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.

What We Feel is Most Important for Breast Implants After the Operation

Today, Dr. Yoho brings you a two-for-one blog post

We emphasize the big three. Number one, support. Number two, fish oil. And number three, Vitamin E. 
 The support will help maintain the shape of the breast. The breast is sort of like Silly Putty, and it will gradually sag if not supported aggressively with the weight of the implant. Sometimes young people can get away with breasts that don’t sag so much for a while, but in the long run gravity catches up.

The other two things we emphasize after breast surgery involve prevention of capsular contracture. Capsular contracture or firming of the breast implant is the most common problem after breast surgery. We really think that Vitamin E is very helpful and have seen patients who weren’t taking their Vitamin E soften their breasts after starting just the Vitamin E. We recommend 800 IU a day in tablet form. This along with the fish oil can be purchased at vitacost.com.

Fish oil is now regarded as an excellent anti-inflammatory. Dr. Yoho takes it in large quantities himself for foot arthritis. We recommend a teaspoon of the fish oil a day and recommend the purified fish oil such as Nordic Naturals, Carlson’s brand or Eskimo brand fish oils. If you must take the capsules, you can take at least four a day, and if you actually have the start of firming of the breasts, Dr. Yoho may recommend a larger dose for a few months. 

Breast wishes,

 _______________________________



Robert Yoho, M.D.

The Advantage of Coming to See Dr. Yoho for Non-Invasive Procedures If You Are Prone to Anxiety

Did you know that because Dr. Yoho’s office is an accredited surgical center with AAAHC accreditation, Dr. Yoho has the ability to use intravenous medications for your more minor procedures as well as the major ones? We have patients that are scared of needles, which is a common phobia. We administer a little bit of relaxation medicine to these patients so they don’t feel anything at all during their Botox injections. Even for those who don’t have needle anxiety, we have reduced discomfort by using 32-gauge needles, which are the smallest needles commonly used in clinical practice. These can hardly be felt during administration of Botox. 

Additionally, we offer no extra charge sedation for our procedure with the fractionated CO2 laser, a procedure which has been popular and successful. You do need to bring a driver if you have sedation administered to you, but this is the only other requirement. We feel the risks are virtually nonexistent for the small amount of medication you’re given in order to accomplish these procedures in a way that’s pain-free and that erases memory of it. Additionally, you can use these procedures for fillers or any other minor surgical procedure if you are one of those people who is a bit anxious about discomfort. Lastly, we can get that intravenous line in your vein with no pain whatsoever in 90+ percent of the cases and in a fashion that most people won’t notice.

 

I like my breast size but they’re just saggy

Is there any way to do a breast lift and preserve my breast tissue?

When he's not in surgery, Dr. Yoho is with his family. Dr. Yoho's daughter in a light moment.

The answer, of course, is if your breasts are appropriate, we can preserve every bit of breast tissue you have and make them much perkier. The “LeJour mastopexy” that we do has a variation that allows for no removal of breast tissue whatsoever. In fact, this is the most common lift procedure we perform. Ordinary breast lifts typically remove 10 percent to 50 percent of the breast tissue, resulting in much smaller breasts.  

 Be sure to ask Dr. Yoho about the breast-preserving breast lift on your next consultation.

How Much Does It Cost For My Facial Procedures?

Moment from a great family vacation (not related to facial surgery).

Many people desire correction of one or two facial problems, such as a very weak chin or saggy eyelids. However, traditionally and very reasonably, when we work on a face, we often will correct all the defects in one appointment. This can include facelift, eyelids, skin resurfacing with peeling, and Botox and filler. Additionally, in most patients facial implants are very helpful, especially in older patients who have lost their fat volume.

Although we price our facelifts at $4,999, we’re willing to do whatever is appropriate for your face for $10,000. This includes all the above treatments, with the exception of nose surgery, which is a whole other specialty and a separate operation, in our view. We will evaluate you and do whatever is appropriate and whatever procedures you agree to have for this price. We think this is reasonable because the typical facelifts are at least $7,500. Facial implants range from $2,500 to $7,000 for one area and the peels can be $800 to $4,000. Eyelids range from $2,500 to $5,000 for uppers and the same for lowers.

We always use our sedation technique with a single agent and our patients don’t have to undergo general anesthesia. They have a reasonably comfortable experience with any nausea or problems afterwards being extremely rare. This is all included in the above pricing scheme.

The Use of Sticky Foam After Liposuction

Dr. Yoho climing El Capitan. No sticky foam here!

Reston foam was commonly used by liposuction surgeons worldwide ten to fifteen years ago. Its utility involved pasting the loose skin just exactly where the surgeon wanted it to the muscle tissues after the liposuction procedure. The advantage to this is that the girdle and the patient’s movement were unable to distort the skin placement and produce strange wrinkles that would take many months to go away. The disadvantage of this was the possibility that the patient would become irritated from the adhesive, have an allergic reaction to the adhesive which would produce a red skin or a rash, or even tear the skin when they were taking the adhesive-backed foam off.

Our solution to these problems is as follows: We instruct our patients very carefully to watch their skin irritation level and come right back into the office if they’re having any problems or any pain. We tell them to soak in a bath at day four, and this dissolves the adhesive to some degree, and then at day five after the surgery, they can more easily remove the adhesive-backed foam. While this is not a comfortable process, we’ve found that the foam, particularly in the front of the abdomen (not so much the sides) generally produces a far smoother result with much less irritation, despite the aggravation of having to take the foam off.

That said, pigment problems, areas of skin irritation or even superficial loss, and some other problems occur with the foam. Despite this, use of the sticky foam is exceedingly helpful, particularly in large-volume liposuction cases.

Another alternative to the foam is if the responsible patient is able to massage the area from day one or day two after the surgery, they can keep the wrinkles from occurring. This usually has to be done, however, in a lying-down position because the patients have a tendency to feel faint when they take the garment off this early.