Saline
implants are made of a solid silicone shell filled with saline liquid.
Saline is salt water, a natural body fluid also used for intravenous
solutions.
These implants have been used successfully in
thousands of women for over 30 years, and are considered very safe.
They are the most common type of implant used in North America.
Saline
implants come in a variety of shapes. The round shape is used most
commonly for cosmetic breast augmentation, while the anatomic or
tear-drop varieties tend to be used more commonly in reconstructive
breast surgery.
The surface of a saline implant can be smooth or
textured. The smooth implants are most commonly used for cosmetic
breast augmentation. Textured implants are thought to decrease the risk
of capsular contracture (hardening), but they are more likely to cause
rippling (wrinkling) of the breasts. They are used more often for
reconstructive surgery, and for patients who have hardening of the
breasts from previous augmentation.
Cohesive Silicone Gel Implants
By Dr. Jerome Edelstein
Introduction
Cohesive
gel implants are the newest type of silicone implant. These implants
are filled with a thicker type of silicone. When you cut into a
cohesive gel implant, nothing oozes out. It is similar to cutting into
a gummy-bear or jello. In contrast, when you cut into a regular
silicone implant, the liquid silicone gel leaks out. Cohesive gel
implants have been used in Europe since 1995, and have been available
in Canada since 2000. In 2007, plastic surgeons in the United States
began using them as well. They are usually anatomically shaped and have
a textured surface, although smooth and textured round implants are now
available as well.
What are the advantages and disadvantages of cohesive gel implants ?
One
of the biggest advantages is that cohesive implants feel more natural.
They feel much more like a real breast. Compared to saline breast
implants, rippling is much less common with cohesive gels because they
are semi-solid. Deflation, which occurs with saline implants, does not
occur with cohesive gels. If a cohesive gel implant ruptures, it
maintains both its shape and integrity. As well, there are multiple
models of cohesive gel implants that vary with respect to projection,
height, and width. This provides flexibility in determining the
appropriate implant size to balance body proportions and breast
aesthetics. Cohesive gels generally produce less unnatural upper breast
fullness as compared to saline implants. A disadvantage of cohesive
implants is that they require a slightly larger incision for insertion,
because they are semi-solid. Due to this, these implants are often
placed through an incision in the fold under the breast
("infra-mammary"). If the nipple-areola is large enough, a nipple
incision could possibly be used instead. Dr. Edelstein is one of a
handful of plastic surgeons in Canada that can place smooth, round
cohesive gel implants through an armpit incision in carefully selected
patients. Cohesive implants are more expensive than saline implants.
Who should consider cohesive gel implants?
Cohesive
gel implants are indicated for women who are looking for a
natural-shaped and proportionate-sized breast augmentation. They are
especially suited to thin women who want to avoid the "feelability" of
saline implants. In thin women, saline implants can often be felt,
particularly over the outer-lower aspect of the breast. Cohesive gels are best for a "proportionate" augmentation in women with relatively symmetric breasts.
What should I do if I'm interested in cohesive gel implants ?
The
first step is to arrange a consultation with Dr. Edelstein. At the
consultation, Dr. Edelstein will discuss all aspects of the surgery
with you, including the various implant options available. He will also
review choices for incisions, whether to place the implant under the
breast alone, or under the breast and chest muscle, and the best size
for you depending on your personal goals and expectations.
Breast Augmentation FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Augmentation Mammoplasty (Breast Enlargement)
Introduction
Breast augmentation is a cosmetic procedure that uses implants to enlarge and shape the breasts.
The
female breast has become a symbol of nurturing, femininity, and
sexuality. Some women feel dissatisfied because their breasts never
developed to a size that meets their expectations. Others want to
restore their natural breast volume which may have decreased after
pregnancy / breast feeding, weight loss, or aging.
Improving the
size or shape of one's breasts often leads to improved self-image and
confidence, looking better in clothing, and better body proportions.
What type of anesthesia is used during the operation?
This
procedure is usually performed under General Anesthesia. An Anesthetist
is always present. If you have any particular problems with anesthesia,
please let us know.
How long is the operation?
The actual surgical time varies depending on the amount of surgery necessary for each patient, but usually is about 2 hours.
Where are the incisions made?
The
incision for breast augmentation can be made in one of three places.
The first type of incision is placed at or slightly above the crease
under the breast (infra-mammary incision). This is one of the most
common incisions because it allows for accurate placement of the
implant. The second incision type is placed along the lower border of
the pigmented skin around the nipple (peri-areolar incision). This
incision usually heals quite well, but this approach is not suitable
for women with very small nipples. The third incision is placed high in
the armpit (trans-axillary incision) eliminating scars on the breast,
but making accurate implant placement slightly more difficult.
What else is done during the procedure?
A
pocket is made for the implant. The pocket can either be made under the
breast itself (sub-mammary) or under the chest muscle (sub-pectoral).
Sub-mammary placement is usually used in women who already have some
breast tissue, or are slightly droopy. Sub-pectoral positioning is
usually used when a woman has little or no breast tissue so the implant
will be less "feelable".
The implant is a solid silicone shell
filled with liquid saline (salt water, a natural body fluid also used
for intravenous solutions). Implants filled with silicone gel have
recently come back on the market. The newest type of implant is the
'cohesive gel implant'. These implants are filled with a thicker type
of silicone. When you cut into a cohesive gel implant, nothing oozes
out. It is similar to cutting into a gummy-bear or jello. If you are
interested in cohesive implants, please see the link to 'Cohesive
Silicone Gel Implants' on the Home Page in the section 'Cosmetic Breast
Surgery'.
If droopiness or sagging of the breast is advanced, it
may be necessary to tighten up or 'lift' the breast in addition to the
augmentation.
How long is the hospital stay?
Breast
augmentation is an outpatient procedure, meaning you can go home the
same day once you have recovered from the anesthetic.
When are the stitches removed?
Stitches are removed between 10-14 days. Sometimes dissolving stitches are used that don't have to be removed.
What happens after the surgery?
Most
people feel tender and bruised after surgery, but are not in a great
deal of pain. Pain medication will make you comfortable. Immediately
after surgery, you will have a bandage and a bra on. A supportive
brassiere should be worn day and night for the first two weeks, and
then during the day for another two weeks.
You should plan to be
off work for 5-7 days. Mild exercise may be resumed after three weeks,
but strenuous exercise (for example, upper body weight training) should
not be started before six weeks. Special breast massage exercises will
be done to keep the breasts soft and help prevent excessive hardness
(scar capsule) from developing.
Drains are occasionally placed
to remove excess fluid when the implant is inserted through the armpit,
and will be removed within two or three days. Showering is permitted on
the 2'nd day after surgery. Scars will initially be red and a little
raised, but over 3-6 months they usually get lighter in colour and
flatten out.
What are the results?
Enlargement of
the breasts with improvement in shape. The scars are usually well
hidden. Most patients are very happy with their results.
What should I do if I'm interested in breast augmentation ?
The
first step is to arrange a consultation. At the consultation, I will
discuss all aspects of the surgery with you, including the various
implant options available. I will review choices for incisions, whether
to place the implant under the breast alone, or under the breast and
chest muscle, and the best size for you depending on your personal
goals and expectations.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also
affects your ability to heal, and I recommend that you stop smoking at
least 2 weeks before surgery. Aspirin, anti-inflammatory pills (like
anaprox or motrin), and vitamin E also should be stopped 2 weeks before
surgery because they can cause extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Incisions for Breast Augmentation
By Dr. Jerome Edelstein
A
small incision is made for inserting a breast implant. Typically, the
incision is 3 - 4cm (1 - 1.5 inches) in length. A permanent scar will
remain where the incision was made. Every effort is made to ensure that
the scar is as inconspicuous as possible. Scars will initially be red
and a little raised, but over 3 - 6 months they usually get lighter in
colour and flatten out. The scars are usually very well hidden.
The incision for breast augmentation can be made in one of three places:
1) INFRA-MAMMARY INCISION:
The
first type of incision is placed at or slightly above the crease under
the breast. This is one of the most common incisions because it allows
for the most direct access to the breast implant pocket, making
accurate placement of the implants quite predictable. It also leaves
the actual breast tissue completely undisturbed, minimizing any effects
on breast-feeding and nipple sensation.
2) PERI-AREOLAR INCISION:
The
second incision type is placed along the lower border of the pigmented
skin around the nipple. This incision is commonly used in women with a
poorly defined fold under the breast, as long as their nipple size is
not too small. It is a popular incision and usually heals quite well.
3) TRANS-AXILLARY INCISION:
The
third type of incision is placed high in the armpit. The benefit of
this incision is that it eliminates scars on the breast itself. The
trans-axillary incision is commonly used in women with poorly defined
folds under the breast and small nipples. Although a scar is avoided on
the breast, it is important to remember that there will be a scar in
the armpit, which may become an issue when wearing certain clothing
styles or bathing suits. Since the incision is somewhat remote from the
implant pocket, accurate implant placement is slightly less
predictable. A scope (endoscope) is often used to perform the surgery
to improve predictability.
There is no single incision that
is ideal for every patient. At your consultation, Dr. Edelstein will
help you decide which incision option is best for you, keeping in mind
your personal desires.
Implant Pocket Selection
By Dr. Jerome Edelstein
When
a breast augmentation is performed, a pocket is created for the breast
implant. The pocket can either be made under the breast itself
(sub-mammary), or under both the breast and chest muscle (sub-pectoral).
· SUB-MAMMARY POCKET:
In the sub-mammary approach, the implant is placed between the breast tissue and the chest muscle.
This
position is often recommended for women who already have a fair amount
of breast tissue, and who may also have a mild degree of breast
droopiness. Having a moderate amount of breast tissue will help to
conceal a sub-mammary implant. As well, mild amounts of breast
droopiness will be corrected. Sub-mammary placement is also
recommended for unusually shaped breasts since the implants will help
to change the shape of the breast better than sub-muscular implants.
Finally, professional, competitive body builders are usually better off
with implants placed above the chest muscle.
· SUB-PECTORAL POCKET:
In
the sub-pectoral approach, the implant is placed under both the breast
and chest muscle. The chest muscle covers the upper 2/3 of the implant,
while the bottom 1/3 is covered by your natural breast tissue. This
helps to provide a natural, tear-drop shape to the breast.
In
general, sub-pectoral placement is more common than sub-glandular. The
sub-pectoral approach is recommended for women who have minimal amounts
of breast tissue. Since the chest muscle covers the implant, it will
act like extra padding, making the implant less 'feel-able' and
'see-able'. Other advantages include a lower risk of capsular
contracture (hardening of the breasts), and making mammograms easier to
read (for example, in a woman with a family history of breast cancer).
There
is no single approach that is ideal for every patient. At the time of
your consultation, Dr. Edelstein will help you to decide which option
for implant pocket placement is best for you, keeping in mind your
personal goals and expectations.
Choosing Your Implant Size
By Dr. Jerome Edelstein
One
of the most common questions women have is "What implant size do I
choose?". There are several methods that can help you to choose the
right implant size:
1) Your Consultation:
Dr.
Edelstein recognizes that every woman will have her own unique goals
and expectations. He will assist you in making this important decision.
At your consultation, Dr. Edelstein will take a number of measurements
of your breast and chest dimensions, as well as your height and weight.
These measurements greatly help in determining which implant size is
right for your particular body size.
At your pre-operative
visit, you will have the opportunity to try on a variety of sample
implants to see which size best suits your taste. Bring a bra and a
tight-fitting T-shirt to this appointment.
2) The Rice (or Water) Test:
Get
a baggie and a measuring cup. Fill the baggie with various quantities
of rice (or water). Note that measuring cup milliliters are equivalent
to cc's (breast implant sizes are usually in cc's). Tie the baggie,
place it into your bra, and put on a tight-fitting T-shirt. Experiment
with different sizes and you will start to appreciate how you will look
with various implant sizes. Keep in mind that the baggie will make you
look bigger than a breast implant of the same size (because the implant
will be more compressed when it is inside the body).
3) Talk to a Friend: Many
women have friends or acquaintances who have undergone breast
augmentation. Knowing their implant size may help you in choosing what
will be best for you.
4) Look at Photographs: There are a
variety of websites that show before and after photos. Usually they
tell you what implant size was used (in cc's). Keep in mind that every
woman is unique, and that photos of one particular woman may not
necessarily represent the result you will obtain with the same implant
size.
Breast Augmentation Toronto Ontario FAQ's
By Dr. Jerome Edelstein
What happens after the surgery?
Most
people feel tender and bruised after surgery, but are not in a great
deal of pain. Pain medication will make you comfortable. Immediately
after surgery, you will have a bandage and a bra on. A supportive
brassiere should be worn day and night for the first two weeks, and
then during the day for another two weeks.
You should plan to be
off work for 5-7 days. Mild exercise may be resumed after three weeks,
but strenuous exercise (for example, upper body weight training) should
not be started before six weeks. Special breast massage exercises will
be done to keep the breasts soft and help prevent excessive hardness
(scar capsule) from developing.
Drains are occasionally placed
to remove excess fluid when the implant is inserted through the armpit,
and will be removed within two or three days. Showering is permitted on
the 2'nd day after surgery. Scars will initially be red and a little
raised, but over 3-6 months they usually get lighter in colour and
flatten out.
What are the results?
Enlargement of
the breasts with improvement in shape. The scars are usually well
hidden. Most patients are very happy with their results.
What should I do if I'm interested in breast augmentation ?
The
first step is to arrange a consultation. At the consultation, I will
discuss all aspects of the surgery with you, including the various
implant options available. I will review choices for incisions, whether
to place the implant under the breast alone, or under the breast and
chest muscle, and the best size for you depending on your personal
goals and expectations.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also
affects your ability to heal, and I recommend that you stop smoking at
least 2 weeks before surgery. Aspirin, anti-inflammatory pills (like
anaprox or motrin), and vitamin E also should be stopped 2 weeks before
surgery because they can cause extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Liposuction Toronto Ontario FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Liposuction
Introduction
Liposuction
is a surgical procedure designed to improve body shape and contour by
removing fatty deposits. It is the most common plastic surgery
procedure done in North America. In women, the most common areas
treated are the waist, hips, and thighs. Men most commonly want their
abdomen treated (the ?spare-tire?). Other areas that can be treated
include the knee region, calves, upper arms, and chin. Some cases of
excess breast development in men can be treated as well.
Liposuction
should not be considered a substitute for weight reduction. The best
results are seen in people with average body weights and firm skin tone
who can?t get rid of fatty deposits despite diet and exercise. The
reality is that certain areas of fat are resistant to diet and exercise
- this is where liposuction can help.
What type of anesthesia is used during the operation?
This
procedure is usually performed under General Anesthesia. Small areas
can occasionally be done under Local Anesthesia with sedation to help
you relax. An Anesthetist is always present. If you have any particular
problems with anesthesia, please let us know.
How long is the operation?
This
very much depends on the number of areas that are going to be treated,
and whether liposuction is going to be combined with other procedures
such as a tummy-tuck. The duration varies between 1 and 6 hours.
Where are the incisions made?
The
incisions are very small, no more than 1 centimeter, placed
inconspicuously in a natural skin fold or crease adjacent to the area
being treated.
What else is done during the procedure?
A
thin, long, hollow tube, called a cannula, is inserted under the skin
through the small incision. First, a salt water and anesthetic solution
is injected - this is called tumescent liposuction. If ultrasonic
liposuction is also used, an ultrasound probe is then inserted into the
fat. Vibration of the probe liquefies the fat. Finally, a high pressure
suction machine removes the fat as the cannula is moved back and forth
underneath the skin. Tumescent and Ultrasonic Liposuction are the state
of the art in this type of surgery. They help to reduce bruising and
swelling, and to speed recovery.
How long is the hospital stay?
Liposuction
is usually an outpatient procedure, meaning you can go home the same
day once you have recovered from the anesthetic. If very large areas
are going to be treated, you may have to stay overnight and go home the
day after surgery.
When are the stitches removed?
Stitches are removed between 7-10 days. Sometimes dissolving stitches are used that don?t have to be removed.
What happens after the surgery?
Most
people feel tender and bruised after surgery, but are not in a great
deal of pain. Pain medication will make you comfortable.
You
should plan to be off work for 4-7 days. During that time you are
encouraged to go for leisurely walks. Athletic activities usually have
to wait until 3-4 weeks.
A support garment is worn for 6 weeks -
night and day for the first three weeks, and then during the day for
another three weeks. This garment will help reduce swelling and conform
the skin to your new shape. Showering is permitted on the 3?rd day
after surgery. Massage of the treated areas will begin 7-10 days after
surgery to help decrease the swelling faster and to smooth out any
irregularities. Scars will initially be red and a little raised, but
over 3-6 months they usually get lighter in colour and flatten out.
What are the results?
Good
improvement in your shape can be predictably achieved. The scars are
usually well hidden. Most patients are very happy with their results.
Is liposuction permanent?
The
procedure re-contours the body by reducing the number of fat cells.
This is permanent. If one does gain a significant amount of weight, the
fat cells that do remain can enlarge diminishing the benefits. Overall
contour, however, remains improved.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also affects your ability to heal, and I recommend that you stop smoking at least 2 weeks before surgery.
Aspirin, anti-inflammatory pills (like anaprox or motrin), and vitamin
E also should be stopped 2 weeks before surgery because they can cause
extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Tummy Tuck Toronto Ontario FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Abdominoplasty (The Tummy Tuck)
Introduction
Abdominoplasty
(tummy-tuck) is designed to remove excess skin and fat from the
abdominal (tummy) region, resulting in a flatter, tighter stomach and a
thinner waistline.
Loose folds of skin are removed, fat is
reduced, and the muscles are tightened (muscle tightening helps to
improve protrusion of the lower abdomen, creating a flat contour).
Abdominoplasty
should not be considered a substitute for weight reduction. The best
results are seen in people with average body weights who can?t get rid
of hanging folds despite diet and exercise. The surgery is especially
beneficial after pregnancy, as well as in older patients with loose
skin, and after numerous weight gain and loss cycles.
What type of anesthesia is used during the operation?
This
procedure is performed under General Anesthesia. An Anesthetist is
always present. If you have any particular problems with anesthesia,
please let us know.
How long is the operation?
The actual surgical time varies depending on the amount of surgery necessary for each patient, but usually is about 4 hours.
Where are the incisions made?
The
incision is usually made across the lower abdomen, a little above the
pubic area and beneath the bathing suit line. An incision is also made
around the belly button to free it from the surrounding skin.
What else is done during the procedure?
After
tightening the underlying muscles, the excess skin and fat is removed.
The incisions are then sutured and the belly-button brought out through
a new opening in it?s natural location. Liposuction is sometimes also used to help reduce bulges, achieving an optimum result.
Occasionally,
a ?mini?-tummy tuck can be done when loose skin is present only below
the belly-button. The advantages of this procedure are that the
incision is shorter, and no incision is needed around the belly-button.
How long is the hospital stay?
Most patients stay overnight and go home the day after surgery.
When are the stitches removed?
Most
of the stitching is dissolvable and woven under the skin to prevent
stitch marks. Stitches around the belly-button are non-dissolvable and
will be removed 2 weeks after the surgery.
What happens after the surgery?
Immediately
after surgery, the skin will feel tight. For the first 2-3 days, you
are encouraged to walk slightly bent forward to avoid pulling on the
incision line, and to put pillows under your knees when you?re
reclining. Most people feel tender and bruised after surgery, but are
not in a great deal of pain. Pain medication will make you comfortable.
This procedure is much less painful than regular abdominal surgery (eg
gall bladder) because we don?t go into the inner abdominal cavity.
You
should plan to be off work for 2 weeks. During that time you should
take it easy - a little walking is okay but not much more. Avoid
straining, lifting, and bending completely over. Strenuous physical
activity (like lifting weights or sit-ups) is not permitted until 6
weeks after surgery. An abdominal support garment is worn for 6 weeks -
night and day for the first four weeks, and then during the day only
for another two weeks.
Drains are usually placed to remove any excess fluid under the skin, and will be removed within 1 week. Showering is permitted after the 1?st post-operative visit. Scars will initially be red and a little raised, but over 3-6 months they usually get lighter in colour and flatten out.
What are the results?
A
nice flattening of the stomach with removal of excess rolls. Loose skin
and stretch marks are improved. The scar is nicely hidden in the
underwear. Most patients are very happy with their results.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also affects your ability to heal, and I recommend that you stop smoking at least 2 weeks before surgery.
Aspirin, anti-inflammatory pills (like anaprox or motrin), and vitamin
E also should be stopped 2 weeks before surgery because they can cause
extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Browlift FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Browlift (Forehead Lift)
Introduction
Browlift
(forehead lift) is a cosmetic procedure designed to decrease the excess
skin or ‘hooding’ in the upper eyelids, elevate the eyebrows, and
decrease the deep creases of the forehead and frown lines between the
eyebrows.
Aging, gravity, and excessive forehead muscle activity
causes drooping of the eyebrows and deep forehead wrinkles. This
creates a heaviness around the upper eyelids that often makes a person
look constantly sad, angry, or tired.
Browlift leads to a more youthful appearance of the upper eyelids and eyebrows, as well as a smoother forehead.
What type of anesthesia is used during the operation?
This
procedure can be performed under General Anesthesia, or, Sedation and
Local Anesthesia (injected freezing). An Anesthetist is always present.
If you have any particular problems with anesthesia, please let us know.
How long is the operation?
The
actual surgical time varies depending on the amount of surgery
necessary for each patient, but usually is about 2 to 3 hours.
Where are the incisions made?
Most
commonly, a forehead lift is done using an endoscope, a small internal
telescope. The procedure is called an endoscopic browlift. This allows
Dr. Edelstein to make several small incisions behind the hairline
instead of one long incision across the scalp (called a coronal
browlift).
Occasionally, if a patient has a very high forehead,
placing the incision behind the hairline is not advisable as it can
raise the hairline even further. In these cases, an incision right at
the hairline may be recommended as an alternative.
What else is done during the procedure?
Through
the small incisions behind the hairline, the forehead and eyebrows are
raised to a more youthful position. This position is maintained by
fastening the scalp to the underlying bone. The muscles of the forehead
are then sculpted to decrease the deep wrinkles and furrows.
Commonly, browlift is combined with upper eyelid surgery to maximize the rejuvenation of this area.
How long is the hospital stay?
Browlift is an outpatient procedure, meaning you can go home the same day once you have recovered from the anesthetic.
When are the stitches removed?
Stitches are removed between 10 and 14 days.
What happens after the surgery?
Most
people feel tender and bruised after surgery, but are not in a great
deal of pain. Pain medication will make you comfortable. Some swelling
and bruising will occur around the upper eyelids for the first few
days. The majority of the swelling will be gone within one week, while
some bruising can last up to two weeks.
A dressing is not
necessary after browlift, only the application of an antibiotic
ointment. Drains are usually placed to remove any excess fluid under
the skin, and are removed the day after surgery. Showering is permitted
after the drain is removed.
Usually, you are back to normal activities within one to two weeks.
What are the results?
Your
forehead will appear smoother and your eyebrows and upper eyelids will
look more youthful. Often, the face appears ‘brighter’, with less of a
tired or sad look. Most patients are very happy with their results.
How long do the results last?
Plastic
surgery helps to turn back the clock, but the clock keeps on ticking.
For example, if a particular procedure makes you look 10 years younger,
you can expect to look similar to today in 10 years time. This is not a
hard and fast rule, but serves to illustrate the concept that you will
continue to age after having plastic surgery.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also affects your ability to heal, and I recommend that you stop smoking at least 2 weeks before surgery.
Aspirin, anti-inflammatory pills (like anaprox or motrin), and vitamin
E also should be stopped 2 weeks before surgery because they can cause
extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Gynecomastia (male breast) FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Gynecomastia
Introduction
Gynecomastia
refers to enlargement of the male breast. In the vast majority of men,
there is no known cause. Gynecomastia treatment involves the removal of
fat and breast tissue, resulting in a chest that is flatter and better
contoured.
The surgery should not be considered a substitute for
weight reduction. The best results are seen in men with average body
weights and firm skin tone. Also, certain drugs (eg. marijuana,
anabolic steroids) and medical conditions (eg. liver disease) can
aggravate gynecomastia - these should be dealt with before considering
gynecomastia surgery.
What type of anesthesia is used during the operation?
This
procedure is usually performed under General Anesthesia. An Anesthetist
is always present. If you have any particular problems with anesthesia,
please let us know.
How long is the operation?
The procedure takes up to 2 hours.
Where are the incisions made?
Two
incisions are usually made for each breast. The incisions are very
small, no more than 1 centimeter, placed inconspicuously near the
armpit, adjacent to the flat part of the nipple (the ‘areola’), or at
the outer edge of the fold under the breast.
What else is done during the procedure?
Gynecomastia
is most commonly treated with ultrasonic liposuction. First, a salt
water and anesthetic solution is injected - this is called tumescence.
An ultrasound probe is then inserted into the fat and breast tissue.
Vibration of the probe liquefies these tissues. Finally, a thin, long,
hollow tube, called a cannula, is inserted under the skin through the
small incision. A high pressure suction machine removes the fat and /
or breast tissue as the cannula is moved back and forth underneath the
skin. Tumescent and Ultrasonic Liposuction are the state of the art in
this type of surgery. They help to reduce bruising and swelling, and to
speed recovery.
Much less commonly, it is necessary to make a
longer incision part way around the nipple in order to remove breast
tissue under the nipple. Rarely, excess skin also needs to be removed.
How long is the hospital stay?
Gynecomastia
surgery is usually an outpatient procedure, meaning you can go home the
same day once you have recovered from the anesthetic.
When are the stitches removed?
Stitches are removed between 7-10 days. Sometimes dissolving stitches are used that don’t have to be removed.
What happens after the surgery?
Most
people feel tender and bruised after surgery, but are not in a great
deal of pain. Pain medication will make you comfortable.
You
should plan to be off work for 4-7 days. During that time you are
encouraged to go for leisurely walks. Athletic activities usually have
to wait until approximately 3 weeks.
A support garment is worn
for 6 weeks - night and day for the first three weeks, and then during
the day for another three weeks. This garment will help reduce swelling
and conform the skin to your new shape. Showering is permitted on the
3’rd day after surgery. Massage of the treated areas will begin 7-10
days after surgery to help decrease the swelling faster and to smooth
out any irregularities. Scars will initially be red and a little
raised, but over 3-6 months they usually get lighter in colour and
flatten out.
What are the results?
Reduction in
the size of the breasts can be predictably achieved. The scars are
usually well hidden. Most patients are very happy with their results.
Is it permanent?
The
procedure re-contours the body by reducing the number of cells. This is
permanent. If one does gain a significant amount of weight, however,
the cells that do remain can enlarge diminishing the benefits. Overall
contour, however, remains improved.
Some additional points:
Make
sure you let me know your complete medical history as well as any
medications, drugs, vitamins, or natural herbs you are taking. For
example, diabetes is known to affect wound healing. Smoking also affects your ability to heal, and I recommend that you stop smoking at least 2 weeks before surgery.
Aspirin, anti-inflammatory pills (like anaprox or motrin), and vitamin
E also should be stopped 2 weeks before surgery because they can cause
extra bleeding.
I strive to make sure all my patients are well informed. Your questions are more than welcome.
Botox FAQ's
By Dr. Jerome Edelstein
Frequently Asked Questions About Botox
Introduction
Botox
is used to treat wrinkles and lines created by the movement of muscles
under the skin over long periods of time. It is most commonly used for
wrinkles between the eyebrows created by frowning, the lines on the
forehead due to repeatedly raising the eyebrows, and the wrinkles
beside the eyes, often called crow?s feet, which are caused by smiling
or squinting.
What is Botox ?
Botox is a substance
produced by a bacterium called Clostridium Botulinum. The drug works by
weakening the muscles that cause wrinkles. After injection, the muscle
gradually relaxes, and the lines diminish substantially or completely
disappear.
How is Botox injected ?
The treatment
takes only a few minutes. A very tiny needle is used to inject the
appropriate muscles. There is minimal discomfort from this procedure,
and pain medication is not necessary.
Where can Botox be used ?
As
was mentioned in the Introduction, the most common areas are the frown
lines, forehead lines, and crow?s feet. Other areas include the upper
lip and neck.
Is there any danger of botulism from Botox ?
No. The amounts of Botox used for wrinkle treatment will not cause botulism.
How long will it last ?
Botox
usually takes 2 or 3 days to start to work, and will continue to
improve over the first 7 to 10 days. The improvement will last up to 6
months. Once the effect starts to wear off, you will need a repeat
treatment to continue the anti-wrinkle result. Some find that the
effects last longer after having multiple treatments, even up to a year.
What are the side effects ?
The
side effects are generally related to the injection of the solution.
There may be a slight discomfort from the needle, and a chance of a
small bruise. A rare side effect is temporary drooping of one eyelid.
This is short lived and is quite uncommon in the hands of an
experienced surgeon.
Who should not have Botox ?
Botox should not be used on patients who are pregnant, breast-feeding, or have a neurological disorder.
