FDA approves new silicone gel implant

The FDA recently gave approval for a new silicone gel implant.  

It is made by Mentor and is called the Memory Shape Implant.  This is a textured (rough surface) anatomically designed implant which is tapered at the top and designed to give the breast more fullness in the lower pole.  It is for women age 22 or older and any woman undergoing breast reconstruction.  

The approval was based on 6 years of data accumulated on 955 patients.  

This product is designed to give a “more natural shape and youthful feel” from  breast augmentation and breast reconstruction.  Memory Shape means the silicone gel within the implant is cross linked which gives it a firmer shape.  

I recently completed online training in the proper use of these devices and am now certified to use them in my Fort Myers, Florida plastic surgery practice. If you would like more information, please contact me at 239-939-5233.

Wrong, Mick. You can get satisfaction

Recent surveys show some interesting findings.  

Over all, cosmetic surgery consumers are more satisfied with their result than not.  Breast augmentation is THE most popular operation currently and patients who go to a board certified plastic surgeon had a satisfaction rate of 94% versus women who went to a NON board certified surgeon and their satisfaction rate was only 88%.  This is really, really important because more and more doctors are touting they are “cosmetic surgeons” when in fact they lack formal training.  

Interestingly enough this was also true for other cosmetic procedures like liposuction, tummy tuck, eyelid surgery and the like.

New Trends in Breast Augmentation

If you see a slender, youngish lady with large and perky breasts, you may wonder if they are implants. 

"Real 'C' cups start sagging by the time you're 30," says a Beverly Hills plastic surgeon.  As a result, some women are now seeking a subtler way to increase breast size. The January 2013 issue of Marie Claire discusses these latest trends:

Fat Transfer or Injection

If you don't want the alleged stigma of implants, you can increase your breast size with your own fat. Assuming you have extra fat to spare from love handles or saddle bags, it can be removed through liposuction and injected into your breasts.

The advantages? You will have no scars, your breasts may feel more
natural, and no one will know that you have had any work done. Further, if you gain weight,  the weight will go straight to your chest, according to a Beverly Hills plastic surgeon.

But there also are disadvantages. This process requires extensive recovery time because of soreness from  the liposuction. Furthermore, it costs more for less volume. Only about half of the fat, equal to about a half to a full cup size, remains after six months. The remainder is metabolized by the body. The procedure can take up to six times as long as the standard 30-minute implant surgery.

Other innovations

Some doctors now have Vectra 3-D Imaging Devices, which can inflate your chest photographically, so you can see what you will look like. Or, if you wonder what will be the most flattering proportion for you, there is an app for a computerized program that uses chest dimensions and nipple spacing to calculate your perfect cup size and most perfect silhouette. A graceful slope to the upper part of the breast looks natural compared with an upper bulge, which looks fake.

You can look ahead to more anatomically-shaped teardrop implants with gummy-bear like silicone filling that help prevent that bulging look on top.

For the most reliable information about for breast augmentation for you, contact a board-certified plastic surgeon.

Two-fers in Breast Surgery

Many women who desire better breast shape require restoration of volume and also elevation due to excessive sagging or what we call ptosis.

This can be a very challenging situation for a plastic surgeon and, believe me, experience DOES matter.  

A recent article discussed doing both operations together.  The overall re-operation rate is 23.2%- this was 20% for primary cases and 30.9% for secondary cases.  The most common complication was hard encapsulation, then poor scarring and recurrent ptosis.   

The re-operation rate of 23.2% is higher than either procedure performed independently.  Again careful patient selection and the experience of the plastic surgeon can go along way to making the combined-one stage procedure safe and effective.

What is it about women's breasts, anyway?

From time to time, as a board certified cosmetic surgeon and member of the ASAPS, I receive interesting articles that I feel are worthy of sharing with my patients and other interested parties. This one deals with the object of hundreds of thousands plastic surgery procedures in 2011. 

WARNING: It is rather explicit. Reading it probably should be restricted to adults.

A recent article in the Huffington Post may help explain why we have such fascination with the female bust. Authors Dr. Larry Young and Brian Alexander pondered the question while discussing their upcoming book, The Chemistry Between Us: Love, Sex and the Science of Attraction.

They point out that the obsession with breasts is uniquely human. Human males (and some females) are the sole mammals that look at breasts in a sexual way, and human females are the only mammals whose chests enlarge during puberty, even if they're not pregnant. Humans are also the only mammals that caress, fondle and otherwise stimulate breasts during sexual foreplay.

Men's obsession with busts is biological. In addition, many women report enjoyment and arousal from the attention focused on their breasts. 

So what is it about breasts that gets everyone so hot and bothered?

The authors believe two current schools of thought are inaccurate. One is that breasts, which are comprised of stored fat, indicate that a woman is in good health, and thus a worthy mate. Another suggests that breasts remind men of women's behinds, which are also known to sexually stimulate males.

Young and Alexander, the authors, claim the love of breasts probably comes more from nursing, and a chemical known as oxytocin. When a newborn breastfeeds, it stimulates the release of this chemical in the mother. This prompts the mother's muscles to release the milk and also causes her to focus her attention entirely on her child. Along with dopamine, oxytocin fosters a bond between mom and infant.

A man stimulating a woman's breasts during foreplay or sex, creates the same chemical releases, according to the authors. They believe women focus on their partner, his face, smell and voice, associating breast stimulation with pleasurable feelings toward their lover.

This theory may explain why many women in Southwest Florida and nationally choose to have breast augmentations or breast lifts. According to the American Society for Aesthetic Plastic Surgery, in 2011, 316,948 breast augmentation procedures were performed nationally.

Women who decide to have plastic surgery to enhance the appearance of their bust, however, should be sure that they are doing so for themselves, rather than to please others. They should discuss what they expect with a board-certified plastic surgeon, and ask to see before and after photos to get a better understanding of the possible kinds of results.

The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, (nor opinions I hold as a plastic surgeon in Fort Myers) but are offered as an educational service. 

For additional information on this subject and other plastic surgery related topics, please go to www.surgery.org

Breast size is increasing

Breast augmentation remains extremely popular.  In 2011, more than 316,000 women underwent breast enlargement.

 I recently read a brief synopsis of a new book authored by Florence Williams, entitled “Breasts: A Natural and Unnatural History.”

The reason behind the book was because Mrs. Williams was involved in a breast milk research study while nursing her daughter.  This led to extensive research and led to her book.  She found out her milk contained toxic materials.  She knew there was much to be learned.

In my practice as a plastic surgeon in Fort Myers, FL, when I do a breast aug, I would rather err on the side of a little too big because patients adjust up easier than they adjust down.  For years, people have been obsessed with breasts and their size.  What was revealing to me was what type of materials were used in breast implants in the early 1900’s.  Such materials as glass balls, ivory wood chips, peanut oil, paraffin and ox cartilage to name a few.

Today, life is much simpler - silicone or saline - and my choice is silicone. A patient must be at least 22 years old to get silicone, unless it is for reconstruction, i.e. a congenital defect.  

Since silicone is back on the market, the popularity of breast augmentation has risen dramatically.

Breast Augmentation & Quality of Life

            Of all the cosmetic procedures that I do, breast augmentation has one of the highest satisfaction rates.  


A team of researchers led by Dr. Colleen McCarthy of Sloan Kettering in New York developed a BREAST-Q questionnaire.  


Forty one women filled out the form before surgery and then 6 months post-op.  More than 80% of the women reported “significant improvement” in 3 out of 6 areas; they are:


1. satisfaction with breasts, 


2. psychosocial well being 


3. greater sexual well being.  


In my experience, I feel the overall satisfaction rate is more than 90%.  In almost 34 years as a plastic surgeon in Fort Myers, I have never been asked to take out implants because a woman didn’t like them!  That’s saying a lot.

Breast Capsule Formation - Dr. Brueck comments.

Another message in Dr. Brueck MD's continuing series of blogs about health and plastic surgery. As a Fort Myers plastic surgeon with board certification, Dr. Brueck strives to keep his patients and others informed about developments in cosmetic surgery. For more information about Dr. Brueck, visit his web site at Beauty-by-Brueck,com.

Having done hundreds of breast augmentations over the past 32+ years, I have to say the most puzzling, most aggravating unintended result is the development of severe encapsulation or breast hardening.

Some things are well known in that if a breast develops a hematoma or collection of blood post-op, the rate of hardness increases. I think it is fair to say that thin tissues or lack of breast tissue leads to greater risk of hardness. I also feel severe encapsulation is more prevalent in smokers. I think severe encapsulation is multifactorial.

A new area of research is shedding light on “biofilm”.

There is now evidence that when the implant is placed in a pocket that bacteria cling to the surface of the implant forming a biofilm or biological coating. Strategies are being developed to prevent this.

One study involves an antibiotic impregnated mesh that is implanted with the implant. In a pig model, all 14 animals that had implants without the mesh, developed capsular contracture AND none of the animals that had the antibiotic mesh developed capsular contracture.

Looks promising. Sign up to receive this blog via RSS feed to stay in touch with developments.

“ONE HOUR BOOB JOB?”

"It's always something", as Dr. Robert J. Brueck MD FACS, who practices plastic surgery in Fort Myers, FL, comments in this blog message. Dr. Brueck covers all sorts of information and issues about plastic surgery at his website, www.Beauty-by-Brueck.com

I guess in plastic surgery we do “a lot” of jobs – a nose job and now a one hour breast job. I recently was asked about this and had to do a little research.

This procedure has enjoyed some popularity overseas but it may be waning.

The product involved is called Macrolane and it is made by 0-Med, a Swedish biotech company who has also brought Restylane successfullyto the market.

Macrolane is an injectable gel made of highly degradable hyaluronic acid. It received a lot of fanfare and publicity.

Unlike Restylane, where maybe one or, at most, a few cc’s are injected, Macrolane was for “big” injections, eg.100,000 or more cc’s per breast. It has been done as a simple one hour outpatient procedure in the doctors office. Can imagine going back to work after a one hour lunch break with a new “profile”?

Well, several of the patients are now surfacing with pain, lumps and assymetrical breasts. It’s one thing to inject a few cc’s of hyaluronic acid versus a few hundred.

In the UK, this procedure cost about $5,000.00 and will last around 18 months or you can get a breast augmentation that lasts years for $8,000.00.

You be the judge – some bandwagons are best staying off of – this maybe one.

Another testimonial for Fort Myers Plastic Surgeon, Dr. Robert Brueck MD

Practicing plastic surgery in Fort Myers, FL brings me many satisfactions. From time to time, a patient heightens that satisfaction by writing me a thank you note. This one struck me as particularly heartfelt because of the patient's background. I hope you agree. (The original printed letter has been transcribed here as written.)

~~~~~~~

"Dear Dr. Brueck and Staff:

Thank you, thank you, thank you. I had a mastectomy in 2009 and was very adamant about not getting reconstructed and using a prosthetic. I did that for a year and a half and was getting tired of not having myself back. I did some soul searching and decided to interview a few Plastic Surgeons. I went on line and did a search and found Dr. Brueck. My husband and I had a consultation with him and immediately knew he was the one. From the minute we walked in his office from his staff to Dr. Brueck couldn't have made my decision any easier. I had reconstruction and a nipple done on my left side and an augmentation done on my right side do to a lumpectomy I had eleven years ago. I feel WONDERFUL and the reconstruction/augmentation looks BEAUTIFUL. Dr. Brueck is blessed with magic hands and a great personality.

Dr. Brueck and his staff made a very difficult sensitive situation easier tio handle. THANK-YOU!" - TC

Another testimonial for Dr. Brueck, Fort Myers plastic surgeon

From time to to time, Dr. Brueck gets testimonial letters that he likes to share with other patients and those considering plastic surgery. Here is one, which also will appear on Dr. Brueck's web site. Other testimonials also can be found there.

"When you look in the mirror, what do you see? For me, I saw WHO I was, but, not HOW I wanted to look. After four children, I was ready for some cosmetic changes that would make me feel more confident and comfortable in my own skin. I met two other surgeons before finally meeting Dr. Brueck. He had this warm personality that immediately made me feel calm and relaxed. I had a vision in my mind, and he somehow captured that vision and with his superb talent, he created that imagined vision into a gorgeous reality.


I had a full tummy tuck with muscle revision and a breast augmentation. My friends, family, strangers.... but, most importantly, Me, are impressed with the results. Everything looks natural. My new breasts are so perfectly placed that they look as though I was naturally blessed with a fabulous set of knock-out breasts. And the abdominoplasty... PHENOMENAL!! My abdomen has NEVER looked this good.

Dr. Brueck's artistic and sincere regard for my final outcome produced glorious results. The scar is so low and almost perfectly symmetrical, I could not have imagined it any better than this. Dr. Brueck is a talented surgeon and a man who truly wants to make the dreams of his clients a reality for all the world to see. Thank you, Dr. Brueck."

Obviously, this is one patient's experience and, while there are other similar stories on the testimonial page of Dr. Brueck's web site, this is not a guarantee that you or any other patient
will have identical results.

A plastic surgery patient testimonial for Dr. Brueck

One of the most important considerations for someone anticipating plastic surgery is how others, who already have had plastic surgery, feel about the results, the process and the doctor. I have recently completed a series of videos with patients who discuss their feelings about the work they had done.

I think you'll find them reassuring.

This one concerns a woman who lost 175 lbs. through bariatric surgery and wanted to renew her shape.

Let me know what you think.

You can leave a comment here or access the confidential contact form on my web site at http://www.Beauty-by-Brueck

Thank you.

Plastic Surgery - What recesssion

The economic downturn has certainly had its effects on cosmetic surgery.

The "lipstick effect", which is a name given to the economic phenomenon of increased sales of lipstick and other feel good products such as cologne and mascara during hard times, seems to apply to cosmetic medicine in particular. The number of invasive procedures performed in 2008 was up 5% compared to 2007.

A large part of this increase was due to people spending less on surgical procedures and choosing minimally invasive procedures instead. The number of surgical cosmetic procedures dropped 9% from 2007 to 2008 and a big part of this was due to the economic downturn.

The overall top surgical cosmetic procedure in 2008 was breast augmentation with 307,000, followed by rhinoplasty 279,000, the third was liposuction 245,000, and eyelid surgery 221,000 and tummy tuck 122,000.

So this is the second year in a row that breast augmentation has topped the charts as the number one procedure. I believe that this is due to the fact that silicone implants have been put back on the market.

Botox continues to lead the pack of minimally invasive procedures with over 5 million injections in 2008. With the recent FDA approval of Reloxin from Medicis , we may see an increase as prices fall and demand will increase.

The second most common minimally invasive procedure was the injection of Hyaluronic acid fillers which was a far distant second with 1.1 million injections; reflecting a 6% increase over 2007.

Overall, women accounted for 91% of all cosmetic procedures performed. One of the most common procedures among men was blepharoplasty or eyelid surgery and that declined 11% in 2008 while rhinoplasty (nose surgery) gained nearly 1%.

Interestingly enough the number of repeat customers or repeat patients in 2008 was up 7%. Office facility procedures were also up 13%. So in general, 2008 was a down year because of the economy.

As the economy rebounds we expect the number of people seeking cosmetic surgical improvement and procedures will increase.

Plastic Surgery - Do breast implants cause cancer?

Do breast implants cause cancer?

It's a question I have been asked over and over.

There is a new study published in the "National Journal of Cancer" that suggests women with breast implants have a lower risk for breast cancer. The analysis included 6,222 women in Sweden and Denmark, 80% of whom had silicone implants.

This study represents the longest follow-up to date of women with breast implants . 85% of the women were followed for over 10 years and 50% for more than 15 years.

Based on general population rates, researchers expected 115.62 women out of this study group to have breast cancer, but only 84 cases developed.

This is statistically significant and once again proves the safety and efficacy of breast implants.

For more information about implants for breast augmentation, please visit my Web site at Beauty-by-Brueck.com and click on the link to breast augmentation.

Bionic Breasts?

We all remember the famous TV hit of manyyears ago, called "The Bionic Man".

We have bionic hips and knees, and may soon have "Bionic Breasts."

A company in Hackney, South Australia is undertaking studies for the new TriBrege titanium coated breast implants (Poly Implants Prothesis or PIP).

Titanium is naturally present in human tissue and is very inert biologically. It is not toxic and induces no inflammatory reaction. This may hold promise to help prevent the unwanted contracture that can occur with normal breast implants.

It currently is undergoing clinical trials. More to come.

Pay a visit to Dr. Brueck's web site for more information about all things plastic surgery and cosmetic surgery.

News for women considering breast augmentation cosmetic surgery

Breast augmentation continues to be one of the leading, if not the leading, cosmetic procedures in my office. It is a wonderful operation.

Perhaps the major drawback is the fact that one or both breasts can become hard due to encapsulation. Every patient will get a capsule in response to a foreign body. This is a normal response.

The key is to keep the breast/implant soft. There have been many theories bantered about as to why one breast will suddenly get hard 3 or more years after surgery.

Recently, one plastic surgeon who did implant exchanges submitted the capsules for microscopic analysis. They saw cotton fibriles through out the capsular tissue studied.

One plastic surgeon recently stopped using cotton products during the course of his operations and saw capsular contracture reduce from 10% to less than 0.5%.

That's impressive.

So we are looking into getting non-cotton sponges for our procedures. Who knows - it all may help.

Cosmetic Surgery Grows in Popularity

So, what’s hot in cosmetic surgery now?

A pleasant surprise is the resurgence in the number of people wanting face lifts. The number of face lifts done in 2007 was 14% more than the number performed in 2006. This may reflect the fact that fillers and botulinum (or botox) can only do so much to rejuvenate one’s face. If there is redundant skin then only a face lift will provide a solution.

Breast augmentation numbers showed and increase of 6% more than the number done in 2006.

Breast reductions increased 2%, while gynecomastion (male breast surgery) operations increased 7%.

Overall there were 12 million cosmetic procedures performed in 2007 a 7% increase over 2006.

The following were the top five surgical procedures:

1. Breast augmentation (348,000 - up 6%)

2. Liposuction (302,000 - unchanged)

3. Rhinoplasty (285,000 - down 7%)

4. Blephoroplasty eyelids (241,000 - up 3%)

5. Abdominoplasty (148,000 - up 1%)

Non-invasive, non-surgical procedures continue their high demand. There were nearly 10 million minimally invasive procedures performed.

1. Botox (4.6 million - up 13%)

2. Hyaluronic Acid Fillers (1.1 million - up 35%)

3. Chemical Peels (1 million - down 4%)

4. Laser Hair Removal (906,000 - up 2%)

5. Microdermabrasion (897,000 - up 10%)

There you have it! The battle to turn back the hands of time continues.

If you're thinking of fighting your own "battle", contact me about procedures and financing we have available to help you have a good (looking) summer.