Your Beauty

Perfected with Precision

Double board-certified Vero Beach plastic surgeon

Dr. Alan Durkin’s enthusiasm for the transformative power of plastic surgery shines through from the very first moment you meet him. He is a passionate believer in aesthetic innovation and an educator at heart.

What Results Can I Expect From My Breast Augmentation?

Breast augmentation is a procedure with very high patient satisfaction.

• Larger & beautiful breasts
• Symmetrical breasts
• Fuller and rounder breasts
• Natural breasts

1) MY PLASTIC SURGEON DIDN’T LISTEN TO ME, AND THIS IS NOT WHAT I WANT.

This is our most common scenario, and it often occurs when patients go to a non-board certified plastic surgeon for their breast augmentation. They often do not hold the same comprehensive understanding of the female breast. In this situation, we start all over. We review all of your records, if available, and treat the consultation as if it were your first. We then plot a course to reverse the effects of the previous procedure, and provide you the best results possible. We commonly offer either an implant exchange procedure with capsule modification, or in severe cases, a neopectoral pocket procedure.

2) WHEN I LIE FLAT, MY BREAST IMPLANTS FALL INTO MY ARMPIT.

Most common complaint in women over the age of 45. As the breast ages, it commonly loses support laterally. This can result in the breast implant falling towards the armpit over time. Depending on the degree of laxity, this can be treated by oversewing the lateral breast, or with creation of a neopectoral pocket. In severe cases, use of an acellular dermal matrix like Strattice is our treatment of choice as it durably solves this problem.

3) MY BREAST IMPLANTS CHANGED SHAPE AND BECAME HARD.

This usually means that you have developed what is known as a capsular contracture. In this instance, removal of the implants and its capsule in its entirety is our procedure of choice. Capsular contracture is an abnormal scarring response that occurs around the implant. It can occur for many reasons, and is uncommonly a result of surgeon error. In severe cases of contracture, our preferred approach to this problem is a total capsulectomy, or removal of the entire capsule with the implant. This brings the breast back to its near native appearance, and has the benefit of removing all of the hardened, painful tissue. This procedure is safe, but does have increased swelling as compared to an implant removal and replacement. Read more about how capsular contracture can be corrected by revisional surgery.

4) MY BREAST IMPLANT RIPPLES.

Very common complaint in patients with larger sized saline implants. Exchange of a saline for a silicone implant can commonly improve rippling along the implant. As well, many women can be treated by moving the implant below the muscle. For severe cases, however, we offer Strattice. Strattice is a fairly recent addition to our plastic surgery armamentarium. It is a biologic mesh that can provide permanent coverage and support for your implant. It is safe, completely natural feeling, and offers a permanent solution to implant rippling. We commonly employ Strattice in our practice, especially in female figure models, and body builders. If you have less than 20% body fat, and are looking for a full D cup augmentation, rippling will occur with any type of implant. We commonly use Strattice in this patient population in both primary augmentations and Breast Implant Revision.

5) I WENT IN WITH 2 BOOBS, AND I CAME OUT WITH 1!

This is called symmastia. This is a complex problem that requires re-creation of the sulcus or gap between your breasts. This is a very complex procedure that commonly requires a neopectoral pocket or total capsulectomy technique in addition to placement of a Strattice Sling. The goal of surgery is to recreate the medial border between the breasts. Time and experience have shown us that suture techniques alone are not as durable as newer techniques. Thankfully, this is an uncommon complication, but it is one which we routinely encounter from both referring physicians and patients.

6) MY BREAST IMPLANT IS FALLING DOWN ONTO MY TUMMY.

This is called bottoming out. This occurs when the structural support of the breast is no longer able to maintain the weight of the implant. In this situation, downsizing the implant and tightening the capsule provides a solid, durable result that pleases most patients. In women that want to maintain their current size, or even increase, placement of extra support with a biologic mesh may be indicated.

7) MY BREAST IMPLANTS ARE UP BY MY COLLAR BONE.

This is either a technical error due to an inadequate release of muscle fibers during surgery, or a situation where the muscle randomly re-adheres too quickly to the chest wall. This is commonly seen in women who receive a submuscular (below the muscle) implant. Commonly, the implant does not appropriately fall, and rides high. When this occurs, release of the muscle in conjunction with precise tailoring the of the breast capsule solves this problem. This issue is not the same as a“Double Bubble. In a double bubble, the natural hang (ptosis) of the breast is involved, and causes a more complex problem requiring a different approach.

Not all silicone breast implants are created equal! The original silicone implants were introduced in the 1970’s, and used a liquid silicone fill. Due to health concerns related to leakage, they were taken off the market by the United States Food and Drug Administration (FDA).

After an exhaustive study extending nearly twenty years, the FDA conclusively proved that silicone is a safe substance for breast augmentation. Since their re-introduction in 1994, the new cohesive gel “Gummy Bear” silicone breast implants have literally redefined breast augmentation. They offer a remarkably natural feel, greater longevity, and better patient satisfaction than their saline counterparts.

ADVANTAGES OF SALINE IMPLANTS

• Advantage #1 – Smaller incision size. Since the implant is empty prior to your surgery, the incision can be less than 3cm in size, and any sized implant can placed through the same incision

• Advantage #2 – Implant rupture detection. If a saline implant gets ruptured, you lose volume immediately, and over the course of hours to days, the diagnosis of a rupture becomes very evident. Removing the ruptured implant and replacing it is usually a simple operation.

• Advantage #3 – Cost. This is the absolutely least important advantage. Breast augmentation is not an accessory. It is a lifestyle choice. If you are looking for the cheapest type, reconsider your reasons for having this done.
  

DISADVANTAGES OF SALINE IMPLANTS

• Disadvantage #1 – Rippling. Extremely common with saline implants. This is a design flaw in the implant, and absolutely nobody likes it. For athletic women, saline implants will always cause rippling.

• Disadvantage #2 – Less natural feel. A saline implant is just that, an implant filled with saline solution. It will feel different than the feel of your breast. This is unavoidable.

• Disadvantage #3 – Swimming. If you swim in cold water with a saline implant, the saline implant temperature balances with the water temperature, while your body remains warm. This can lead to a “turkey is done” effect, which can be socially awkward on the beach or at the pool.
  

ADVANTAGES OF SILICONE IMPLANTS

• Advantage #1 – Natural feel. No question about it. Silicone implants feel remarkably like the natural breast tissue. Because of this, we see 1-2 patients a week with saline implants requesting a change to silicone. Dr. Durkin has NEVER had anyone ask to go from silicone to saline because they like the “fake feel” better.

• Advantage #2 – Safety. Silicone breast implants have been scrutinized like absolutely no other surgical device or prosthetic. The FDA recently completed a 10 year double-blinded clinical trial that clearly demonstrated the safety and efficacy of silicone implants. The cohesive gel implants (i.e., Gummi Bears) are safe.

• Advantage #3 – Swimming. Silicone mimics the body tissue. You get less of the “turkey is done” effect.

• Advantage #4 – MINIMAL RIPPLING. Almost never see or hear of it unless a very, very large implant is selected in a petite patient. Very common with saline.
  

DISADVANTAGES OF SILICONE IMPLANTS

• Disadvantage #1 – Rupture. If you have an implant rupture, your implant will not deflate. This is a good and a bad thing. With the new cohesive gel implants, the majority of ruptures are completely un-noticed and asymptomatic because the new implants have solid state silicone, not liquid. So, you can have a ruptured implant for years without any problems whatsoever. However, if you have concerns over rupture, you can only diagnose it with an MRI scan.

• Disadvantage #2 – Incision size. Silicone implants come prefilled. Because of this, it is common to use a slightly larger incision to place the implant. As well, you cannot have this type of implant placed through the belly button.

• Disadvantage #3 – Cost. Again, I shudder to mention this, because it is more of a difference than a disadvantage. A silicone implant is superior in quality, feel, and minimizes rippling. In the end, you are paying for a superior product.
  

During the next phase of your Vero Beach breast augmentation consultation, you get to try on any of the breast implant styles that interest you. Dr. Durkin and our Patient Care Coordinator assists you with on trying on different types of implants with different types of bras and different styles of clothing.

At this stage, we finalize together the pathway to your ultimate goal from surgery. Ocean Drive Plastic Surgery is the ONLY aesthetic practice in Florida to offer our patients a full, on site sizing consignment of the Cohesive Gel Implants. We have the largest aesthetic experience in the state of Florida with these new implants, and we firmly hold the opinion that this implant is the next quantum leap forward in cosmetic breast augmentation.

Visit Ocean Drive MedSpa for non-surgical alternatives that can help you achieve the body and skin you've always wanted.