Archive for the ‘Breast Augmentation’ Category

breast augmentation Chattanooga, Tennessee

Breast augmentation patients  have different motivations for undergoing surgery. Some want to restore volume lost during nursing while others may simply prefer to achieve a more appealing aesthetic. Patients may also seek breast surgery for reasons related to athletic performance. It seems breast implant surgery and breast reduction are two of the most popular cosmetic procedures among female athletes.


Breast Reduction

Breast surgery is not always motivated by sheer aesthetics.  Athletes with large breasts may be at a disadvantage. Not only can oversized breasts be uncomfortable, they can actually interfere with athletic performance. When this is the case, athletes may opt for breast reduction surgery.


A prime example is tennis star Simona Halep.  At the age of 17 the athlete underwent breast reduction. She felt her breasts slowed her reaction speed and caused discomfort. She went from a 34DD to a 34C and seems very pleased with the outcome of her procedure.


While breast reduction can allow for great relief for athletes, the procedure does require some down time. Although most patients are up and walking the day after surgery, strenuous activities (including sports) should be avoided for six weeks.


Breast Augmentation with Implants

Many athletes are characterized by their lean physiques. While such a low degree of body fat beautifully showcases abs and shoulder “caps” , women may also lose most of their breast tissue.  Breast implants are a great way to add a more feminine touch to a lean, athletic frame.


Breast implants can be placed either under the muscle (Subpectoral) or over the muscle (Subglandular). Although under the muscle (Subpectoral) implant placement is typically the most natural and preferred method, over the muscle can be particularly ideal for extremely athletic patients such as bodybuilders who are more susceptible to muscular distortion which sometimes occurs when the implant is placed under the muscle. It is important to note however that subglandular placement does not appear as natural and also carries a higher risk of capsular contraction.  Choosing smaller sized implants can also help with a more natural appearance.


Whether you would like to reduce or enhance your breasts, Board Certified Surgeon, Dr. James E. White,  has several years of experience performing breast reduction, breast lift and breast augmentation surgery. To learn more, call 423-648-4011

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Plastic Surgeon Chattanooga, Tennessee

While many prospective breast augmentation patients may have visions of sexier, skimpier brassieres on their mind and a trip to Victoria’s Secret on their post-op to-do list, breast implants actually require sufficient care and attention. Many of the breast patients we initially consult with in our practice have been misled to believe that “fake” breasts cannot sag like natural breasts and therefore , do not need complete support…….hence the new wardrobe of lacy bras that serve no function and provide no support are far from truth.

Although rare, breast implants can displace and descend below the original pocket. Also known as “bottoming out” , this complication occurs when there is not enough support to keep the implant in place. As a result, the implant drops low on the chest and causes the nipple to appear abnormally high on the breast mound. Not a natural or optimal look.

While any size or type of breast implant is susceptible to “bottoming out”, larger implants are more likely to pose this risk from shear weight. Implant placement also plays a factor in the likelihood of implant displacement. Implants placed above the muscle are more likely to descend than those placed completely under the muscle. Under the muscle provides more support with dense tissues. Also a factor is skin type as women with thin breast tissue are particularly at risk.

Bottoming Out: Prevention

The best way to prevent implant displacement is to follow your surgeon’s post-operative instructions. Support, support, support. Because smoking can damage  skin elasticity, it is also advisable to refrain from nicotine and tobacco use. While it may be tempting to go bra-less, or only wear those cute lacy yet functionless bras, implants need proper support just as natural breast tissue. Cute and lacy may be used for limited amounts of time; but support bras should be a daily routine.


When performing high risk activities, breast augmentation patients should use common sense. Activities that involve excessive bouncing like running and horse-back riding will put extra pressure on breast tissue. Therefore, it is wise for patients to invest in highly supportive sports bras.

While breast implants are great for restoring youth, volume and perkiness of the breast, patients must take care of their investment so that their results remain aesthetically appealing. If you are interested in breast augmentation surgery, call 423-648-4011 and schedule your private, complimentary consultation with our Board Certified Surgeons.

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breast reduction

Image Courtesy of Dreamstime

Looking to go down a cup size? You may not need as invasive of an approach as breast reduction surgery to accomplish your goals. For patients who desire only a small decrease in breast volume, no lift…no drastic alteration in size.., liposuction can be a viable option.

Breast Reduction Surgery

While formal breast reduction surgery is a well-established procedure with a successful track record, it comes with a price: visible scarring, post-operative discomfort and increased surgical costs.

During a formal breast reduction surgery, multiple incisions must be made including one around the nipple, another vertically under the nipple plus or minus additional incisions.  If a large nipple lift is needed it may be necessary to complete a long anchor incision at the horizontal crease under the breast. Excess skin and breast tissue are then removed and re-contoured using a combination of liposuction and sharp dissection to lift the nipple and shape the breast.  Eventually, these incisions result in visible scarring.  While, in less severe cases, we can use a less invasive incision technique to reduce the appearance of scarring, breast reduction surgery is ultimately more intensive than a simple reduction by means of  liposuction.

Following breast reduction surgery, patients typically require 5 to 8 days of recovery. Although most patients are up and walking the day after surgery, strenuous activities should be avoided for six weeks.

For patients seeking a significant change in size and a re-contouring effect, breast reduction/lift surgery remains the best course of action.  Not only can it reduce breast size, it can also lift, firm and provide a more “perky” appearance to sagging breast. The cost of breast reduction surgery can range anywhere from $5,000 to $8,000.

Reduction with Liposuction

Another breast reducing option is breast reduction liposuction.  Although still a surgical procedure, is considered less invasive, less costly and results in minimal to no visible scarring.  While liposuction cannot drastically alter size, provide lift or a more pleasing contour, it can decrease breast volume by one cup size.   Skin reduced in size will often respond with some skin tightening.  For patients only wanting a small reduction, liposuction may be the more sensible option.

During liposuction, the breasts are treated with a tumescent solution intended to numb the area and control bleeding. The cannula, less than 3mm in size, is inserted through small 3mm incisions. VASER ultrasound can be used to dislodge fat from the surrounding breast gland tissues using sound waves.  The liposuction cannula then suctions the desired amount of fat tissue from the treated areas.

Following breast reduction with liposuction, patients will be required to wear a compression garment for 1 to 3 weeks. Depending on the patient’s occupation, many can return to work only a few days after surgery.  The cost of liposuction starts around $3000.

While patients desiring more extensive changes in breast size and contour may be better off with formal breast reduction surgery, patients only hoping to achieve slight alteration in size can bypass increased costs, scarring and recovery time by opting for reduction by liposuction.

If you are interested in exploring your options, call 423-648-4011 to schedule you complimentary consultation with our Board Certified Surgeons.

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Plastic Surgeon Chattanooga, TennesseeIn 1992, a sense of panic overshadowed the credibility of breast augmentation surgery after the FDA removed silicone breast implants  from the market. The ban was enforced out of suspicion that the devices were responsible for connective tissue disorders, autoimmune diseases and cancer. As a result, saline became the go to material for breast implantation.   Fast forward more than twenty years, and you will notice a stark contrast in breast implant preference among women.

According to the American Society of Aesthetic Plastic Surgery (ASAPS) , 72 percent of the implants used in breast augmentation surgery today are silicone. Based on such data, it is fair to say that silicone breast implants have become the more popular choice since their reintroduction to the market in 2006. But what distinguishes new silicone implants from the older form of silicone?

New Silicone Implants versus Old Silicone Implants


Differing from the implants used in the 1960’s thru 1990’s, the shell of  modernized silicone implants are more durable. They are so durable that their  rupture rates are practically negligible. In addition to an  improved implant shell or covering,  the actual silicone filling has transformed from a once oil-like substance to a  more cohesive,“gummy bear-like” silicone gel. As a result, free silicone implant leakage is nearly impossible.

While leakage or silicone migration instances are extremely rare, it is critical to note that  the inability of silicone implant deflation makes rupture detection difficult.  Unlike saline implant deflation where the water filling actually leaks and deflates, the only way to detect silicone implant breakage is by breast MRI.

After fourteen years of silicone implant research and an additional seven years of market use,   silicone breast implants have proven to be safe when used properly. However, whether you choose saline implants or silicone implants,  the devices are not constructed for lifetime use. It is recommended patients exchange their breast implants every ten years. To screen for possible silicone implant breakage, patients are  also advised to receive a breast MRI every three years.

Why is silicone more popular than saline?

So, why do the majority of patients and surgeons prefer silicone? Implant preference is often based on cosmetic reasons.  Silicone implants tend to look and feel more natural than saline implants. They also present less of a risk for visual rippling and capsular contracture.  Please note,  the FDA has not approved silicone implants for use in patients under 22 years of age.

If you would like to learn more about breast implant options, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons or visit www.advsurgical.com

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By Dr. James White


While many cosmetic surgery candidates assume breast implant size is the only variable in breast augmentation outcome, they are misinformed. Breast implant type, shape and positioning also play an important role in breast enhancement cosmetic results.

Although a fair amount of patients are aware of the pros and cons of implant type (saline or silicone?) and size (small “C” cup or DD?), a vast majority of patients do not realize the role implant placement plays in the overall aesthetics of breast enhancement. In fact, breast implant placement can be executed through several different approaches. Primarily, they can be placed completely under the muscle (subpectoral), over the muscle subglandular or partial sub muscular (dual-plane).

Under the Muscle/Subpectoral

When a surgeon refers to “subpectoral” or “under the muscle” placement, this typically implies that the implant will be placed completely beneath the pectoralis muscle. This technique can be advantageous particularly for women with extremely thin tissue as this type of placement allows the entire implant to be camouflaged and padded by overlying muscle and existing breast tissue. As a result, wrinkling and rippling of the implants less likely. In addition, this technique greatly reduces the likelihood for capsular contracture (hardening of the breast due to the abnormal development of scar tissue of the capsule around the implant). Although this techniques has many advantages, it can cause more immediate postoperative discomfort and require longer recovery time than subglandular placement. Flex of the pectoralis muscle with submuscular implants can cause implant distortion.

Over the Muscle/Subglandular

Subglandular placement is executed by placing the implant over the pectoralis muscle directly under the breast tissue . While this technique may not require as long of a recovery and less postoperative discomfort as subpectoral placement, the chances for capsular contracture are greatest with this approach. At our practice, subglandular placement is not the preferred method not only due to potential for capsular contracture but also because of the potential for visible implant rippling and a less natural feel of the breast implant. However, it can prove beneficial for extremely athletic patients such as bodybuilders who are more susceptible to muscular distortion which can occur when the implant is placed under the muscle.

Dual-plane/Partially under the muscle

When a patient exhibits a slight droop of the breast, often due to deflation of the breasts after a pregnancy or weight loss, yet still possesses good skin quality, we often prefer to perform a dual-plane breast augmentation. A dual-plane placement allows for the upper portion of the implant to be covered by the pectoralis muscle while the lower portion of the implant is only subglandular. This technique provides a gentle lift, without the need for a more invasive breast lift and the scarring and discomfort that a formal breast lift entails. Even better, this technique still has a low likelihood of capsular contracture formation, the best of both worlds.

In order to accurately determine the most beneficial placement for your unique body, it is necessary to consult with a Board Certified Surgeon experienced in breast augmentation surgery. To book a private complimentary consult with our Board Certified Surgeons, call 423-648-4011.

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breast implants Chattanooga, TennesseeFrom a superficial standpoint, it is widely recognized that breast augmentation is effective in providing greater volume ,improved shape and better symmetry. Recently, however, a study proved the effects of breast enhancement extend to more substantial, internal benefits.

Patients who receive surgical breast implants cite improved quality of life according to the journal of Plastic and Reconstructive Surgery.

During the study, forty-one females completed questionnaires before and after breast implant surgery. The questionnaires were created to evaluate six components associated with quality of life. Ultimately, more than 80 percent of the participants reported “significant improvement” through indicators of well-being and satisfaction. Interestingly enough, satisfaction and gains in quality of life were considered great when compared to results reported by hip replacement study participants.

When trying to make sense of this phenomenon, American culture may play a crucial role. As ideals for feminine beauty are concerned, our society can be quite harsh. When women perceive themselves as “flat-chested” or “boyish”, their self-worth may be negatively effected. Such insecurities can impact one’s ability to enjoy life. Tropical vacations, parties and even everyday activities can be less gratifying for women insecure with their breasts.

Considered one of the most popular cosmetic surgery procedures in the US, more than 300,000 women received cosmetic breast augmentation in 2011. Two-thirds of those women chose silicone implants.

Just as we invest in our well-being by paying for gym-memberships or purchasing health food and supplements, breast enhancement surgery is an investment that can provide long-term benefits. Confidence and satisfaction with one’s body image can enhance other areas of our lives.

If you are interested in seeing what breast augmentation can do for, call 423-648-4011 to schedule your complimentary consultation with our Board Certified Cosmetic Surgeons.

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cosmetic surgery Chattanooga, TennesseeYou have been good all year…why not treat yourself to a long-term investment like cosmetic surgery for the holidays? Unlike designer handbags and shoes which eventually go out of style, looking fabulous and improved self-esteem never gets old. Plus, colder weather and more time off during the holidays allows for ideal recovery conditions. Here are some procedures we have found popular in our practice this time of year.

Face Lift and Laser Resurfacing

A Facelift is a surgical procedure used to lift sagging facial tissues to a higher more youthful position. Most facelift procedures address the SMAS [underlying fibrous tissues of the face/neck], the platysma [neck muscle] and the skin of the face/neck. Confirming what we have seen in our Cosmetic Surgery practice for years, a study published in the Archives of Facial Plastic Surgery revealed that patients looked an average of 9 years younger than their actual age after receiving facial rejuvenation procedures like facelift surgery. More recently, it was proven through scientific research that more than five years after facelift surgery, three-fourths of patients still look younger than they did before surgery. For optimal results, many patients combine facelift surgery with laser skin resurfacing.

Laser resurfacing is a less-invasive yet effective way to correct sun damage exhibited by age spots, fine lines and wrinkles. Laser treatments use thermal technology to remove the damaged, superficial layers of skin to ultimately reveal more fresh and youthful skin.

While recovering from facial rejuvenation procedures like laser resurfacing and facelift surgery, patients are instructed to avoid sunlight exposure. The shorter days of winter make such post-op recommendations more ideal and feasible . After all, many patients will see minimal sunlight given it is dark during their daily commutes. Even more, between sunny vacations, boating and a plethora of outdoor activities, avoiding the summer sun is almost impossible for many thus making winter a practical choice for facial rejuvenation procedures.

Body Contouring through liposuction and breast augmentation

Liposuction removes excess fatty tissues to reveal a trimmer silhouette while breast augmentation, by surgical implantation, can provide feminine curves by providing shape and volume. Although sun exposure is not particularly an issue in regards to liposuction and breast enhancement recovery , patients are required to wear post-operative garments while healing. Wearing such garments in the hot summer months can be uncomfortable and difficult to conceal. Even more, patients may not feel comfortable baring their bodies in skimpier clothing until they have fully healed. Cold weather attire allows for easy concealment of compression garments and bandages.

An added benefit to undergoing cosmetic surgery during this time of year, is more ample recovery time. With extra time off from school or work, the holidays allow many patients extra downtime. Many cosmetic surgery procedures require a 1 to 2 week recovery period in which many patients do not feel comfortable being seen in public. To ensure recovery time without having to ask for additional time away from school or work, many individuals book their surgery over Christmas vacation.

If you have been seriously contemplating cosmetic surgery, you may want to consider scheduling your procedure within the next few months. As an added incentive, many cosmetic surgery practices offer holiday specials. Until January 31, 2013, we are offering a discounted rate on silicone breast implants. To schedule your complimentary consultation, call 423-648-4011.

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breast augmentation Chattanooga, Tennessee

Q.What kind of breast enlargment surgery gives results closest to natural appearance and feel?

A. There are multiple types of breast enlargement procedures. Fat transfer, saline or silicone implants can all be used to augment breast size. Providing the most natural appearance, fat transfer to the breast can enlarge the breast but only by 1 cup size . In terms of safety, the jury is still out . Your best chances for natural looking breast augmentation results are by means of silicone implants placed under the muscle using a duel plane technique.

Q.What’s the age requirements for breast implants?

A. Breast implant regulations can vary state to state; but in general patients can get saline breast implants at 18 years of age. Patients must be 22 years of age in order to get silicone implants. This age restriction was placed by the FDA upon the most recent approval by the FDA regarding silicone breast implants.

Q.What are the long term risks of getting breast implants?

A. Patients who receive breast implants have a 1 in 5 chance of additional breast surgery. Repeat surgery most often includes implant exchange, implant removal, pocket revision, breast lift, capsular contraction and removal of leaking saline implants. Breast implants are not intended as a lifetime device and , as recommended by most manufacturers, should be replaced every ten years.

To view our breast augmentation before and after gallery, visit www.advsurgical.com.

Call 423-648-4011 to schedule your complimentary consultation.

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Have you ever wondered what you would look like with breast implants? Or, maybe you are seriously considering breast augmentation but are unsure of just how much larger you would like to go.

Our practice is proud to announce the arrival of the new Crisalix 3D breast imaging simulator to our private, breast augmentation consultations. This cutting edge technology helps patients by taking the guesswork out of size and style selection.

Using photos uploaded to a computer from a digital camera and a few measurements of the patient , the Crisalix preview technology reconstructs the patient’s body in 3D . The patient then can make endless adjustments to implant size and style to preview how it will look from a 3D perspective. This technology is the world’s first physical 3D simulator . Integrating properties of the muscle, skin, fat and glandular parts , this technology allows for realistic detail never achieved before.

To celebrate the addition of this technology to our practice, we are currently offering silicone breast implants to first time breast augmentation patients for $3775. Breast augmentation surgery must be completed from November 1, 2012 and January 31, 2013. Certain restrictions apply, so call our office at 423-648-4011 for more details.

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