September 3rd, 2008
I received an email today from a patient that writes, “I have breast implants and am turning 40. Should I have an annual mammogram?” She goes on in the letter to talk about her worries of causing rupture of the implant when her breast is compressed during the study. I want to make it perfectly clear to this patient and to any woman that has breast implants that following the ACS guidelines for yearly mammograms beginning at age 40 is absolutely critical. Yes, absolutely have your annual mammogram; it could save your life!
Let me go into this a little further. Breast augmentation is the most commonly performed plastic surgical procedure in the United States. Approximately 300,000 cases were performed last year alone. If one in every 8 women is expected to develop breast cancer in her lifetime, that would mean that of this cohort, 37500 women would be expected to develop breast cancer. This is a huge number and breast cancer screening is critical to these women. While it is true that breast augmentation decreases the sensitivity of mammograms, this does not seem to impact prognosis or survival rates. I am aware of 3 studies that have evaluated this issue and all 3 concluded that mammography should be used for augmented patients at appropriate intervals as part of a woman’s screening for breast cancer. At this point in time, other screening methods are not recommended, although ultrasonography may become an increasingly important modality in augmented women with very dense breasts. What is important, however, is that an augmented woman that is planning to undergo mammography should have the study performed by clinicians who are trained in implant imaging.
Here are the current recommendations of the American Cancer Society and this table and additional information can be found at their website www.cancer.org:
| What Has Changed and Why |
| |
Former guidelines (1997) |
Updated guidelines and information (May 2003) |
Explanation |
| Women at average risk |
| Mammography |
Annually starting at age 40 |
No change from 1997 recommendation. There is a tremendous amount of additional, credible evidence of the benefit of mammography since 1997, especially regarding women in their 40s. |
Women can feel confident about the benefits associated with regular screening mammography. However, mammography also has limitations: it will miss some cancers, and it sometimes leads to follow up of findings that are not cancer, including biopsies. |
| CBE |
Every three years for women 20-39; annually for women 40 and older |
CBE should be part of a woman’s periodic health examination, about every three years for women in their 20s and 30s and annually for women 40 and older. |
CBE is a complement to regular mammography screening and an opportunity for women and their health care providers to discuss changes in their breasts, risk factors, and early detection testing. |
| BSE |
Monthly starting at age 20 |
Women should report any breast change promptly to their healthcare provider.Beginning in their 20s, women should be told about the benefits and limitations of BSE. It is acceptable for women to choose not to do BSE or to do it occasionally. |
Research has shown that BSE plays a small role in detecting breast cancer compared with self awareness. However, doing BSE is one way for women to know how their breasts normally feel and to notice any changes. |
| Older women and women with serious health problems |
Additional research is needed. |
Continue annual mammography, regardless of age, as long as a woman does not have serious, chronic health problems. For women with serious health problems or short life expectancy, evaluate ongoing early detection testing. |
There is a need to balance the potential benefits of ongoing screening mammography in women with limited longevity against the limitations. The survival benefit of a current mammogram may not be seen for several years. |
| Women known to be at increased risk |
| Women known to be at increased risk |
Women with a family history of breast cancer should discuss guidelines with their doctors. |
Women known to be at increased risk may benefit from earlier initiation of early detection testing and/or the addition of breast ultrasound or MRI. |
The evidence available is only sufficient to offer general guidance. This guidance will help women and their doctors make more informed decisions about screening. |
The abbreviations CBE represent clinical breast examinations performed by your doctor, and BSE is bilateral self examinations performed by you.
If you worry about implant rupture with mammography, this is a risk. But let me ask you, is the cost of replacing an implant worth your life? I don’t think so, speak with your doctor and please follow the ACS guidelines.
Our website, www.beauty-surgeon.com has additional information and before and after photographs of breast augmentation for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or breast cancer screening in augmented patients. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Breast Cancer, Home | 1 Comment »
September 2nd, 2008
I received an email over the weekend from a woman that has undergone a breast augmentation approximately 5 months ago by another surgeon. She noted that her implants were placed through the axillary (arm pit) approach and that her implants have fallen too low on her chest. She writes, “My breast implants have dropped, what can I do?”
Implant malposition following breast augmentation is probably a more frequent problem than is identified in the literature. It can be seen with any of the surgical approaches. Malposition can be due to a technical error or it can be the result of the weight of an implant and it’s effect of stretching or dissecting the breast tissues. It is clear that larger implants are more prone to malposition than smaller ones. We would describe this woman’s problem with implants that are too low as “bottoming out.” Malposition can occur in any direction, that is, implants can be positioned too high, too low, too far towards the center of the chest, or to far towards the arm.
If conservative measures fail to improve implant malposition, there are several surgical techniques that can be used to correct the problem. These involve using suture lines to close down a portion of the implant pocket and correct the implant’s malposition. In the technique that I use, I also perform capsulotomies (incisions in the breast capsule) opposite the location of the suture lines to take some of the tension off of the repair. Patients are required to tape the breasts and to wear underwire bras for several weeks after surgery to support the repairs while they are healing.
Here is an example of a patient that experienced implant malposition following a transaxillary breast augmentation. She was an A cup before her initial procedure and had very short nipple to inframammary fold distances. She had selected a sizable implant for her initial procedure. If you consider the history of this patient, she was a set up for problems with implant malposition. When she presented to my clinic she had “bottoming out” of her implants; that is, they were positioned too low on her chest wall. Here is the preoperative photograph:
During our consultation she expressed a desire to use the same size implants as her initial surgery. Her goal was to correct the low position of the implants on her chest. I performed capsulorraphies (suture closure of the breast pocket) at the lower aspect of the breast on both sides to reconstruct the breast fold and move the implants to a higher position on the chest. During the procedure I also performed capsulotomies opposite the suture lines at the upper aspect of the breast to take some of the tension off of the repair. Here is the postoperative result:
The operation achieved her goal of correcting the low position of her implants through reconstructing the breast folds on both sides. She is now very pleased with her results.
Our website, www.beauty-surgeon.com has additional information and before and after photographs of breast augmentation for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or reconstructing implant malposition. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Correcting Problems with Breast Implants, Home | No Comments »
August 18th, 2008
I saw a young woman today in clinic who was considering breast augmentation. She was recently married and considering when she and her husband might like to have children. She wondered, “Will breast implants harm the development of a baby?”
This question is not an infrequent one. Women are concerned about the possibility that their baby could be exposed to silicone during the pregnancy or afterwards during breast feeding. In addition, there are several reports that have suggested a relationship between esophageal problems attributed to a scleroderma like syndrome, myalgias, neonatal lupus, perinatal mortality, and congenital anomalies in children born of mothers that have undergone cosmetic breast augmentation using implants. Unfortunately, these reports are very limited by the number of patients involved and it is difficult to draw conclusions from them.
Let me first begin by saying that women with implants do not have higher circulating silicone levels than women that do not. Second, silicon levels are comparable in breast milk from women who have implants and those that do not. Kjoller et al. posed a similar question about breast implants and reviewed four epidemiological studies to answer this question. I’d like to summarize this report because it does a nice job of looking at the current state of this issue. The conclusions from this review were derived from looking at the data surrounding literally thousands of children born to mothers who had undergone a breast augmentation in comparison to children whose mothers had either undergone a breast reduction, other surgical procedure, or selected randomly from a Medical Birth Registrar. The numbers of children involved are the real strength of these studies and allow for adequate power to make some reasonable conclusions about how implants may affect the development of a baby.
The bottom line of this review is that the current evidence does not suggest that there is an increased risk for connective tissue diseases, birth defects, esophageal problems, or perinatal mortality in infants born to mothers who have implants versus those that do not.
-Brice W. McKane, M.D.
Posted in Breast Implants and Babies, Home | No Comments »
August 12th, 2008
I am writing today to talk about a problem that I see frequently in my clinics. As a board certified Plastic Surgeon it is my obligation to inform my patients to the best of my ability about the procedures that they are considering. Ethically, I am unwilling to minimize or to ignore the risks associated with the surgeries during my discussions with my patients. This discussion is a vital component to an informed decision.
Unfortunately, this doesn’t seem to be the case for all surgeons. I see a fair number of revision breast augmentation cases in my practice and very frequently I hear, “I thought my breast implants would last forever! My surgeon never told me that I would need another operation!” This misconception about the “immortality” or implants can be perpetuated by misleading information found on the internet or in advertising, or through the anecdotal experience of a patient’s friend who had undergone the procedure before her.
I am here to set the story straight. Implants do not last forever and there can be problems with them. Unfortunately, the fact of the matter is, many women who undergo a breast augmentation will need a secondary procedure in the future to address some issue with their implants.
Rupture of either a saline or a silicone implant may occur at some point in time following a breast augmentation. Removal of the implant is recommended following a rupture, and this is particularly true of silicone implants. The reason for removal is that the silicone gel can escape from the implant and implant capsule and penetrate into the breast tissue. Gel that has migrated into the breast tissue may require removal of some of the breast tissue to fully address. Replacement of implants is common following rupture as many women are unwilling to return to a smaller breast size .
The development of capsular contracture is another problem that can occur with time. As this develops, the breasts can become firm, change shape and even become painful. Significant capsular contracture is another reason that a woman may consider a reoperative procedure following her breast augmentation. This may prompt you to ask, ”If you have surgery to address capsular contracture, it won’t come back. Right?” Unfortunately, that’s not the case and the risk of recurrent capsular contracture is higher following the secondary surgery. Furthermore, reoperative procedures do not reduce the risk of needing future surgeries for other reasons.
Here is an example of patient that underwent a saline breast augmentation 13 years ago. She presented to my clinic with a complaint that “I woke up this morning and my implant had ruptured.” She wanted to replace her implants with new implants of similar volume. On examination there was marked asymmetry of her breasts and she had a ruptured left saline implant. The right breast had a very mild capsular contracture. There was a nearly imperceptible inframammary (breast fold) scar. Here is the preoperative photograph:
During our consultation I spoke with her about removing and replacing her implants into the dual plane. I performed capsulotomies (incisions in the capsule) on both sides to help open the scar and allow it to remain soft. I did not remove the capsules on either side because they were mild. The patient’s original implant volume was not known until the time of surgery as there was no record of her procedure available. She decided that she would like to use a 325 cc size and this is what I used for her. The original implant volume turned out to be 300 cc’s. Here is the postoperative result at 3 months:
This patient was very satisfied with her saline implants and wanted to remain augmented following her rupture. She was unprepared to return to her pre-augmentation size as she felt more proportional with her implants. The operation that I performed achieved her goal of restoring the volume lost when her implant ruptured.
Our website, www.beauty-surgeon.com has additional information and before and after photographs of breast augmentation for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or reoperative surgeries. Please feel free to contact our office at (713) 661-5255 if you have any questions about this procedure.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Correcting Problems with Breast Implants | No Comments »
August 8th, 2008
I had a consultation with a woman today for a breast augmentation. She was very concerned about nipple sensibility after breast augmentation and inquired if it is possible to lose sensation with the procedure.
Unfortunately, sensation changes of the breast skin or the nipple and areola can occur following breast augmentation. If you look at the data available from the manufacturer from a study involving 901 patients using saline implants, the reported rate for moderate or greater loss of sensation is 8% at 3 years. This sensation loss ranged from having no feeling in the nipple or breast to having partial feeling or strange sensations. The changes that a patient experiences may be temporary or may be permanent. This depends on the type of injury a nerve experiences during the surgery.
So how do you reduce the risk for sensory loss following breast augmentation? There are several things to consider for this. In the past, anecdotal evidence suggested that the incision used may impact breast sensation. However, recent literature indicates that choice of incision, either periareolar or inframammary, does not appear to have a signficant effect on nipple sensitivity following breast augmentation. Mofid et al. evaluated nipple sensitivity after breast augmentation and found no significant difference in sensation with either approach. However, both approaches were associated with a significant change in sensation when compared to unoperated control patients. A surgeon’s technique may contribute to sensation loss following breast augmentation. Anecdotal evidence suggests that surgeons who use less sharp dissection in the outer portion of the breast pocket may have patients that experience less sensation loss. While there is no study that I know of that can substantiate this, it makes anatomic sense. The path of a portion of the nerves that supply sensation to the breast are not cut, and hopefully, are only stretched. This potentially allows for improved recovery in comparison to nerves that are completely transected. Recovery seems to reach its maximum at 3 to 6 months following surgery. Beyond this time point, patients were unlikely to enjoy further recovery of sensation. This study also implicates implant size as a controllable risk factor that impacts sensation. Data support that there is an inverse linear correlation between implant volume and sensation outcomes. That is, patients who choose to use larger implants relative to a smaller or tighter breast envelope will be at greater risk for sensation loss. This was particularly true for implants larger than 475 cc. Therefore, if you would like the greatest chance of preserving nipple sensation, select an implant with the help of your surgeon that is appropriate for your soft tissue characteristics.
Our website, www.beauty-surgeon.comhas additional information and before and after photographs of breast augmentation. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Home, Nipple Sensitivity | No Comments »
August 6th, 2008
I received an email from a woman yesterday looking to use a very large implant on a very small frame. She inquired if there would be problems in doing this. In a word, “Yes.” There will be problems to using a very large implant in a patient like herself. Let me go into this further.
Appropriate implant selection is one of the most important decisions that a woman will make when choosing breast implants. There are long term ramifications to using an implant that is larger than the soft tissues can handle. An implant has weight and over time will thin the breast tissues and cause descent of the breast on the chest wall. Furthermore, it is possible that breast tissues can thin enough to cause significant problems with rippling or even implant extrusion. Large implants are very heavy and cause significant stretching and thinning and put patients at greater risk for these problems. The fact that heavy breasts fall sooner may be obvious to women who were well developed in their teens who later in life have breasts that are much lower following pregnancy or breast feeding. However, young women who are seeking breast augmentation usually don’t have issues with breast positioning and are unlikely to recognize this potential problem.
During your consultation with me, I analyze your breast using a technique outlined by Dr. Tebbetts. The approach is called the “High Five Process” and is designed to systematically assess five critical aspects of breast augmentation planning to come up with an “ideal” procedure for an individual patient. I use the process because I believe that there is probably an “ideal” implant volume for a given patient that can be derived from her soft tissues. Implants that are signficantly larger than this “ideal” will be at greater risk for complications. Furthermore, I believe that if an “ideal” procedure is used that there will be a reduction in the rate of reoperations following breast augmentation.
Here is an example of a patient that underwent a breast augmentation in my practice using the “High Five Process.” She is a 27 y/o that presented wanting a saline breast augmentation. She was internally motivated and wanted a proportional augmentation that would not have an increased risk of breast thinning and descent with time. On examination she has some mild asymmetries and modest soft tissue coverage. Here is the preoperative photograph:
During our consultation I used the “High Five Process” to derive an implant volume based on her soft tissue characteristics. The implant volume was 425 cc’s. Due to the thinness of her soft tissues at the upper pole of her breasts the implant was positioned into the dual plane. Here is the postoperative result at 4 months:
The operation achieved her goal of a proportional breast augmentation using an implant that was individualized and idealized for her soft tissue needs. This implant should reduce her risk of tissue thinning and other complications in comparison to a larger implant.
Our website, www.beauty-surgeon.com has additional information and before and after photographs of breast augmentation for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or the “High Five Process.” Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Breast Implant Selection, Home | No Comments »
August 4th, 2008
I wrote the other day about silicone implants. Following this, I received an email from a woman in Clear Lake asking if saline implants were a good choice. Implant selection is a very important decision to make, and as such I feel that I should also spend some time addressing saline implants.
Again, let me begin by saying that both types of implants have benefits and trade-offs associated with them. Since the recent FDA approval for their use, it has become fashionable to use silicone implants. Certainly in some patients there are benefits to using a silicone implant, but let’s not forget that saline implants have a large amount of long term data collected on them that support that they are not only effective devices, but that they are safe devices. The current generation of silicone implants does not have long term data collected on them at this point. Definitive conclusions about their safety and efficacy can’t be made yet. In fact, the post approval study to address these very issues is being conducted as we speak.
In the plus column for saline implants: Saline implants are approximately half as expensive as silicone implants at the time of surgery. They are also less costly in the long run. To monitor for silicone implant rupture, the FDA has recommended that patients undergo a breast MRI at year 3 following their surgery, and every 2 years thereafter. This is a very expensive study, and is not necessary for saline implants. When saline rupture occurs, the patient or her surgeon are usually able to make the diagnosis. Saline implants can be placed through a much smaller incision since they are not prefilled and can be rolled to a small size during insertion. Revision surgeries are often necessary after breast augmentation and these procedures may be easier if saline implants were used during the initial procedure. The rupture rate for saline implants is probably lower than silicone implants. This is being evaluated currently in the post approval study. Between 93 and 98% of saline implants remain intact at 10 years, contrasted to 60-85% seen in the historical data for silicone implants. The capsular contracture rate for saline implants is also probably lower than silicone implants. This question is also being evaluated currently. The capsular contracture rate after saline implants is 16.6% at 10 years in comparison to 38.5-90% seen in the historical data for silicone implants. Lastly, patient satisfaction with saline implants is also very high and is on the order of 87-95%.
In the negative column for saline implants: Feel. Some patients prefer the texture of a silicone implant and believe it to feel more like breast tissue. Wrinkling and rippling is also a greater problem for saline implants as saline is not a cohesive substance. Silicone implants have less problem with wrinkling and rippling, and may be a very good choice for a woman who is thin and who has little soft tissue coverage for this reason.
So to answer the question ”Are saline implants a good choice?” The answer is yes. We have a large amount of data in the literature that supports their use. Are they better than silicone? It depends. The individual needs of the patient will make this determination. Again, I truly believe that a patient that is fully informed about her options will make the best decision for herself, be it saline or silicone.
Here is an example of a patient that underwent a saline breast augmentation in my practice. She is a 25 y/o that presented desiring saline implants. She was concerned about needing repeated MRI’s to monitor for implant rupture. She was uncomfortable with the fact that she might not know that her implant had ruptured and could be leaking silicone gel. On examination she has some mild asymmetries, and fair soft tissue coverage. Here is the preoperative photograph:
During our consultation, she expressed a desire to have a proportional for her frame augmentation that would appear natural. She did not want an overly round look to her breasts. She decided that she would like to use a 325 cc saline implant and to place it in the dual plane. Here is the postoperative result at 7 months:
The operation achieved her goal of a proportional, natural appearing breast augmentation using implants that have demonstrated both safety and efficacy in many patients without the need for an expensive followup study.
Our website, www.beauty-surgeon.com has additional information and before and after photographs of breast augmentation. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or saline implants. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Breast Implant Selection, Home | No Comments »
July 30th, 2008
Since the 2006 FDA approval for silicone implants to be used in breast augmentation, I have received several emails a week inquiring whether silicone implants are better than saline implants. Lately, my patients have been asking this question almost every day. I feel part of this is due to recent marketing campaigns being conducted by the major breast implant manufacturers in the United States. Silicone is all the rage. Right?
First, I’d like to respond to this question by saying that both types of implants have benefits and trade-offs. As a board certified Plastic Surgeon, I feel that I am obligated to educate and inform my patients about their options.
In the plus column for silicone implants: There is little doubt that the texture of the gel more closely mimics breast tissue than saline does. Also for patients who are extremely thin or who have little breast tissue, rippling and wrinkling can be less of an issue with gel implants than with saline implants. Lastly, the satisfaction rates for silicone implants are very high and approach 97% in some studies.
In the negative column: Silicone implants are more costly in both the short and long term to patients. At the time of surgery, the devices are approximately twice the cost of saline implants and this cost is translated into a patient’s quote for surgery. Over the subsequent years, breast MRIs are currently recommended to monitor for silicone implant rupture. Under the current guidelines, this study is to be performed at 3 years after surgery and then every 2 years thereafter. Patients should understand that this study is very costly and not likely to be covered by insurers. Very quickly, the cost of repeated MRIs will exceed the cost of the initial surgery. Also silicone implants come prefilled and due to this require incisions that are twice as large to place them. This impacts recovery times and scarring. Furthermore, patients need to understand that breast implants don’t last forever and very often they will need to be replaced in the future due to rupture. Silicone implants can complicate these future surgeries. Lastly, the capsular contracture rate associated with silicone implants should be considered. A capsule is a scar that develops around an implant on the inside of the breast. This scar can shorten or contract over time causing firmness in the breast, change of breast shape, or pain. The historical rates for capsular contracture at 10 years is on the order of 38.5-90% for silicone implants. Saline implants have a 10 year capsular contracture rate of 16.6%.
So to answer the question, “Are silicone implants better than saline implants?” It depends. Blanket statements by the public, surgeons, or manufacturers can not be made. The individual needs of a patient will make this determination. One woman may decide that the feel of the silicone implant in comparison to a saline implant makes it better for her, and with this, she is willing to accept certain tradeoffs. Another woman may decide that the benefits of saline implants in terms of capsular contracture outweigh the feel of her implant. I truly believe that a patient who is fully informed about her options will choose the best implant for herself, be it silicone or saline.
Here is an example of a patient that underwent a silicone breast augmentation in my practice. She is a 26 y/o woman that presented desiring silicone breast implants. She was very concerned about the feel of her breasts after surgery and wished to have an augmentation that would closely mimic the natural feel of her breasts. On examination, she has some mild asymmetries and only fair soft tissue coverage. Here is the preoperative photograph:
During our consultation, she expressed that she would like to have a large augmentation. She decided that she would like to use 500 cc silicone implants. Due to her soft tissue characteristics and due to her desire for a silicone implant, I recommended that she undergo a dual plane breast augmentation through an inframammary (breast fold) approach. Here is the postoperative result:
The operation achieved her goal of a large breast augmentation with implants that feel very natural.
Our website www.beauty-surgeon.com has additional information about breast augmentation and before and after photographs for review. I invite you to schedule a consultation with me if you would like to learn more about silicone implants or breast augmentation. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.
Posted in Breast Augmentation, Breast Implant Selection, Home | No Comments »
July 28th, 2008
This is the final post regarding breast shaping options and why a woman might choose one option versus another.
Why would a woman choose to have a breast reduction (reduction mammaplasty)?
Excessive breast development can cause significant physiological and psychological distress. A woman may feel self conscious about the large size of her breasts and feel that they are an impediment to her ability to perform her job, exercise, or to wear certain fashions. The weight of the enlarged breasts may cause significant neck and back pain as well as significant grooving in the shoulders from brassiere straps. This grooving may lead to nerve compression and result in numbness of the hands. Hygiene may be an issue with large breasts, and a woman may experience chronic skin irritation or infections in the fold of her breasts especially in the summer. In severe cases of breast enlargement, skin ulceration can occur. Breast enlargement may limit a woman’s ability to exercise and place her in a vicious cycle of weight gain. These problems are improved or resolved with breast reduction surgery. Over 90% of women surveyed following breast reduction are happy they underwent the procedure and would undergo it again. In many instances, health insurance carriers may cover a breast reduction procedure.
Why would a woman choose to have a breast reconstruction?
Congenital deformity, or in more severe cases, complete absence of the breast may motivate a woman to seek a breast reconstruction procedure. Alternatively, a patient who has undergone treatment of breast cancer may feel that she is missing a component of her identity. Mastectomy without reconstruction removes the entire breast and leaves a scar on a flat bed that once had a feminine contour. Breast conservation therapy followed by radiation can leave a woman with a contracted, disfigured breast. These situations are painful daily reminders of a woman’s encounter with a potentially fatal disease. Breast reconstruction is designed to help in the healing process of a woman, restore her identity, and help make her feel whole again. Typically, reconstruction is performed in several stages that begin with the creation of a breast mound using either implants, the patient’s own tissues, or a combination of both. Additional procedures such as a breast lift or reduction for the other breast are performed to improve the symmetry between them. The reconstruction culminates with the reconstruction of the nipple and ultimate tattooing of the areola. In 1998, the Women’s Health and Cancer rights Act was enacted requiring health insurance carriers to cover breast reconstruction in conjunction with mastectomy.
Our website, www.beauty-surgeon.com has additional information about breast contouring procedures and before and after photographs for review. I invite you to schedule a consultation with me if you would like more information about these procedures. Please feel free to contact our office at (713) 661-5255.
-Brice W. McKane, M.D.
Posted in Breast Contouring, Home | No Comments »
