The New Ideal Breast Implant: Ideal for some...

The Ideal saline breast implant was developed to address some of the issues that saline implant have as compared to silicone implants.  These issues include the feel, the motion sensation, and the surface wrinkling of the implants.  My opinion is these issues are most concerning in the very small breast sizes (A cup or less) where the Ideal implants can improve results.  I am the first Plastic Surgeon in the Fort Wayne region and second in Indiana to offer the Ideal Implant.

I have been doing saline breast augmentation for over 20 years and my patients have been very happy with their results.  You will better understand the Ideal implants in the context of implant history and choices so I am outlining it here.  At the end, I will describe the Ideal implant more specifically and what patients they are "ideal" for.

Saline implants are filled with saline solution.  Saline is essentially salt solution (NaCl) that is isotonic, or has the same concentration as the body fluids.  (You are sitting there at about 80% saline solution).  Most saline implants have a one way valve on the surface that is opened by a special filler tube.  The implant can placed through a small 1 ¼ inch incision because the implant can be deflated, inserted into the dissected implant pocket, then inflated to the desired size.

Silicone is an inert substance that is found everywhere in our daily lives.  Depending how it is processed, it can be made into a liquid, a gel, or a solid.  The silicone implants of the 1960?s to the 1990s were of a runny consistency.  The new silicone implants are more gel like.  The implant companies have avoided the name "silicone" and call their implants words like "Gels" or "Gummies".  This is a result of the very negative press silicone implants got in the mid 1990's when patient's complained of illnesses like rheumatoid arthritis, lupus, scleroderma, fibromyalgia and other systemic autoimmune ailments.  The main implant company at the time, Dow Corning Wright, was sued in a class action and the FDA restricted their use for cosmetic augmentation pending further studies.  Since then, tens of thousands of patient's have been studied and none have shown any systemic illness associated with silicone implants.

Silicone implants come pre-filled and require a 3 or more inch incision to insert the implants safely without damage.  Silicone implants have less of a tendency to ripple on their surface than saline, which allow an over the muscle approach.  On the other hand, the highest risk of capsular contracture (too much scar formation around the implant) is with a silicone implant on top of the muscle.

It is felt that silicone implants have an advantage over saline with a softer feel and less of a tendency to have surface wrinkling.  For the most part, appearance of saline and silicone is the same.  It is very rare to have a patient complain of saline implants being too firm or the subtle wrinkling seen in the outer breasts in the very thin, small breast patient.  I used to offer silicone implants in these patients but now offer the Ideal implants in patients who benefit from them the most.

Saline implants are recommend in my practice in more than 95 percent of patient?s for the following reasons:

Breast size: Saline implants are filled during surgery and can be adjusted to be just right for a given patient.  This is particularly helpful for asymmetrical breasts so that different fill volumes can be placed.  Also, it is not uncommon for patients to wish they were bigger following surgery (especially those who where adamant that they didn't want to be too big).   This can be done in our office under local anesthesia and oral sedation ($2250 for our own breast augmentation patients, $2500 for patients from other practices).  The filler tube valve is located and the change in volume is made using the same small incision.  With silicone implants, once the box is opened, the implants are yours without any ability to change their size during or after surgery.  To change your size, new silicone implants would have to be used (about $1500 just for the implants, plus all the other surgical fees.)

Incision size: Saline implants can be deflated and placed through a smaller incision than silicone.  Silicone implant incisions need to be at least twice as long as the saline implant incision. There is increased risk of implant damage in silicone implants that are ?forced? through incisions the surgeon is trying to keep too small.

Implant failure: When a silicone implant ruptures, there is no easy way to tell as the silicone substance remains in the pocket within the breast.  Typically, a patient with silicone finds out there has been a rupture with symptoms of capsular contracture; a hard and often painful breast implant area.  Removing a ruptured silicone implant often involves having to remove the associated scar encapsulation, requiring a general anesthetic.  Until recently, the FDA mandated that all patients with silicone implants have MRI scans every 2 years to detect the "Silent Rupture".  To me, it is ridiculous for a cosmetic elective procedure would lead to an expensive MRI scan every other year typically used to detect severe medical illness.   When a saline implant ruptures, the patient knows because the saline is absorbed and the breast deflates.  A saline implant can be replaced in the office under local anesthesia and oral sedation in our practice.

Longevity: There is the notion out there that implants have to be replaced every 10 years.  This is false and based on studies that have shown that about 50% of patients have a procedure related to their breast augmentation in the first 10 years.  My rate is more like 5% and the most common reason being "I wish I were bigger".  I believe most of my saline implant patients will have these for life and certainly won't have any procedure just because 10 years have passed.  The new silicone implants have not been around long enough to be sure of their longevity but most recent rupture rates are of a concern.

The Ideal implant is a saline implant and have all the advantages I listed above.  There are some other advantages based on their design.  Their overall shape allows the implant to sit and hug the chest wall leading to less wrinkling along the sides.  They have two chambers and two fill valves on the back and the front of the implant.  The back chamber is like a saline implant and is filled to a certain amount. The front chamber has baffle membranes to prevent "slooshing" of the saline, much like a water bed design.  This chamber has a range of saline that can be placed so they are also adjustable like the typical saline implants.  The design also prevents wrinkling of the perimeter of the implant that might be seen in the very small breast patient (flat to A cup) on the outer and/or the lower breast surface in the naked state.  These wrinkles may also be palpable.  The Ideal implant gives a more natural feel than the saline implants approaching that of silicone implants.

In the B-cup or greater size breast augmentation, I will continue to recommend Mentor's Moderate Plus Profile Saline implants.  These patients have adequate soft tissue coverage of the implants where the issue of wrinkling and feel of the implant should be minimal.  For the flat to A-cup breast, I will offer the Ideal implant as an option for breast augmentation.

The cost for Ideal implants are in the range of silicone implants.  The Indiana Plastic Surgery Center offers typical saline implants at $4995 and Ideal saline implants at $5995.

All my best!

Breast Augmentation

Dr. Severinac's saline implant augmentation.

Full, shapely breasts can make any woman feel more feminine, beautiful, and secure. Breast Augmentation or Augmentation Mammoplasty is a cosmetic procedure designed to increase and enhance the size and shape of a woman's breast. The end result is a more curvaceous, sexy bust line and a natural, proportionate figure. During this outpatient procedure, an incision is made beneath the breast and a saline or silicone implant is inserted beneath the pectoral muscle. The end result is a full and fabulous new figure.

Saline vs. silicone implants?  This is addressed by Dr. Severinac's 18 years of experience in his blog "Will That Be Saline or Silicone With Your Augmentaion".

Breast augmentation can give a lifting effect but is sometimes combined with a breast lift if there is excess skin and drooping of the nipple. Join the hundreds of patients who have benefited the skilled hands of Dr. Severinac if you feel a Breast Augmentation is for you.

To learn more about augmentation mammoplasty in Fort Wayne, Indiana contact Indiana Plastic Surgery Center for a private consultation.

Botox and Fillers

An injectable parable:  Botox & Fillers

A local non-plastic surgeon directed medical spa tells clients that the reason their Botox and Fillers are more expensive than anywhere else in town is because the nurses who administer it are "much more qualified" than anyone else in town.  Even more qualified than a Board Certified Plastic Surgeon?

Dr. Severinac personally treats all his patients with Botox and Fillers in our Fort Wayne office  His keen sense of anatomy gives him a huge advantage over others ability to get beautiful consistent results.  He also injects himself with these products and has an appreciation for how the products are best placed with minimal discomfort.  Our prices are kept low because Dr. Severinac sees these treatments as a way to meet patients who may be interested in other procedures in the future.  He welcomes any questions regarding plastic surgery during these treatments.  

BOTOX

Wrinkles between the eyebrows (frown lines), around the eyes (crow’s feet), and across® the forehead are actually caused by overactive muscles just below the skin.  The skin folds in the central neck are caused be the platysma muscle and can also be treated.  Through a very small needle, BOTOX® Cosmetic is injected into these areas to relax the underlying muscles. This smooths out the wrinkles they are causing, giving you a more vibrant and youthful appearance. The effects typically last three to four months, but in some patients who learn to stop animating those parts of the face, the effect can last longer. Be good to yourself, for a change: Botox.

FILLERS

Injectable fillers for the laugh and marionette lines, the lips and the corners of the mouth is very popular.  Most fillers are comprised of Hyluronic Acid which is a substance found between cells of all animals.  It works best for the lips and nasolabial folds and lasts 3 to 9 months.  Place your face in the skilled hands of Dr. Severinac, it will be the simplest, best thing you've done for yourself in a long time.

Contact us to treat the wrinkles you've earned but wished you never had!

Skin Resurfacing

Skin resurfacing are procedures designed to improve the texture and complexion of the skin.  We offer microdermabrasion, dermaplaning, chemical peels, and non ablative 1540 fractionated laser through the Rejuva Medspa and dermabrasion through the Indiana Plastic Surgery Center.

Microdermabrasion

Microdermabrasion with the Diamontome involves using a diamond dust impregnated wand with suction to sand the top keratinized layer of skin.  Crystal systems are also used.  This thins the epidermis or the top layer of skin giving immediate smoother skin.  It can also be used in conjunction with peels and skin care to allow deeper delivery of products yielding even better results.  This is done by our Aesthetician at Rejuva Medspa.

Dermaplaning:

Dermaplaning uses a modified surgical blade to smooth the top layer of skin (epidermis) leaving the skin immediately smoother. It can also be used in conjunction with peels and skin care to allow deeper delivery of products yielding even better results.  Dermaplaning also removes all that "peach fuzz".  This is done by our Aesthetician at the Rejuva Medspa.

1540 Fractionated Laser:

This is a nonablative type of resurfacing meaning the the top layer of skin is not completely destroyed such as older laser systems (CO2 for example).  It drives multiple micro columns of laser into the skin in a pixalated fashion leaving most of the skin intact.  The healing is fast with  some redness in the first few days.  Fractionated laser produces a more unified and smoother complexion and over the following months, a more supple fuller feel to the skin as collagen content is increased.


Dermabrasion

Dermabraion is performed with a rotating diamond dust burr creating a controlled abrasion. The skin is essentially sanded down to the deepest level of the scar making them less noticeable. Usually, healing to the point of makeup application is seen in one week, and redness may be present for weeks to months as the area heals.  One example is the radial wrinkles seen around the lips in smokers and those who purse the lips when expressing themselves. Another is in acne scarring.

Depending your specific needs, we have multiple options to make your skin radiant and youthful: skin resurfacing fort wayne - IN.

To learn more about skin resurfacing in our Fort Wayne office under local anesthesia and oral sedation please contact us today.

Otoplasty (Ear Pinning)

Otoplasty or Ear Pinning is performed to correct misshapen or poorly formed ears and bring protruding ears closer to the head. With “ear pinning”, or otoplasty, an incision is made behind the ear. The cartilage is sculpted and sutured to stay back (no pins are actually used).  This procedure can be done at any time but is often best around age six to prevent ridicule at school. It drastically improves overall appearance and self-confidence.  The procedure is done under a general anesthetic in the child.

In an adult, otoplasty can be performed in our office surgical suite under local anesthesia with oral sedation, reducing cost significantly.  Prominent ear, cauliflower ears, cup ears, Spock ears can all be address with Otoplasty in our Fort Wayne office.

The recovery is less than one week to dressings removal and 6 weeks of night time head band use to keep the ears against the head.

If you think you or a child you know might be a candidate for otoplasty, please contact us  today to find out more.

Just look at the difference Dr. Severinac can make!

Chin Implants and Cheek Implants

Chin implants

A poorly defined chin or cheeks can give the face an overall weak appearance. Chin implants in Fort Wayne, IN can give you the confidence you've been looking for. Dr. Severinac uses implants that allow tissue ingrowth which secures the implant making it look and feel like its a part of yourself. The incision is typically made in the submental crease, a natural crease line found just under the chin.  Look at the transformation to a balanced face by Dr. Severinac.

Cheek Implants vs Fat Grafting

While chin implants give the appearance of a stronger jaw, cheek implants lend definition and improve the overall contour of the face.  These are placed through incisions inside the mouth and are performed in the outpatient general anesthesia setting.  Most patients, however, opt for facial fat grafting to give more volume to the cheeks. 

Facial implants and fat grafting are placed through inconspicuous incisions under local anesthesia with oral sedation in the office procedure room. To learn more about facial implants,the contact the Indiana Plastic Surgery Center today.

Lip Implants

Thin lips can diminished an otherwise beautiful face.  These can have a significant impact on self-image and esteem. Lip implants permanently augment the lips avoiding repeated injectable treatments.  These are placed through small incisions on the inside corner of the mouth under local anesthesia with oral sedation.  Dr. Severinac uses two types of implants.  The Perma Facial Implant is a silicone implant which is soft and does not limit movement or puckering of the lips.

PTFE type implants which are more rigid and somewhat prevent puckering of the lips.  This implant is ideal in patients who have lines on the lip and are having these treated with dermabrasion.  The implant can be placed at the same time as the dermabrasion.  The idea is to help prevent return of these lines by reducing the puckering that causes them.

Fuller and more natural appearing lips, permanent with no more injections.