Our very own Denver plastic surgeon, Dr. Nick Slenkovich, was recently featured on Colorado and Company discussing breast augmentation surgery. Dr. Slenkovich explained the differences in the types of implants, including saline, silicone, and the Natrelle 410 implants, as well as how possible breast implant sizes are determined. To learn more about breast augmentation, view real patient results or see how the 3D breast implant simulation is done, watch the video clip of the segment below.
“Changing your body. It seems that most of us would alter at least one thing if we could. But sometimes making those big changes takes getting some help from a doctor that you can trust. Colorado Plastic Surgery Center understands your concerns. Their caring, attentive staff and revolutionary technologies allow patients to feel very comfortable and very confident.
Dr. Nick Slenkovich is a double board certified plastic surgeon and a Patient’s Choice Award Winner for 2012. He is a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons. He is with us today to discuss a very popular procedure, cosmetic breast augmentation. You’ve got the credentials to prove that don’t you! You’re a busy guy.
Fifteen years of cosmetic surgery experience, along with what I said during the introduction. Breast augmentation continues to be one of the most popular surgeries, why so?
Good morning and thank you. In my practice it certainly is. For many years, it has been the most common procedure that we perform. Women often have changes in their breasts whether through pregnancy or simply not being satisfied with the shape of their breasts. Implants offer us a way to help reach those goals.
It’s come so far. It can really be such a natural, subtle look which is what we as women want!
Absolutely! Particularly if that is the goal, though it isn’t always the goal. It is a starting point that I would agree is a great option that is available.
The cosmetic surgery consultation process is important also to get an understanding of how things are going to go and how they are going to look. So you take people through everything?
Sure. Think about it, going to a plastic surgeon office, baring your soul, talking about something you are personally very concerned about, isn’t at the top of the list for most of us. We understand that and work to focus on learning about your circumstances, what your goals are, what your knowledge of a procedure is ahead of time and if there are any specifics that you want to learn about during the consultation. Then after really listening, we engage in a lot of education. We discuss how you might be a candidate and we don’t want you to leave without understanding what you can anticipate. There are a lot of tools that we use to accomplish that for every consultation. Ultimately the right fit for the person is our bottom line goal.
Dr. Slenkovich, I love that you offer 3D imaging simulation so patients actually get to see that result. What is that process like?
It can be very hard to imagine and specifically visualize what your result could be. For years, we used sizing where you place implant sizers into a bra. It is a very important element and we still use that today, but being able to visually see what those changes would have dramatically helped patients with that selection process. Also to see shape difference. We’ll get into the different shapes in a minute, but our computer imaging program takes a 3-dimensional picture that allows us to look from multiple directions and show right on you the result you can anticipate, including the differences between sizes. We would look at the various sizes, as well as the different shapes from the various implants.
It is such amazing technology. How that 3D image really gives you a true look. It’s fascinating to watch. What type of breast implants do you offer?
We’ve long used both saline and silicone gel breast implants. The current silicone gel implants were approved by the FDA in 2006. Then, more recently in 2013, the shaped or tear drop implants, that have a more anatomical shape were approved.
We used to hear a lot of bad press about the silicone implants. But that’s changing, isn’t it?
I would say that it has long since been changed. Silicone implants are very safe. Any concern about health effects, autoimmune disease in women, has really been ruled out. From that standpoint, I’m very confident using silicone implants in all patients, even in patients that are family members, or colleagues, or staff members. In all patients, it is going to be a good option and is by far the most popular implant.
I actually had the opportunity to tour the Allergan manufacturing facility. I came away highly impressed not only in the fact that they are at the very top in terms of manufacturing safety standards, but that here in the US we have the best quality implants of anywhere in the world.
You want to specifically speak about the Natrelle 410 implant. What makes this one special?
This is the Allergan Natrelle style 410 silicone implant. You can see this implant has a difference in shape versus the round, symmetrical shape of the general silicone gel implant. It is what we call a form stable implant, meaning it is a firmer gel that goes back to its shape and maintains it shape. By having a teardrop shape, it allows us to get more fullness to the lower part of the breast without giving an overly rounded, or overly full, shape to the upper part of the breast. For many patients, this is an excellent option for the natural look.
Let’s look at some pictures of the implants and take a look at what you can do.
Here is an example of the silicone implants. There is a wide variety of before and after outcomes that we can obtain.
This picture is showing the Natrelle 410 implant. We have some fullness in the upper pole, or upper portion of the breast, in someone who has tighter tissues where a round implant may give an overly rounded image of the breast. In a patient where the tissues may be a little tighter, this becomes a good option.
You do beautiful work. It looks so natural, is the first thing that comes to mind. We have another picture here that is the Saline implant.
This is a saline implant. It has a little more of a round characteristic at the very top of the breast that you can see in the pictures. That isn’t something we always see, but if we are going with a more significant size change or a larger implant, we can see this in some patients. Some patients desire it and we will look to achieve it, as in her case.
How do you work with the patient to determine the size?
It is a really important process. Fundamentally we place an implant during surgery and can’t easily change it afterward without re-operation. The first step in that process is determining the appropriate width. Here on the table, we have examples of four different shapes of implants. All of these implants have the same base width and would be an option for the same person. For you, as a patient, we identify the optimal breast width then we look at implants that meet that width.
One of the things I really like about the Allergan implants is they offer four different shape profiles for a given width, more than other companies offer. From a low profile, or much smaller implant, to the fuller profile, we have most options.
Of course, people might be thinking I would love to do this, but I don’t know about my time down. What is that like?
We are always working to optimize a rapid recovery. There are many steps that we take, but most patients are back to work within a week if they work in a light activity or office environment. There are a number of things that we can do surgically with the anesthesia. We use what we call a twilight anesthesia and there are a couple of major benefits. One, is you are asleep. From the standpoint of procedure, you have no consciousness, but you are getting less anesthesia and not a general anesthesia so you don’t have the general anesthesia hangover. That can last for several days in most people.
Also, I’m spending the first five minutes locally blocking the nerves that provide sensation to the breast making the breasts completely numb. It’s common for us to have a “no pain” rating from patients directly after surgery. They may feel a bit of pressure, but not sharp pain. That generally provides a smoother post-operative course of recovery.
The final thing we do is a post operative massage therapy. The lymphatic stimulating therapy gently manipulates the tissues removing fluid that helps with the rapid recovery process.”