Scar Free Breast Augmentation

Breast augmentation remains as one of the top cosmetic plastic surgery procedures in the country. The use of a breast implant is a very successful and rapid method of getting breast enlargement due to the immediate placement of the implant device. Getting the implant in place, however, requires an incision somewhere to introduce the implant through into the breast pocket.

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Scar free breast augmentation refers to using an incisional approach off of the breast. This is most easily done through the axillary (armpit) region. There are natural skin creases in the armpit (scars always are less conspicuous and heal better when placed along a skin crease) which make placing an incision easy. Also the armpit lies immediately beneath the outer edge of the pectoralis muscle where is where you want to be for breast implant placement anyway.

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A very small one inch (2.5cm) incision cam be made immediately below the edge of the muscle in a skin crease. Because of this small size, saline breast implants must be used as they are inserted deflated. Meaning they are rolled up like a burrito, inserted through the incision and under the muscle, and inflated after being in position through a long detachable tube. Because of this small incision size, it is not possible to use silicone gel implants because they are bigger being prefilled from the manufacturer. (it is possible to place silicone implants through this incision but it must be made much bigger...as pectoral implants are placed through this same incision)

While there is another non-breast incisional approach to use, the belly button or umbilicus, this requires dissection up through the abdominal tissues which creates pain at two sites rather than just one. I see no advantage to the transumbilical approach over the transaxillary approach.

Scar free breast augmentation has been possible for some time using an axillary incision. Dissolveable sutures are used to close the incision and there is no wound care afterwards. One can shave and use deodorants one week after surgery. The armpit scar heals so well that it is virtually impossible to detect in most patients within months after breast augmentation surgery.

Scar Free Breast Augmentation

Dr Barry Eppley is a board-certified premiere plastic surgeon in in Indianapolis, Indiana where he practices at his Ology Spa locations in Clarian North Medical Center in Carmel Indiana and Clarian West Medical Center in Avon, Indiana. (http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com. Dr. Eppley may be heard weekly on his radio show, Doc Chat, on WXNT 1430 Indianapolis on Saturday afternoons.

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Rejuvenation of the Aging Mouth - Corner of Mouth Lift and Nasolabial Fold Augmentation

Age changes around the mouth area are more than just wrinkles and vertical lip lines. The upper lip actually lengthens, the corners of the mouth turn downward and the lips lose fullness. Three distinct grooves appear around the mouth including the nasolabial lines (oblique lip-cheek grooves), marionette lines (vertical chin-facial groove) and the horizontal labiomental groove below the lower lip. These grooves frame the mouth and add to its aging appearance.

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Contrary to popular perception, no type of facelift or necklift can change the tissues around the mouth. The pull of these operations is too distant from the mouth to affect the tissues that immediately frame it. The only methods to change the aging mouth must treat it directly.

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The changes around the mouth with age represent a problem with the thinning and downturning of tissues. Treatments that reverse these problems must, therefore, be about thickening and uplifting these tissues. Direct surgical approaches include thickening with injectable fillers and uplifting through lip lifts and advancements.

The combination of injectable fillers for the nasolabial folds and a direct corner of the mouth lift is an excellent approach to certain aspects of the aging mouth. This combination is particularly beneficial because both procedures affect the same vertical line of tissue aging. Both can be performed as a short office procedure under local anesthesia with no significant downtime.

The use of injectable fillers is a common and very effective method for most deepening nasolabial fold areas. They are not effective when the folds are so deep that they are inverted however. But for shallow and moderate depths folds, injectable fillers will provide a nice softening with an instantaneous result. There are numerous filler options and all will work. I prefer those that last the longest such as Juvaderm, Perlane, Evolence, Radiesse, or Sculptra. Injection under an infraorbital local anesthetic nerve block makes the injection painless.

The corner of the mouth lift is done to turn up the corners of the mouth. This small procedure is quite powerful as it alters the sad mouth appearance. By removing a small triangle of overhanging or downturned skin above each mouth corner, the mouth line becomes level. This does result in a fine line white scar that lies along the upper lip border and extends slightly beyond the mouth corner. This does result in a scar but it is only visible on very close inspection. The little scar is red for a while but will fade to a white color over time. Tiny little dissolveable sutures are used and make-up can be applied immediately.

The combination of nasolabial fold augmentation with injectable fillers and a corner of the mouth lift helps address collateral areas of the aging mouth. In my Indianapolis plastic surgery practice, I perform both under local anesthesia in the office which takes about an hour to complete. These changes are effective and easy to go through with no recovery. Some corner of mouth lifts may require a touch-up but they are very long-lasting. Injectable fillers are temporary and they will need to be repeated every year for their benefits to be maintained.

Rejuvenation of the Aging Mouth - Corner of Mouth Lift and Nasolabial Fold Augmentation

Dr Barry Eppley is a board-certified premiere plastic surgeon in Indianapolis, Indiana where he practices at his Ology Spa locations at Clarian North Medical Center in Carmel Indiana and at Clarian West Medical Center in Avon Indiana.(http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com. Dr. Eppley can be heard weekly on his radio show, Doc Chat, on WXNT 1430 AM every Saturday afternoon.

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Rapid Recovery After Breast Augmentation

Breast augmentation is both a popular and highly successful procedure that is done over 300,000 times per year in the United States alone. Some women, however, fear the procedure due to the belief that there is a lot of pain after surgery and that their return to work or normal activities may take several weeks. Breast augmentation surgery today, however, can put the patient back to a near normal schedule within days.

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Breast augmentation, from a simplistic standpoint, is really a big 'pulled muscle'. In this
case, the pectoralis muscle on the chest is 'pulled'. Breast augmentation, in most cases, is the lifting up of this muscle and placing an implant partially underneath it. No breast implant is completely under the muscle or it would be positioned too high and the nipple would be pointing downward. As the pocket into which a breast implant is placed controls the final shape of the breast, recovery after breast augmentation is really muscular. From a physical therapy standpoint, how do you recover from a pulled muscle? Do you not move it...or bind it up and keep it from moving? The answer is.....use it! Early moving and stretching of an injured muscle is the key to a faster recovery after breast augmentation. You can't hurt the breast implant by using your arm and chest muscles and early movement will not be responsible for an implant 'getting out of position'.

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In Indianapolis, the approach to a no recovery breast augmentation program begins in the operating room. A dose of steroids is given at the start of surgery and a bioelectric device, known as Actipatch, is placed over each breast before the patient leaves the operating room. This device, which is worn for 48 hours after surgery, helps control pain and swelling. I then start my breast augmentation patients on range of motion arm exercises beginning the night of surgery as well as 800mg of Ibuprofen twice a day also. The goal is to get patients off narcotics in 24 hours, if possible, and be able to get out of the house for dinner or shopping the next day. While not every patient achieves this exact timeline for a 'rapid recovery', this aggressive approach helps make a breast augmentation easier to go through than ever before.

Rapid Recovery After Breast Augmentation

Dr Barry Eppley is a board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. (http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com

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