Category Archives: Breast Procedures

Wilmington Breast Lift

Categories in: Body Lift, Breast Lift, Breast Procedures

Many women struggle with breasts that have begun to sag and droop. This is happens for many reasons. Breast feeding, changes in weight, genetics and the natural effects of aging all take their toll. Dr. Chris Saunders has helped countless women restore their breasts to create a more youthful appearance through Wilmington Breast Lift surgery.

In a Breast Lift procedure an incision is made around the areola and excess, sagging skin is removed. The areola may also be repositioned, reshaped, or re-sized to create the most ideal results. The remaining skin is then closed creating firmer, perkier, more youthful breasts. In some cases, a breast augmentation may be coupled with a breast lift procedure.

If you would like to learn more about the breast lift procedure and to find out if you are a good candidate, contact our office to schedule a consultation with Dr. Saunders.

Wilmington Breast Enhancement

Categories in: Breast Procedures

Many women unhappy with the size of their breasts have daydreamed what it would be like to have larger breasts, most in proportion to the rest of their figure. Board certified Wilmington area plastic surgeon, Dr. Chris Saunders has helped a number of these women make those daydreams a reality through Breast Augmentation surgery.

Arguably one of the most popular procedures in plastic surgery, Breast Augmentation helps women of all sizes, shapes and ages increase and enhance their busts and even create symmetry when breasts are of two varying sizes. Dr. Saunders understands that each patient that comes to him comes in with varying challenges, needs and desired results. He works to accommodate each of their individual needs and to understand the results they want. He will help evaluate what is possible from what is not and construct the most ideal treatment plan to give you the outcome you are looking for.

View our before and after Breast Augmentation gallery to get a better idea of the kind of results actual patients of Dr. Saunders have enjoyed.

Have questions? Contact our office to schedule your consultation with Dr. Saunders to find out if you would be a good candidate for Breast Augmentation.

Breast Revision Surgery Delaware / Breast Redo Surgery Delaware

Categories in: Breast Procedures, Breast Revision
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Part Two

Breast Revision Surgery or Breast Redo Surgery are operations done to fix, improve, and enhance the results after cosmetic breast surgery has already been done. Dr. Saunders specializes in cosmetic breast surgery, breast revision surgery, and breast redo surgery. Patients travel from many states to see Dr. Saunders. These include Delaware, Pennsylvania, New York, Maryland, and other states even much farther away. These educational writings on this topic are divided into three parts, described as follows. Part One describes general concepts. Part Two describes breast augmentation revision or breast redo augmentation. Part Three- A describes breast lift revision or mastopexy revision. Part Three-B describes breast augmentation and lift when both have been done.

Breast augmentation or breast enlargement is an operation with incredibly high satisfaction and results for many. Most recommend the operation without reservation because of the very high success rates. However, not everyone gets so lucky. Unfortunately, breast augmentation doesn’t always go as planned. Results can be less than expected and sometimes very disappointing.

It can take time to heal after breast augmentation. Breast augmentation settling or breast enlargement dropping takes time. Occasionally women just need patience to allow healing. See Dr. Saunders writing on breast augmentation settling. If healing has happened, and the breasts are still high, than breast augmentation revision or breast redo augmentation is needed. This means surgery to fix, improve, and enhance the results of the prior surgery.

Different things can go wrong after breast augmentation surgery, and this writing is going to cover three different things that can lead to the need for breast revision surgery. The first is excessive rippling or visibility of the breast implants, the second is “hardening of the implants” or capsular contracture, and finally the third is implants that have dropped too low and need raising.

1: Excessive rippling, feeling, or palpability of the breast implants

Rippling is seeing the breast implant more than is normal. Excessive palpability is feeling the implant more than is normal. Most women do not get these problems after breast augmentation surgery. However, it can occur from being placed on top of the muscle or from having very poor “soft tissue coverage.”

“Soft tissue coverage” is an important concept with breast surgery, breast augmentation revision, and breast redo augmentation. The tissue that hides the breast implants is called the soft tissue. It provides the coverage that covers the implant and makes it harder to see or feel. Poor coverage leads to a greater chance of seeing and feeling the implant. Good coverage hides it better. Placing the implant beneath the muscle is the greatest way to get the best “soft tissue coverage.”

Sometimes the rippling and feeling the implant comes from being on top of the muscle. This is a condition that can require placing the implants behind the muscle. The muscle will dramatically help with the situation. The space left behind on top of the muscle must be addressed. This can require a breast lift, staged operations, or other procedures to completely repair. The added cover of the muscle usually dramatically helps with a more normal feel and appearance to the breast.

Some women are surprised to find that rippling and feeling the implant to a “minor” degree is normal. In these situations nothing needs to be done. However, silicone implants can really help this problem, and this is an option.

Please see the educational writing on saline vs. silicone implants.

2: Hardening of the implants

“Hardening of the implants” is called capsular contracture. It really is not the implant hardening but the scar tissue around the breast implant. This scar tissue is also called the capsular, and hence the medical term is called capsular contracture.

The cause of capsular contracture is not know although subclinical infection is a possibility. Also, the location of implants above the muscle is another factor leading to the problem. Small degrees of hardening does not always require treatment but more hardening does.

Treatment is usually surgery. Complete capsulectomy gives the best results over lesser procedures like partial removal. Dr. Saunders strives to give the most thorough and most complete scar tissue removal possible to allow for the best results and the lowest chance of it’s recurrence. Most of the time the implants can be replaced after the scar removal. This allows for a single operation and recovery.

Recurrence of the scar tissue can occur and in this situation it is recommended that a staged procedure is done. Recurrence of capsular contracture can be a problem and can be concerning to patients with this condition. Stage one is complete removal of scar tissue and the breast implants. The second stage is replacement of the breast implants at a later operation. The staged procedure is believed to address possible subclinical infection that might be the cause of the recurrent scar tissue or capsular contracture. Dr. Saunders believes this is a key to better results with this condition.

3: Breast implants too low

When breast implants drop too low, the breast can get a very unnatural appearance. The nipples can look too high, and there is no fullness in the upper parts of the breast. Women might feel like they need a lift or that the implants have deflated. There are different terms for this problem- such as the implants have “come out of the pocket” or “bottoming out.”

Treatment is almost always surgery. Larger sizes can be an easy solution because it fills up the upper aspects of the breast, as the implant gets bigger. However, the added weight can sometimes lead to the problem worsening. Other surgery is directed at suturing the pocket up higher (capsulorrhaphy) and giving the breast a more natural appearance.

Breast redo augmentation or breast augmentation revision is surgery directed at fixing problems that can occur after cosmetic breast augmentation. Breast augmentation revision surgery can be complicated and require more than one stage or operation. Breast revision surgery cost varies depending on the exact operation required and treatment needed.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. He is also specializes in breast revision surgery, breast redo surgery, breast augmentation revision, and breast redo augmentation. Please check out the breast revision surgery before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Breast Revision Surgery Delaware / Breast Redo Surgery Delaware

Categories in: Breast Procedures, Breast Revision
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Part One

Breast Revision Surgery or Breast Redo Surgery are operations done to fix, improve, and enhance the results after cosmetic breast surgery has already been done. Dr. Saunders is a breast revision doctor and breast revisions and redo operations are one of his specialties. Patients will come not just from Delaware but many other states such as Pennsylvania, New York, New Jersey, and Maryland. These educational writings on this topic are divided into three parts. Part One is on general concepts. Part Two is on specifics of breast augmentation revision or breast redo augmentation. Part Three- A is on breast lift revision or mastopexy revision. Part Three-B is on breast augmentation and lift when both have been done.

Breast augmentation, breast lift, or both operations together are frequently performed operations for cosmetic purposes. According to the American Society of Plastic Surgeons, these are some of the most popular cosmetic operations done almost every year. Most women end up with more attractive, full, and perky breasts. Success for most cosmetic breast operations is extremely high. However, sometimes things don’t always go as planned. Breast revision surgery is also called breast redo surgery and this is sometimes necessary for improvement in the breasts.

Breast revision surgery is surgery that is done to improve or to enhance the cosmetic appearance of the breast after thing have not worked out after the first operation. Different things can go wrong from minor isssues easy to fix to more complicated problems that can require more than one operation to fix or repair. For example, breast augmentation surgery might lead to a size or shape that is not desired. The solution in this case might be something easy such as placing larger breast implants. Some women want larger shape and size to the breast after breast enlargement. Breast Implant exchange is a type of breast revision where the goal is larger and fuller breasts.

Sometimes problems after surgery can be much worse. Although extremely unlikely, people can end up with very unusual appearances and shapes. Problems with the muscle and/or pocket can lead to the need for complicated surgery and breast revision surgery.

Dr. Saunders believes that women in this unfortunate situation must understand two important points. First, it is not always possible to correct all issues. It is not always possible to make things “perfect.” Sometimes a women must accept that there are limitations to what can be done. This can be hard for some than others to accept.

Second, minor issues are sometimes best left alone. A breast or implant slightly “off” might not be worth the risks or expense of surgery to fix or improve. When to call it “quits” and accept what one has is another difficult thing for some women.

An expert panel of some of the best breast revision surgery doctors came to the conclusion that minor issues are best left alone. More surgery to make little changes can open a “can of worms” and might not be recommended. This is also called where “risk benefit ratio” does not warrant more surgery.

Breast revision surgery cost can be MORE than the original surgery. This can be a source of frustration to many patients. The operation can be “more” expensive because it is more difficult, long, and skilled. The breast revision doctor might have higher expenses and costs than the first doctor or operation. One can always choose to stay with the first surgeon. Because he was paid the first time and because most surgeons care about the patient, it might be less expensive to stay with that doctor and not switch doctors. However, maybe it is also worth the expense to switch to another doctor, in particular a breast revision doctor. This is true especially if you have lost confidence with your doctor.

Insurance almost never covers expenses for breast revision surgery. This can be frustrating to many people! Plastic surgeons wish it was but it almost never is covered.

Breast revision recovery is very dependent on whether the muscle work has been done or is needed. Please see Dr. Saunders writing on Breast Augmentation, Breast Enlargement: What about the muscle? If the muscle work has been done, than breast revision surgery and breast revision recovery can be surprisingly easy. If muscle work is needed than pain unfortunately can be more. Dr. Saunders uses a “Pain-Buster” that is a fantastic device to help with recovery.

Finally, the most complicated revisions require multiple stages or more than one operation. This is another source of frustration to some. The idea is to take everything out and allow healing. The second stage can allow for a better result and sometimes decreases risks of scar tissue returning. Many times superior results can be achieved.

A classic example of this type of problem that may best be repaired with more than one operation or stage is recurrent capsular contracture. In this case, the “hardening of the implants” may be best treated with a first operation to remove the scar tissue. Dr. Saunders does a complete capsulectomy versus a partial capsulectomy because he believes this gives the best results. The second operation or stage is done after everything has healed. This operation involves replacement of the breast implants. Because the cause of capsular contracture may involve a sub-clinical infection, the staged approach allows the body to heal the possible “infection,” and hence may lead to decreased chance of recurrence.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. He specializes in breast revision surgery, breast redo surgery, breast augmentation revision surgery, and breast redo augmentation. Please check out the breast revision surgery before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Breast Augmentation, Breast Enlargement: “What about the muscle?”

Categories in: Breast Augmentation, Breast Procedures
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Cosmetic breast enlargement or breast augmentation is done to give a women a more attractive, full, and larger shape to the breast. The operation has a very high success rate and is considered extremely safe. The operation is almost always done on an out-patient basis with a reasonably quick recovery. Women interested in the cosmetic operation often ask about “muscle work” or “the muscle” and this educational writing on breast augmentation will review this.

The chest of a women has a large flat fan shaped muscle called the pectorals major muscle beneath the breast. This is the large chest muscle you see in male body builders. This pectoralis muscle is the main muscle for breast enlargement. The serratis anterior muscle and the rectus abdominus muscles play a smaller role for breast surgery, but most of the focus is on the pectoralis muscle.

Breast implants are placed either beneath the pectoralis muscle or on top of it. Placing it beneath the muscle is called sub-muscular placement. Placing the breast implant on top of the muscle is called sub-glandular. This means beneath the breast- BUT on top of the muscle! Breast augmentation technique involves placing the implant in one of these two locations.

Most medical studies show superior results with placing the breast implants beneath the muscle. The muscle provides improved coverage and lower complications. Dr. Saunders emphasizes how the muscle and breast together are an important concept he calls “soft tissue coverage.”
“Soft tissue coverage” is all the muscle, breast, and skin that are covering the breast implant and “hiding” it. The more tissue or coverage that hides the breast implants- the better the result will be.

Imagine a women who naturally was as “flat as a board” and then gets extremely large breast implants. She now is at the beach! She will look fake, round, and not natural. Many people don’t want this result after breast augmentation surgery. She looks like this because she has poor “soft tissue coverage.” She has mainly “skin” covering the breast implants. She will also have a worse “feel” and a worse “look” to the breast with higher complications.

It is placing the implants beneath the muscle that gives us the most “soft tissue coverage” possible. Dr. Saunders tries to get the breast implants behind all the muscle possible that a women has on her chest. These breast augmentation techniques give the best results with the softest breast, most natural result, and lowest complications. Understanding the importance of the muscle is the key to understanding the latest breast augmentation techniques.

More info: Saline vs Silicone Breast Implants

Breast implants placed on top of the muscle sometimes is done. As far as breast enlargement techniques is concerned- this can be a mistake! It is not the first choice for location as described above. Higher complications can occur in this location. These problems might be seeing the breast implants (wrippling) or feeling the breast implants (palpability) more than normal or desired. Options include placing them beneath the muscle or switching to Silicone breast implants. Saline breast implants versus silicone breast implants is discussed in detail in another educational writing. You can link to this now. It is called – Breast Implants Saline or Silicone? For extra discussion- consultation is recommended in this situation.

People interested in breast augmentation cosmetic surgery or breast enlargement cosmetic surgery or other topics such as breast augmentation cost, breast augmentation recovery, or breast augmentation technique should please call the office for an appointment. Dr. Saunders will review your breast surgery with you in detail!

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. Please check out the breast enlargement before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Click here to visit our Breast Augmentation photo gallery.

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