FAQ
 
BREAST ENHANCEMENT SURGERY
 
Do breast implants produce cancer?
In multiple studies done all over the world, it has been demostrated that there is no direct relation between the development of breast cancer and the use of silicone implants.  As a matter of fact,  almost the worldwide, silicone implants are the most used, including patients who have gone under breast reconstructive surgery after a mastectomy due to cancer.  Multiple studies done in the world, show that women with breast implants have less incidence of breast cancer, than of those who donīt have them.
 
How many types of breast implants are there ?
There various types of breast implants, they all have a cover made out of silicone,  the difference is what is inside.  We have saline solution implants, which are first placed in the patient and later filled with saline solution.  This type of implant is the most used in the United States due to the restrictions that the FDA has on the use of silicone gel implants.  And silicone gel implants and hydrogel  implants.  All implants come in different sizes which are measured in cubic centimeters (cc).
 
As to the surface, it can be smooth or texturized..  The smooth surface implants should never be placed in front of the major pectoral muscle, because if it is done, there is an incidence  of 80% or higher of capsular contraction.  The smooth implants should only be placed behind de pectoral muscles.  The texturized implants, on the contrary, have a lesser incidence of formation of capsular contraction, no matter where they are placed, whether it be in front or behind  the muscle.
 
Another characteristic of the implants is the contour:  there are three types of contours, low, high and extra high.  The higher the contour, the higher the projection of the breast.  The higher the ccīs, the more the volume.  In this manner we may find implants,  of lets say, 325cc of low contour, high or extra high.  And last, the shape.   There are round implants, which are the most used worldwide and the anatomic implants, or tear shaped, that most resemble the form of the natural breast.  The difference of these anatomic implants versus the round ones, is that the upper part of these, have less volume, therefore, this is reflected on the patients breast, showing less volume in thesuperior pole of the breasts.
 
How are the implants placed?
There are 4 different ways of placing the  breast implants in a patient.  The most frequent way, is placing them through the aureolas, where an incission is made in the lower half of each one, to have access to the front or back of the pectoral muscle. (depending on the given case).  In this manner they can make the pocket which will hold the implants.  Another way of placement, is through the axilas (arm pits).  In this manner,  the surgeon makes an incission of approximately 3 or 4 centimeters.
 
In one of the folds that are under the axilas, and with the use of an instrument designed specifically for this type of surgery,  the surgeon  makes way for the pockets where the implants will later be placed.  Anoter method of placement, is under the breast,  at the lower  level of the fold that the breast makes .  This type of incission is less used by surgeons, because it leaves a visible and unesthetic scaring.  Particularly we do not use this type of incission..  Another way of placing the implants is through the belly button, nevertheless it is a tedious surgery and can only be used with saline solution implants.
 
In front or behind the muscle?
This is a must question by the patients to their surgeon.  There exists a false premise that all breast implant surgeries must be made placing the implants behind the muscle.  The fact is, that all patients are different from each other, and there exist precise indications of the placemente of the implant, whether it be in front or behind the pectoral muscle.
 
Those patients with little breast tissue, those who have barely any breasts or those who havae a moderate breast volume, but are not sagging,  are the ideal candidates for the behind the pectoral muscle placement.  On the contrary, patients that have sagging breasts, especially if they have a moderate or larger volume, these are candidates for placing the implants in fron of the pectoral muscle.  Why?   The answer is that these patients who have a certain breast volume, even without placement of implants, will continue to suffer throughout the years or from future pregnancies, the sagging of their breasts.
 
If  these patients have their implants placed behind the muscle, at a determined moment, when the patients breasts continue to sagg, the look will be that of what is known as double breast,  and that is not more than the patientīs natural sagging breast and the implant on the top behind the pectoral muscle, since this muscle will never allow the implant to fall.  Placing the implants in front of the muscle, these patients as the natural breasts begin to sag, the implants will do it also in a very subtle manner and will allways  maintain the volume of the upper breast without the look of the double breast.
 
How long does the surgery take?
Depending on what type of access is used, the surgery will take approximately 20 minutes (to an hour or an hour and a half, using the aureola introduction).  After the surgery,  the patients will have a recovery  time of approximately 3 to 4 hours and then they may go home.
 
May I become preagnant?  If I become pregnant, do I loose the surgery?
Absolutely not.  The breast augmentation surgery does not hinder your becoming pregnant, and if you do, you do not loose your breast surgery becasue of this and have to have another operation.  Those patients whose implants have been placed in front of the pectoral muscle, have a major tendency of the breasts falling a bit after the pregnancy and lactation period.  But not to a degree that they loose the surgery.
 
May I breast feed my baby?
Of course you may.  Any patient with mamary implants may breast feed their infant, without this implying any risk for the baby or of loosing the surgery.  Many scientific studies have demonstrated that women with breasts implants may feed their babies without any harmful effects to their baby.
 
Must I stay hospitalized?
The breast augmentation surgery, as with allmost all plastic surgeries, are ambulatory. This means that the patient is operated and may go home on the same day.
 
Could I loose sensibility in my nipples?
It is not very common for this to happen.  On the contrary, usually it increases sensibility in this area ( called hipersensibility) in the aureolas in the weeks following the surgery.  The patients describe it as a burning sensation.  This sensation will slowly dissapear until it goes away completely.
 
What does it mean that an implant becomes encapsuled?
The capsule is a term commonly used to describe the hardening of the breasts.  But the correct term is contractive capsuling,  since the capsule allways forms when a patient is operated and has implants placed.
 
The capsule is a normal reaction of your organizm, reacting to a foreign body that was not there before.  The orgarnism protects itself from this foreing body, by forming tissue that surrounds the implants covering them.  This capsule, in determined cases, may adopt a strong and hard consistency.  And this is what gives the hard consistency to the breasts, and what is known as contractive capsuling.
 
What happens if  contractive capasuling occurs?
When contractive capsuling occurs even with the post surgery massages, and ultrasound sessions, the proper conduct is to operate the patient to eliminate or treat the capsule so it does not contract again. 
 
How large can my breasts be?
The volume of the implants placed in a patient, depends basically  on the anatomical characterists of the individual patient  Stature, weight, toraxic dimensions, previous volume of the breasts amongsy others, are taken into consideration.  Nevertheless, there does not exist a reasonable limint to the volume of the breast implant that may be placed. But, the esthetic and natural harmony of the body must be taken into consideration.

LIPOSUCTION-LIPOSCULPTURE
 
Whatīs de difference between liposuction and liposculpture? 
Actually  the term correspond to the same procedure, but the word LIPOSCULPTURE is alittle more descriptive.  Since in this surgery, you search for fat lodged in certain parts of the body, such as abdomen, back,thighs  etc..  Accomplishing the sculpting or molding of the proper details of these areas.
 
It is important to remember, that this is not a corrective surgery for obesety.  It is used to mold the figure giving a more pleasant aspect.  Therefore, if the problem is overweight, ideally you should first undertake a special and individualized program to point out associated, medical problems. And give each case the adequate treatment, hence, getting better results.

Who are the best candidates for liposuction?
The best candidates for liposuction are those patitients with good health and with real expectations as to the results that may be obtained with this surgical procedure.  The Liposuction offers fantastics results, but not perfection.
 
Even though age is avery important factor to take into consideration, as to who is an ideal candidate for Liposculture.  The general conditions of your organizm are even more important.   The ideal candidates are those who have dieted and or exercised but still have unesthetic fat deposits.   The overweight patients, may benefit from this procedure, eventhough it does represent a weightloss method. It offers good results.  Nevertheless the ideal condition is that the patient have at least a near normal body weight.  There are absolutely no age limits for having a liposuction.
 
Does celulite decrease or dissapear with Liposuction?
Lipsuction does not eliminate celulite, nevertheless, it can lessen its aspect depending on the amount and other factors.  Celulitis, is the result of fat accumulation, toxin deposits and bad circulation that result in the orange peal aspect, associated to hereditary factors, nutritional, circulatory and sedentary amongst others.  Therefore, the treatment must be towards bettering the disengaging factors.  Integrally with weight reduction, the increase of fiber and liquid intake and excersice.  The  measuraments may be, as with endormology, ultrasound, muscle tonification and with procedures such as liposculpture.   Associated to the afore mentioned measures, and hence you can achieve a better aspect of the celulitis.
 
After a liposuction will I ever gain weight?
Totally false.  Having a liposuction is the same as going on a diet.  When you diet and reduce a determined amount of weight, you can take care as to not gaini back the weight, by a balanced nutrition, exercise, etc.,  It is the same with liposuction.  The results may be the best, nevertheless, if you do not take care of yourself, you will gain weight and become fatter.  The advantage of the liposuction, is that if this weight gain is not exaggerated, when you loose extra pounds, you will have the same figure as when you had the liposuction.
 
How much weight will I loose with a liposuction?
Patients should expect an extraordinary weight loss after liposuction surgery.  Liposculpture is not a weight loss method, nevertheless, there is allway a decrease of the same.  What the patient should expect is a reduction  of measuraments, that may be of two to four sizes, depending on each patient in particular.  The amount of fat that may be lipsuctioned in each session depends on each individual patient, but it should never exceed 6 ltrs., liposuctions greater that this amount, require blood transfusion from the same patient (autotransfusion).
 
Must I use a girdle, and for how long?
The use of the post operative girdle is very important to guarantee the optimal results of a liposuction.  The post operative girdle complies with various functions,  at first, immediatelly after the surgery to reduce bleeding and initial inflamation process.  Later on the girdle is favorable for the retraction of the skin and it allows the same to mold itself to the body, and to the new figure sculpted by the surgery.  The girdle must be used for a time period of two to three months, since this is the time it takes the tissues to go back to their natural state after the surgery and the inflamatory process.

If I get pregnant will I loose the surgery?
It all depends on the weight you gain during  your pregnancy.  If your weight does not exceed that of the weight suggest by your obstetritian, and it is not more than 30 or so pounds, the shape of your body will be approximately the same as that which you obtained by your liposuction.  Nevertheless, the posibility allways exists, that certain fat deposits may remain that eventually could be eliminated with excercise or a touch up with another liposuction.
 
GENERAL QUESTIONS
 
Who are the best candidates for plastic surgery?
The best candidates for plastic surgery, are those that enjoy a good health, and above all have realistic expectations as to the results of the surgery, and are conscious of the limitaions of medicine,  the technology and the characteristics of each patient.  Only in this manner will the patient feel pleased with the results of the plastic surgery.
 
How soon may I go back to work after surgery?
The recuparation period of a plastic surgery depends on each procedure in particular and varies from one patient to another.  Some procedures allow the patient to resume their labor activities in about two days, while other require about two weeks for the person to go back to work.
 
Can stretch marks be eliminated?
Stretch marks are due to damage in the collagen of the skin, which behaves as a scar, which, the same as a scar of another origin, it is impossible to erase.  They can improve their aspect in color and texture in time, there exists no procedure that can erase them indefinately, and the only surgical alternative is removing the sking where they are located as for example when the sking is removed from the abdomen in an abdominoplasty (tummytuck).  There exists theraputic alternatives that can help to accelarate the recuperations of the aspect of the stretch marks, such as, ultrosound or endermology, but eliminate them, never.
 
What type of anesthesia is used?
There exist different types of anesthesia:  Local, regional, general.  Each one of these is done in a different way and its objective is that no pain is felt during the surgery.  Each procedure has different alternative to the type of anesthesia, but it is important to have a visit and previous evluations by the anesthesiologist, so that by the individual characterics and the patients background, it can be determined what type of anesthesia is more convenient in each case.
 
An anesthetic act done by expert hands, with the appropriate technological support, is safe in any of the alternatives,  as long as the patient has the pertinent studies that may discard any complication.   The doubts about the characteristics of each type of anesthesia can be explained in the consultation with the anesthesiologist.