It seems that there are still misconceptions regarding the presence and magnitude of pain and discomfort following breast augmentation surgery. Many women believe that considerable pain is inherent to the procedure – unavoidable, natural and expected. This belief has actually caused some women to delay or abandon their dreams of acquiring larger, more voluptuous breasts.

The reality is that breast augmentation surgery does not have to be a very painful procedure. It is the surgical skills and techniques employed by the plastic surgeon which are of primary importance in affecting the presence and extent of pain postoperatively. When performed proficiently, expect the level of discomfort initially to be of a mild to moderate nature which then usually subsides fairly quickly.

Of course, there are always the outliers. These are the patients who, for example, must take a week off from work due to the “debilitating” pain of an ingrown fingernail or need the following day off due to a brain freeze caused by gluttonously devouring chocolate ice cream earlier in the day.

Immediately following their breast augmentation, a majority of my patients experience only a mild to moderate amount of discomfort which is usually well controlled with their prescribed medication. In fact, many take little or no narcotic pain medication after 24 hours and are already engaging in some more normal but non-strenuous activities. I believe that the relatively atraumatic techniques that I use in surgery along with an effective postoperative regimen are paramount in helping to minimize my patients’ discomfort.

In the video below, a recent patient of mine who just had a breast augmentation 24 hours earlier, candidly shares her experiences and thoughts including her level of comfort.

If you are strongly considering pursuing breast enlargement surgery and are very apprehensive about the associated pain, hopefully this information will help to ease your mind.

For more information on a breast augmentation or on any other plastic surgery procedure or to schedule your complimentary consultation, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Silicone breast implants are used in the majority of breast augmentations that are now being performed. In fact, in 2012 they constituted 72% of the total number of breast implants used for breast enlargement with the remaining 28% being saline. In my practice, due to my firm evidence based convictions on the superiority of silicone implants over the saline ones, nearly 99% of my patients choose the silicone ones.

This preponderance of silicone implants being placed in breast enlargements was “artificially” eliminated between 1992 and 2006 due to the federal government’s (FDA) restriction on their usage. As a result, during this period, women electing to have this surgery either had to accept the usage of saline implants for their breast augmentations or forgo the surgery. (There were some exceptions to this edict.) In the last year of the moratorium which was 2006, 81% of the implants used were saline ones.

As you might expect, virtually all women decided that a breast enlargement with saline breast implants was better than having no surgery at all. Clearly, the benefits from undergoing this surgery – such as more aesthetically pleasing and alluring breasts and appearance, improvements in self-esteem, confidence, in relationships with others and in one’s sex life – far outweighed the downsides associated with saline implants.

Why are silicone breast implants so popular and chosen by the majority of women?

The reason is that they simulate quite well the feel and consistency of the female breast. They are the gold standard of breast implants. Cosmetically, they are light years superior to the saline ones which many people characterize as feeling like water balloons. Additionally, you can actually feel the envelope of the saline implant which often presents firm, discrete edges – not a natural occurrence in the female breast and a not so subtle reminder of their presence. Particularly in thin skinned individuals and those with their implants placed above the muscle, these edges can often be felt and seen as ripples of the overlying skin.

Despite all of this, many women who have saline implants are extremely happy with their results which they consider to be very good. The following patient of mine with a 10 year follow-up is but one example:

At the age of 37, this patient decided to pursue a breast enlargement which she had been thinking about for a long period of time (Fig A, C and E). Because of the restriction on the usage of silicone breast implants for primary breast augmentations, she underwent the procedure with saline implants that were placed behind the muscle. That was 10 years ago. She has been very happy with her results and has had no problems including rippling, hardness (capsular contracture) or contour irregularities (Fig B, D and F).

A). Before breast augmentation

B). 10 years after breast augmentation

C). Before surgery – side view

D). After surgery – side view

E). Before surgery – side view

F). After surgery – side view

My examination revealed that her breasts were soft, the implants naturally mobile and that there was no rippling present. She did develop some laxity of the skin over time from gravity and age. The implants themselves could barely be felt.

This patient, like many others who have had breast augmentation with saline implants, demonstrates that despite the superiority of silicone breast implants, saline ones can still provide excellent aesthetic results.

If you would like additional information on breast augmentation surgery, on silicone or saline breast implants or on any other plastic surgery procedure that I perform, please feel free to contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

In my blog, Gummy Bear” Silicone Breast Implants Just Approved by the FDA for Usage, I shared with you the news that the FDA finally allowed widespread usage of these next generation silicone breast implants after over a 12 year wait. Also, rather than being referred to as “gummy bear” implants, they have now been given an official name, the Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants – or Natrelle® 410, for short.

Is this an earth shattering event?

Has there been a recent increase in seismic activity or an unusual number of earthquakes subsequent to this announcement?

No, and of course not!

However, if you are considering having a breast augmentation or a mastopexy (breast lift) with implants, now you have one more option available to you. These Natrelle® 410 implants do have several advantages over the round highly cohesive silicone gel breast implant (as I noted in that post). There are also a few drawbacks.

These are anatomic shaped implants (tear drop in configuration) so if you are looking for a “push-up” look with a lot of roundness and fullness at the top of your breast, this style implant will not be for you. If you are also desiring to be disproportionately large, the same holds true – so go with the round silicone breast implants.

These Natrelle® 410 implants require far more precision in their selection and insertion than the round silicone implants (although I already am very precise and meticulous as regards the round silicone gel implants). In fact, this is such a crucial issue that that any plastic surgeon desiring to offer these implants must obtain certification for their usage.

And guess what?

I have completed the certification program and am fully certified to offer and use these Natrelle® 410 implants.

Finally, these new implants are substantially more expensive than the round silicone gel breast implants. Consequently, this will translate into a significant premium to the cost of undergoing a breast augmentation if you opt for using them. This additional expense to the procedure will vary among plastic surgeons, but it could be in the range of $2000 – $3000 more.

If you would like additional information on the new Natrelle® 410 silicone breast implants or on breast augmentation surgery in general or if you would like to schedule your complimentary consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants

After waiting years for approval of the widespread usage in the United States of the so called “gummy bear” silicone breast implants, the U.S. Food and Drug Administration (FDA) yesterday finally announced their formal approval to the manufacturer of this implant, Allergan, Inc. This implant will be officially known by the marketing name Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants or Natrelle® 410 for short.

Or “gummy bear” implant if all this is too technical!

This breast implant has undergone the most rigorous scientific research for years and that has also included numerous clinical studies. Additionally, it has already been used worldwide for 20 years including in Canada and Europe. What has been learned is that women love them overwhelmingly (and so do men!). In fact, the satisfaction rate in those who have them is 96.5%, which even exceeds the already extremely high rate of satisfaction associated with the silicone breast implants that we have been using.

There are a few characteristics that make this silicone breast implant unique – and its formal name says it all. It is an anatomically shaped implant in the form of a tear drop or wedge compared to the round implants which have been used for decades. It also consist of a silicone gel that is highly cohesive – it sticks together to a very high degree, far greater than any other previous breast implant. Consequently, it maintains its intended anatomic tear drop shape for a more natural look but still has somewhat of a soft feel. Additionally and importantly, there has not been noted to be any silicone gel migration from the implant at 7 years.

This gummy bear implant also has the advantage of staying in place versus what can happen at times with the round breast implants. This is a double-edged sword in some ways, though. A well trained experienced plastic surgeon can place it precisely where it is desired allowing for even greater control of shape and other factors. There isn’t the so called “dropping” effect that many people have heard about with the round implants (though this doesn’t really occur either). Conversely, if the insertion is not performed skillfully, the results may reflect this.

Because of how this implant is constituted, the associated risks of rippling or wrinkling are virtually non-existent – at less than 1% at 7 years in primary breast augmentations. This is less than that of the “present” day round silicone breast implants and light years better than that associated with the saline breast implants.

This style 410 silicone breast implant is intended for usage in breast augmentation, breast reconstruction and breast revision surgery with the additional FDA stipulation that a woman must be at least 22 years of age. It will also not be for everyone who wants silicone breast implants. In fact, it may end up be a niche type choice partially because the results will be more “natural” in appearance which is not what many women are looking for (though many are as well!). The round implants that we are presently using provide that more popular appearance of considerable fullness – that round, push-up bra look.

And then there is the cost… It will be priced higher than the round silicone breast implants.

Once these Natrelle® 410 implants become physically available within the next week or so, I will be offering them as another silicone breast implant option.

For more information on the newly introduced Natrelle® 410 silicone breast implants, on breast augmentation surgery in general or on any other plastic surgery procedure that I perform, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

For a woman who has undergone breast augmentation surgery or even a breast lift with an enlargement, it is not necessarily one and done with regard to the implants. That is, there is a substantial likelihood that those aren’t the last pair of implants that she is going to have in her lifetime.

Why?

First of all, breast implants are not permanent medical devices and will not last forever if given long enough. At some point in time, they will either need to be replaced (implant exchange) or removed due to rupture or loss of integrity. It has been my experience that most women, even those in their 70’s, elect to have new implants put back in again rather than have them removed permanently. They just don’t want to be walking around without “breasts”.

This is not the only reason for changing out breast implants, a type of breast revision surgery. Some of the other reasons that women choose or need to obtain new implants include:

1) a desire to change their breast size – usually going bigger; rarely do they elect to go smaller
2) switching their type of implant from saline to silicone; the reverse, going from silicone to saline is extremely rare
3) a desire to alter the shape and projection of their breasts such as going to a higher profile implant to obtain more projection
4) to replace very old implants with newer but similar ones
5) to treat hardness or irregularities that have developed around the implants such as significant capsular contracture
6) development of infection (exceedingly rare)

This breast revision surgery is typically associated with minimal initial postoperative discomfort and is a far easier and more pleasant experience than the initial breast augmentation or breast lift with implants. I have found this to be almost universally true in my practice over more than 25 years.

The following patient of mine exemplifies a few of the reasons why women electively decide to pursue breast implant exchange surgery. At age 18 she underwent a breast augmentation that involved the submuscular placement of smooth surfaced moderate profile saline breast implants with 240cc on the left and 265cc on the right (Fig A, C and E). This gave her the shape and “C” cup that she had wanted so that she was very happy with the results.

A) Breast augmentation with saline implants – prior to implant exchange

B) After breast implant exchange, going from saline to silicone

C) Before implant exchange – side view

D) After implant exchange – oblique view

E) Before implant exchange – side view

F) After implant exchange – side view

After several years and experiencing no problems whatsoever, she decided that she wanted her breasts to be even larger and to also switch to the much more natural feeling silicone breast implants. For her breast revision, she had placement of smooth surfaced ultra high profile silicone breast implants with 360cc on the left and 400cc on the right (Fig B, D and F). There was virtually no discomfort following surgery and she went back to work within a few days. The results were just what she had desired and she was extremely happy.

For more information regarding breast revision surgery, breast augmentation or on any other plastic surgery procedure that I perform, please contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

If you are considering having a breast augmentation or a breast lift along with a breast enlargement, figuring out the size that you want to be and how that will look on you can be VERY confusing. Compounding this dilemma is the lack of standardization of cup size. After all, two different bra cup sizes produced by different bra manufacturers may fit you exactly the same presently.

How do you better express the appearance that you desire?

Many women state that what they want is to be proportional or somewhat natural looking.

What is that?

Proportional or natural looking means different things to different women. What is proportional for one may be far too small for another.

A woman may indicate that she wants to be a moderate “C” or a large “C”. Or maybe even a small to moderate “D” but not too big.

What exactly is a moderate “C” or a large “C”? Or a moderate “D”?

Exactly!

There is no such specific thing.

For more than 25 years, I have been highly successful in using an approach for my patients wanting a breast enlargement which can accurately determine the look that they desire and then translates that into the appropriate breast implant sizes. This system uses extensive and crucial information that I obtain from my patients during their thorough consultations and examinations as well as during surgery. Still, there are some women who really need to see what they will look like before undergoing their breast augmentation.

Fortunately, I can now provide a good solution for this: computer imaging of their breasts that algorithmically projects their results based both on implant size in cc’s and profile (moderate, high and ultra-high). In this fashion, my patients can visualize the effects of various implant sizes as well as their configurations on the appearance of their breasts, their chest and overall proportionality.

Though I find the results from this high tech imaging still not highly accurate and predictive, the patients of mine that have requested it have found the simulation to be quite helpful for them in many ways.

If you would like more information on breast augmentation surgery or on any other plastic surgery procedure that I perform or to schedule your complimentary consultation, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Phoenix, AZ — According to the American Society of Plastic Surgeons (ASPS), over the past ten years, breast implant removals have decreased by 45 percent, while the number of breast augmentation procedures has increased by 45 percent, making it the most popular cosmetic surgical procedure for 2011. As modern technology continues to advance the safety and effectiveness of breast implants, Dr. Steven Turkeltaub, a board-certified plastic surgeon in Phoenix, says breast augmentation patients are now able to enjoy the benefits of longer-lasting results and less noticeable scarring. However, Dr. Turkeltaub reminds his patients that breast implants are not permanent medical devices, and there are a number of reasons why they may need to be replaced in the future.

At his Phoenix plastic surgery practice, Dr. Turkeltaub indicates that nearly 98 percent of his patients choose silicone implants rather than saline implants for their breast augmentation. The major factors in their decision are the far superior aesthetic appearance and feel as well as the greater longevity of silicone implants as compared to the saline ones.

Dr. Turkeltaub notes that many of his breast implant revision procedures are on patients who originally chose saline but are now interested in exchanging them for their more natural-looking and feeling counterparts. In fact, he states that most of his patients who have saline implants and are seeking to have them replaced for any of a number of reasons, nearly always switch to silicone ones whereas going from silicone to saline is exceedingly rare and is never done for aesthetic reasons.

Another very common reason for breast implant revision surgery is that implants will ultimately wear down over time and either rupture (silicone) or deflate (saline), necessitating a revision surgery. However, Dr. Turkeltaub says that most patients who experience a rupture and need a replacement procedure would like to have another implant put back in.

A less frequent reason for replacing breast implants is that patients’ bodies change over the years and the proportionate relationship that once existed is no longer the right fit. Consequently, Dr. Turkeltaub says patients often state that their breasts appear disproportionate or are either too large or not big enough for their bodies and they are looking to restore a proper balance to their figure.

Dr. Turkeltaub states that recovery from a revision breast augmentation typically is far better than that experienced following the original procedure, adding that there is usually only a fraction of the discomfort in comparison and most patients have a much easier time functioning after surgery. Generally, the same incisions can be employed so that no new scars are added unless there is a need to also perform a mastopexy, or breast lift, says the Arizona plastic surgeon.

As with any plastic surgery breast procedure, Dr. Turkeltaub says that obtaining desirable results from implant revision is strongly impacted by extensive training and experience as well as a great aesthetic sense. He encourages anyone considering this type of surgery to consult with a dedicated and experienced board-certified plastic surgeon in order to help maximize the probability of obtaining the desired results.

About Steven H. Turkeltaub, MD, PC

A graduate of the Six-Year Medical Program at Boston University and the Boston University School of Medicine, Dr. Steven Turkeltaub is board-certified by the American Board of Plastic Surgery. He is also a member of several professional organizations including the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, and the Arizona Medical Association. Dr. Turkeltaub has dedicated numerous hours to his continued education through advanced courses and lectures, in addition to being published in a variety of plastic surgery journals and textbook chapters. He has been selected as one of the “Top Doctors” in the Phoenix Metropolitan area, and also one of “America’s Top Plastic Surgeons.”

With two locations at 10290 N. 92nd St. Suite 207 in Scottsdale, AZ 85258 and 18275 N. 59th Avenue Bldg. E Suite 126 in Glendale, AZ 85308, Dr. Turkeltaub’s practice can be reached at (480) 451-3000. It can also be contacted online via the websites arizonabreast.com, turkeltaub.com, or facebook.com/drturkeltaub.

Phoenix, AZ — At his center for plastic surgery in Phoenix, Dr. Steven Turkeltaub says breast reduction has become an integral and increasingly popular part of his practice’s ability to help women feel more confident and more comfortable with their bodies. Through a personalized and precise approach to surgery, he says patients across a wide age demographic are able to experience the benefits of undergoing a breast reduction to enhance their overall health as well as their physical appearance.

By removing significant amounts of breast tissue and reshaping the breasts to more natural contours, Dr. Turkeltaub states that a breast reduction is designed to not only alleviate patient symptoms such as neck, back and shoulder pain, but also to create a more proportional balance to a woman’s body. He also notes that patients who have experienced chronic pain in their upper body, skin irritation, rashes, restricted physical activity, and self-esteem issues uniformly find the procedure to be a welcome relief from the burden of uncomfortably large breasts. Also, while patients younger than 18 may still be candidates for surgery in certain situations, the board-certified Arizona plastic surgeon says that any woman from 18 years of age or older who suffers physical or emotional discomfort related to her disproportionately large breasts may strongly benefit from breast reduction surgery.

“Patients should consider breast reduction if they are having neck, back, or shoulder pains or other symptoms related to the large size of the breast,” says Dr. Turkeltaub. “Many women also complain that the very large size of their breasts attracts undesirable attention, comments and even ridicule, and generally projects an image that they don’t want. This can also lead to lowered self-esteem, depression, eating disorders and even affect romantic relationships. Clearly there are significant functional and aesthetic benefits that can be gained from this surgery.”

In order to help patients decide what size is right for them, the Phoenix plastic surgeon states that he seeks out the patient’s goals relating to the surgery including the overall look, general cup size and extent of proportionality. He says that some patients are looking to go as small as possible whereas most others simply want to be much smaller yet still have a proportionate, balanced look. He notes that the majority of patients desire and end up being somewhere around a “C” or “D” cup size.

“When it comes to the end result of a breast reduction, the aim is to ensure that patients achieve their goals which typically are to be proportionately sized, rejuvenated-appearing breasts that no longer are the source of physical or emotional issues,” he says.

Regardless of whether women are looking for a breast reduction or a breast lift, Dr. Turkeltaub states that choosing the right practice for one’s plastic surgery procedure is an essential step. He encourages anyone considering breast surgery to consult with an experienced and reputable, board-certified plastic surgeon before undergoing any treatment.

About Steven H. Turkeltaub, MD, PC

Dr. Steven Turkeltaub graduated from the Six-Year Medical Program at Boston University and Boston University School of Medicine, after which he completed a general surgery residency at the University of Miami/Jackson Memorial Hospital and Northwestern Medical Center as well as a plastic surgery residency at the University of Massachusetts Medical Center. Board-certified by the American Board of Plastic Surgery, he is a member of the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, and several other professional organizations. Dr. Turkeltaub has authored several papers and textbook chapters on advanced techniques in plastic surgery, and he has dedicated numerous hours to his continued education.

With two locations at 10290 N. 92nd Street, Suite 207 in Scottsdale, AZ 85258 and 18275 N. 59th Ave. Bldg. E Suite 126 in Glendale, AZ 85308, the Arizona Center for Aesthetic Plastic Surgery can be reached at (480) 451-3000. It can also be contacted online via the websites turkeltaub.com, arizonabreast.com, or facebook.com/drturkeltaub.

Do you want to know some of the secrets of making your breasts look as youthful and attractive as possible?

Of course you do!

We’re not talking here about surgical procedures that enlarge, lift or reduce the size of your breasts like breast augmentation, breast lift or breast reduction surgery. These are very effective procedures that can definitely have a great impact on their size, shape and allure but involve surgery and are performed on what is already there. Instead, based on your genetic code for breast size, quality, shape, etc., there are actually actions that you can take and other ones that you should avoid in order to keep your breasts looking as youthful and attractive as possible.

And there is no charge!

Or scars!

What are these breast beauty “secrets” and how were they discovered? (Surely not by reading the latest issue of Cosmopolitan magazine!)

The appearance of one’s breasts are affected both by genetic as well as environmental factors, the latter which includes actions or habits on your part. By controlling the genetic factor in a study, the effects of other factors can be better assessed.

How can this be precisely done?

By using identical twins and then evaluating other variables.

A study was performed through the Dept. of Plastic Surgery at Case Western Reserve University School of Medicine in Cleveland that consisted of 161 pairs of identical female twins with an average age of 47 years. It analyzed numerous independent external factors such as pregnancy, breast feeding, smoking and alcohol consumption and assessed their impact on breast quality and beauty based on several precise parameters. The data was then rigorously and statistically analyzed in order to determine the scientific significance of the findings.

So what were their findings (translated to beauty secrets for the breasts)?

Factors that had an adverse impact on the appearance of the breasts included multiple pregnancies, higher weight (BMI), cigarette smoking, alcohol consumption, sun exposure and larger cup and bra size. Skin quality was universally affected by all of these factors. It was interesting that of the 16 parameters used to assess the breast quality, cigarette smoking negatively impacted 8 of them.

One more factor that I can add to this list which wasn’t mentioned in the study is exposure of the breasts in tanning beds. Over the years, I have seen numerous women, including many still in their twenties, who have sustained significant damage and premature aging of their breast skin through multiple exposures to tanning beds.

On the positive side, it was found that daily moisturizing of the skin of the breasts resulted in less wrinkled, more youthful appearing skin. Hormone replacement therapy after menopause was associated with more attractive breast shape, size, projection and areola size and shape. Surprisingly, it was also discovered that breast feeding resulted in better appearing breast skin than those who were pregnant but did not breast feed.

So, if you want your breasts to remain youthful and as attractive looking as possible, avoid becoming overweight, don’t smoke, keep alcohol consumption to a minimum and don’t sunbathe or tan in tanning booths topless.
And find that hunk or significant other who would surely enjoy applying moisturizers to your breasts on a daily basis. (This may just be the easiest one to do!)

If you would like some information on cosmetic plastic surgery procedures of the breast such as breast augmentation, breast lifts or breast reduction, you can call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Scottsdale, AZ – The field of plastic surgery is celebrating the 50 year anniversary of silicone breast implants that are used in breast augmentation as well as breast reconstruction surgery. In those fifty years, numerous major technological advancements have been made as a result of the painstaking work and unwavering dedication of countless scientists and doctors seeking the “perfect” breast implant.

The first breast implant procedure was performed by Dr. Thomas Cronin and Dr. Frank Gerow in Houston. This team developed an implant consisting of a thick silicone gel encased in a silicone rubber lining—a revolutionary design that far superseded in quality and results all other materials that had preceded it. Since that time, breast implants as well as the breast augmentation procedure, in general, have continued their evolution to become safer and with results that look and feel more natural. According to the most recent study from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 316,000 breast augmentation procedures were performed in 2011—a clear indication of the major and positive impact of this surgery and the associated silicone breast implant.

Dr. Steven H. Turkeltaub, a board certified plastic surgeon in Scottsdale, has been selected as one of “America’s Top Plastic Surgeons,” exhibiting his commitment to excellence in providing effective procedures that are uniquely customized for the individual patient and at the forefront of contemporary practice. He operates within the philosophy that society’s continual emphasis on beauty makes physical appearance an important, impacting factor in social interactions, career paths, confidences, and sense of self-worth. How an individual looks and feels on the outside can largely affect how they feel inside. Dr. Turkeltaub, has been practicing plastic surgery in Scottsdale for twenty-five years and has received numerous honors and recognition including being selected as a Patients’ Choice Physician.

About Steven Turkeltaub, MD

Dr. Steven Turkeltaub trained in general surgery at the University of Miami/Jackson Memorial Hospital in Miami and Northwestern Medical Center in Chicago. This was followed by training in plastic surgery at the University of Massachusetts Medical Center where he learned from world-renowned plastic surgeons. He also held an academic appointment as Clinical Instructor and Attending in Plastic and Reconstructive Surgery. He has authored several papers and textbook chapters on plastic surgery as well as several magazine and newspaper articles.

Dr. Turkeltaub is board certified by the American Board of Plastic Surgery. He is a member of many medical societies including the American Society of Plastic Surgeons (ASPS), Arizona Society of Plastic and Reconstructive Surgeons, Arizona Medical Association, Maricopa County Plastic Surgeons Society and the Maricopa County Medical Society. He has served as President and as Secretary/Treasurer of the Maricopa County Plastic Surgeons Society.

To contact Dr. Steven H. Turkeltaub at Arizona Center for Aesthetic Plastic Surgery, visit the center’s website at arizonabreast.com or call 480-451-3000. The center’s Scottsdale office is located at 10290 N. 92nd St., Suite 207, Scottsdale, AZ, 85258. The center’s Glendale office is located at 18275 N. 59th Ave., Bldg. E Suite 126, Glendale, AZ 85308.

Scottsdale Plastic Surgery Practice Stands Behind U.S. Breast Implant Safety

Scottsdale, AZ — Breast augmentation remains the most popular surgical cosmetic enhancement in the U.S., which is mirrored in the Scottsdale plastic surgery practice of Dr. Steven Turkeltaub. He believes the extensive, exhaustive studies and research conducted over the years supports the general safety of both silicone and saline breast implants and refutes the nebulous charges of self interest groups. Furthermore, he states that the strict requirements and thorough oversight by the FDA in their approval adds additional credence to their safety.

The recently publicized breast implant safety issue concerned the French breast implant manufacturer Poly Implant Prothese (PIP), which was caught substituting industrial grade silicone for some of their implants instead of using the far more expensive medical grade silicone. Fortunately, none of their silicone breast implants were used in the United States because the company failed to meet the numerous and strict regulations and guidelines established by the FDA. As a board-certified Scottsdale plastic surgeon, Dr. Turkeltaub says that a patient who has had a breast augmentation in the U.S. from a reputable board-certified plastic surgeon need not be concerned about this issue.

Dr. Turkeltaub says he strongly believes in the safety of silicone gel implants for patients looking for breast augmentation in Scottsdale, Phoenix, and Glendale. “Silicone gel breast implants, which are FDA approved, are probably the most studied medical device ever. I feel extremely comfortable reassuring my patients of their safety and effectiveness and recommending them.” In fact, Dr. Turkeltaub says silicone breast implants in Scottsdale are the most popular choice of implant for patients at his practice, noting that more than 95% of his patients select the gel option for its natural look, feel and durability. “My patients find that silicone feels more like natural breast tissue, whereas saline implants can feel more like a water balloon. When considering a procedure that can have such a significant impact on the way a woman looks and feels about her body, I’m not surprised a majority of women choose the silicone gel implants.” The American Society for Aesthetic Plastic Surgery (ASAPS) confirms his observations, reporting that 62% of breast augmentation procedures used silicone implants, whereas only 38% of cases used saline.

Whether patients are looking for silicone or saline implants for a breast enlargement in Scottsdale, Dr. Turkeltaub says consulting with an experienced and reputable board certified plastic surgery practice is essential for having a much greater likelihood for achieving an aesthetically-pleasing outcome. He also stresses the importance of seeking a board-certified plastic surgeon who is caring, easily relates with patients, and spends an appropriate amount of time discussing all aspects of the procedure and answering their questions.

“Board certification with the American Board of Plastic Surgery is critically important when considering a procedure such as breast augmentation. Many of my patients have told me that word-of-mouth from friends and acquaintances who are or have been patients of the plastic surgeon can be quite helpful.”

About Steven H. Turkeltaub, MD, PC

A graduate of the Six-Year Medical Program at Boston University and Boston University School of Medicine, Dr. Steven Turkeltaub completed his general surgery residency at the University of Miami/Jackson Memorial Hospital and Northwestern Medical Center in Chicago, as well as a plastic surgery residency at the University of Massachusetts Medical Center. He is a member of the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, the Arizona Medical Association, and several other professional societies. Board-certified in Plastic Surgery, Dr. Turkeltaub has also been published in several scholarly articles and textbooks on plastic surgery, in addition to a number of magazines and newspapers.

With two locations at 10290 N. 92nd Street Suite 207 in Scottsdale, AZ and 18275 N. 59th Avenue Bldg. E Suite 126 in Glendale, AZ, Dr. Turkeltaub’s practice, the Arizona Center for Aesthetic Plastic Surgery, can be reached at (480) 451-3000. He can also be contacted online via the website turkeltaub.com, arizonabreast.com, or the Arizona Center for Breast Surgery Facebook page.

Contact:
Rosemont Media
Aaron Hurst
aaron@rosemontmedia.com
(858) 200-0044

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Breast augmentation continues to be the most popular cosmetic plastic surgery procedure being performed today and for very good reasons (which I won’t delve into here). Related to this is the finding that an astounding 94% of women who have undergone this procedure would make the same decision to pursue breast enlargement surgery if they had to do it all over again. Looking at this from another perspective, there are few things in life that 94% of women can agree on (well, maybe unless it has to do with some complaints regarding men in general!).

There is considerable disagreement, however, on the amount of discomfort that is experienced immediately following a breast augmentation where the breast implants are placed behind the muscle. Many women are under the impression that there is necessarily a considerable amount of pain for several days following the surgery. They might have heard this from some of their friends or even read about it online. This can create anxiety prior to surgery or even cause some women to abandon their pursuit of a breast enlargement.

How true is this?

Should you expect to be in a considerable amount of pain for days after your surgery?

For most women, when the breast augmentation surgery is performed by a plastic surgeon employing the most advanced and meticulous plastic surgery techniques, the immediate postoperative course can be surprisingly tolerable with mild, fairly easily manageable discomfort. Of course and unfortunately, this is not true in every situation.

In the pursuit of seeking the ideal ways to minimize immediate postoperative discomfort following a breast augmentation, my techniques and approaches have evolved considerably over my 25 years in practice here in Scottsdale and the Phoenix metropolitan area. The result is that it is not very common for my patients to complain about greater than mild to moderate pain that can’t be controlled with analgesics and muscle relaxants. Unfortunately, there are many plastic surgeons and other physicians performing breast augmentations who are not very mindful of the ways to make the postoperative course far more pleasant and tolerable.

The following is a video of a recent patient of mine who wanted to share with others her experiences and perspectives following her breast augmentation surgery.

If you would like more information on breast augmentation surgery or for any other plastic surgery procedure that I perform, or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

A very significant percentage of women that I see in consultation for breast reduction surgery (reduction mammoplasty) are well above their ideal body weight. Many of these same women express a desire, serious or not, to lose a substantial amount of weight in addition to breast size.

When considering weight loss and breast reduction surgery, should a woman lose some or most of the weight:

A.)  prior to breast reduction surgery?
B.) after the breast reduction surgery?
C.) or some before and the rest afterwards?

In a perfect world, my recommendation would be to lose as much of the excess weight prior to breast reduction surgery rather than afterwards. The advantages of this are many. When the breasts are reduced in size and contoured into a desirable shape with a rejuvenated appearance, there is a fixed ratio of skin and enclosed breast tissue. This can be maintained to some extent over time if weight remains constant though gravity continues to take its toll with regard to continuation of drooping over time. With a postoperative weight loss well in excess of 5 or 10 pounds, there will be additional loss of breast volume yet the amount of skin remains the same. The result would be even smaller breasts that are less firm and shapely and droopier than they otherwise would have been.

What are other advantages of preoperative weight loss?

At a substantially lower weight, surgical and anesthetic risks may be decreased as would the risk of infection and healing problems. This relevant for those individuals whose body mass index (BMI) places them in the obese or morbidly obese categories.

Unfortunately, what is best and what can be accomplished are often not the same. Many women may desire to lose their excess poundage but know that they can’t and won’t. Others can actually lose at least some of the weight but nowhere near all of it. Regardless, both of these groups of women should not be denied breast reduction surgery and its associated benefits if they are otherwise excellent candidates for it and are relatively low medical and anesthetic risks.

The positive impact of a reduction mammoplasty on the quality of life is difficult to overstate. It is so rare for any woman who has undergone this procedure to regret her decision. In fact, the satisfaction rate for this procedure even exceeds that of breast augmentation surgery which is around 94%.

For more information on a breast reduction surgery or on any other plastic surgery procedure that I perform or to schedule your consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Doctor-Patient Communication is Essential for Successful Results Says Scottsdale Plastic Surgeon

At his center for plastic surgery in Scottsdale, Dr. Steven Turkeltaub says initial consultations with one’s surgeon can have a profound impact on the quality of results they can achieve as well as overall patient comfort. Dr. Turkeltaub offers tips for finding a practice dedicated to patient satisfaction as well as how to increase the effectiveness of doctor-patient consultations.

Dr. Steven Turkeltaub, a plastic surgeon in Scottsdale, says with an improvement in the economy on the optimistic horizon, there should be a significant increase in the number of plastic surgery procedures being performed. He adds that some of this will be related to pent up demand from patients who have long desired to have cosmetic surgery, but couldn’t afford it due to the dire and protracted economic issues that have plagued the US for several years.

As patients pursue plastic surgery, Dr. Turkeltaub says they need to consult with a surgeon who has the proper training, qualifications, and passion for excellence in patient care. He states that this can be quite difficult to discern given deceptive advertising, marketing and even information imparted by less than forthright physicians. “When seeking the right surgeon, a patient should start by making sure their doctor is a plastic surgeon who is board certified by the American Board of Plastic Surgery. Many less-than-scrupulous physicians will deceptively claim that they are ‘board certified,’ but it either is not an officially recognized board or one in an area that is not plastic surgery.”

The importance of the initial consultation cannot be overstated, according to Dr. Turkeltaub. Patients can enhance the value and experience of their consultation by some preparation beforehand. He states that specifically identifying one’s cosmetic goals for a procedure such as for breast augmentation and the use of breast implants in Scottsdale prior to the consultation helps the plastic surgeon and the patient in the decision-making process and in selecting the best course of action.

Dr. Turkeltaub also adds that preparing a list of important questions or concerns can help patients feel more comfortable about the procedure(s) that they are considering as well as relieve the expected anxiety and indecisiveness. “I thoroughly discuss the contemplated procedure or procedures in detail including the surgery itself, the postoperative course, expectations, and risks and complications. Usually, I cover everything that most patients would normally ask so that few have any additional questions. This further creates a greater sense of comfort, trust, and understanding.”

For example, Dr. Turkeltaub offers some typical questions patients must address when considering breast augmentation: How can I be sure that I will be the size that I want to be? How painful is the procedure? How long is the recovery period? How long do the breast implants last? Are they durable? Do they have to be changed every 10 years? Do I have any long-term limitations? He adds that it is imperative for patients to be knowledgeable and informed regarding both their implants and breast enlargement in general so that they feel much more comfortable when making their decisions.

Whether they are seeking a non-invasive enhancement like BOTOX® Cosmetic or a surgical procedure such as breast augmentation in Scottsdale, Dr. Turkeltaub says patients should be sure to choose a plastic surgeon and associated office staff that are respectful, courteous, empathetic and willing to spend the necessary time with them. “Researching a practice and plastic surgeon ahead of the consultation and procedure will increase the likelihood of an overall better experience both during and after the surgery.”

About Steven H. Turkeltaub, MD, PC

Following graduation from the Six-Year Medical Program at Boston University and Boston University School of Medicine, Dr. Steven Turkeltaub completed a post-graduate training residency in general surgery at the University of Miami/Jackson Memorial Hospital and Northwestern Medical Center in Chicago. He also trained during a plastic surgery residency at the University of Massachusetts Medical Center, where he held an academic appointment as Clinical Instructor and Attending Physician in Plastic and reconstructive Surgery. Having authored several papers and textbook chapters on plastic surgery, Dr. Turkeltaub is also a member of the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, the Arizona Medical Associations, and several other professional organizations. He regularly attends national symposiums and meetings each year to keep up-to-date on the latest in plastic surgery techniques and technology.

Dr. Turkeltaub’s practice, The Arizona Center for Aesthetic Plastic Surgery, has two locations at 10290 N. 92nd St., Suite 207 in Scottsdale, AZ and 18275 N. 59th Ave. Bldg. E Suite 126 in Glendale, AZ, reachable at (480) 451-3000. He can also be contacted online via the website www.arizonabreast.com, www.turkeltaub.com, or facebook.com/drturkeltaub.

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Enlarge your breasts two cup sizes in 90 days with our new, amazing breast growth tablets. There is no pain. No greasy lotions to stain your clothes. You don’t have to suffer the embarrassment of getting caught while rubbing some cream on your breasts that must be applied six times a day. No dangerous chemicals to mix. And best of all – there are absolutely no side effects.

Just larger, fuller, firm, voluptuous, and sexy breasts. Like you always dreamed about.

Your friends in Scottsdale, Phoenix, Glendale, Mesa and even Chandler and Gilbert will be astonished at the new, improved shapely You but no one will know your secret but You! And it’s permanent (provided you continue with my inexpensive maintenance pack).

There is no need for risky breast enlargement surgery. Say “no thanks” to those dangerous breast implants.

No! No! No! No! You don’t want those fake, manufactured things in YOUR body!

Plastic surgeons will be outraged … but you can laugh, look great and not have to pay those exorbitant surgical fees. And best of all: avoid surgery!

How is this possible?

It can’t be true, can it?

I, myself, never thought it possible that some rare and exotic herb could have such beneficial effects. Being highly skeptical, I hiked deep into a remote region of the Amazon to visit a primitive tribe I heard about where all the women were at least a “D” cup. Even more amazing, as I subsequently learned, was that their breasts remained firm and youthful well into their 50’s – even after several pregnancies and breast feeding.

What is their “secret”?

The answer is a diet rich in a leafy plant that only the women eat. It’s an herb that is found nowhere else on the planet.

Until now.

So if you want your breasts to grow bigger the natural way, without the risks and pain of breast augmentation surgery, you don’t have to go to the Amazon rainforest to obtain this amazing herb. I’ve brought it back for you in my safe, all natural proprietary formulation.

So hurry now and take advantage of this introductory, discounted limited time offer! You can get 100 of these amazing, patented breast pills for the easy low price of $89.99 plus S & H. And for the first 1000 callers, I will throw in a second bottle at no charge.  You just pay the additional S & H.

To place your order now, just call 800-TIT-PILLS (or 800-848-7455). Operators are standing by 24 hours a day.

If you call in the next 60 minutes, we will include for free in your order, 25 tablets for your man that contain another tropical herb that will help to further extend his interest in you …

Do you really believe advertisements like this touting incredible pills, tablet, or lotions guaranteed to enlarge your breasts or your man’s manhood?

Hopefully not, as they don’t exist!

These scams only serve to enlarge the bank accounts of the con artists promoting their quack medications and formulations. As the old adage goes: “If it sounds too good to be true, it probably is.”

If you would like some information on the real thing, breast augmentation surgery, or for any other plastic surgery procedure that I perform or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

“Natural” looking breasts.

Over the years, many thousands of women have seen me in consultation for their breast augmentation. When sharing their goals to me, a majority of them invariably requested that they wanted their breasts to look “natural”. Then they proceeded to describe these desired outcomes that were in reality not so very “natural”. What might be “natural” to one woman would not be very satisfactory to another who was also looking for that “natural” result. Furthermore, many women just use the term but haven’t really thought about what it means to them except that it doesn’t include obscenely big.

What are natural looking breasts?

Are they a so called “C” cup or a “D” cup? Or even a “B” cup for the very petite? And which company’s bra will be the standard to make that determination?

Are they somewhat round, broad and with moderate projection? Or are they more projecting and less wide?

Is a tear drop shaped breast more natural or more desirable than a smooth and round one?

I could go on but you get the gist. Though it may give some people the warm and fuzzies, the use of “natural” together with breast implants and breast augmentation is not a very useful, descriptive or precise term. The one thing that it does convey is that the woman does not want to be grotesquely large (whatever size that may be!).

“Natural”, like beauty, is in the eyes of the beholder. When you are seeking to have a breast augmentation, know exactly what it is that you want and if you still insist on using the term “natural”, explain to your plastic surgeon exactly what that means to you. This includes such considerations as relative cup size, proportionality, cleavage, roundness, fullness, etc. Providing some photos showing women both in more revealing clothes and naked can be helpful to convey your thoughts.

If you don’t express exactly what it is that you want from your breast augmentation, there is a greater chance that you might not be entirely satisfied with the outcome.

For more information on breast augmentation surgery, breast implants or for any plastic surgery procedure that I perform, or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

A French manufacturer of breast implants, Poly Implant Prosthese (PIP), has been in the news worldwide and for all the wrong reasons.

Inferior quality breast implants that break easily.
Usage of unauthorized, non-medical grade silicone in their silicone implants.
Poor quality control and manufacturing techniques.
Concern that their implants may be associated with an increased incidence of cancer.
And now there are allegations that a fuel additive, untested in any human trials, was used in these implants.

These issues show an egregious violation of standards, ethics and integrity. On top of this, European medical regulatory agencies and other government agencies failed to protect the consumer.

Women in numerous countries around the world who had these implants used for their breast enlargement are quite understandably in a panic. There may be hundreds of thousands of them.

What about American women? Do they have anything to worry about here? How many of these implants were used in the United States?

Fortunately, the answers to these questions are both easy and positive.

PIP sold only saline implants in the United States for a short period of time – between the end of 1996 and 2000. In their investigation of the company and its saline implants, the FDA (Federal Drug Administration) in 2000 cited numerous issues and concerns including quality control problems and the unacceptably high deflation rate. This led to PIP immediately withdrawing these implants from the United States market.

And now for even better news: No PIP silicone implants were ever legally sold or used in the United States. Therefore, despite the worldwide uproar and concerns about these disastrous PIP silicone breast implants, American women don’t have to worry about this issue because they were never available for implantation here.

If you would like to obtain information on silicone breast implants, breast augmentation surgery or for any other plastic surgery procedure that I perform, or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

A few days ago, there were countless headlines and stories in the media about a woman whose breast implant was “swallowed” by her body while doing Pilates. These were in response to a medical report documenting an unusual case that was just published in the Dec. 15th issue of the New England Journal of Medicine.

These reports garnished quite a lot of attention and also provoked some anxiety, concern and questions particularly in some women who already have breast implants. They want to know: “Is there a risk that the body can really “swallow” a breast implant?”

This case report involved a 59 year old woman who had previously undergone a bilateral mastectomy for breast cancer and had reconstruction with breast implants. During a Pilates stretching exercise, her right breast implant … disappeared. Gone in a flash! No external trace. She experienced no symptoms such as pain or shortness of breath.

A medical evaluation was performed including obtaining an ultrasound, chest X-ray and CT scan. What was discovered was that her intact breast implant was in her right chest cavity. It had been sucked into it during her stretching exercise.

She was taken to surgery during which the implant was extracted from the chest cavity and repositioned on the chest wall again where it belonged. A defect between the ribs which had allowed the implant to be displaced, was repaired. And she lived happily ever after. (Well, I don’t exactly know about that!)

So how did this bizarre situation occur?

This was the result of a confluence of issues and factors that together created the “perfect storm” for this rarity. The patient already had weak, flexible ribs. Her implants were not very large. And most importantly and what wasn’t clearly disclosed: she recently had undergone a mitral valve (a heart valve) replacement for a leaky heart valve and the approach used to access the heart was between the same two ribs that the implant slid between. The normal anatomy was disrupted by the surgery and a significant defect remained between these two ribs. Now, add to all of this a stretching maneuver that separated the ribs and created a negative force and, voilà, her breast implant was sucked into the chest cavity.

As you can see, the odds of this happening are less than being struck by lightning or winning the lottery. It is about on par with the probability of Obama suddenly becoming an adherent of conservative policies and slightly higher that the likelihood of taking a snapshot of the Loch Ness monster frolicking with its family or eating lunch with the Abominable snowman.

There are more important things to worry about in life.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

The incision that I have always preferred for a breast augmentation is the inframammary one (with rare exceptions). The reasons have been many including the relatively inconspicuous location and healing of the incision, better surgical exposure that facilitates precise technique and control, a reduced risk of developing capsular contracture (tight scar formation around the implant causing the breasts to feel hard), and what intuitively seemed to have a lower risk of affecting the sensation of the nipple-areola complex (NAC). No large scale study had been conducted to prove or refute my sentiment on the effect of the incision location on sensation until now.

A large scientific study was conducted in Italy that evaluated the possible effect of the incision location for breast augmentation surgery on the postoperative sensation of the nipple-areola complex. This assessed data from over 1200 women who had the same plastic surgeon perform their surgery over a slightly greater than six year period. Among the variables investigated were patient age, the breast implant size and whether the implants were placed above or below the muscle.

What the study found was that the implant size had no significant impact on the sensation of the nipple-areola complex postoperatively, an outcome that may surprise many. In addition, neither the patient’s age nor whether the implant was in a submuscular or submammary pocket, had any influence on sensation. The only variable that had a statistically significant association with reduced NAC sensation after surgery was the incision location, with the periareolar affecting 9.5% of women compared to 3.5% with the inframammary one which translates into a 2.7 times greater risk of sensory loss. It also had a 3.5 times greater risk of causing areolar pain.

Now there is even more convincing evidence supporting the superiority of the inframammary incision over the periareolar one for breast augmentation surgery.

If you would like to obtain more information on breast augmentation surgery or for any other plastic surgery procedure that I perform, or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

A question that many women have who are either considering a breast reduction or have already undergone one is “When can I start wearing an underwire bra?” Some are under the impression that they are not suppose to wear one any more following surgery; others have heard recommendations that involve widely differing periods of time. This can be decidedly confusing.

What is the right answer?

Well, there really is not one absolute, definitive answer. (Even this sounds vague!) One of the reasons for this is that there are no evidence based studies in the medical literature which identify one specific period of time following breast reduction surgery that is better than any other to start wearing an underwire bra again. Consequently, each plastic surgeon determines his or her own protocol based on a variety of factors including experiences with their patients. Some may recommend waiting at least 3 or 4 weeks whereas others may suggest 2 to 3 months or more.

What is my protocol for wearing an underwire bra following a breast reduction?

Upon removal of their operative dressing a few days after surgery, my patients are placed in a sports bra which they will wear for a couple of weeks. After this, they can wear any comfortable but supportive bra which they like and which includes an underwire bra. The purpose is to help to maintain the improved shape of their breasts for a longer period of time by counteracting, to some extent, the relentless forces of gravity.

With normal postoperative healing, the incision along the crease at the bottom of the breast will be inflamed and even tender for several months. During this period of time, an underwire bra may be somewhat uncomfortable to wear. As a result, most patients will wait at least 2 to 3 months before being wearing one on a regular basis.

For more information on breast reduction surgery or for any other plastic surgery procedure that I perform or to schedule your free consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona