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Breast augmentation and reconstruction. How far have we come?

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Posted: Friday, November 1, 2013 6:41 pm | Updated: 7:15 pm, Fri Nov 1, 2013.

Breast augmentation is one of the most common cosmetic surgeries performed in the United States, But there are other considerations for women wanting reconstruction following a mastectomy to treat or prevent breast cancer.

If you were born a thirty two a, it wasn't long ago you had no choice but to shop in the junior bra section. If you underwent breast augmentation the implants looked and felt anything but natural, and following mastectomy the only choice was external prosthetics, well, things have changed.

"We now have the ability to provide silicone implants again as opposed to just saline." Said Suncoast plastic surgeon, Raja Nalluri, M.D.  The FDA stopped approving the use of silicone implants for breast augmentation in the eighties said Nalluri, and they were taken off the market. He added, "Since that time many studies have been done in many country's and they've proven silicone implants to be safe so we now have those available to offer to patients."

Saline filled implants have a different feel said John L Strausser, M.D. they have a valve and start empty before being filled with salt water. "This is one of the problem with saline implants is that they can leak. You'll also notice that they tend to form little pointy areas."

And the old silicone implants weren't without their problems. He said, "Old silicone if you were to open would leak out like pancake syrup all over and if the implant ruptured it would be very hard to get all of that out."

The consistency of newer silicone polymer called a cohesive gel is more like grape jelly, Said Dr. Nalluri, "It helps it stay together." and its not just the inside texture that has changed. Dr.l Strausser said, "This has texture to it, which tends to resist the firmness that some people will get after a breast augmentation."

And round isnt the only shape to choose from. "Teardrop shape, and that's very good for reconstructive case, because you want to be able to see the shape of the implant." Said Dr. Strausser.

In the seventies and eighties, external prostheses were most widely used following mastectomy, now, there are choices for reconstruction. "They range from the simple implant, to putting in a tissue expander, where you can stretch the tissue over time after the initial surgery and then replace it with an implant. To the natural tissue options." Said Dr. Strausser.

Dr. Nalluri explained "We can use issue from your belly or from your back, or other parts of your body to recreate a breast." and Dr. Strausser said you can even use a free flap where you take tissue from elsewhere on the body, a buttock for instance and use it to create a breast mound."

And there are newer procedures, "Fat injection is coming to the forefront, although the limitations are there in terms of how much we can add."

But, when it comes to risk factors, size does matter said Nallurri, "Studies indicate that going with a large volume is associated with a higher risk of complication."

Before you make any decision, this is what you may want to ask your doctor said Dr. Strausser, "How many of these reconstructions have you done, and what what would you recommend for me knowing my history.

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