Implants, lasers and peels


Q: I had a breast reduction done when I was a teenager (now age 30)and now, if you can believe it, I’m thinking about getting breast implants. I am a 34B and was thinking of getting 350cc silicone gel implants if this will not make me too big. My main concern is am I more likely to have something go wrong. Is it (augmentation) more difficult since I already had breast surgery?

A: Surprisingly it is not rare thata former breast-reduction patient will one day later desire a breast augmentation. Teenage breast reduction has the potential for this to happen as the reduced breast will be exposed to pregnancies, which cause breast involution or breast-tissue shrinkage. When coupled with the prior breast reduction, a woman can eventually end up with almost no breast tissue at all. The desire for augmentation after reduction may also occur if the amount of breast tissue removed was excessive.

Prior breast-reduction surgery has no negative influence on the subsequent placing of breast implants. Reduction surgery occurs above the muscle; implants are generally placed below the muscle.

Q: I have a few wrinkles and extra skin on my lower eyelids I would like to get rid of. I have read about lasers and chemical peels. Which of these two lasts the longest? Which is the most natural looking result? Which is least likely to excessively tighten skin? I am curious as to why laser resurfacing is so popular over chemical peels.

A: Both methods, laser versus trichloroacetic acid chemical peel, are commonly used and it is a matter of comfort and experience as to which method plastic surgeons use.

It is likely you may also benefit by a pinch lower blepharoplasty with a TCA peel, but I would have to look at your lids to answer that question. This is a favorite method of mine for the lower eyelids because it works very well with a very small amount down time. It is also the most minimalist method to guarantee lower lid skin would be tightened to some degree.

Lasers are more popular than peels today for a few reasons. First, they are more “high-tech,” and with that comes the assumption they produce better results. In addition, their high cost and the need for the manufacturers to sell them drive a lot more visible marketing efforts.

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