What happens during Breast Implant surgery?

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Breast implant surgery is performed to add volume, restore firmness and add fullness to the breasts. Breast augmentation can also subtly lift the breast but not enough to correct significant droopiness. Dr. Charles Slack, voted one of the best plastic surgeons in Dallas and Collin County by D Magazine, helps women achieve a natural look that is long lasting.

After pregnancy, breastfeeding, and/or weight loss, breasts can lose volume and fullness. On the other hand, sometimes you are just not happy with the size of your breasts. A breast augmentation procedure is obviously intended to enlarge the breasts. However, a great surgical outcome involves much more than simply deciding on the cup size you want to be. It is important to choose a board-certified plastic surgeon who has extensive experience in cosmetic surgery. Also important is to be in good physical and mental health and have realistic expectations. In a cosmetic consultation, Dr. Charles Slack can guide you in achieving your desired look.

There are numerous types and sizes of breast implants to consider. Natrelle®, Ideal Implants®, Sientra, and Mentor are all options that Dr. Slack offers to his patients. Choosing the appropriate implant for your breast is a critical part of the process to help you achieve the breast augmentation results you are looking for. The factors considered in determining the right implant for you include:

  • breast shape
  • breast width
  • desired height of fullness
  • natural or rounded look
  • body type
  • desired increase in size
  • your lifestyle
  • Dr. Slack’s surgical judgment and recommendations

Now through August 31, 2020, Dr. Slack is offering savings on Natrelle® silicone breast implants! After breast augmentation surgery using Natrelle® silicone breast implants, you will receive $250 in credit toward Botox Cosmetic®, Juvederm® or other skin treatments. As an added bonus, you will receive 25 units of Botox Cosmetic® treatment. The best way to consider how you can look amazing is to schedule a private consultation with Dr. Slack. He will discuss your concerns and goals in detail with an explanation of what can and cannot be achieved for you with breast augmentation. Patients find Dr. Slack to be the kind of surgeon whose wisdom and compassion make him easy to talk to about the sensitive topic of breast surgery. Contact Dr. Slack today to schedule a consultation.

The Doctor Becomes the Patient: Dr. Slack’s Experience with Neograft Hair Restoration

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I started thinking about it about three or four years ago. I began to notice that I could see the light shining through my hair when I was looking in the mirror. I didn’t really notice any specific bald spots, but certainly my hair was thining and my hairline was receding a little bit. Having two teenage boys with really thick full hair I thought, “Hey I could be that person again.”

This is how Dr. Slack’s own story of undergoing Neograft® Hair Restoration began. But things got serious after grabbing a snack at the hospital one day.

I was paying for a bag of chips at a self-service snack bar in our hospital when I noticed a man on the kiosk security screen. He was wearing my clothes and had a rather large bald spot on the back of his head. I turned around hoping to see someone dressed like me, but I was all alone… just me and my bald spot.

This is the moment that led Dr. Slack to research the latest technology in hair restoration. During his plastic surgery training in the 90s, the “strip method” was used. The surgeon removed a big strip of scalp off the back of the head. They sewed the wound up, but it often left a noticeable scar. Then they chopped up the strip and implanted it as “plugs.” These often had an unnatural look, and recovering from the procedure was painful. Dr. Slack knew he wasn’t interested in that approach – for himself or his patients. But his research revealed a major advancement in hair restoration in a method called Follicular Unit Extraction (FUE). 

With FUE, individual hair follicles are harvested one by one, and implanted one by one. There is no noticeable scarring and the pain is much less than the other, older methods out there. In addition, the fact that follicles are placed individually allows for a far more natural look than could previously be expected with a hair transplant. Dr. Slack explains, “It’s truly an art form, and it’s totally different than the way I was taught to do it.”

Neograft® is a company that developed a medical device to individually harvest and collect hair follicles. So, even though it is called the Neograft® procedure, Neograft® is just a tool used to simplify the FUE method for harvesting hair follicles.

Dr. Slack eventually opted to include Neograft® in his practice (and to use it for his own hair restoration) because he felt they offered the best technology and expertise for success. One aspect that means a great deal to Dr. Slack and his patients is that Neograft® sends Hair Transplant Technicians with a minimum of five to ten years experience to help conduct each hair restoration procedure.

Before a patient undergoes a Neograft® procedure, Dr. Slack visits with them to make sure they’re good candidates. Some people aren’t. Maybe they are young people who are likely to lose a lot more hair, or perhaps they have lost so much hair that there is not enough donor hair left to transplant in order to achieve the kind of result they are looking for. “I’ve turned more people away than I’ve accepted because some are just not good candidates. I would rather them spend their money on something else instead of spending it on a hair transplant that won’t give them the look they are seeking.”

For himself, Dr. Slack prepared for the procedure about a month in advance.

The back of your head has to be shaved so they can see the individual follicles. This look kind of looks awful. Having normal length hair everywhere else and then just a straight  shave in the back  – it’s the classic chili bowl cut. I decided to have my barber kind of do a fade cut about 10 days before my procedure. She wouldn’t cut it as close as I needed it cut, but at least it blended in better after the procedure and didn’t look quite so ridiculous. It also allowed people I knew to get used to my shorter hair cut before I actually had the procedure. To be honest, I would have never walked in and asked for that kind of hair cut but I actually liked it.

Dr. Slack recommends that his patients do the same before hair restoration. Getting a haircut that will work well with the shaved part of your head will make things less obvious. 

Besides his hairstyle, Dr. Slack started thinking about pain control. As a plastic surgeon, his patients’ comfort is always on his mind, but things are a bit different when planning for your own pain control.

The only thing I was worried about was having to get the numbing shots in the back of the head. Local anesthetics (lidocaine or Marcaine) are injected into the back of the scalp wherever the grafts are going to be implanted. I didn’t really relish the idea of multiple needle sticks but they were surprisingly not that big of a deal. A little a vibrating device is used to “distract” the nerves during the injections, so it wasn’t nearly as bad as I thought it was going to be. Some people may want to take a small dose of valium or hydrocodone prior to the surgery, but I couldn’t really prescribe them for myself legally. I didn’t really need them anyway.

Once his head was numbed, Dr. Slack was ready for his procedure to begin. The entire thing, from harvesting to implanting the follicles took about eight hours. The first few hours, when the follicles were being removed from the back of his head, weren’t too bad.

I was face down on a massage table when they were harvesting from the back of my head, and I would lie on my side one way or the other when they were harvesting from the sides. When I was on my side I just slept. When I was on my stomach I was on my phone, since there is a hole cut out in the head rest you can look through. I surfed the internet, answered emails and watched Netflix. So that was no big deal.

 

The part that was a big deal was simply being in a chair for so long. Dr. Slack appreciated taking a break to check emails and stretch his legs and a longer break to get lunch after the follicles had been harvested.

I came back to my office – we ordered from Jason’s Deli. I had a nice corn beef sandwich and some soup. The technicians had a little lunch break, too. It felt good to get up and move around and not be in the chair.

However, Dr. Slack found the next step – implanting the follicles – to be the most difficult. They had to access his hairline in the front and the bald spot on the back, so he was propped upright by pillows. He admits he found this uncomfortable after a while.

When they’re putting the hairs in, you’re just sitting up in the chair and they’re putting them in wherever they need to put them in so you can watch TV. We’ve got an iPad stand that you can use so you can watch Netflix or something else during the implantation. That’s the only time for me it got tedious.  In that last hour, I was ready to be done and felt kind of uncomfortable sitting in basically one position for so long. 

Once the procedure was complete, Dr. Slack was able to drive himself home since he had not taken any Valium or Hydrocodone. He had a light bandage on his head, and sat up and watched the Mavericks game, using a little Tylenol for pain. The next morning he washed his hair according to the same instructions he gives his patients – pouring soapy water over his head and then pouring more water over it to rinse. No rubbing or scrubbing.

I’d say the biggest problem for me was finding a comfortable position to sleep in. If you put the grafts in the back of your head to cover a bald spot, you can’t lay on the back of your head or you’ll dislodge your grafts. So the recommendation is you sleep with your head a little propped up off your pillow. I used one of those airplane pillow that goes around your neck, and I just couldn’t get comfortable. It was really hard to sleep that first night but it got better the following nights.

Over the next few days, Dr. Slack was prepared for what to expect from his experience with is own patients.

 

I knew I could go back to work in a couple days if I wasn’t self conscious about having some bruising, eye swelling, and maybe some scabbing. I went back to work and saw patients two days after I had the procedure, and did surgery a couple days later. Remarkably, nobody ever really commented on how I looked unless I pointed it out to them.

 

 

 

 

 

Dr. Slack did experience swelling around his eyes at day three or four, but that wasn’t too bad for him, as there was minimal pain. He was able to manage the discomfort with Tylenol, and he says, “it was not a bad recovery at all.”

Dr. Slack likes to remind everyone that the follicles will grow hair a little at first, but not to get too excited – this hair will fall out and it will take about eight months for the follicles to come out of their dormant state and begin growing new hair for good. This was Dr. Slack’s own experience and it’s been the experience of his patients, too. Even so, it didn’t prevent him from enjoying himself.

It isn’t Amazon prime. It’s not going to be on your doorstep tomorrow morning. You really can’t judge the results for about a year or so. But by two weeks I went on a boys’ trip to Detroit to watch the Cowboys and the Michigan games. I didn’t feel self-conscious one bit, and it didn’t look like I had anything done. I was fine. 

Men don’t come in for a lot of procedures. They may come in for Botox, or maybe some liposuction, but clearly what bugs men the most is not having their hair.

 

It was the same for Dr. Slack, and he seems to have found a solution to offer his patients that worked for him, too.

 

What You Should Know About Plastic Surgery Videos on YouTube

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Everyday people watch more than a billion hours of YouTube. Increasingly, those hours include some time searching for health information and watching plastic surgery related videos in particular. Unfortunately, many of these videos are low quality and should be watched with caution, says new research published in the journal Plastic and Reconstructive Surgery.

Researchers graded over 500 videos on subjects like breast augmentation, breast lift, breast reduction, eyelid surgery, face lift, and tummy tuck. The videos analyzed came from a variety of sources, mainly physicians, patients, and product companies.

The videos were rated using the EQIP (Ensuring Quality Information for Patients) scale, scoring on a wide variety of criteria including:

  • Quality and accuracy of information presented
  • Clarity of video sponsorship or funding
  • Disclosure of risks, potential complications, and alternative treatments

With the average video scoring 13 out of 27 on the EQIP, the results of the study were not encouraging.

“Patients should be aware that the information contained in aesthetic surgery videos could be of low-quality and has the potential to be inaccurate,” said Ash Patel, MBChB, senior author of the study in this press release. “It involves a little research from the viewer, but they should check if the video is produced by a board-certified plastic surgeon.”

YouTube is a social media and entertainment platform, never intended as a gatekeeper for high quality medical information. Nonetheless it is a place where people seek this kind of information, and what they find often influences their health care making decisions.

That is why we urge all our patients to use a critical eye whenever viewing plastic surgery information on social media platforms like YouTube. Here are some questions to ask yourself the next time you view one of these kinds of videos:

Who produced the video?

Anyone can upload a video to YouTube and say nearly anything they want, but, according to the study, videos created by physicians tended to be of higher quality. Make sure the video you are watching is produced by a legitimate medical center, government entity, plastic surgery society, or board certified plastic surgeon. Look for logos and links to websites for verification.

Is the language general or product specific?

No one product, medication, or surgical procedure is perfect for everyone. Watch out for videos that appear biased toward one brand, as they are likely sponsored and created primarily to sell you a specific product. Language should be clear with limited use of jargon, and products should be presented using generic names. Not all sponsored videos are bad, but this information should be clearly disclosed.

Are risks, complications, or alternative treatments mentioned?

A well trained board-certified plastic surgeon is trained to put the patient first, and sometimes this means saying no to certain procedures. A careful balance of risks versus benefits should be part of every treatment decision. Pre-existing medical conditions and lifestyle choices are among the many considerations that come into play. A high quality video will address issues like risks, complications, and treatment alternatives to some degree.

Here, at North Texas Plastic and Reconstructive Surgery, we encourage you to do your homework when it comes to medical procedures and choosing a plastic surgeon. The internet, YouTube, and other social media can be terrific sources of information, as long as you use a critical eye. Always back up any information you learn there by talking to an actual board-certified plastic surgeon who knows you specifically, like Dr. Slack. And be on the look out for Dr. Slack’s new YouTube channel coming soon.

If you have questions about something you’ve seen on the internet, contact our Allen, TX office. You can make an appointment for a consultation today. 

Preparing for Your Plastic Surgery Appointment

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For many people that walk through our door, it is the very first time they are seeing a plastic surgeon. A bit of nervousness is common. Louis Pasteur said, “Fortune favors the prepared mind,” and we believe that is true. The time you spend preparing for your first appointment will help calm the butterflies while it will also help ensure you get the very most out of your visit.

Hone in on your goals

The path that leads us toward plastic surgery is different for everyone. It can start with a vague notion of wanting to look and feel better, or a clear objective to change a specific aspect of your body. Either way, it is important to match what you have in your head with the reality of what plastic surgery can or cannot do.

We have found that the people who are the most satisfied with their surgical outcomes have very specific goals in mind: something like reducing their breast size by two cup sizes, instead of something like make me more beautiful. The goals should also be realistic. No matter how much surgery you have, you will probably never be able to look like your favorite celebrity.

A good place to start is by looking at some before and after photos of people who have had procedures done on the part of the body you are thinking about changing. Feel free to bring notes and pictures that show what you mean so that you and your surgeon can be sure that you are on the same page.

Consider your timeline

Does the change you want to make have something to do with an event coming up? Say, a wedding, a job interview, or a Hawaiian vacation? Knowing your timeline is important because different procedures have different recovery times. Unfortunately there is no way to force nature to hurry along when it comes to healing. Pain, swelling, and not being able to get incisions wet can all dampen a good time. If you have less than a month until a special event, you are better off considering a non-surgical procedure like botox, fillers, or skin resurfacing. Save that tummy tuck for when you will have the time to fully recover.

Take a health inventory

To get the very best results possible you should be in the best health you can be. This means eating well, exercising, and not smoking. You will also need to limit your intake of alcoholic beverages before and after any procedure. Make sure to get a handle on any bad habits before considering surgery. Certain medical conditions, like diabetes, which can impair healing, may also impact results, so work with your primary care doctor or any other specialists to get these under control.

Know your surgeon

Just because someone offers to perform a procedure, doesn’t mean you should let them do it. To start with, look at their credentials. They should have an MD after their name and be board certified by the American Board of Plastic Surgery (ABPS). They should have hospital privileges in your area, even if they will be performing an in-office procedure. It is also a good idea to find out if they have a professional membership in the American Society of Plastic Surgeons. Here are some good tips for choosing a plastic surgeon.

Nail down logistics

Nothing will put a kink in your plans like getting lost on the way to your appointment. Make sure you have considered even the simplest of logistics, like where the office is and how you are going to get there. You will also have some forms to fill out when you arrive so have your ID and insurance card handy. Bring the contact information for your primary care provider, pharmacy, and any important specialists you see. A list of current medications and health history will also be a big help to your surgeon.

If you have any concerns or questions about what you will need for your first plastic surgery appointment with us, don’t hesitate to give us a call. We look forward to partnering with you as you take that first step toward the change you are looking for.

After Tummy Tuck with Muscle Repair

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Not all tummy tucks are alike. Some involve more extensive surgery than others, and for this reason, what to expect during recovery can vary from person to person. The aim of the tummy tuck is to slim and tighten the waist for a more shapely and youthful appearance, but the surgical route to get you there (and into some cute new clothes) can vary quite a bit.

Depending on the amount of excess skin and fat to be removed, incisions can be shorter or more extensive, including the repositioning of the belly button. But one of the biggest factors to impact recovery from a tummy tuck, also called an abdominoplasty, is whether or not a muscle repair is included.

Why the muscle sometimes needs a repair

If you have seen the abs on even one superhero you will know the muscle we are talking about. It is called the rectus abdominis and it runs vertically from your sternum to your pubic bone. It has a left and right side separated down the middle by a band of tissue called the linea alba.

The linea alba can become over stretched, usually during pregnancy but also due to extreme weight gain or a lifting injury. When this happens the two sides of the muscle move further apart, resulting in an outward bulging of the belly that doesn’t go away, even when weight (baby or otherwise) is gone. This condition is called diastasis recti.

Besides being a cosmetic issue for some people, this condition can affect posture and trunk strength. It can cause pain in the abdomen, hips, and back, as well as bowel and bladder issues, all of which can have a huge impact on quality of life.

Why the muscle sometimes doesn’t need a repair

Not all tummy tucks include a muscle repair because not all bellies that can benefit from a tummy tuck have a diastasis recti. Even when the linea alba is stretched out, it can sometimes return to its normal size on its own. Furthermore, if a woman has had a cesarean section, a repair will likely have already been completed at that time.

How the muscle is repaired

Diastasis recti can be corrected by a general surgeon, but plastic surgeons routinely do this as part of their tummy tuck procedure. The surgery involves folding over the stretched tissue of the linea alba and suturing the two sides of the rectus abdominis muscle together. Though you can’t see it from the outside of the body, this involves suturing up and down the whole length of the abdomen.

Why a muscle repair impacts tummy tuck recovery

The difference in recovery between a tummy tuck with muscle repair versus one without has to do with the fact that muscles contract. Unlike the skin and fatty tissue that cover the abdomen, the muscles underneath (and the rectus abdominis is a big one) are prime movers and stabilizers of the whole trunk. This means that they contract nearly any time you move your body. Even simple movements like lifting your arms when sitting upright or rolling over in bed can engage these muscles — and then there’s coughing and sneezing.

When the muscle is repaired it needs time to rest so that it can heal up. Over exerting yourself too early can compromise your results and will certainly be painful.

How a muscle repair impacts recovery

When a muscle repair is included with your tummy tuck, you will be required to be more careful and your recovery will take a bit longer — from three to four weeks longer.

Symptoms
After a muscle repair patients often experience feeling more full quickly when eating and the sensation of not being able to take as deep a breath as they used to. This is due to a decrease in the amount of room inside the abdominal cavity caused by tightening the muscles. The stomach has less room to expand and the diaphragm meets more resistance as it moves down to allow you to take a breath. Both of these issues, if they occur, typically resolve within four to six weeks.

Abdominal Binder
Shortly after surgery you will be given an abdominal binder to help support the repaired muscle and to reduce overall swelling. You will be given instructions on how to put it on and will be told to wear it regularly. You will probably need help putting it on and taking it off in the first few days.

Lifting restrictions
After surgery, your doctor will restrict you to lifting no more than about 10-15 pounds. You will be prohibited from lifting anything heavier for a full six to eight weeks after surgery. You will also not be allowed to do any core strengthening exercises, such as sit-ups, to avoid stressing and potentially tearing the repair.

Posture
It is typical of all patients after a tummy tuck to have slightly hunched over posture. This is normal and it is important not to force an upright position and put undue strain while your incision heals. This becomes even more important after a muscle repair. You may even be given a walker to get around the first week after surgery.

You still have to get out of bed
Even with a muscle repair, your surgeon will require that you begin moving about within a day of your surgery. This includes getting up to go to the bathroom and with some restrictions, taking a shower. This is important for your overall health and healing and the prevention of blood clots. Many patients opt to sleep in a recliner to make these movements easier. Have someone at home to help you, especially during the first couple of weeks.

Though the muscle repair does add some challenges to your recovery, the long term benefits can far outweigh them. A study published last fall (2019), showed postpartum women who underwent a rectus abdominis repair had significant improvements in trunk function, urinary incontinence, and overall quality of life.

If you are considering a tummy tuck and want to know more about muscle repair, Dr. Slack would be pleased to offer a consultation in his office near McKinney, TX. Please contact us now to schedule your appointment.

Why Drinking Alcohol and Plastic Surgery Don’t Mix

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Woman drinking during the holidays. Remember Alcohol and plastic surgery simply don't mix.

‘Tis the season to be jolly, and often that means drinking more than usual. In the month between Thanksgiving and the New Year holiday, Americans spend more than $12 billion on distilled spirits – that is one-quarter of the industry’s yearly profit. If this season, you are giving yourself the gift of plastic surgery, however, we recommend you skip the spike in your eggnog. Alcohol and surgery (before or after) can be a bad mix.

We’re not just talking about excessive drinking, either. Research has shown that even drinking moderate amounts of alcohol before surgery can impair the immune system and increase the risk of respiratory complications. Heavy drinkers are also more likely to suffer from complications of wound healing and infections. They are 30 percent more likely than non-drinkers to be admitted into the intensive care unit after surgery.

Alcohol affects a number of different body systems already taxed by surgery. Here are five of the most common types of complications:

Pain

Alcohol in your system can make it more difficult to get the dosing of anesthesia to an optimal level during surgery. This can result in pain and increased awareness during surgery. Alcohol consumption also decreases pain tolerance in general, making for a more difficult recovery.

Swelling

Swelling is a natural part of any kind of surgery. Alcohol has the effect of dilating blood vessels and can make your tissues even more prone to swelling. This is not only uncomfortable, it can result in poor fluid balance after surgery as well as poor wound closure.

Bleeding

Alcohol is a natural blood thinner. Its use can lead to increased bleeding during surgery as well as in the days and weeks following a procedure. Excessive bruising and increased swelling are also possible, both of which can cause more pain and delayed healing time.

Dehydration

Surgery can result in dehydration. Add alcohol, a diuretic, to that and the effect can be dangerous. Dehydration can affect wound healing and it can make your recovery far more uncomfortable than it has to be.

Wound Healing

Excessive Alcohol consumption is linked to poor wound healing. This is especially important when it comes to plastic surgery. While your surgeon will do all he can to minimize the appearance of scars, they are nonetheless a natural outcome of surgery. Infection or excessive swelling can result in larger more misshapen scars, greatly diminishing the beneficial effects of having plastic surgery in the first place.

Dr. Slack takes the medical risks associated with drinking alcohol very seriously. He, like many other surgeons, requires patients to quit or significantly limit alcohol in the weeks before and after surgery.

Quitting alcohol may be no problem for you, but if you are a heavy drinker you need to consider the risks of withdrawal if you quit suddenly. Withdrawal from alcohol can be dangerous and can further complicate surgery and recovery. That is why it is important to take a hard look at your drinking and take steps to quit in a safe manner, well before any planned procedures. Sometimes this means quitting under the supervision of a physician.

The holidays can be an especially difficult time to quit drinking. But remember that being healthy and safe is the best gift you can give yourself. So if you have plastic surgery coming up, let that thought help you resist the champagne and hot buttered rum.

The Mental Health Effects of Plastic Surgery

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Man looking in mirror with blurry reflection - what are the mental health effects of plastic surgery?

Most people choose to have plastic surgery because they want to feel better – either physically or mentally. Some aspect of their appearance bothers them enough that it makes them self-conscious or uncomfortable. Plastic surgery may offer a way to resolve those issues.

Previously we talked about the physical health benefits that plastic surgery can provide. These include restoring balance, improving vision, and easing breathing issues. Many individuals also experience mental health benefits from pursuing a well considered plastic surgery procedure.

When someone is bothered by a specific aspect of their appearance, it can influence how they feel about themselves in general. This will vary widely from person to person, though. Some women think the changes in their body after childbearing contribute positively to their appearance, while other women miss certain aspects of their pre-child body. Some men embrace hair loss and grab a razor to help it along, while others choose to fill in their hairline and boost their confidence with hair implants.

Nobody is wrong in these scenarios – the key is acknowledging what it is that is bothering you and making an educated decision about how to address it. The boost in self-esteem that comes from taking steps toward self-improvement is powerful. This can make you feel more attractive and self-confident.

In fact, research in the journal Clinical Psychological Science compared people who had a plastic surgery procedure to those who were interested in one but didn’t have it. Those who chose to go forward with their procedures reported mental health improvements across a wide range of factors, including:

  • Anxiety
  • Social phobia
  • Goal attainment
  • Quality of life
  • Life satisfaction
  • Attractiveness
  • Well-being
  • Self-esteem

Some of these, like attractiveness or self-esteem, appear to have a direct connection to plastic surgery, but others reveal some surprising effects. Why would plastic surgery improve your goal attainment? Well, if you feel better about your appearance and your self-esteem is improved, you may be more willing to take the risks needed to achieve your goals. Regardless of the relationship, it’s safe to say that feeling good about one’s appearance has an effect beyond looking good in your favorite swimsuit (which is great, too!)

There are some caveats to these effects. Research published in Plastic and Reconstructive Surgery revealed some circumstances in which the psychological and psychosocial outcomes of plastic surgery were not positive. While most people in the study did report improved mental well-being, certain groups did not experience good psychosocial effects, even when their surgical results were as planned. Specifically, individuals with unrealistic expectations, previous unsatisfactory plastic surgeries, and a history of certain mental health disorders – including body dysmorphic disorder – did not gain the psychological benefits that others did.

Again, most people in this research did have positive results, but these exceptions emphasize the importance of having any cosmetic procedures performed by a surgeon certified by the American Board of Plastic Surgery. These surgeons, like Dr. Slack, are trained not only to perform plastic surgery to the highest standards, but also to help patients understand the results they can expect from surgery. They are skilled in identifying those who are least likely to experience the positive mental health effects of plastic surgery and able to counsel them on how to move forward to achieve their goals.

When performed by a board-certified plastic surgeon, plastic surgery most often has positive effects on both physical and mental health. If you wonder whether you can benefit from plastic surgery, go ahead and schedule a consultation with Dr. Slack. There is no obligation to move forward with plastic surgery, and he will offer honest counsel on the results plastic surgery can achieve for you.

Will Breast Density Limit My Plastic Surgery Options?

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Getting good news about breast density and plastic surgery options

The last time you got your mammogram results, did you notice a little note about your breast density? If you are like 40 percent of women, it might have said something like, “Your breasts are heterogeneously dense, which may obscure small masses and may put you at greater risk of developing breast cancer in the future.” Though this may sound a bit scary, it’s actually a normal reading.

Normal breast density exists on a spectrum from not dense at all to extremely dense. Knowing this information is important; it helps women and their doctors decide which breast screening methods are best, and how often they should get them. According to the American Cancer Society, whether a woman has dense breasts or not, regular screenings (mammograms in particular) are still the best way to find cancer early.

Because of the relationship between breast density and cancer risk, it is now the law in many states that breast density information be conveyed to each woman who has a mammogram. You may have seen talk of this newer legislation on the news.

What this means is that more women than ever before know that breast density matters, and many can tell you just how dense their own breasts are. Knowing this has also left some women wondering if their breast density will affect their options when it comes to cosmetic breast surgery.

To help answer this question, it will help if we first explain what doctors mean when they talk about breast density.

Breast density is a radiologic (mammogram) finding that has nothing to do with how breasts look or feel from the outside. The classification of density has to do with the ratio of fat (not a dense tissue) to everything else that makes up the breast, including glandular and fibrous tissue. On a mammogram, the fat shows up dark and the other stuff shows up white. The more white seen on a mammogram, the more dense the breast classification. The breast density classifications that may be assigned are – from least dense to most dense – the following:

  1. Fatty
  2. Scattered Fibroglandular
  3. Heterogeneously Dense
  4. Extremely Dense

Only about 10 percent of women are categorized as having extremely dense breast tissue. You can learn more about these breast density types, and see images too, at the American Cancer Society.

Here at North Texas Plastic and Reconstructive Surgery, Dr. Slack performs a wide range of cosmetic breast procedures including breast implants, liposuction, breast lifts, and breast reductions. In some cases, he may perform a combination of one or more of these procedures, depending on the goals of the patient. Here is how breast density may come into play with each of these procedures:

Augmentation

Breast implants are placed underneath the breast tissue not within in. This means that the breast tissue itself, no matter how dense, sits on top of the implant and therefore has little bearing on whether a breast implant is possible.

Liposuction

Liposuction alone is sometimes an option for women who are looking for a mild reduction in breast size. It is possible that a woman with extremely dense breasts, which means they have a lower ratio of fat to other tissue, may have a limit as to how much fat can be successfully removed using this method.

Breast Reduction or Lift

A breast reduction or lift sometimes includes liposuction, and the limitation just mentioned may come in to play to some degree. However, because these procedures also include an open surgical component, the goal of the reduction usually isn’t limited by breast density.

Here is the big takeaway: None of these procedures are off limits to a woman simply because she has higher breast density.

There are many factors that will limit a person’s plastic surgery options, including poor health, weight instability, and a bad smoking habit, but breast density usually isn’t one of them. That said, every person who walks into our clinic has their own unique anatomical identity, and that includes breast density. Dr. Slack takes all of this (and more) into consideration when advising each patient and planning their surgery.

If you have more questions about breast density and which breast procedures might be right for you, call our office today and schedule a consultation with Dr. Slack.

Men, Masculinity, and Plastic Surgery

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Though many more women still seek out plastic surgery than men, according to recent statistics, that gap is closing. In 2018, 1.3 million cosmetic procedures were performed on men. That is up by nearly 30 percent since 2000.

Men seek out these procedures for many of the same reasons women do: to increase attractiveness, to stave off the effects of aging, and to increase self-esteem. Increasing the appearance of masculinity is also a goal some men pursue through facial plastic surgery. 

“Of biggest concern to men and one that often times affects their masculinity and feeling of vitality is hair loss,” says Dr. Charles Slack. “I am seeing more men for this as I have started using the Neograft system for hair restoration. In my practice I would say that botox is the most common treatment for men followed by fillers and then eyelid surgery.”

A new study, published in JAMA Facial Plastic Surgery, showed perceptions of attractiveness, likeability, social skills, and trustworthiness all increased after surgery. Interestingly, this study showed facial surgery had little effect on the appearance of masculinity, however. The authors point out that this is contrary to similar studies that have shown significant increases in the appearance of femininity in women who have had facial plastic surgery.

The JAMA study was conducted using the before and after photos of 24 men who underwent a number of facial procedures at Georgetown University Medical Center. The procedures included one or more of the following:

One hundred and forty five people reviewed the men’s photos and rated them on attractiveness, masculinity, and a variety of personality traits, including aggressiveness, extroversion, like-ability, risk-seeking, sociability, and trustworthiness.

The ratings of each of these traits tended to differ with the type of facial surgery performed. For example, facelift and upper eyelid lift were associated with increased like-ability and trustworthiness. The only procedure associated with an increase in masculinity was a neck lift, which was also associated with perceived extroversion.

Oddly enough, chin implants, a procedure commonly sought to increase the appearance of masculinity, was the only procedure that had no effect on any of the factors: personality, attractiveness, or masculinity.

“It is really interesting that different anatomic areas of the face have varying degrees of contribution to overall personality perception,” says the study’s senior author Michael J. Reilly, MD in this press release. “And it is also noteworthy that the study did not find a significant change in masculinity. […] This suggests that the current menu of cosmetic procedures for men are likely not as gender-enhancing as they are for women.”

Regardless of this study’s findings, masculinizing plastic surgery is on the rise. According to statistics by the American Society of Plastic Surgeons, in 2018, nearly 10,000 men got chin implants, that is up five percent since the year 2000. They also underwent about 4,000 cheek implants, a procedure that can give a broader more masculine shape to the face. These were up 133 percent since 2000.

It should be noted, however, that these numbers are small when compared to the total number of cosmetic procedures performed among men in 2018: 1.3 million. Of those, one million were actually non-surgical or minimally-invasive treatments like botox, laser hair removal, microdermabrasion, and fillers. The same trend is seen in women: of the 14.7 million cosmetic procedures performed on women in 2018, the majority (13.3 million) went in for non-surgical procedures.

These statistics tell us that while the gender playing field is still far from equal, when it comes to cosmetic procedures, the aims of men and women may not differ that much. And according to this latest research, increasing masculinity may not be as viable goal as once thought for men undergoing facial surgery.

All that said, no matter the reason you are seeking cosmetic surgery, it is a decision that should not be made lightly. Despite what national statistics or one research study tell us, all procedures affect each individual uniquely. If you are considering any cosmetic procedure, make sure you consult with an experienced board certified plastic surgeon. If you are in Collin County, Texas, call our office and make an appointment to see Dr. Charles Slack.