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Question
Hello Dr. Thank you for your time. My wife, youthful 40, with a swimmers physique feels it is time to look more proportionate.
I have two questions that I have gotten different answers to from different doctors.
1) should the implant ( gel filled ) be placed beneath or on top of the muscle tissue,
2) is it possible that you may damage nerve endings and interfere with sensations by cutting around the nipple,
3) should she take supplements to control bleeding i.e. vitamin C or any other prior to surgery that will aid in the healing process.
If there is anything you care to add, we would appreciate it very much.
RS
from Dr. Alan Engler
www.bodysculpture.com
Hi Rick,
In general, when there are several choices it is unlikely that there will be a right or a wrong answer; otherwise, there wouldn't be different ways of doing things. So, with that:
1) I almost always recommend placing implants beneath the muscle if possible.
2) You can have changes of sensation with this procedure regardless of where the incision is. It probably has as much, or more, to do with the size of the implant than the location of the incision, since a larger implant requires a greater disruption of the existing breast architecture.
3) I advise a normal, balanced diet before and after the surgery and would avoid supplements, as they may contain substances (such as Vitamin E) that, when used to excess, can actually increase bleeding.
There's lots more about this at my site, www.bodysculpture.com, in my book (BodySculpture) and at the sites of the plastic surgery societies (asaps.org, plasticsurgery.org).
I hope that this helps, and good luck,
Dr. E
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Answers by Expert:
Alan M. Engler, MD, FACS
Expertise
Dr. Engler has answered over 3100 questions as a volunteer expert for AllExperts. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Thanks for "Likiing" Dr. Engler on Facebook - http://www.facebook.com/pages/New-York-NY/Alan-M-Engler-MD-New-York-Plastic-Surgery-and-Aesthetics/107206405967267?ref=ts&__a=8
Experience
Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York, and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.
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