Breast Implants ~ what causes rippling?

by Terrye Tebbetts

I recently joined a conversation between several women about what causes rippling in breast implants and was amazed to find all focused on the filler of the implant.  The debate was whether saline breast implants wrinkled more than silicone.  Although filler should be considered, there are several other significant factors that effect rippling.  One lady in particular described herself as a fairly slight woman of 115 lbs, wearing a 34AA now and had not had any babies – so no stretch to her breast envelope yet - – for her and all like her, it is important to remember that it is not just the filler of the implant that you must consider.

There are two basic types of rippling – 1.  Caused by ANY implant that is underfilled  – saline or silicone – the more underfilled they are the more the shell collapses and thus the rippling.  2.  Traction rippling – again – ANY implant that is too big – too heavy for you, will put excessive weight on your tissues and cause the pulling or traction rippling that is so very common in thin women with big implants and then they bend over……we have all seen it and it isn’t pretty and traction rippling is entirely preventable!!!  You avoid it with wise, well thought out implant size choices before surgery.

This young woman of 20 years and her plastic surgeon are planning on using a  425 cc breast implant.  I would ask that surgeon seriously about the risks of traction wrinkling and rippling with those implants in your body.  It would just be nice to know if that choice of size (let alone filler) will present a significant risk of deformity.  If so, backing off the size and weight will help reduce that risk – -  being willing to adjust expectations ie not being able to safely attain the size you dream about, but in the end having breasts that will still be bigger than they are now and prettier sans the rippling effect!

Once faced with reality, most patients will consider adjusting and balancing their expectations – honesty goes a long way.  No one goes into breast augmentation surgery wanting a disaster or a re-do!  This particular patient’s final comment was something to the effect of, “I am just trying to get my money’s worth.”  This is a concern most all women have when they look into breast implants, but getting value out of your choices and being happy with your result, you may find, comes in lots of different forms other than SIZE!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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Before and After Photos of Breast Augmentation

by Terrye Tebbetts

Before and after photos have always been a part of plastic surgery – a way to judge the quality of the result.  But with the advent of the Internet, suddenly the role of photos in plastic surgery are changing……

“I went to what I thought was going to be my last consult and really liked the doctor except for one thing. Not only did he not have ANY before and after photos in the office( he says bc patients and their husbands don’t want pics of their boobs on the net) which doesn’t make sense to me bc why would they care if there are pics on a site intended for breast aug and PLUS no one would ever know it was them anyways. I can see how there would be some…maybe even quite a few paranoid pep. that would object but you would think at least 30% or so would consent right??
I know that having no pics is a red flag and I’m wondering if anyone else experienced this? The previous doc I went to had only 4 or 5 photos on the site but had a whole book in the office for me to look at. ”

Dr. Tebbetts and I are a classic example of the photo dilemma.  We don’t publish photos on our website, but have them in our book and a large book of before and afters in our office for patients to look at if they would like to.

The main problem with photos is that patients will use them to “shop” for their result.  You look for some one that is about your age, your height, your weight, had the same number of babies and you see if you like their result…..or if you have an implant size in mind – you look at before and afters with that size and decide if it’s right for you.  This type of “shopping” is dangerous – - because no matter how much that lady sounds like you, she isn’t you and her result has nothing to do with you and your body, your breast tissue and your ps.

Before and after photos should be used to see and review a large body of work of the surgeon you are interested in – you may like some and hate some – but all the afters should be an improvement to the befores!  Use photos wisely and they can be a tremendous help to you as you chose a surgeon – giving you an added layer of comfort in your choice.

Bottom line, all surgeons should have photos to show you – they may not publish them in a book, or on the net, but there should be some for you to review.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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High Profile Breast Implants – the new wears off, now what??

by Terrye Tebbetts

I received this email from a lady who is experiencing a very common dilema.  Several years after getting breast implants and at the time deciding that BIGGER is better and going for it all – big implants and High Profile implants – she is now realizing that they are too big and “get in the way”.  I think the thing that disturbs me most is all the angst surrounding size – because I live in the John B. Tebbetts, M.D. world of the High Five Measurement System, there is never any angst about what size breast implant to chose for a patient – never – because the patient’s body choses the size – it is the correct amount of fill EVERY time!  Read on….

“I have 425 high profile implants now that I had placed
with a full lift almost 6 years ago.
They are way too big for me and i don’t like the fullness at the top of
my breast.  I am very active and these
just get in my way.  Also I’m having a
hard time with wearing certain clothes as most everything I try on is way too
tight across my chest yet fits great everywhere else.

I am scheduled for revision surgery and
have chosen 300 low profile implants.  My
concern is the diameter of the 300 low as it is 12.6cm and the diameter of the
implants I have now is 12cm.  Therefore will my new implants be too wide for my frame.  Also I’ve heard low profile implants have a “droopy” look over time.  What is your opinion of low profile implants? I do want a natural looking implant and yet everything that I’ve found on the internet says that most PS don’t use the low implants much.

I don’t see much of a difference between the high and the moderate as far as projection which is why I chose the low (my PS did give me the option of 339 cc moderate profiles).  I should mention these are silicone implants.  I was also thinking about going with the 270 low profile as the diameter is comparable to what I have now (12.2).  The reason my PS chose the 300 over the 270 was to improve my cleavage. Can you please give me your honest opinion?  I want to make the right choice. ”

Living and dying by the measurement system has been the saving grace that keeps me sane in this business – I think it makes the decision to have breast implants for our patients much easier and comfortable, safe and enjoyable because they are not worried that they made the right decision – - their body made the choice.

Although you have implants now and it will be a bit more difficult, it would still be helpful to try to get a few of the measurements from the sheet.  I am copying Krystin on this note, when our office opens again tomorrow, she will email you the High
Five Sheet.

How did your current ps come up with 300 or 339?  Do you know what the base width of your breast is now?

High profile implants can be really dangerous to the breast tissue over time because of the pressure they put on the tissue (the extra force) – - they are more narrow than most implants so that they can concentrate the volume and thus the pressure outwards.  So I am not surprised the others recommended now are wider – what we are missing is the width of your breast – - if the implant chosen is wider than your own breast – you will see implant edges.

Nothing makes cleavage – - – the space between your breast is call the intermammary distance – the area over your sternum – if it’s
4 cm wide – it will always be that – -implants should NEVER be used to try to
close that distance – doing so creates symmastia (one big una-boob) that is not
surgically correctable.  Take having more
cleavage off your wish list and buy a really good bra!

What makes a pretty natural breast is an implant that is
the CORRECT amount of fill for your breast envelope – - you don’t like the
425′s because they are too big (producing too much upper fullness).  Getting a natural look this time around, will
mean simply filling the empty space.
It’s not so much about profile – it is about the correct amount of
volume.

Until we have measurements all we have is conjecture ……and more angst!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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Breast Implants and Rice Bags ~ planning surgery in a dream world

by Terrye Tebbetts

I offer to share our High Five Measurement sheet with anyone who is actually interested in determining breast implant size based on what their tissue will allow.  I recently received a request from this young lady and gladly sent her the sheet, then got this note back from her….

Hi Terrye,

I have just had my first consultation.  I go on the 2nd of December for my
sizing and pre-op.  At that appt. my surgeon told me to use bags filled
with rice in a bra.  I am to bring them to the next appt
so she could look at those and get a pretty good idea of what to
use.  I am sure she will measure then too.  Or at least I would
hope.

Thanks so much!!

If a surgeon is asking you to bring in BAGS of RICE from home to your preop appointment to determine size – - I doubt that surgeon is going to consider using clinical, objective measurement systems like the High Five System to plan your operation.  The bags of rice stuff in your bra tell them what you want and they are simply, most likely going to give you what you want with no consideration for what your body will safely allow you to have.  Pushing tissue to a desired size is asking for trouble in the long run.  Yes, you will temporarily get what you want but sooner or later the weight of what you asked for will start to succumb to gravity and time and then you will find yourself back in the operating room.

Breast augmentation is a surgery that will change your body forever.  Isn’t it time we started treating it like a medical procedure again and not a new hair cut?  Seeking surgeons that will treat you like a patient and less like a client will ultimately hopefully yield not only a result that meets your expectations – your wishes, but will also respect your tissues.

Where is the medicine in plastic surgery?

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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Mammograms after Breast Implants – a personal experience in Dallas

by Terrye Tebbetts

Today I went for my second annual mammogram with implants so while it is fresh on my mind, I wanted to share it with you ladies. I was supposed to check in at 3 pm with my mammogram scheduled for 3:15 – but I was a tad bit late, so I checked in at 3:15 and I was in my car headed to carpool pick up at school at……wait for it……3:45!! I swear it took longer to fill in my new insurance information on the in take forms than it did to do the actual views! Thank you so much, Tammy, my tech, for taking such good care of me!

Since I have implants, they had to do 8 views instead of 4. I asked Tammy if they still called them Ecklund views and she said yes but most commonly they use the term “push back” views with patients. She did the push back views first – I promise you – no pain – no discomfort! I love the new digital machines!! Then she did the regular views and honestly – the only one uncomfortable in that series is where they try to get a view up in your axilla (under your arm) to view the lyph nodes and even it did not hurt it was just uncomfortable for about 2 minutes.

She also explained that you get more radiation on a flight from Dallas to LA than in a mammogram. And with this new technology she did not even have to wear a protective vest and yet stayed in the room with me the whole time – and all the other women she had done mammogams on all day long.

Bottom line – do not fear a mammogram – physically it is not bad – - although we will always fear the unknown – but with the advances made in breast cancer today – - and with early prevention cures are possible. So it is better to know than to be in the dark – - with or without breast implants.

In our practice we require all patients who want to have breast implants that are over 30 years old to have a baseline mammogram so that when they hit 40 and need to go every year, they have a great baseline for comparison and to send it to their OBGYN as well as to us. Some surgeons don’t but because Dr. Tebbetts was a general surgeon before he was a plastic surgeon, he feels it is really important to have that baseline – - to be sure the breast you augment is healthy but also so that once that patient needs regular mammograms, there is a base line comparison that is available to the radiologist.

I will be the first one to admit, that even though I know, I was nervous – flipping though magazines I never would want to read while sitting there in the wierd poncho cover deal……but in the end it is worth it and it is not bad at all!

 

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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Breast Augmentation Recovery in Dallas

by Terrye Tebbetts

I absolutely love getting these kind of notes from patients! Who wouldn’t? Here’s another 24 Hour Recovery Experience…..

Hi Terrye!

I just wanted to write and check in! I’m at just over 7 weeks post-op, and have stuck to the instructions given to me. I have had no complications, and my breast augmentation recovery has been amazing, especially compared to everyone else I know who has had a breast augmentation. I am extremely happy with my size and results, and am SO happy that I took the time to research and go to Dr. Tebbetts! It has been an amazing experience- I almost wish I could do it all again!

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Tell Tale Signs of Recovery to Come – Breast Augmentation Recovery

by Terrye Tebbetts

I ran across this post from a lady who shared what her pre-op appointment for breast augmentation surgery was like and it jolted me – actually nauseated me!  I forget how easy Dr. Tebbetts has actually made breast augmentation surgery and breast augmentation recovery for patients!!  Here’s how her pre-op appoiment went…”Just thought I would share with you all…. I had my pre-op appointment today and my surgery is in one week. I am supposed to wash with anti-bacterial soap for three days before surgery, take an antibiotic after surgery, take a stool softener for a couple days before surgery, wear an anti-nausea patch the night before and a few days later. I also got a muscle relaxer and oxycodone, and arnica. I am going to have to wear a band after surgery, and do some massage, but otherwise he said no special bra required. Maybe just a shelf cami.”

Ok – really???  What you read above tells you what her recovery will be like – awful – full of constipation and pain and nausea and bruising and straps and bands!!

Dr. Tebbetts’ patients with 24 Hour Recovery Breast Augmentation take no pain meds, no muscle relaxers, no herbs to prevent bruising and wear no post op surgical bands or straps.  Tebbetts’ preop or lab appointment consists of having blood work drawn, a nasal swab for MRSA, completing paperwork for surgery and going over instructions about what to do the night before and after surgery – and all instructions are sent home with the patient for review and comfort.  The only thing our patients have to take after surgery are an antibiotic for 5 days and Ibuprofen to help with the normal movement.

There is no pain because what happens in the operating room is radically different!  If a surgeon is telling you to fill your Rx for Oxycodone and muscle relaxers – my bet is that it’s going to be a rough time in the old OR that night!!

If you want a better breast augmentation recovery – you have to look for, find and demand better surgical techniques in the operating room – an advanced level of skill from your surgeon and his or her OR team.

Having breast implants is an elective procedure – it is something you WANT for yourself.  There are much more sophisticated and advanced methods of doing this for you that not only provide you with an immediate 24 Hour Recovery but reduce your risk of reoperation long term.  This level of redefined experience for you has been in place in Dallas Texas and offered for 18 years – this level of breast augmentation recovery is Dr. Tebbetts contribution to patients!

Demand more from your experience.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

 

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You Get What You Pay For – the Surgical Facility fee

by Terrye Tebbetts

When considering breast augmentation, I don’t think many patients give much thought to where the actual surgery will be performed. Once they have chosen a surgeon they trust, patients generally get into a sheep mentality and are just herded along through the balance of the surgical process – which is ok – provided they have done their due diligence and research BEFORE the round up begins. If Surgeon SOandSO,MD is several thousand less than Dr. X – yet the surgeon fees are comparable, the implant fee is the same – - how can Dr. SOandSO charge so much less???

If you recieve a break down of all fees involved in breast augmentation surgery, it should include some type fee for a surgical facility. A breast implant procedure can be done in a hospital, a small surgical center, an accredited surgical facility, or an office operating room. Fees for all will range widely.

Having surgery in a hospital, a small surgical center or an accredited surgical facility should all run about the same price range. Breast augmentation surgery facility fees in Dallas, for example, can run any where from $1100 – 1500.00 for the first hour of time in the operating room. It will be important to ask your surgeon how long the procedure will take in the operating room and verify if you are paying a one time fee or if you will be billed by the surgical facility for extra time or fees depending on the length of surgery. Sometimes lab fees are included in the surgical facility fee – but sometimes, they are additional – and costly, so it is important to understand what the fee you will pay for your surgical facility includes.

Surgical facilities like hospitals and accredited centers have certain levels of quality control and safety precautions that must be met for them to be in good standing and retain their licenses to operate. For example, Dr. Tebbetts’ AAAA surgical facility must be peer reviewed, charts are randomly sent in for peer review, an independant pharmacist must come in and verify all drugs, there must be an emergency evacuation agreement with a large hospital near the faciliy, it must maintain emergency crash cart equipment and medications and most importantly – - breast implant surgeons must maintain priveleges at other facilities (thus receiving peer review of surgical techniques and skills).

An office operating room or procedure room, on the other hand, may or may not be held to the same standards – no outside peer review, no quality standards to be met or and no emergency arrangements. Most importantly, it would allow a surgeon to operate in his own office while he or she may have been denied priveldges at larger accredited facilities. If you are simply given a total for the procedure, with no break down, how will you know what type of facility your surgeon uses? How will you be able to determine if that facility meets the highest standard of care and safety? If there is little or no fee for the surgery facility – that should be a BIG red flag waving in your face!

When contemplating any type of surgical procedure, let alone, an elective one like breast augmentation — do you really want to skimp on the surgical facility? Would a cheaper hospital price really make you feel better and safer about your upcoming breast implants? In the end, you do get what you pay for – if the OR is cheap – I can guarantee you it is your safety that is being skimped on!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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You Get What You Pay For ~ breast implant fee

by Terrye Tebbetts

The cost of a breast augmentation is often lumped into one total sum. Breaking this total apart and understanding it’s pieces is crucial to making an informed decision about having breast augmentation surgery. One of the very first things we advise patients to be prepared for in The Best Breast 2, is the financial end of deciding to have breast implants. If you are not in a financially safe position, spending money on anything that is not essential will ultimately cause drama and trouble in the end. If you are financially secure and prepared to spend on an elective procedure, you will still want to make quality, careful decisions about what you spend on a breast surgery procedure – - because in the end, you do get what you pay for.

After deciding on a surgeon and qualifying the fee per his or her experience and specialization in breast augmentation techniques and breast augmentation recovery, then you must decide on which implant to use. Some patients chose an implant based on what their friends have, some on safety issues, some on how natural they think it will be and some based purely on the surgeon’s recommendation. However, some patients decide on an implant because of it’s price.

Saline implants are cheaper than silicone implants. I see all too often patients chose saline because they believe it will save them money.  Saline breast implants run about $650.00 a pair.  Silicone breast implants run about $1750.00 a pair.

Evaluating what a breast implant really costs must involve more than the sticker price.  When silicone implants were taken off the market in the early 1990′s, Dr. Tebbetts was forced into using nothing but saline implants almost exclusively for the next 16 years.  Averaging 6-8 breast augmentation surgeries a week – over 16 years – that is a heck of a lot of saline breast implants used.  We learned from our experience as well as published data that saline implants have a much shorter device longevity rate than other breast implants.  Saline implants tend to be heavier and weigh more on breast tissue causing excelerated aging and stretch in a breast.  Saline implants also come to the surgeon unfilled and are made with a valve – the valve can fail and the saline implant will deflate.  Once deflated, the patient is faced with another operation – more risk and more down time – more expense.

It is just like when you buy a new car – you head to that dealership looking for the best value for your money – looking for a vehicle that will cost you the least amount in maintenence and will hold it’s value and age well over time.  Breast implants are no different.  If you go for the cheapest breast implant in the beginning, you are likely to end up with a lemon at the end.

There are women out there with 20 year old silicone breast implants and there are women out there on their second or third pair of saline breast implants due to implant failure in the first 5 years!  Wonder what they would they you about the cost of a breast implant and how to determine it’s value?  All implants have pros and cons and your choice of breast implant must be discussed with your plastic surgeon carefully to determine what is best for you.

But remember the cost of a breast implant cannot be determined by it’s initial sticker price.  It’s value will be determined in the longevity of your result.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

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Breast Augmentation – You Get What You Pay For – the Surgeon fee

by Terrye Tebbetts

Now, I will be the first one to say that just because something is MORE expensive then anything else, doesn’t necessarily mean it is better than everything else. On the other hand, most everything that is the cheaper than everything else, tends to be, well, worse than everything else.

It’s like buying a cheaper dish washing cube thing thinking it will save a couple of bucks but every time you use it, there is still crap all over the dishes and you have to do it again so now you have used twice as much soap and they still aren’t clean!!

When choosing a physician to help with heart disease, diabetes or cancer, do we look for the cheapest, or the best – the most experienced, the one that has published the most about the condition you have, the one that has made the most scientific advances to improve the treatment of what you have??? We seek the best – no question.

So why is it when it comes to having breast augmentation, patients tend to look for the best deal instead of the best surgeon? Is it because getting breast implants is totally elective? Do patients feel guilty because choosing to have this surgery is just that, a choice? No one NEEDS breast implants, they WANT them because they cannot change their breasts any other way than to have surgery.

Once the decision has been made to have breast augmentation surgery, you owe it to yourself and your family to go to the best surgeon – not to get the cheapest deal. The average surgeon fee can range between $3000.00 – $5500.00 across the United States.

There are surgeons in Oklahoma and across the border in Mexico, who charge $3000.00 total for the entire operation – not just the surgeon fee! So when you see this “deal” – it should raise some pretty big red flags!

The surgeon’s skills and level of experience should effect the fee that they charge. However, they should be able to back up their fee with data and experience. In other words, the patient should be able to ask why the surgeon’s fee is $X. In Dr. Tebbetts’ case, our surgeon fee is backed up by countless peer reviewed and published scientific articles and books advancing and redefining the level of breast augmentation and breast augmentation recovery. Our surgeon fee is backed by published reoperation rates of less than 3%.

Our fee is backed by documented experience in the specialty of breast augmentation. Our fee is backed by our improved 24 Hour Recovery procedures in breast augmentation that allow patients to reduce down time to one day – which means costs savings to the patient in the long run (ie not having to fly Grandmother in to take car of the kids, or hire a sitter for a week or miss work for a week and hubby doesn’t have to miss work for several days to care for you – down time to you is a cost!)

When you see a plastic surgeon for breast augmentation, you have to ask for the same type of back up of their fee. How many articles has the surgeon published on breast implants? This will show his or her level of research and specializing in breast augmentation surgery. How many breast augmentations does the surgeon do every year? How many of those patients require reoperation and why? What is the recovery time produced by the surgeon’s skill in the operating room?

A surgeon fee shouldn’t be more just because he or she lives in NYC or LA. A surgeon fee shouldn’t be more just because he or she “thinks” it should be. A fee that is more should give you more – -added value – a better outcome – a better result – a better recovery with fewer risks. Paying more for your surgeon fee should add value to your total experience – reducing your overall costs in the long run.

Paying less, going the cheaper route, is likely to put you in the hands of a very inexperienced surgeon or one that would rather charge less but do more surgeries – putting in the midst of the masses with very little focus on quality surgery and quality results. Paying less in the beginning puts you at higher risk of paying more in the end. More reoperations, more down time, more expense both in emotions and money.

If you decide to have breast augmentation surgery and change your body forever, please, please remember – this is not the time to bargain shop. Educate yourself about the risks and options and advances in breast augmentation and breast augmentation recovery. Do thorough consults with at least 3 board certified plastic surgeons and know without a doubt why they charge what they charge. In the end, you do get what you pay for – - be ever wise when choosing a surgeon.  The quality of your result starts and ends with your surgeon.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.

Posted in 24 Hour Recovery, Back to the Basics, Breast Augmentation, Choosing a Surgeon, Recovery Experiences | Tagged , , , , | Leave a comment