Update: State-of-the-Art 3D Imaging Still Has A Way To Go

by Andrea L. Algar

Dr. Robert Young has always been in the forefront of technologies available to women who want to improve their self-image, their confidence, or their looks with breast enhancement surgery. Dr. Young has performed so many breast augmentation surgeries over the years that he is widely known as the "breast doctor" in San Antonio, Texas, where his office and Outpatient Surgery Center is located. 

Dr. Young recently added a service he thought his patients would like using brand new, state-of-the-art 3D imaging technology. After uploading a few photos, answering a few questions and selecting implant sizes you're interested in, 3D images would be made showing what the implants would look like on your own body. After using the system for several months, however, Dr. Young found that it doesn't quite deliver. The results were disappointing and he decided to discontinue use until the makers could work out the host of problems.

And this isn't the first attempt at utilizing this type of technology. Dr. Young has owned and used imaging software for well over 10 years which "morphs" patient photographs, projecting potential surgery outcomes by manipulating the photo in the office. As Dr. Young describes, "We prefer not to use the morphing techniques because actual outcomes can be quite different than those projected by computer." The computer cannot take into account unique body characteristics that a skilled surgeon knows how to handle and to what extent can or cannot be changed. "Computers cannot deal well with asymmetry or uneven breasts, tubular breasts, wide-spread breasts and other problems we as plastic surgeons are trying to correct for our patients," explains Dr. Young. "I like to rely on what my thirty years of experience have taught me."

The good news is that the methods that Dr. Young been using in his consultations with patients continues to work very well. Since Dr. Young has performed an estimated 8,000 breast augmentations, he has a large collection of before-after photographs which contain a wide variety of body types and breast implant sizes used. This is an excellent way for you to see the quality of his work and how saline or silicone breast implants may look on you.

Dr. Young uses a variety of breast implants including saline and silicone gel implants, in many different sizes, styles and projection heights in order to create the look you desire. There are many different surgical methods available to you as well. Dr. Young is happy to discuss endoscopic, minimal incision methods that leave the smallest scars possible and help you return to your everyday life as quickly as possible. He can address questions about awake surgery, TUBA incisions, adjustable implants, fat injections and many of the more recent trends in breast augmentation surgery.

REFERENCES:
dryoungforever.com - Dr. Robert N. Young, MD, FACS, Board Certified Plastic Surgeon
                                
ABOUT DR. YOUNG

Robert N. Young, founder of Aesthetic Enhancement Cosmetic Surgery & Laser Center, is a Board Certified Plastic Surgeon with over 30 years experience. He has been trained and has extensive experience both as a reconstructive plastic surgeon and a cosmetic plastic surgeon. He has become known as the breast doctor of San Antonio. His San Antonio practice includes a fully accredited outpatient Surgery Center staffed with qualified Registered Nurses, Anesthesiologists and surgical technicians. As a leading plastic surgeon in San Antonio, Texas, Dr. Young is a member of the following professional organizations:

- ABPS Diplomate - Board Certified by The American Board of Plastic Surgery (ABPS)
- Member, American Society for Aesthetic Plastic Surgery (ASAPS)
- Member, American Society of Plastic Surgeons (ASPS)
- Fellow, American College of Surgeons
- Member, Texas Medical Society (TMS)
- Member, San Antonio International Society of Plastic & Reconstructive Surgery (SAISPRS)
- Bexar County Medical Society (BCMS)
- Accreditation by the American Association for Ambulatory Surgical Facilities (AAAASF)

What is the Most Effective Liposuction Technique?

To try and answer this question, the American Society for Aesthetic Plastic Surgery (ASAPS) went to those who perform liposuction most - Board Certified Plastic Surgeons. The professional association's members were surveyed recently, and asked which methods they prefer most, and which ones they perceive as the safest.

The results are in! Overwhelmingly (at 51.4%), they preferred suction-assisted liposuction (or commonly called "traditional" liposuction, which includes tumescent liposuction). Second and third most preferred (23% and 20.9% respectively) were PAL (power-assisted liposuction) and UAL (ultrasound-assisted liposuction).
LAL or "laser-assisted liposuction" accounted for only 3.9% of plastic surgeons preferring this procedure. LAL methods go by many trendy names, but all are assisted by the use of a laser. Many manufacturers claim that the procedure can be performed under local anesthesia, however, in our experience, most patients cannot tolerate liposuction under local anesthesia, especially for large areas. Patient discomfort can lead to the procedure being aborted earlier than desired.

Dr. Young prefers traditional tumescent liposuction techniques and the use of our own PAL "Tickle Lipo". It seems that Dr. Young is not alone in his perception of what works best!

Dr. Young has been performing liposuction in his private cosmetic surgery practice for over twenty years, and has this information to share: When considering your need for fat removal, realize that problem areas are identified by "area", such as abdomen, hips, thighs, or "love-handles" for men! Liposuction is also very effective for arms, neck or chin, and for reducing large breasts on men. When considering liposuction, consult with a Board Certified Plastic Surgeon, as they are the physicians who have received the highest levels of appropriate cosmetic surgery training.

In recent years, Dr. Young has perfected his technique of Brazilian Butt Lift, where fat is suctioned from one or more areas of the body is transferred into the buttocks, creating a shapely, voluptuously full figure that is so in fashion. Fat transfer techniques are also effectively used on the face, where loss of volume naturally occurs as we age. While fat transfer to the breast is once again being talked about as a viable alternative to traditional Breast Augmentation with either silicone or saline breast implants, the use of fat in the breasts often requires multiple procedures to end up with the volume you desire. This is because not all of the fat injected survives. Many prefer the tried-and-true methods that have been perfected in Breast Augmentation with advent of endoscopic technologies which allow for minimal incisions, good placement of implants, and beautiful, lasting outcomes. Liposuction is suitable for both men and women, and Dr. Young has seen a steady rise in the number of men who are electing to have liposuction surgery performed. In experienced, skilled hands, liposuction has evolved into an extremely safe and effective surgery for those wanting to reduce problem areas, sculpt the body, and even to add volume to areas lacking shape.


Robert N. Young, MD, FACS is a Board Certified Plastic Surgeon with his own private Surgery Center in San Antonio, Texas. For more information on Dr. Young, visit his website at www.dryoungforever.com.

Keller Funnel Makes Breast Implant Insertion Easier and Less Painful

by Robert N. Young, MD, FACS

Board Certified Plastic Surgeon

Having just returned from the cosmetic meeting in Miami, it was exciting to have a first-hand introduction of a new device that makes breast augmentation easier.

The Keller Funnel is a cone shaped device which aides in the placement of silicone breast implants, allowing for smaller incisions and less rubbing as the implant is being inserted. The funnel minimizes trauma to breast tissue, and puts less stress on the implant itself. Because the cone is lined with a special lubricant coating that when moistened makes the funnel extremely slippery, silicone implants (which are pre-filled at the desired size) can easily be inserted without the surgeon ever having to touch the implant. 

What is exciting is that in addition to the standard nipple incision long used for silicone implants, it now allows silicone implants to more easily be inserted through the armpit, which is exciting news for patients who are concerned about scarring on their breasts.  Many of my patients have avoided silicone implants because they did not want incision scars that would be visible on their breasts.  Patients who want no breast scarring often choose the transaxillary incision, which is made in the armpit and leaves a tiny scar that is virtually impossible to see once healed. The transaxillary procedure can be preformed with or without the help of an endoscope (a tube with a small surgical camera on the end). Up to now, saline implants were the primary choice for the armpit incision, because of the distance from the incision to the breast pocket. With the Keller Funnel, silicone implants can more easily be inserted through the armpit.

Even more exciting is that with use of the Keller Funnel, silicone breast implants can be placed  either below the muscle or subfascially.  The subfascial insertion allows for faster recovery times and much less pain, which is the primary post-op complaint.  I am able to achieve outstanding results with an armpit incision using the Keller Funnel and placing the implants below the fascia.  My patients now have even more reason to consider the choice of silicone breast implants with the introduction of this great new invention.

For more information about the Keller Funnel, visit the following links:
1) theplasticsurgerychannel.com
2) http://www.kellerfunnel.com/

I'm happy to discuss how this new procedure can benefit your Breast Augmentation surgery with me.  If you would like to contact me, please visit my website dr-youngforever.com  or  e-mail Dr. Young.

I'm afraid of anesthesia...is the "awake" method good for me?

by Robert N. Young, M.D.

Board Certified Plastic Surgeon

We've seen a new trend in Cosmetic Plastic Surgery...promotions of "Awake Breast Augmentations".  It is talked about as something new, but in actuality, surgeries performed under "local anesthesia", or "twilight anesthesia" have been around for many years.  Whether it is a good choice for patients is being hotly debated.

Because Breast Augmentation has become such a popular procedure, and is more readily talked about by society, some feel it has become somewhat frivolized.  It is easy to forget that this is still a major surgical procedure. While endoscopic (minimal incision) techniques have made the surgery less invasive and easier to recover from, the procedure is best done under general anesthesia with a Board Certified Anesthesiologist. "Twilight anesthesia" can be dangerous without an anesthesiologist present.

There is quite a bit of debate recently about practitioners who are advertising "awake" surgeries.  These are usually performed by physicians who are not Board Certified Plastic Surgeons, and may not even be Plastic Surgeons at all.  Sometimes they are Dermatologists, General Surgeons, or even Family Practitioners who elect to perform the surgery under local anesthesia because they do not have  privileges in a hospital or certified surgery center to perform those procedures. In my Surgery Center, all anesthesia is administered and monitored by Board Certified Anesthesiologists who are experienced in Cosmetic Plastic Surgery.  I feel this is best for my patients, and myself, as it allows me to concentrate on my area of expertise, which is the surgery itself.

My Surgery Center is fully certified by the AAAASF and meets strict standards to perform surgical procedures. Sure, the surgery costs a little more, but it is worth having the extra standards and safety factors. That's why doctors are credentialed and surgery centers are certified. If we didn't adhere to these standards we would be cheaper also. So when you get a fee quote that is cheaper because it is under local anesthesia in an office back room, be careful of what you are asking for.

Board certification by an ABMS member board provides assurance of a physician’s expertise in a particular specialty and/or subspecialty of practice. Professional organizations, such as the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery (ASAPS) require that members be Board Certified within their specialty.

Some advertisements even go so far as to state that you'll be awake enough during your procedure to pick the size of your breast implants (this would only be possible with saline implants which are inserted and then filled to the desired size) during your surgical procedure itself!  If you have had sedation you are going to feel woozy and wobbly.  I don't think you would be coherent enough to make this selection during surgery!

We recommend that you ask questions that will ensure that you are well informed concerning the qualifications and experience of your surgeon and the types of anesthesia that you are offered.  Here are questions generally recommended:

• Are you Board Certified? 
• If so, what specialty board?
• Are you licensed to practice surgery in this state?
• How many breast augmentation surgeries do you perform each year?
• How many years have you performed breast implant procedures?
• Where is my procedure performed?  
• Is the surgical facility accredited?
  
• Who administers anesthesia during my surgery?
• Is the person who administers my anesthesia Board Certified in this specialty? 
  
• What are my options for anesthesia?
  

When you come in for a consultation visit with me, I will make recommendations based on my extensive experience as first a reconstructive and then cosmetic plastic surgeon. I invite you to ask questions regarding various surgical methods, anesthesia, recovery and any other questions you may have so that you can make an informed decision about your surgery.  You may contact my office at 210-496-BODY (496-2639) or e-mail me at nubody@dr-youngforever.com.