Massage Therapy of Breast Implants and Breasts After Breast Implantation

On the beach in Trinidad

Most surgeons believe massage to be of critical importance after breast implantation, as it is thought by most to decrease the chances of firming of the breast or capsular contracture. We generally recommend massage, but it must be done in specific ways, so please discuss this with Dr. Yoho during your follow-up visits.

During the first few days after breast implantation, you do not have to massage your breasts because generally they are too tender. But if you can handle a little light massage, this will help you get the best results. The first object of massage is to keep the area above the implant open. In order to do this, you squeeze the bottom of the breast implant and breast with your thumb on one side and your fingers on the other, several times a day. Again, these techniques must be individualized, so if your breasts are taped up or you are in a special garment, don't massage it until after your first follow-up visit.

The other wonderful thing about massage is that you can reshape your breasts, particularly in the first few months after your implantation, with the proper massage. For example, in order to lower or increase the pocket in an area that seems to need a larger pocket, in other words, if there is a little flat area, pull up on the skin right next to the fold, push the implant down, and massage right along the fold with your other hand. We will demonstrate this technique in follow-up. If your fold seems too high on one side, you can lower the fold a bit by doing this type of massage. Examine the lower part of your breasts where the chest skin meets the upward swell of your breast, so you can understand the curve and how each breast is different, because they are always a little bit different. You can dramatically improve your breast implant results by the proper massage.

We also use a variety of support bras to improve the result. We strongly recommend that most patients wear bras continuously for the first nine to twelve months after the breast implant procedure. Many patients are a candidate for a properly fitting under-wire bra relatively soon after the surgery, but if you have an under-wire bra that sticks into your breast, that's not proper so please don't wear anything like this. If you're having discomfort, we want to know about it and see you as soon as possible. Please stay in close contact over the telephone and by coming in for your follow-up as directed in order to achieve the best results. Remember that your surgery is not done the moment you leave the office, because if you don't follow up and you don't follow our instructions properly, you may have breasts that hang too low, or have one breast higher than the other, or run into a variety of other complications. Rarely do we need to perform a second surgery to improve a result, and this is generally not necessary in a patient who is able to follow directions about bra wear and massage properly.

We Frequently Have Our Thank-Yous Delivered by Florists

The accompanying photo is of a beautiful flower arrangement that was given to us by a patient who had just had a large-volume liposuction. She gave us a little card (I cut her name out of the card so that it would protect her privacy online). She was very enthusiastic about her results. She could tell that she obtained a beautiful result even four days postoperatively, which is when we received the flowers.

Dr. Yoho and Judy Go to Swim Camp in the U.S. Virgin Islands

Recently, Dr. Yoho and Judy decided to improve their swimming technique and went to the U.S. Virgin Islands for a camp which consisted of four hours of swimming a day. It wasn’t as hard as you might suspect, because a lot of it was instruction. Judy was at about the dog-paddle stage. Dr. Yoho had a confident stroke, but it wasn’t very refined and he’d never swum on competitive teams in the past. The mission was to attempt to learn “total immersion” technique from Terry Laughlin, who can be found at http://www.totalimmersion.net/ with lots of videos to explain this particular kind of swimming. The object is to swim long distances without expending a lot of energy. It’s harder than it looks, and despite swimming four miles once during camp, Dr. Yoho has still a long way to go in his technique. Judy made great improvements and had great instruction and had a lot of fun, but is still not a super-confident swimmer. They thought that few of these photographs might be fun for our patients and friends to see.

We recommend active and healthy lifestyles, and here is a link to our website where Dr. Yoho recommends nutrition advice as well as exercise advice.

Have You Heard About the Liposuction Revolution?

Dr. Yoho (while NOT performing liposuction) and friends

There is a new device that we have had for several months that has revolutionized our ability to extract fat in a safe, even fashion. This instrument is a mechanical device which rotates 360 degrees in each direction every second. And this motion is safe and makes the liposuctionist's ability to extract fat in an even, rapid fashion much better. 

Our experience with this has been all positive. We've never had any significant complications. We seem to be cutting our times down by about 25 or 30 percent, which helps the patient because they receive less anesthetic and therefore are not as groggy after the case. Having them get in the compression garment sooner is a big advantage because the tissues don't have time to get swollen. 

There is nothing else different about how we do the procedure; we use the same local anesthetic and the same sedation techniques we describe in our other blogs, and the operation by the surgeon mimics identically the stroking that is necessary in the older technique. 

We would like you to come in and we can show you this device and tell you more about how it has improved our liposuction results in practice.

The Best Thing Since Sliced Bread

We believe our Fractionated CO2 laser, the SmartXide DOT is absolutely fantastic and many of the experts in the field have said that it’s a huge advancement in laser technology. 

The technique is that the laser sprays tiny treatment areas—literally, many tens of thousands of them onto the face with each treatment.  It leaves bridges of normal skin in between the treated areas which are very tiny and which allow the face to regenerate in a very natural fashion.  The treatment takes about fifteen minutes. 

We have had great results with people of all different skin types; and particularly with moderate, intermediate skin types such as Hispanic and Middle Eastern skin types.  The color improvement can be marvelous.

Please come in for your free consultation as soon as you can so you can get your laser treatment lined up.  We offer free sedation if you have a driver--and your experience will be a very pleasant and relaxing one; furthermore, you won’t even remember the procedure!!!



Fractional Laser Improves Skin Color Irregularities in Previously Laser-Damaged Skin

Gorgeous getaway--Dr. Yoho vacation photo

We have a patient who had a prior laser procedure on her neck and had irregular pigmentation where there were some white areas and some darker areas. This individual had this problem for over ten years and had tried all kinds of things, including the Fraxel laser treatment, which is another wavelength than the fractional CO2 laser, even though the names sound very similar. 

With a couple of fractional CO2 laser treatments with our SmartXide DOT laser, all of the skin on her neck evened out to a healthy tan color and the “splotchiness” went away. We think that these fractional CO2 treatments stimulated the pigment in the areas that were lighter and also took away pigment in the areas that were darker. It just has a very nice quality of evening the skin texture and color and making a much more pleasing and youthful finish on the skin. It has been quoted to be one of the biggest advances in laser technology we've had in the last 15 years by at least one famous dermatologist, and we believe this is true. We have more or less abandoned use of the other treatment modalities for light and intermediate depth peels because the fractionated laser works so well. 

We only charge $750 for a full-face laser treatment and a bit more for face and neck and chest. Many of the dermatology offices charge twice this. We use this as an accompanying treatment in many of our surgeries and the patients really appreciate their results.

Did You Know That the Upper Pelvic Area of Female Anatomy Has Different Standards of Beauty in Different Cultures?

In certain South American cultures, the area below the belly and above the vagina is deemed very beautiful if it’s plump and even a little over weight by most American standards. Certain people and certain cultures like this area bigger, and fat transplant can accomplish this if you think that your area is too thin.

For the most part, however, American women like this area liposuctioned when we liposuction the rest of their trunk area or torso. We do this as a matter of course unless there are other requests.

We occasionally come across someone who has a different standard of beauty and for these people fat transplant is not appropriate.

So it’s entirely up to you. We can change your body the way that you think is best by either fat transplant or liposuction. Please come in for your consultation to see just what we can do for you.


All the best,


Robert Yoho, M.D.

If My Breasts Are Uneven After My Implant Surgery, Can I Have a Touchup?



Dr. Yoho and Judy Yoho enjoying some time away from the office

These cases are very individual. Many times the breast implant surgery is a compromise between creating scars on the breast by doing more incisions, and having the best shape. Each case is its own animal, so to speak, and we need to carefully evaluate and do a lot of thought before touching up breast surgery.

That said, if your breasts are significantly uneven after our initial surgery, sometimes a simple procedure is all that is needed to make them closer to perfect.

Touching up breast implant always involves further risk of capsule formation or hardening of the breasts. This problem probably increases with every additional surgery on the breast, and additionally, careful attention must be given to the original approach to the breast implant to be sure that we’re not cutting off additional circulation to the breast tissue. The rule of thumb is that if it’s possible, we need to use the same incisions as were used originally. We view these cases as a challenge, and we need our patients to have proper expectations about this sort of surgery. Particularly, patients need to understand the idea that a second touchup might be necessary in cases like these.

Generally, the implants are changed out with new implants if the implant space is entered.

Most of this depends on you: Your psychological setup about your expectations, your level of perfectionism, but most importantly, just what your breasts look like and how much breast tissue you have to work with over top of the implant.

Breast wishes,


________________________
Robert Yoho, M.D.

Did You Know That You Can Have Your Breast Implants Insured?

 No, this doesn’t mean that you’ll get a million dollars if one of your breast implants ruptures and you’re not as pretty as you were before. It does, however, mean that for ten years your surgeon will be paid to replace your breast implants if there’s a deflation or loss of volume in your implant. The insurance covers both implants, and you can get the other one replaced at the same time as the problem implant at no extra charge. The fee is just $100 and you have to turn in your insurance forms and pay your $100 within 30 days of your surgery in order to get this special coverage. We recommend it to all of our breast implant patients and we think it’s really worth the nominal fee.

Breast wishes,
______________________

 Robert Yoho, M.D.

Dr. Yoho’s New Skin Care Product

We have developed a new skin care product that is better than anything we’ve tried before, and we’ve been using it for our patients with sun damage and irregular skin and have found that it has impressive results for our patients. This new skin care has a special fresh ingredient without preservatives, so it has to be refrigerated. The product creates new collagen in the skin and turns over the surface skin in a way that makes your skin refreshed-looking and usually lighter in color (producing a more even appearance). 

Note that if you’re not using sun screen, any skin care or special products just won’t work very well. The sun is your enemy in this department. And if you don’t wear your sunscreen, no skin care which is supposed to improve your skin will stand much of a chance. 

We recommend Fallene brand sunscreen, which has both a chemical and a physical sunscreen product included. The physical sunscreen are tiny particles of metallic substance which will go on clear if you rub it into your skin, and this provides instant protection in addition to the chemicals which absorb the sun’s harmful rays.

Botox and the New Botox Medications

One of Dr. Yoho's daughters at the Louvre

Botox is one of the most popular cosmetic procedure options ever, and certainly there are more Botox treatments than any other kind of cosmetic surgery performed in America. Unfortunately, the material only has an affect for three to four months or a bit longer and has to be repeated, but the good side is that if you repeat it regularly for a year at three-month intervals to four-month intervals, less Botox is probably needed.

The other good news is that a cheaper Botox is available now and this is called Dysport. Despite claims of the manufacturers that one is superior to the other, we find these products in practice to be virtually identical, with the advantage of Dysport being a bit less expensive. Whether or not the surgeon passes this savings on to the patient is up to the individual surgeon.

Also, surgeons are ordering these products from outside of the country. This is actually against the law, but in practice, the material seems to be identical, although the bottles can be identified by someone who knows what they’re looking for. Dr. Yoho does not use out-of-the-country Botox or Dysport. 

The second piece of good news is that a new neuromuscular blocker or muscle relaxer is on the horizon and slated to be marketed this year, hopefully for a lower price even than Dysport. We would love to have a product that lasted longer, but we’ve heard no reports to the effect that this new Botox lasts any longer. Hopefully, though, we will be able to pass the price savings on if the new product turns out to be virtually the same as Botox or Dysport.

So don’t believe any claims that one of these things is better than the other. The skill of the injector, the amount used, and just where the material is placed are the critical variables in how long it lasts and what kind of a result you have. Remember to check with your administering surgeon or medical aesthetician two weeks later if you have any question or problem with your Botox or Dysport result. Often there will be a little irregularity in the response or a problem that can be fixed with a few units of additional material, and we do this for free.