Bougainvillea Clinique Blog | Dr. Hartog

Tuesday, December 30, 2008

Safety of Saline and Gel Breast Implants - get correct information

Occasionally we call other plastic surgeons' offices to find out what kind of information they provide to their patients. Unfortunately, we have found that the receptionists at many offices often provide very poor, or even false information with regard to the safety of breast implants. We are not sure whether the information they provide reflects the opinion of their surgeon, or whether they are just poorly informed. We suspect that they are at least reflecting the bias of their surgeon. This is particularly the case with regard to saline and gel breast implants. One office we called indicated that they never do gel implants because they are bad, and another office told us they never do saline implants because they are bad. The reasons they provided where even more interesting. The office where the surgeon did not perform gel implants, informed us that gel implants were bad because the gel goes all over the body and makes people sick. Really now, do you honestly believe the FDA, after all the publicity, would have released gel breast implants back on the market (after 14 years of intensive study) if this were  true? Clearly not. The office whose surgeon does not do saline implants, said saline implants were bad because when they leak, they just go flat. Pretty obvious, but why is this bad, when it is a simple matter to replace a leaking implant.
The reality is that gel and saline implants are both artificial devices, both have advantages and disadvantages depending on the individual patient, and neither implant is 'bad' or unsafe. Yes, there are potential complications with both gel and saline implants such as capsular contracture (hardening), but neither implant poses general health risks of any kind to the patient.
At the Bougainvillea Clinique we offer saline and gel breast implants, and we make recommendations based on your body type and the size, shape and feel that you want from your breast augmentation procedure. We explain the advantages and disadvantages of saline versus gel implants, and let you make the final decision. So be cautious regarding some of the misleading information regarding breast implants out there on the internet, and unfortunately from some surgeons' offices. Feel free to schedule a complimentary consultation with us, where we promise to provide honest, straight forward information based on my experience with over 4000 breast implant procedures, both saline and gel. Remember we are also the first, and presently the only practice in Central Florida to offer the Vectra 3-D Breast Imaging service, to give you a state-of-the-art look at how your breasts will look after the procedure, and allow you to make the best informed decision possible with regard to the size implant you should choose.

posted by DoctorH at 6:27 PM

Wednesday, December 24, 2008

Breast Augmentation anesthesia options

At the Bougainvillea Clinique we offer our breast implant patients many options and choices. We provide saline and gel implants, under the muscle and over the muscle placement, and all the various incisions, including under the breast (inframammary), under the nipple (areolar), through the belly button (TUBA) and through the armpit (transaxillary). One of the questions we are sometimes asked, pertains to the options available for anaesthesia. Like any other cosmetic surgery procedure, breast augmentation can be performed under local anaesthesia, local with sedation (twilight) or general anaesthetic. Some surgeons place a lot of emphasis on the fact that they do breast augmentation under pure local anaesthetic, and although we will provide this if our patients specifically request it, it is not our recommendation for a number of reasons. Before I explain these reasons, I would like to emphasize that all the surgeons in the Orlando area who strongly promote local anaesthetic, do not have fully accredited and licensed surgical facilities, and as such, it is illegal for them to provide any services under intravenous sedation or general anaesthetic in the State of Florida. At the Bougainvillea Clinique, we have the fully state and federally certified Aesthetic Surgery Center of Winter Park, so we are able to make recommendations based on what we think is best for you, and not based on the limited options that some other surgeons are able to offer.
Breast augmentation is a relatively short and quick procedure, so our objective is to make sure that your procedure is done safely, with minimal discomfort, and a rapid recovery. After performing more than 4000 breast augmentation procedures without a single anaesthesia complication, I have found that the deep sedation and general anaesthesia techniques that we use, combined with local anaesthetic works best for our patients. The technique is similar to the technique used thousands of times everyday in the US for short surgical and diagnostic procedures such as colonoscopy.
The combination of short acting sedation and anaesthetic medications, combined with local anaesthetic in the area around the breast, allows the procedure to be performed with zero discomfort during the procedure, quick recovery and rapid return to normal activities. 
Another reason that some other practitioners promote as a reason to use local anaesthetic only, is that this allows you to see the size of the implants during the procedure. I believe this is very misleading, as it requires large amounts of local anaesthetic fluid in the breast tissues to perform the procedure purely under local anaesthetic. This fluid distorts the breast shape and size, so you will not be able to accurately decide on the size of the implant with this procedure.
Finally, the use of local anaesthetic only for breast augmentation may require high doses of local anaesthetic to make the patient comfortable, and may need to be placed in an area of rapid absorption, particularly for under the muscle placement of the implant. There have been reports of overdosage of local anaesthetic in situations like this, which can result in complications such as seizures. Yes, breast augmentation can be performed under local anaesthetic only, but it may not be the simple, comfortable and safe procedure that some surgeons would have you believe. If a surgeon recommends breast augmentation under local anaesthetic alone, be sure that his facility is licensed to provide all types of anaesthesia, including general anaesthesia. Be certain that he is recommending local anaesthetic as an option, and not the only option he can provide.

posted by DoctorH at 4:47 PM

Monday, December 22, 2008

Vectra 3-Dimensional Imaging helps Breast Implant decisions

We have been using the Vectra Breast Sculptor 3-Dimensional Imaging system for approximately 6 months, and the response from our breast augmentation patients has been extremely positive. 
As part of the consultation and planning for the breast augmentation procedure at the Bougainvillea Clinique, patients can now see 3-Dimensional images of their breasts with the implants they choose. Implant size and type can be changed, and then the result visualized again, until the patient is satisfied and comfortable with their choice. The Bougainvillea Clinique is the only facility in Central Florida with the Canfield Vectra and Breast Sculptor 3-Dimensional Imaging system. We believe this allows us to provide the most comprehensive breast augmentation consultation and procedure planning available anywhere.

posted by DoctorH at 6:12 AM

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