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Sientra: The New FDA-Approved Shaped Gel Breast Implant

· Breast, Breast Augmentation, Breast Implants, Choosing the Best, Safety · No Comments

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. Following the breast implant lawsuit crisis of the early 1990’s most silicone gel manufacturers fled the U.S. market. Only two companies, Allergan (formerly McGhan/Inamed) and Mentor/J&J, remained and have dominated the market for the past 20 years. One consequence of this implant duopoly is that the cost of breast implants increased from hundreds to thousands of dollars since the 1980’s.

 

Earlier this year the U.S. F.D.A. which regulates medical devices approved a third breast implant manufacturer. Santa Barbara based Sientra was approved to offer silicone gel prostheses for sale in the U.S.  Allergan and Mentor are also based in Santa Barbara, leading to the affectionate term of “Silicone Alley” for the Southern California region.

 

Dozens of breast implant companies exist throughout the world. Many of these brands are sold in Latin America. Sientra’s parent manufacturer has sold implants internationally, but of course U.S. approval is a highly coveted achievement.

 

A Good Thing…and a New Thing

 

The arrival of a third player to the U.S. breast implant market is expected to be a good thing for American women. In addition to providing greater competition, Sientra offers a unique line of shaped gel implants. These “teardrop” or “anatomical” breast prostheses are commonly used in Europe and Latin America. A saline-water filled version has been available for years in the U.S. However, Sientra is the only manufacturer granted F.D.A approval for the gel filled type.

Shaped implants offer greater options for both cosmetic and reconstructive breast surgery. The prostheses come in a variety of shapes, sizes, base diameters and projections giving both the patient and surgeon greater versatility in body contouring.

 

The augmentation procedure using shaped implants is different from the traditional round prosthesis insertion. Therefore it is advisable that patients choosing these implants consult with experienced breast plastic surgeons. As a corporate philosophy, Sientra will only sell and warranty implants placed by plastic surgeons recognized by the American Board of Plastic Surgery.

 

Editor’s Note: Dr. Perez can be seen on ABC News in Miami discussing the Sientra implant at:

www.Youtube.com/user/PerezPlasticSurgery

 

 

About the Author:

 

Dr. Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan). Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. More information is available at

The Dirty Little Secrets of Plastic Surgery…Part 2 “Free” Consultations: You Get What You Pay For (Original Article)

· Choosing the Best, Safety · No Comments

 

Plastic surgery is booming. A combination of an aging baby boomer demographic, greater disposable income, affordable surgery and greater awareness, have all contributed to an increase in both surgical and non-surgical enhancements.

 

Patients are able to enjoy improvements to their face and body appearance like never before. However, along with the highly publicized successes of plastic surgery, there exist pitfalls and drawbacks that patients need to avoid. We call these the dirty little secrets of plastic surgery.

 

Part 2: The “Free” Consultation: You Get What You Pay For

 

The first step towards self-improvement through plastic surgery starts with the consultation. Some plastic surgeons offer “free consultations” in order to keep their waiting rooms and surgical schedules full. These usually go hand-in-hand with heavy advertising, phony car dealer-type “discounts” and a slick sales pitch. Ironically, places that lure patients with free consultations often charge more for surgery than honest, reputable plastic surgeons.

 

The problem with free consultations is that the patient usually gets what they pay for, nothing. Although there are exceptions, it is difficult to have a thorough and meaningful consultation with a plastic surgeon when dozens of other patients are also waiting for their brief “free” consultation. Patients typically complain that they felt like they were taking a number at the supermarket deli counter. I recall one patient who told us that her free consultation consisted of the doctor shaking her breasts and remarking, “Yup, you could use a boob job”!

 

Our office policy is to charge a modest cosmetic consultation fee. However, even though our fee is modest, it serves as a sufficient screening method. Amazing as it might seem, since plastic surgery is such an important, life-changing process that typically costs thousands of dollars, some patients quibble over paying even a modest fee for a consultation. We’re happy to refer them elsewhere for their freebies.

 

The decision to have plastic surgery is an important one that should be given the time, effort and seriousness that it deserves. The patient should invest in a thorough, honest and meaningful consultation. We have heard no greater regret than the patient who fell for a free consultation and slick sales pitch only to need to have the surgery redone.

 

Remember, unlike bad food, bad plastic surgery can’t be cured the next morning. So take your time, avoid “free” consultations, see several reputable doctors, and choose wisely. Remember, it’s your face and your body, don’t compromise.

 

About the Author:

 

Dr. Perez is a graduate of The Albert Einstein College of Medicine. He has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. A limited number of personalized consultations are offered by appointment only.

The Dirty Little Secrets of Plastic Surgery…Part 1 Choosing the “Best” Plastic Surgeon (Original Article)

· Choosing the Best, Safety · No Comments

Plastic surgery is booming. A combination of an aging baby boomer demographic, greater disposable income, affordable surgery and greater awareness, have all contributed to an increase in both surgical and non-surgical enhancements.

 

Patients are able to enjoy improvements to their face and body appearance like never before. However, along with the highly publicized successes of plastic surgery, there exist pitfalls and drawbacks that patients need to avoid. We call these the dirty little secrets of plastic surgery.

 

Part 1: Choosing the “Best” Plastic Surgeon

 

The relationship between patient and plastic surgeon is unique. It is different from any other doctor-patient relationship. Plastic surgery patients choose to have elective, medically unnecessary surgery. However, even elective surgery can carry risks and potential complications. Therefore, selecting the right surgeon is the first step towards self improvement. I like to define the “right” plastic surgeon in terms of 3 components; training, experience and personal compatibility.

 

Training at a top medical school and university residency program is a valuable foundation for any physician in practice. Plastic surgery training is broad and diverse and includes birth deformities, burn care, hand surgery, trauma and cancer reconstruction, as well as, of course, cosmetic surgery.

 

Plastic surgeons may focus their practices on any of these areas. However, only a small percentage of doctors are able to sustain a successful word of mouth, cosmetic surgery practice. Many must rely on heavy advertising, “free consultations” (more about that later) and cheesy car dealer-type “discounts” in order to keep their waiting rooms and surgical schedules full.

 

Another accolade some offices rely upon to lure patients is a “Voted the Best” designation. However, these doctors are usually “Voted the Best” by the very magazine they are advertising in. Cute, but plastic surgeons are not like pizzerias. Patients don’t usually have a facelift with every surgeon in town just to see who’s “the Best”.

 

Castle Connolly/U.S. News & World Report conducts a nationally recognized survey each year to identify Americas Top Doctors. This survey seeks the opinions of physicians and healthcare leaders to choose the top 1% of physicians in each specialty. It is an independent, blinded survey, so doctors do not, and cannot, buy their way onto the list.

 

Finally, it is important for a patient to choose a plastic surgeon who takes the time to listen and perform a thorough and honest consultation. It is often difficult to get that kind of personalized attention in factory style plastic surgery centers. However, unlike bad pizza, bad plastic surgery can’t be cured the next morning. So take your time, have multiple consultations, and choose wisely. Remember, it’s your face and your body, don’t compromise.

 

About the Author:

 

Dr. Perez is a graduate of The Albert Einstein College of Medicine. He has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. A limited number of personalized consultations are offered by appointment only.

10 Questions Every Plastic Surgery Patient Should Ask

· Safety · No Comments

About the Surgeon:

Question 1: Are you certified by The American Board of Plastic Surgery? Then call the Board to verify at 1-800-635-0635 or visit www.PlasticSurgery.org to confirm.

Question 2: Where did you obtain your plastic surgery training? Training programs in plastic surgery affiliated with medical schools are generally regarded as the best.

Question 3: What percentage of your practice is dedicated to aesthetic surgery? Many plastic surgeons concentrate on other areas of specialization, such as burns, reconstruction, or hand surgery. Also, plastic surgeons who focus on lasers, injectables and fillers often do so because their surgical procedure practice is not busy.

Question 4: How many times per year do you perform this operation?

Question 5: At which local hospitals to you have privileges to perform this procedure? Even if surgery is performed in the office, the surgeon should have at least one hospital as a backup. Then call the hospital’s medical staff office to verify the privileges.

Question 6: Who responds to patients’ questions or problems after hours and on weekends? Does someone else answer the page? The relationship with your plastic surgeon only starts on the day of surgery. You want to know that you can reach the doctor if an emergency arises. Try calling on a Saturday afternoon before surgery to see how difficult it is to get through.

About the Facility:

 

Question 7: Where will the operation be performed? (Hospital? Outpatient Surgical Center? Office?) Many reputable surgeons choose to operate in their office. However, sometimes this is a tip off that the doctor does not have hospital privileges.

Question 8: If the operation is done right in the office, what happens if there is a problem during surgery? Is there enough backup staff and equipment? There is no mandatory certification of office surgery in Florida. It is up to the facility to maintain its staff, equipment and procedures up-to-date in case of emergency.

Question 9: May I see the operating room? If it is not possible right now, make an appointment to come back when it is convenient. Don’t take no for an answer. It if doesn’t look safe, run, don’t walk, to the exit.

Note: Plastic surgery clinicsoften boasta “Certified Facility”, even though they are merely on-the-premises office operating rooms. They are cheaper and more convenient for the surgeon/owner. However, the problem with these facilities is: 1) Backup (see Question 8) and 2) Accountability (independent ambulatory surgery centers have strict peer review processes that ensure quality care. Private offices typically have no such patient safeguards.)

About the Anesthesia:

Question 10: Who will be administering the anesthesia and what are his/her credentials? (A doctor, a nurse, the plastic surgeon?) The anesthetist is an important and integral part of the safety and comfort the patient will experience during the surgery.

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