Body Language - Denver Cosmetic Surgery Blog

Last year, Americans spent $13.2 billion on cosmetic surgery nationwide. That amount was the cost paid for 11.7 million surgical cosmetic procedures. Non-surgical treatments like BOTOX injections counted for another 2.8 million procedures done in 2007, according to a survey by the American Society for Aesthetic Plastic Surgery that included responses from 12,000 surgeons, dermatologists and otolaryngologists.

Dr. Ben Lee saw a rise in numbers of his patients interested in pursuing breast enhancement surgery due to FDA approval of silicone implants. Until the FDA gave the go-ahead for silicone, a number of patients were “on the fence” about enhancement surgery, says Dr. Lee. These patients were not willing to proceed with the surgery when only saline implants were approved because of the advantages of silicone over saline.

Silicone implants require less recovery time as the implant is placed over the muscle tissue, unlike saline implants that are inserted under the muscle which results in a longer recovery period.

“Time is precious to people,” says Dr. Lee. “Patients are increasingly desirous of keeping their youthful looks and even improving their natural looks, but they have to fit that into their active lifestyles, careers and obligations when scheduling their elective surgery.”

The top five cosmetic surgeries performed in 2007 were:

• Liposuction
• Breast augmentation
• Eyelid surgery
• Abdominoplasty (tummy tuck)
• Breast reduction

Cosmetic surgery has gained speed since the 1990s. Since 1997, surgical procedures have increased by 114 percent while noninvasive cosmetic treatments have risen 754 percent.

Besides breast enhancement (augmentation and reduction), Dr. Lee performs liposuction, the most popular cosmetic treatment of all in the 2007 report. Half a million liposuction surgeries were performed by doctors nationwide in 2007. The types of liposuction he performs are Lipoplasty, traditional liposuction and tumescent liposuction, depending on the area treated and the patient’s unique needs.

Dr. Lee also performs eyelid surgery and tummy tucks, procedures he says patients seek to look more youthful, giving them back the eyelids they had as a young person that don’t droop over the eyes and eliminating the bags under the eyes. The same goes for tummy tucks, he says. Patients are opting for tummy tucks to restore a sleek abdominal area, often after childbirth.

Share This

Too small, too big, too…? Like it or not, your breasts here to stay. But that doesn’t mean you have to live with what have if you don’t like ‘em. Not if you know Dr. Ben Lee of Englewood, CO, a double board-certified plastic and reconstructive surgeon who has done hundreds of breast enhancement procedures.

Studies show that most women feel that their breasts are their most important feature when it comes to attractiveness. And you don’t need a survey to tell you they’re pretty high on a man’s list of what he notices in a woman. That’s why esthetic breast enhancement is the most sought-after procedure in Dr. Lee’s cosmetic surgery practice today.

Age and childbearing take a toll on breasts. Even taking better care of yourself can have a negative effect on your breasts. Many women who come to Dr. Ben Lee for breast enhancement do so after losing weight. The nice resilient breast tissue of their youth is no longer there and after shedding those pounds, they’re left with a bad case of droopy chest.

“After about age 40, the fibrous breast tissue called stroma starts to be replaced with fatty tissue and the skin begins to lose its elasticity,” Dr. Lee says. “The combination of these factors is the principal cause of sagging breasts.”

While there is little to be done about the loss of stroma (although according to Dr. Lee there may be some encouraging news coming out of stem-cell research), there are some common surgical procedures that have given positive results for thousands of women over the years. They fall into four general categories: reconstruction, augmentation (enlargement and/or reshaping), reduction, and lifts.

Nature has blessed women with an incredible variety of breast shapes and sizes. But sometimes the size or shape is not what an individual wants. Board-certified plastic surgeons like Dr. Ben Lee are there to help. “Sometimes a woman’s breasts are too large and uncomfortable, some are smaller than she wants, or sometimes they just aren’t the right size or shape for the rest of her body,” Dr. Lee comments. “And there are also times when breast reconstruction is needed, like after injury or breast cancer surgery.”

Breast enhancement isn’t just about vanity. Self-image and self-esteem are often the motivation. “Many women tell me that after breast enhancement, they feel ‘normal’ again,” Dr. Lee says.

Dr. Ben Lee is widely respected when it comes to breast enhancement, whether it’s major reconstructive surgery or the latest in surgical implants. If you and Dr. Lee agree that an implant is right for you, the next step is choosing the type.

Silicone implants were removed from the cosmetic surgery market in 1992 after several complaints about leakage, not because they were dangerous, but because they were unable to be proven safe under some very strict FDA guidelines. They were still allowed for reconstructive procedures and in some closely monitored investigational studies.

“There are some definite advantages to silicone implants and the manufacturers were able to convince the FDA that a need existed,” Dr. Lee explains. “They continued to be used in other countries without any unusual problems, so in late 2006, the FDA approved their use again in women 22 years old or older.”

Each type of implant has its pros and cons. Experienced plastic surgeons like Dr. Lee use both, each in its own best way. Dr. Lee will discuss this with you in detail during your consultation.

Saline implants have the advantage that if they should leak they will collapse and the solution will be absorbed and naturally expelled by the body. Their disadvantage is that due to their lower density (water vs. gel), they may show some rippling if placed near the skin’s surface. Some women also say saline doesn’t feel as natural to the touch as does silicone.

Since silicone is an elastic gel, it feels and moves much like natural breast tissue. A leaking silicone implant may not collapse like saline does. “Although the silicone implants we use today are safe from a medical point of view, I do like to see my silicone patients regularly to make sure the implants are functioning properly,” Dr. Lee says.

Dr. Lee will also discuss the different implant techniques with you and will help you choose the one that best accomplishes the outcome you want from your breast enhancement.

Breast implants are not necessarily a life-long solution to your appearance. Weight loss, pregnancy, aging and menopause may all have affects. If that should be the case, further surgery may be an option. On the other hand, some women do not experience those affects or, even if they do, are still comfortable with the natural changes.

“There’s no reason a woman today should be unhappy with such a major appearance factor as her breasts,” Dr. Lee says. “I would encourage any woman who feels that her breasts are causing her physical or emotional problems to come in for a consultation.”

Share This

Q. What are the most popular plastic surgeries women are having today?

A. According to the FDA, the top five cosmetic surgeries for women in 2006 were:

• Breast augmentation = 383,885
• Liposuction = 350,420
• Eyelid surgery = 182,397
• Tummy tuck = 164,800
• Breast reduction = 145,822

Q. How do I know if I’m a candidate for a particular surgery?

A. As with all surgery, says Dr. Lee, one must be realistic about expectations and outcomes. “No cosmetic surgery will change your life, but patients regularly report back that their self image is improved after plastic surgery. That translates to their outlook on life and they feel better about how they look in clothing. We want our patients to seek surgery for the right reasons: not at the urging of a partner or spouse, but rather because the patient has tried all else—exercise and eating right—and has yet been unable to restore their physique to that of their younger years.”

Some surgeries just go with the territory of aging. Eyelids begin to look puffy and eyelids that get too droopy can impede vision. Tummies that aren’t toned get flabby and particularly after childbirth, the tummy can be extended and never again return to its original tautness. Dr. Lee recommends that patients do a couple of things prior to electing cosmetic surgery:

• Quit smoking as it increases the chance for blood clotting
• Exercise to firm up muscles that have gone “soft” without adequate workouts
• Diet to lose the extra weight and maintain that ideal weight for 6 months prior to surgery.

By doing these three things, a person can expect the best results from the surgery they opt for and they will also improve their overall lifestyle, important after the surgery so that the surgical results can be maintained indefinitely.

Share This

Q. I am in my 40s and have been opposed to breast implants until lately. They always looked fake, almost like a shelf on some women. But now, my breasts are aging faster than my face or other parts of my body. They are sagging, and no longer full. I don’t even like to wear T-shirts any longer and “cover up” with sweaters during winter to hide my lack of shape. Am I a candidate for implants?

A. If you were opposed to breast implants previously because you didn’t want to look like you were wearing two half cantaloupes on your chest, then yes, there have been changes in implants that you will want to consider. The FDA approved silicone implants in late 2006 and after completing 90 days of online advanced education courses, surgeons nationwide are approved to use silicone implants on their patients. At Dr. Ben Lee’s office, we’ve seen a jump in the numbers of patients seeking breast implants because silicone implants are more pliable, naturally feeling and looking than saline implants that are not malleable like real breast tissue.

Q. It may be ironic, but saline sounds softer than silicone would be. Explain the difference.

A. Prior to the FDA’s endorsement, silicone implants were limited to reconstructive surgery for post-mammogram patients, so Dr. Lee, who is highly regarded for his reconstructive surgery as well as breast enhancement surgery, was already familiar with silicone implants. He immediately underwent the training and is now performing the surgery for patients who’ve been anxiously awaiting their scheduled surgeries. The differences between saline and silicone run much deeper than cost and feel. Silicone implants are less painful by far, and require less recovery time because they are implanted on top of the muscle tissue rather than underneath it like Saline implants. Silicone is also the optimum type of implant for women without a whole lot of breast tissue, something most women seeking implants don’t have naturally.

Q. How safe is silicone?

A. Silicone breast implants are possibly the most extensively studied implant in existence, even according to FDA spokesmen. Over a more than 10-year period, independent studies examined whether silicone gel-filled breast implants were associated with connective tissue disease or cancer. The studies, including a report by the Institute of Medicine, have concluded there is no convincing evidence that breast implants are associated with either of these diseases. However, that doesn’t mean the studies will stop. Post-FDA-approval studies are continuing with the FDA monitoring makers of the implants—Allergan Corp. (formerly Inamed Corp.), Irvine, Calif., and Mentor Corp., Santa Barbara, Calif.—following 40,000 women for 10 years.

A. What was the conclusion of the FDA about silicone from its studies already done?

Q. Daniel Schultz, M.D., Director, Center for Devices and Radiological Health, for the FDA, was quoted in the FDA News in November 2006 as saying, “The extensive body of scientific evidence provides reasonable assurance of the benefits and risks of these devices. This information is available in the product labeling and will enable women and their physicians to make informed decisions.”

The full disclosure that the FDA spokesperson refers to is in the package and patient labeling on the implants required by the FDA. Risks and benefits highlighted in this literature include:

• Breast implants are not lifetime devices and a woman will likely need additional surgeries on her breast at least once over her lifetime
• Many of the changes to a woman’s breast following implantation are irreversible
• rupture of a silicone gel-filled breast implant is most often silent, which means that usually neither the woman nor her surgeon will know that her implants have ruptured
• A woman will need regular screening MRI examinations over her lifetime to determine if silent rupture has occurred, the first three years after her initial implant and then every two years thereafter.
• If implant rupture is noted on an MRI, the implant should be removed and replaced, if needed.

Q. What will continued studies look for?

A. Post-approval studies will collect information on the safety and effectiveness of the implants, including:

• rates of local complications
• rates of connective tissue disease and its signs and symptoms
• rates of neurological disease and its signs and symptoms
• potential effects on offspring of women with breast implants
• potential effects on reproduction and lactation
• rates of cancer
• rates of suicide
• potential interference of breast implants with mammography
• and MRI compliance and rupture rates. 

Q. What do implants cost?

A. Implants run about $6500 and about $8000 with a lift in Dr. Lee’s practice.

Even though silicone is a higher priced implant over saline, it’s not stopping patients from choosing the “real” look and feel over saline implants that are too perky for most women’s preference. Silicone implants run approximately $800/pair (materials cost to the surgeon) vs. $350/pair for saline.

Patients should also consider that if they’ve had implants, they are advised to get an MRI three years after surgery and then again every two years to check for leaking. The cost of an MRI is approximately $2000 today and this type of MRI would not be covered by insurance. That means that over the lifetime of one’s implants the MRI testing will exceed the cost of the original implant surgery.

Q. How long do implants last?

A. No implant, according to Dr. Ben Lee, is meant to stay inside the body for more than 20 years, which means replacing the implants at some point.

Q. How do I know if I’m emotionally prepared for implants?

A. Undergoing implants is a highly personal decision, one that Dr. Lee insists patients make for themselves rather than at the urging of a male friend or husband. His patients who have had breast implants routinely tell the doctor that they feel much better about their physique. “That’s what the surgery is all about in the first place,” adds Dr. Lee.

Share This