Indiana Plastic Surgery Blog

A study published recently in the American Journal of Surgery confirmed the common perception that breast surgery can be more efficiently performed outside of hospitals in dedicated outpatient ambulatory surgery centers (ASC).

According to study results, performing breast surgery in an ASC rather than a hospital saved 69 minutes on average, and most of the time savings was attributable to decreased preoperative time, or time spent preparing for surgery.

Key time-saving advantages of the ASC include:

• Avoidance of unscheduled surgeries, such as add-on cases and emergency cases common in hospitals
• Better case flow as a result of having a surgeon assigned to a single room in the ASC
• Smaller, more consistent ASC staffing
• Smaller physical ASC facility that makes it easier to move patients and equipment

The study also concluded that while the type of anesthesia used during surgery can also affect recovery time immediately following surgery, this did not significantly affect overall surgical time from the preparation stage to the patient discharge stage.

Hospital vs. ASC study details

In 2005, the study authors’ ASC facility was closed, which forced all outpatient breast surgeries to be performed alternatively in a hospital setting.

Study authors Drs. Terrence Trentman, Jeff Mueller, Richard Gray, Barbara Pockaj and Daniel Simula compared the surgical records of 92 patients who had breast surgery in an ASC facility between January 2004 and December 2005 with the surgical records of 92 patients who had breast surgery in a hospital facility starting January 2006.

All study subjects were female patients of similar age, with similar recovery room times, and each breast surgery procedure was performed by the same two salaried surgeons who did not receive additional bonus pay for productivity.

ASC pre-op vs. post-op

In addition to concluding that ASC facilities offer significant preoperative time-savings, the results of the study also suggest that breast surgery patients spend an almost identical amount of time in an ASC as in a hospital once they reach the operating room.

Revisionary breast procedures may include breast implant removal, a change in size, or a switch from saline to silicone.

During such procedures, some patients may benefit from a breast lift, when down sizing or after weight changes.  Over time, skin loses its elasticity, which requires excess skin to be removed and/or tightened.  The amount and degree are determined by the patient’s desired breast size and the amount of elasticity remaining in your skin.

Site location, above or below the muscle, as well as the type of implant (saline or silicone) will also determine the appropriate procedure and your final result.  In some circumstances, patients may not need a lift and instead may benefit from a site change.

The cost of breast augmentation depends on several factors including the following:

• Implant type – saline vs. silicone
• The physician
• The geographic area
• The type of anesthesia

The approximate cost at Indiana Plastic Surgery ranges from $5200 (package price for saline implants, includes my fee, facility, anesthesia, cost of implants and postop visits) to $6200 (package price for silicone implants).

This price may vary depending on whether a patient is having a revision or replacement, as well as the possible need for a breast lift with an augmentation.
Beware of prices that seem to good to pass up and be sure to verify your plastic surgeon’s credentials, making sure he or she is certified by the American Board of Plastic Surgery.  Also, check on the facility where your surgery is being performed to make sure it is accredited by the state in which your physician practices.

A 20-year-old patient recently asked us about breast augmentation with silicone implants, explaining that an Illinois cosmetic surgeon had offered to perform the procedure if she signed a waiver.

When the FDA reintroduced silicone breast implants for use in cosmetic breast surgery, the restriction put in place was patients had to be at least 22 years of age.  The only exception was for patients with severe rippling from a previous breast augmentation or patients requiring them for reconstructive reasons such as Polands Syndrome or other congenital breast deformities.

Use of silicone implants for any other purposes than stated above are considered off label uses.  This means the implant manufacturer will not be liable for any problems that may occur.

We told this patient that the proposal to sign a waiver to get silicone implants under the age of 22 seemed unusual and even suspicious.  An ethical, board certified plastic surgeon probably would not make such an offer.

It is common for patients who get breast augmentation to feel quite different after getting implants. Breast implants can bring new mental and physical feelings and change the way you experience life. Adjusting to these changes requires time.

After several months (sometimes sooner), almost all patients adjust to their implants and begin to accept them as a part of themselves. With time, breast implants will look more natural and become a part of you.

We tell our patients that “time is on their side.” While it is rare, patients that feel uncomfortable about their implants several months after the procedure can have them removed or changed.

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Why undergo breast augmentation surgery? A patient discusses her reasons for getting breast implants, saying “I wanted to look more feminine; I wanted to have cleavage.” Perhaps the most important point she touches on is about education: “I had fears to begin with, but my fears lessened the more information that I gathered.” Check out our breast page or the ASAPS site for more on breast augmentation.

The American Society for Aesthetic Plastic Surgery produced this educational video, and is devoted entirely to advancing the field of cosmetic plastic surgery through education and research.

Statistics from the American Society for Aesthetic Plastic Surgery reveal that for the first time, breast implants have surpassed liposuction in popularity.

The figures indicate that 355,671 breast augmentation surgeries were performed last year, compared to 341,144 liposuction procedures.

In a press release, ASPS President Alan Gold, MD comments that “for the first time in the twelve years these statistics have been collected, liposuction is a runner up in popularity to breast augmentation.”

Dr. Gold theorizes that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.”

Of the 10.2 million cosmetic procedures undergone in America in 2008, 92 percent were had by women.

Last year’s top 5 surgical procedures are as follows:

1. Breast Augmentation
2. Liposuction
3. Eyelid Surgery
4. Rhinoplasty
5. Abdominoplasty

Last year’s top five non-surgical procedures include:

1. Botox
2. Laser Hair Removal
3. Hyaluronic acid wrinkle fillers (Juvederm, Restylane)
4. Chemical Peel
5. Laser Skin Resurfacing

For many women seeking to enhance their physical appearance in Northwest Indiana, breast implants may be an option.  Up until recently women have only had the choice of using saline filled breast implants.  In November of 2007, the FDA approved silicone breast implants safe for use in the United States.  Silicone implants have the advantages of feeling more like a natural breast and weighing less than saline, which over time could possibly lessen the risk of ptosis.  The new silicone gel implants are also created with a thick gel that does not bleed in the event of a rupture.  There has been over 14 years of extensive testing on the safety of silicone gel implants, more than any other medical device or drug.  To learn more about your breast implant choices, contact Indiana Plastic Surgery today for your free consultation.Dr. David Robinson is board certified by the American Society of Plastic Surgeons and can help you make an informed decision on whether breast implants are right for you. 

 

Spring time is almost upon us and this is the time when people living in Northwest Indiana and the Chicago, IL area are beginning to come out from under the heavy confines of the clothes they wear during the winter.  Wearing less clothes makes people more self conscious of the appearance and their bodies.   At Indiana Plastic Surgery, Dr. David Robinson is a board certified plastic surgeon who can help you make an informed decision on whether cosmetic plastic surgery is an option for you.  Dr. Robinson has perfected the art of breast augmentation. He is skilled in using both silicone and saline breast implants and has a collection of before and after images of hundreds of very happy satisfied breast augmentation patients.Contact Indiana Plastic Surgery and Dr. Robinson or call our Munster, IN office at (219) 513-2100 or our Valparaiso, IN office at (866) 613-2100 today for your consultation .