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What's New
Larry Nichter, MD, FACS
Breast Enlargement Using Your Own Body Fat
Want to enlarge or improve your breasts with your own fat?
For years, Plastic Surgeons and their patients have desired to transfer unwanted fat from their tummy or thighs to their breasts. We are now are able to do this safely.
If you have been considering Breast Augmentation or improving your appearance after breast augmentation or Breast Reconstruction but are not comfortable with introducing artificial material into your body, you may want to look into the benefits of breast augmentation with fat transfer. An alternative to breast implants is fat transfer also known as fat grafting or lipoinjection. This technique allows women the option of enhancing the appearance of their breasts without the potential problems of saline or silicone implants such as hardness, rippling or rupture.
Who is a candidate?
· Any woman who is healthy
· Women with sufficient body fat for the procedure
· Women considering breast augmentation who wish to be one cup size larger or less
· Women who have had breast augmentation or reconstruction but who lack fullness or have contour concerns. Fat transfer can further enhance and reshape your breasts while smoothing out visible or palpable edges of breast implants. This will disguise implant rippling and wrinkling.
· Women with normal mammography
Dr. Nichter and Dr. Horowitz have successfully transplanted fat into the face, buttocks and other body areas for decades and are now using this same technology to enhance breast shape and size. Plastic surgeons have been transplanting fat to the breast since 1995 but caution and study were necessary to make sure there were not harmful effects. Furthermore, results in the past were variable, dependent on surgical equipment, technique, surgeon's skill, and individual patients healing abilities.
Since 1995, recent advances have led to the development of special instruments made just for fat grafting. Dr Nichter and Dr. Horowitz use their decades of experience and advanced knowledge of this technique to transfer body fat from other unwanted areas to the breasts. Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully. The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction, or to minimize the visibility or rippling of existing breast implants. Typically up to one breast size enlargement is possible in most patients. Fat transfer to the breast is usually done as a single procedure resulting in approximately half a cup volume increase. In women desiring additional breast enhancement a subsequent procedure can be performed. Each surgery consists of two components:
1. Harvesting the fat: Fat is removed from your abdomen, hips, “love handles” or other areas using a fine cannula similar to the one used for liposuction but skinnier. This fat is rinsed with sterile saline solution and then packaged into syringes and prepared for transfer. Approximately 20% of fat removed is suitable and available for fat grafting.
2. Fat transfer into the breasts: The prepared fat is injected in small amounts at a time and widely distributed within the layers of the breast so that these living fat cells can pick up a healthy new blood supply.
Advantages of Fat Transfer to the breasts:
· Fat cells are natural and you are using your own tissue without any foreign body or implant.
· Harvesting of the fat by liposuction has the added benefit to enhance your shape by removing unwanted fatty deposits
· The breast can be shaped or sculpted in more detail than is possible using implants alone.
· Minimal incisions reduce the possibility and degree of scarring
· No implant is used, therefore there is never a need for replacement, or any potential for capsular contracture (hardening of the implant).
· Fast Recovery Time: Recovery time is about 1 week and usually less uncomfortable from implants that are placed beneath the muscle.
Although, breast augmentation performed with the lipoinjection technique takes longer than traditional breast augmentation (with implants) the benefits are substantial including no need for implant replacement in the future.
In the past, significant questions were raised about the ability of Mammograms or MRI to detect breast cancer after injecting fat into the breast. However, there is no evidence that fat transfer to the breast is less safe than any breast surgery. Large studies have begun over the last several years to study fat grafting to the breast. With or without breast surgery, calcifications and lumps can occur. Breast diagnostic studies including physical examination and mammograms should be used to monitor every patient diligently using standard guidelines.
As a general rule, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results. We believe fat transfer should only be performed by surgeons certified by the American Board of Plastic Surgery that have experience in fat grafting. Few plastic surgeons have this experience. This ensures that your surgeon has advanced knowledge and technical familiarity, but also the subtle anatomy and aesthetics of breast augmentation.
Our patients remain the biggest source of our referrals. Over time they continue to remain thrilled with their results from these and similar procedures. I continue to share their enthusiasm and appreciate their long lasting rejuvenation which seems to affect them inside and out.
Larry S. Nichter, MD, MS, FACS
For more information about the No Implant Breast Augmentation by fat grafting or other cosmetic procedures performed by Dr Nichter and Dr. Horowitz call our office number; 714 902 1100 or go to our web site: PacificCenterForPlasticSurgery.com
Larry Nichter, MD, FACS
Advances in Minimal Scar Facelift Surgery: The Lite Lift™
Minimally invasive procedures are the focus of all surgical fields and plastic surgery is no exception. The trend for looking your best has moved towards procedures that have rapid healing times, reduced risk and leave significantly less scarring than traditional methods. More importantly, most patients want a natural, refreshed look without the appearance of having had surgery. The Lite-Lift™, modified facelift procedure, exemplifies these principles by having 40% less scarring, and nearly half the surgical down time. Rather than being performed with general anesthesia, most are performed in our office with oral sedation and local anesthesia without an IV. Dr. Nichter and Dr. Horowitz are experts in this technique and are able to tailor your rejuvenation to better achieve the patient’s desired results.
It seems rational that the more extensive a procedure is, the more dramatic and long lasting the outcome will be but this is not always true. Though there is still a place for the traditional facelift, with it there is also increased recovery time and potential for problems. By using advanced techniques deep to the skin, we are able to minimize external skin incisions and scarring. For example, placing the scar within portions of the ear and ending the incision behind the earlobe crease eliminates the usual telltale scar of a full facelift. Similarly, repositioning the incisions to hide them is also used. For example, beveling the incisions just behind the hairline allows the sideburn not to be displaced too high while allowing hair to grow through the scar to conceal it. In contrast to the traditional facelift, the Lite-Lift™ re-draping of skin is upward, a more natural, antigravity, direction eliminating the “swept away” unnatural pull too often seen in Hollywood stars with older facelift techniques. These and other advanced techniques along with modifications and innovations by Dr. Nichter and Dr Horowitz are what make up the essence of the Lite Lift™.
The techniques of the Lite Lift are advanced and predictable in the most skilled hands of Plastic Surgeons Board Certified by the American Board of Plastic Surgery of which Dr. Nichter and Dr. Horowitz are members. The best candidates are those patients with some remaining skin elasticity (late 30’s to 60’s) but this technique is also applicable to most patients including those in good health but advanced age. Best of all, this technique can incorporate synergistic procedures such as blepharoplasty (eyelid lift), temple/brow lift, cheek lift, and liposuction of the neck and jaw line, chemical peels and more. These added procedures heal simultaneously so a speedy recovery is expected.
Our patients remain our biggest source of our referrals. Over time they remain thrilled with their Lite-Lift™ results. I share their enthusiasm and appreciate their long lasting rejuvenation which affects them inside and out.
Larry S. Nichter, MD, MS, FACS
For more information about the Lite-Lift™ or other cosmetic procedures performed by Dr Nichter and Dr. Horowitz call our office number; 714 902 1100 or go to our web site: PacificCenterForPlasticSurgery.com
A New Breast Implant unlike all of the others:
"Ideal Implant" - this breast implant by the same name, is undergoing an FDA approved study - which has just started. It is an internal designed saline implant to have the feel of Silicone. To the public eye this has "the safety of saline: and is designed to feel and decreased waviness of silicone". Dr Robert Hamas of Texas has patented this device. At Pacific Center of Plastic Surgery, Dr Larry Nichter and Dr Jed Horowitz are the only Plastic Surgeons in Orange County, California that are allowed to use this implant as study investigators. Participants will be eligible for a a significant financial award for completion of all follow-up study appointments.
The Ideal Breast Implant
Ideal Implant Incorporated was founded January 2006 to develop an ideal breast implant that would combine the best of both current implants: the natural result of silicone gel and the safety of saline for “Peace of Mind.”
While the silicone gel implant has a certain appeal, many women are uncomfortable with the idea they could have a silent rupture, undetectable except with an MRI scan, and prefer to have saline instead of silicone gel in their body. Women have expressed their desire for an improved saline-filled breast implant, one that gives a natural appearance and tissue-like feel similar to the silicone gel implant, but not the wrinkling, bouncing and globular look of the current saline implant. In short,
a “hybrid” breast implant.
Years of research, testing and input from women and plastic surgeons led to the design of the investigational IDEAL IMPLANT® Saline-filled Breast Implant. On the outside, it looks like a standard saline implant, except that the edges have been lowered so it may contour better to the chest wall. On the inside, it simply contains a series of additional implant shells that are nested together. This internal structure was designed for control of saline movement to reduce bouncing, and for support of the implant edges to minimize wrinkling and prevent collapse of the upper portion of the implant.
The Clinical Trial
The IDEAL IMPLANT is now being studied in an FDA-approved nationwide clinical trial, limited to 500 women having their first breast augmentation or replacement of existing saline or silicone gel implants. Your plastic surgeon is an investigator and has the information about how you can become a participant in this study.
The Ideal Implant Study Participants' Trust Fund
Payment for Participation
You will not receive any payment for enrolling in this study. All costs of your surgical procedure are your responsibility.
You will receive payment for participation in the follow-up visits over 10 years that give information on safety, efficacy and outcome of the study implants. If you complete ALL required follow-up visits during the 10-year follow-up visit phase of the study, you will receive a lump sum payment from an independent Trust Fund. Required follow-up visits are at 2 and 6 months, and at 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 years.
In addition, the Trust Fund will act as a financial protection plan to reduce your financial risk should Ideal Implant Incorporated cease operations. In that case, you could use your Trust Fund payment toward the cost of removal or replacement of your study implants.
Highlights of the terms of this Trust Fund are:
• When you have your surgical procedure, Ideal Implant Incorporated will deposit $3,500 into
the Trust Fund
• The Trust Fund will invest in a stock and bond portfolio.
• Depending on the market, the value of the $3,500 deposit will fluctuate. Based on history, the
$3,500 will grow to between $8,083 and $12,136, with an average of $10,010, during the 10
years of the study.
• When the last participant completes her 10-year follow-up visit, the Trust Fund will be closed
and those who remained in the study and completed all required follow-up visits will receive an
amount equal to the total in the Trust Fund divided by the number of participants.
• If you miss ANY required follow-up visit, you will be dropped from the study and lose your share
of the Trust Fund. However, your share will remain in the fund and be divided among those who
stay in the study.
• If your study implants are removed and replaced with non-study implants, you will be dropped
from the study and will receive a payment of $290 for each required follow-up visit that you
completed.
As enrollment is limited make an appointment at Pacific Center for Plastic Surgery as soon as possible to see if you are a candidate for this study...Contact us or call to set up your complementary appointment: 714 902 1100.
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Breast Reduction with Minimal Scars
Dr. Nichter and Dr. Horowitz are some of the few Plastic Surgeons in the United States who regularly perform breast reduction surgery utilizing advanced techniques to minimize scarring. Most patients are candidates for this "vertical scar" technique. Rather than using the more common methods that leave extensive "anchor pattern" scarring, superior results can be obtained with only half the scarring. This newer technique eliminates the entire lower curved scar that typically extends from the sternum to the lateral chest wall. The result is a natural shaped breast, with enhanced ability for the surgeon to adjust the width and height of the breast with less chance for thickened red scars.
Additional benefits to the patient may include, no surgical drains , decreased blood loss, less postoperative discomfort and faster return to work. Over the past year all of out patients' surgeries with this technique have been performed on an outpatient basis. Similar short scar techniques can also be utilized for cosmetic and reconstructive (asymmetry) breast fits.
More about Breast Reduction >>
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