-50% of the breast tissue can be obstructed by implants! Less breast tissue is obstructed if the implants are below the muscle.

If this is the case, discuss your concerns with your radiologist. For high risk patients with a family history of breast cancer, an MRI can be performed to look for suspicious areas. Most radiology companies will bulk bill high risk cases.

Plastic Surgeon Dr Justin Perron talk breast implants and breast cancer detection

Guest post by Dr Justin Perron

www.ffclinic.com.au

Mater Private Clinic–South Brisbane

Phone: (07) 3010 3300

Book a consult with Dr Justin Perron here and get a voucher for $50 of the consultation fee. Mention this blog post and Breast Implant Advice when booking.

How to Choose the Right Breast Implant - Guest post by Dr Justin Perron
July 8, 2016

Breast aesthetics are highly subjective, based on opinion, expectation and individual goals. Probably the most considered question after the decision to have a breast augmentation is ‘what size implant should I choose?’. In considering implant size, there are many important aspects to consider. While size is important when considering an augmentation, shape is equally as important.

Implants come in many shapes, sizes, and textures. It can be incredibly confusing to consider all of them. While there can be significant brand loyalty by each surgeon, stick to brands that are backed by:

  1. Warranty – the manufacturer should be able to provide a warranty for the expected life of the implant. What happens if it ruptures? What happens if there’s a contracture? How long does it last? What does the warranty cover?
  1. FDA/TGA certification – They should be certified and used in other countries around the world
  1. Reliable tracking – Serial numbers/Lot numbers/microchips

Manufacturer

Each manufacturer will have a selection of shapes, sizes (width/height/volume), content (filler or type of silicone), and surface texture.

The two general shape classifications are round, and anatomical. A round implant has the same diameter, and varies by its projection (see below), and volume. Anatomical, or teardrop implants, have a specific shape that is made to more closely approximate the shape of a breast. The shape of the implant usually varies in both width and height as well, to accurately fit the shape of the breast. Breast implant manufacturers will have their own variations to each of these implant types.

 

Breast implant fill

The majority (if not all) breast implants sold in Australia will be filled with a cohesive silicone. Again, each manufacturer will have their own slight variations related to the gel to create a firmer or softer feeling implant. Being cohesive is important, as it prevents the silicone from leaking if the implant ruptures.

Surface texturing

There are two general types of implant texturing; smooth and textured. Textured implants tend to stay in place, and ‘velcro’ themselves to the surrounding tissues. Round implants do not, and are best used as a round shape only.

Decision making

The following factors each play a role in determining what implant is best for you:

  1. What look do you want? Fake or natural?
  2. What are your breasts like now (size, shape, symmetry)?
  3. What is your current body shape?
  4. Do you have any ptosis (sag, droop), and if so, how much?
  5. What is the amount and integrity of your breast tissue?
  6. What is your lifestyle and physical activity level?

Projection

Projection, or profile, refers to the distance an implant projects, or sticks out from your chest wall. Low projection implants don’t project as far as a high projection implant.

 

The decision on which implant projection is most appropriate for you, has to be taken in the context of your body shape, the size of your existing breast, and look that you are trying to achieve. Generally speaking, high profile implants will give a more fake look, while a moderate projection will favour a more natural look.

When choosing an implant profile, your existing breast shape is an important factor. There are a few key measurements that determine which implant profile will work best for your body, and should be discussed with your surgeon.

Size

When considering size/volume, this is determined by your existing chest shape and width, and breast size. Round implants have a certain diameter, and this needs to fit on your chest wall.  So considering an implant that does not fit your chest wall width, will not work for you.

Volume is not the most important consideration!! In fact, volume is secondary to shape when narrowing down the implant that you want. Because an implant is chosen based on yourspecific measurements, the size that fits you may not be appropriate for someone else!

Ptosis

This can be a big determinant when considering if you need a simple breast augment, or a lift (mastopexy). There are a few key measurements that need to be examined on your breast to make this differentiation. It is best to visit your surgeon in person to get an accurate assessment.

Lifestyle

If you lead an active lifestyle, choose an implant that suits you. Being active doesn’t mean you can’t have implants, but you should select ones that aren’t going to hinder you. Big implants can cause problems such as bottoming out, rippling, rotation, and being palpable.

Trial Sizing

In addition to trying on an implant sizer, ask about the availability of a 3D simulation. Both can give you an idea of what the implant size feels like, before having surgery. While not 100% perfect, both methods approximate the look and feel of having implants.

As a rule of thumb, 150-200cc equal one cup size. This can vary depending on the bra manufacturer, and your own breast shape.

Be guided by your surgeon, and their own expertise in the area. At the same time, if you think an implant choice is too big, too small, or doesn’t seem right, get a second opinion! Make an informed decision without being pressured.

 

Guest post by Dr Justin Perron

www.ffclinic.com.au

Mater Private Clinic–South Brisbane

Phone: (07) 3010 3300

Book a consult with Dr Justin Perron here and get a voucher for $50 of the consultation fee. Mention this blog post and Breast Implant Advice when booking.

My Breast Augmentation Journey
February 7, 2014

Our Practice Manager, Renee, underwent a Breast Augmentation in late 2013. She shares her journey here:


I have always been slight in frame and felt self-conscious about not having any curves. I had heard of Breast Augmentation/Breast Enlargement but without having any friends or family who had undergone the procedure, my only impressions were those through the media which often highlighted the celebrities who had opted for large/outstanding implants, which in my opinion looked "faked".  This didn't appeal to me at all.  This being the case, I naively formed the opinion that all Breast Augmentations looked like this so never investigated further.  That is until I started working at Form & Function Clinic.


I have been working for Dr Ingram for three and a half years now.  During this time I have helped many women through the process of planning and undergoing a Breast Augmentation.  They were just like me; desiring a natural looking breast but wanting more volume (were either never blessed with, like me, or trying to get back the volume they had lost post child birth or weight loss).  Seeing all these women post operatively, having achieved their desired outcome of a natural looking, larger breast, and then after a further reduction in my breast size due to my exercise regime, my mind was made up!  I too wanted to be rid of the dreaded push-up bras that I always wore to feel more in proportion.


Don't get me wrong, I didn't make this decision lightly.  I, like most of the women I speak to, had my own individual list that I was weighing up; I am in my early thirties, whilst not considering having children in the near future I always wanted to keep my options open, I exercise a lot, the risks of complications and undergoing anaesthetic; however after weighing all these up and speaking with my loved ones at length I decided that Breast Augmentation was right for me.


Consultation
Being familiar with the process, the only daunting thing about having a consultation, regardless of how much of a great boss Dr Ingram is, was the fact that I was about to have to show my boss my breasts (silly, I know, but I'm sure that you can sympathise with me!).  As soon as the consultation started, however, I understood why so many patients who come in to see Dr Ingram say "he made me feel completely at ease", not that those comments ever surprised me, of course.  


For anyone who has gone through the process or is currently considering a Breast Augmentation, you may be wondering if I was anxious about which implants to choose.  Naturally, the main issue concerning most patients is the many varied implant options available to you.  I completely understand this feeling; the reason that you are initially coming in to see the surgeon is you aren't happy with the current size of your breasts so you want to make sure that you select the correct implant to achieve your desired new look.  I have confidently assured so many women that the surgeon will help them select the best implant for them (after all it's their job – they have trained for years and have the experience to know which implants suit different frames).  I confidently say this as time after time I have witnessed how happy patients are with their outcomes, therefore I had complete trust that Dr Ingram would recommend the best implants for me.  With the use of our Vectra 3D Imaging device which takes a 3D image of you and provides a simulation of your projected surgical outcome, along with ‘trying on’ the implants here in the clinic, we very easily selected my implants.  So that was it! I was all ready for the procedure.


Day of the procedure
I would be lying if I said that I wasn't nervous.  Arriving at the hospital I was admitted at reception and then taken to the welcome lounge.  Following a check-up with the clinic nurse I was dressed in my gown and TED stockings and taken through to the theatre holding bay.  The hospital staff were lovely and kept me fully informed at every step along the way.  Dr Ingram came and saw me in the pre-operative holding bay to mark me up for surgery and shortly afterwards, the theatre staff wheeled me through to theatre.  Dr Ingram’s team were fantastic and made me feel completely at ease.  They even had me laughing!  The distraction was perfect as the next thing I knew, I was waking up in the recovery area.


I was staying overnight in the hospital so when I was recovered enough from the anaesthetic I was wheeled up to the ward.  ‘How were you feeling?’ is what everyone wants to know at this stage.  From the time that I woke up following the surgery I was never in pain.  The best way that I can describe the feeling is to liken it to muscle tenderness after a hard work-out.  I was able to move around as normal and go to the bathroom by myself.  The only thing that I asked the nurses to help me with was after lying down I needed the support of an arm behind my back to help me sit up.  Staying in hospital overnight was fantastic as I knew that I had the nurses there to help if needed, however, I believe that as long as you have someone at home to help you get in and out of bed then you would be comfortable at home.


Post-surgery
Tip:  Bring a button up shirt or dress for when you are discharged (something that you can slip on and not have to put your arms above your head)


I really did not experience any significant discomfort after the procedure. In fact, not once did I require anything stronger than Panadol for pain relief during my entire recovery period.  After Dr Ingram saw me in hospital the morning after surgery (this is a benefit of staying in overnight) I was discharged home.  I rested over the next few days and having had my surgery on a Wednesday, I was even out having breakfast on Sunday morning.  I returned to work on Monday, catching the bus to and from work as I didn’t feel ready to drive just yet.  I called this my T-Rex arms period – I felt protective of my chest and limited my arm movement.  However, this quickly resolved and at the end of the second week I was back to normal.  I resumed all normal daily activities (excluding strenuous exercise) and after checking with my car insurance and Dr Ingram I commenced driving again at the end of week two.


Since then, I have noticed a marked improvement each week as the swelling reduced and the implants settled.  I returned to my regular exercise regime after my six week check-up.  As I write this I am exactly three months post-op and am amazed at how much the implants have settled and started to soften - they are already looking natural!  I am very much looking forward to seeing how they continue to develop over the coming months.  I'll keep you posted.

Dangers of Cosmetic Tourism In The News
January 17, 2014

It seems that the dangers of 'cosmetic tourism' are all over the news at present! We've seen several articles on the topic this week alone and have been approached by a popular women's magazine to weigh in on the discussion.

We've also noticed a significant rise in the number of patients coming to us to correct the results of 'cheap' cosmetic surgery procedures performed overseas. Below is an interesting article highlighting the devastating effects some patients experience after undergoing these types of procedures.

If you're considering a cosmetic procedure, make sure you understand your surgeon's credentials, the credentials of the facility in which your procedure is to be performed and the level of care available to you during your post operative recovery period.

http://www.mirror.co.uk/news/real-life-stories/women-who-went-abroad-cheap-2992507

Dr. Scott Rides for Cancer!
January 16, 2014

This weekend marks the beginning of a huge undertaking for our Clinical Director, Dr Scott Ingram. Scott is riding in the 2014 Beat Cancer Tour as part of the Santos Tour Down Under.

Riding every stage of the grueling Santos Tour in front of the pros each day, the Beat Cancer Tour covers an average of 150kms a day over 6 days with all funds raised going to the Cancer Council.

Scott has set himself the ambitious task of raising $100,000 for Cancer Council's Beat Cancer project, a cause very close to his heart.

You can show your support by making a donation to the Cancer Council.