Despite the fact that Washington, D.C. is the capital of the United States, when most people think of where to find “the best” of anything, such as shopping, dining, cultural offerings, or even the best plastic surgeon, they are much more likely to think of New York City. New York breast implants surgery is a highly lucrative line of work. There are plenty of wealthy people in New York, and people who live there feel great pressure to “make it” in the world, whether based on their skills, their talents, or their looks. A New York plastic surgeon can become wealthy in large part from operating on women who want breast implants.
Cosmetic plastic surgery like breast augmentation is something that most patients pay for out of pocket. (In cases of breast reconstruction after a mastectomy, insurance will pay part of the costs.) Therefore, a Manhattan plastic surgeon can easily make a living by implanting large breast implants into women who like the look and have the money to pay for it. And there’s no need for the surgeon to employ several people solely to deal with insurance companies since in most cases insurance companies don’t cover the surgery and the patients pay the costs out of pocket. They may, however, work with financing companies to help those who want to pay for their surgery in installments.
New York breast implants – like those found anywhere else – are filled with one of two substances: silicone gel or saline. For a period of 14 years (from 1992 to 2006) saline was the only option for women undergoing routine breast enlargement. The U.S. Food and Drug Administration took silicone breast implants off the market except for use in women undergoing reconstructive breast surgery, such as after a mastectomy. That ban was lifted in November of 2006, and silicone breast implants jumped right out into first place in terms of popularity.
Most patients and surgeons prefer silicone breast implants to saline because they feel more realistic and are thought to be more realistic looking than saline-filled implants. Saline implants are sometimes described as feeling like water balloons. Also, if a saline implant ruptures, the breast will “deflate” whereas if a silicone implant ruptures, it may only leak very small amounts of silicone. Silicone breast implants are available with either a smooth or textured covering. Some surgeons believe that the implants with textured surfaces are less prone to a condition called capsular contraction, where scar tissue forms and hardens around implants. But other surgeons don’t think the textured surface makes any difference, and that they feel less natural than implants with smooth surfaces.
Some New York Breast Implants surgeons like Dr. Jennifer Walden prefer to place breast implants underneath the chest muscle rather than on top of the chest muscle. In an interview with Medscape.com, Walden said that she prefers the so-called sub-muscular implants to the sub-glandular implants. However, with sub-muscular placement, implants with textured coverings can become stuck to the surrounding tissues. This can result in the implants being stuck in a position that is too high and unnatural looking.
Walden and other New York plastic surgeons prefer the sub-muscular placement of implants because of a lower incidence of capsular contracture. Often, patients with sub-glandular large breast implants will have severe capsular contracture and require additional surgery to break up scar tissue in an attempt to make the results look and feel more natural. Some studies indicate that capsular contracture happens less frequently with sub-muscular placement of breast implants. However, sub-muscular placement is not as easy or as quick a procedure as sub-glandular placement.
There are four places that the surgeon may choose to make the incision for breast augmentation surgery: in the crease under the breast, around the edge of the areola, in the armpit, or in the navel. The incision in the crease under the breast is the most common because it allows the surgeon the best visual access and because the scars are very well hidden. Women who don’t have well-defined creases under the breasts may have the incision around the lower edge of the areola. In women with fairly firm breasts, a short torso, and no chest wall abnormalities, the incision may be made in the armpit. Incisions in the belly button are the least common, but some surgeons prefer the technique because of the easily hidden scar.
Even the top New York breast implant surgeons have to manage patient expectations and make sure that patients are giving their fully formed consent after learning about the risks involved. In patients with pronounced breast asymmetry, or unusual breast shapes (like “tuberous” breasts), it is important for patients to understand that while they may expect improvement in the look of their breasts, they are not as likely to come out of the procedure with the Hollywood-perfect bodies that are so often shown on TV and in magazines.
Some of the most challenging cases when it comes to breast implants are those where patients have very small breast base diameters and tight skin over a tight, muscular breast pocket. This is a common feature of Asian women and makes it more difficult for a surgeon to place the implant through a small incision. It is one more reason that patients should insist on choosing a board certified plastic surgeon, because their skills and experience will better allow them to customize the surgical procedure to the individual needs of a patient.
A plastic surgeon will use objective data about a patient’s breasts, like the base diameter and the thickness of the natural breast tissues to inform the choice of breast implant size and profile. Ideally, the surgeon and the patient can come to an agreement on the best size, shape, and placement of breast implants and will have some idea what results to expect. Other parts of the informed consent process when it comes to breast augmentation include understanding that perfect symmetry is not usually possible, and that breast implants are not expected to last for a lifetime. Most patients will eventually need additional surgery later on to replace the implants, or deal with capsular contraction or deflation.
New York City plastic surgeons don’t only deal with breast augmentation, but many of them also perform breast reduction on women who have breasts that are so large that they cause serious back pain and posture problems. Breast reduction surgery is a much more complicated procedure than breast implant surgery. It takes longer in the operating room, and there is more of an art to reshaping very large breasts into more proportional breasts that fit the patient’s frame.
In the case of breast reduction surgery, insurance companies may be involved. Some insurance policies will cover the cost of medically necessary breast reduction surgery if it is likely that the surgery will reduce the risk of further back problems for the patient.
Breast lift surgery is a fairly common procedure that is often combined with breast augmentation in cases where a woman’s breasts have been stretched out of shape by breast feeding or by loss of a significant amount of weight. Breast lift surgery involves repositioning sagging breasts, removing excess skin, and in many cases filling out extra skin volume with implants. In cases of severe sagging, a breast lift may require the nipple and areola to be repositioned on the “new” breast.
So how does one go about finding New York breast implants surgeons with the best reputations? There are a number of ways. For one thing, there are numerous websites run by New York plastic surgeons, complete with statistics like the number of procedures a particular New York City plastic surgeon has performed, before and after photographs, and sometimes even an online consultation or appointment form that visitors can fill out and email for more information or to set up an appointment.
It is highly recommended that patients search for a board certified plastic surgeon. In the U.S., board certified means that a surgeon has certification from the American Board of Plastic Surgery. To qualify, a surgeon must graduate from an accredited medical school, finish a five-year residency, acquire three years of general surgery experience, practice plastic surgery for two years or more, and pass comprehensive exams on plastic surgery.
Choosing a board certified New York plastic surgeon ensures that the surgeon has extensive experience and developed skill in numerous plastic surgery procedures, including strictly aesthetic procedures like breast augmentation. Board certified plastic surgeons know numerous surgical procedures and are more likely to be able to tailor breast implant surgery to the body and desired results that a patient has rather than pushing one type of procedure for all patients.
Despite the huge popularity of large breast implants in America, the procedure is surgical and does involve all the risks that surgery entails, including the risks inherent with general anesthesia. While there are a few New York plastic surgeons (and a handful in other areas of the U.S.) that will perform some breast implant procedures under sedation with local anesthetics, these are the exceptions. In most cases today, general anesthesia is required, though the procedure can often be performed in a one-day surgery facility.
Anyone who chooses to have breast implant surgery should understand that surgeons don’t consider implants to be a “lifetime” product. In other words, it is very likely that the implants will have to be replaced, removed, or have scar tissue excised at some point in the future. There are some studies now advocating that breast implant surgery be followed up with magnetic resonance imaging (MRI) scans at three year intervals to detect the so-called silent silicone leaks – leaks small enough that the person with the implants does not feel it. This can add significantly to the long term costs of breast implants, since MRI scans are expensive and in cases of breast implants may not be covered by insurance. In short, having breast implant surgery is a big decision and should be a very informed one.
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