World renowned Dr. Garth Fisher, the first plastic surgeon from “Extreme Makeover” says that the way breasts and implants look has more to do with the technique rather than the type of implant used and that there is an excellent chance that women who undergo breast augmentation surgery will have more than one surgery in her lifetime. This exclusive interview is part of a Make Me Heal series of conversations with top plastic surgeons.
MMH: Have you started using silicone implants since the FDA approved their use?
Dr. Fisher: I have been involved in the FDA study with silicone implants since 1991 and have been using them for the past 17 years. I have continued using them since the FDA approved their use, and have always been a supporter of silicone breast implants. During that time, I was one of the largest single surgeon users of Mentor breast implants in the western United States.
MMH: Do you think more women will opt for silicone implants than saline implants over the next 5 years? What percentage would you speculate will get silicone versus saline?
Dr. Fisher: I definitely think more women will be asking for Silicone gel implants in the future now that their fears have been further alleviated. I don’t think the plastic surgery community of surgeons ever felt they presented unique health risks. I would estimate that 50% more women will be asking for silicone implants.
MMH: Do you feel silicone implants look aesthetically better and more natural relative to saline implants?
Dr. Fisher: The way breasts and associated implants “look” has more to do with the technique, than the type of implant. BOTH saline and silicone implants can look and feel great and natural. Patients who have thin skin and little breast tissue benefit more from silicone implants because in those patients, their implants comprise a higher percentage of the composition of their breast. Thus, you are able to see and feel the implants more. Silicone implants in those patients feel more natural and they see less “rippling”. (See naked truth about plastic surgery vol 2 at www.garthfisher.com.)
MMH: Do silicone implants feel more “real” to the touch compared to saline implants?
Dr. Fisher: Silicone implants feel more real to the touch compared to saline when you are just holding them in your hand. However, if a woman has thick skin, or a lot of breast tissue, saline implants feel very “real” and “natural”. Putting the implants under or “partially” under the muscle also helps to make the implants feel more natural within the body.
MMH: Are silicone implants lighter, heavier, or have the same weight as their saline counterparts?
Saline and silicone implants of equal size basically weigh the same.
MMH: Is the recovery from having silicone implants any different from having saline implants?
Dr. Fisher: The recovery period after augmenting a patient with saline and silicone implants is the same. The recovery differs with various techniques and surgeons.
MMH: Do you think silicone implants present any safety issue as far as rupturing and the potential health effects if silicone leaked to other parts of the body?
Dr. Fisher: I personally do not feel this represents a significant health risk, but do advise removing them if they are ruptured. Many ruptures are “silent”, in that they difficult to diagnose and detect. Monthly breast exams, follow-up appointments with your doctor, age appropriate screening mammograms are essential. For silicone implants, MRIs every 3 years are advised. It is important to know that there is an excellent chance that you will have more than one surgery in your lifetime if you have a breast augmentation surgery. For information regarding MemoryGel silicone gel-filled breast implants, I recommend visiting the website www.mentor4me.com
MMH: If you do not believe that there are any safety downsides to using silicone implants, are there any remaining advantages to getting saline implants now that the FDA approved silicone implants?
Dr. Fisher: I continue and will continue to use saline implants, as I believe they are excellent devises for breast augmentation. When using the right technique in the proper patient, they feel and look very natural. Advantages of saline implants are numerous and include: a) Smaller incisions can be used as the saline implants are inflated “after” they are implanted. b) They can be inflated to any size to help with patients who have “asymmetric” or different breasts. Silicone implants come “prefilled”, although they do come in many prefilled sizes and shapes. c) In the event of an implant rupture, saline is excreted in your urine. (Saline composes roughly 75% of your body makeup). d). For those who continue to be fearful of silicone, saline is an excellent option!
MMH: What is the ideal profile of a woman who should elect for silicone implants?
Dr. Fisher: I don’t think there is an ideal profile for a woman electing for silicone implants. She should get as educated as possible regarding the risks, benefits, and alternatives of surgery so she can make a intelligent decision. She should set up numerous consult appointments with plastic surgeons specializing in breast augmentation to develop a rapport and comfort level with her surgeon. She should feel both types of implants and determine what is best for her unique anatomy and goals.
MMH: What is the profile of a woman who should not elect to have silicone implants?
Dr. Fisher: Women under 22 cannot have silicone implants at this time.
MMH: What is the best incision in your opinion?
Dr. Fisher: You can see wonderful and awful results from any incision. So much is dependent on the skill of your surgeon. I personally prefer the incision under the nipple as it can provide minimum scarring that will be seen by the fewest people. I think the incision through the belly button is more risky, makes less sense, and is least appropriate.
MMH: Is it true that there is usually no loss of sense of touch of the nipples?
Dr. Fisher: Losing sensation in your nipples has less to do with the incision location and more to do with the size of the implants. You can lose total sensation of the nipple through belly button and armpit incisions as the nerve is damaged in the dissection area when developing a pocket for the implant. In general, the larger the implant, the larger the dissection area, the larger the risk of losing sensation. Incisions at the bottom of the nipple should not be made large enough to damage the main nerves to the nipple.
MMH: Do breasts with implants experience greater sagging over time than natural breasts?
Dr. Fisher: I think it makes sense that the larger an implant, or the more a breast weighs, the more it is prone to sag over time. Some patients however, develop enough scar tissue that it keeps the breast high. On the other hand, breast implants are an excellent treatment for stages of drooping and to that degree, often make the breast look fuller and better as the drooping process evolves.
MMH: What bra do you suggest for post-surgery? Below is a link to some post-surgery bras:
The bras suggested on your store link (see below) are excellent bras for post op recovery for breast surgery. It is important to listen to the advice of your doctor and follow his instructions.
MMH: Name celebrities that you think had great breast augmentations and celebrities that you think had bad breast augmentations?
Dr. Fisher: I am frequently asked to comment on celebrities plastic surgery. Some of these are my patients and confidentiality is the backbone of my business. We pride ourself in keeping the related medical information “confidential”. I don’t feel a plastic surgeon is required to identify those with “bad” plastic surgery. J [smiley emoticon]
Dr. Garth Fisher is a renowned Plastic surgeon who is board-certified by the American Board of Plastic Surgery. His office is located in Beverly Hills, California, USA. As the first doctor selected for ABC’s hit “Extreme Makeover” series, Dr. Fisher is the plastic surgeon who started the “Extreme Makeover” phenomenon. Dr. Fisher specializes in aesthetic/cosmetic plastic surgery of the face, nose, and breasts. His busy practice includes entertainers, celebrities and business executives from around the world. His surgical skills and judgment are sought after by a large international clientele.
Dr. Fisher has been honored by being selected as “one of the top plastic surgeons in the United States for facial cosmetic and breast surgery” in Best Doctors in America, an authoritative listing of the nation’s top physicians in each medical specialty. Similarly, his selection by his peers as “one of the best plastic surgeons in Los Angeles” was reported in Los Angeles Magazine. Town & Country magazine listed Dr. Fisher as one of the best doctors for facelift procedures in the United States, and Dr. Fisher also appears in Marquis’ Who’s Who in Medicine and Healthcare. He skillfully utilizes the latest proven advances in technology and innovations, including laser surgery and surgical scar minimization techniques.
For more information, please visit Dr. Garth Fisher’s website.
Tags: celebrity, plastic, surgery