What is the Earliest Age That A Breast Augmentation Should be Done?

In our society, there is a strong emphasis on breasts and breast size. From magazines, television, movies and even advertisements, there is a preponderance of voluptuous well-endowed women that are seen as the ideal. Their presence seemingly everywhere can be quite stressful for the adolescent girl experiencing considerable hormonal and emotional fluctuations and physical changes along with a fragile body image.

When an adolescent girl realizes that her breasts are not and will never be the size that she would like them to be, what is the youngest age that it would be reasonable for her to pursue breast augmentation surgery? Taking physical, emotional, and intellectual issues and maturation into consideration, my recommendation is for her to wait until at least 18 years of age before undergoing a breast enlargement.

As with many things, there are some exceptions. If a girl has breasts of such significantly different sizes that is difficult to hide with normal clothing or if there is either severe underdevelopment or absence of one breast (which is often congenital in nature), proceeding with surgery at an earlier age may be more prudent. Surgery in these situations may even be considered to be reconstructive.

If you would like additiona information on breast augmentation, breast implants or other cosmetic procedures, you can contact my office at 480-451-3000.

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

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How Common is Male Breast Enlargement?

Male breast enlargement is much more common than many men with the problem think. Also known as gynecomastia, the cause of this problem is related to the absolute and relative amounts of the sex hormones testosterone and estrogen that are being produced. Factors that can affect these levels include puberty, aging, medications, illicit drugs, alcohol, specific diseases and congenital defects.

During puberty when sex hormone levels are wildly fluctuating, around two thirds of boys will experience enlargement of their breasts to varying degrees. Of those who are affected with gynecomastia, around seventy five percent will fully resolve within two years and around ninety percent by three years. That means around ten percent of boys who experience enlarged breasts will have persistence of the problem making it a common issue.

As men get older, their production of testosterone decreases. By ages 40 to 50, it is not uncommon to see the onset of breast growth which becomes more substantial with time. Some estimates have as many as twenty five to forty percent of men between the ages of 50 and 80 with gynecomastia. This can be further exacerbated by medications used to treat medical problems common during this period in life such as for an enlarged prostate.

Men who are considerably overweight may also have enlargement of their breasts. This is often referred to as pseudogynecomastia as opposed to true gynecomastia but the outcome is the same. Weight loss alone may resolve much of the enlargement.

The treatment for male breast enlargement is with surgery and is usually very effective and successful.

For further information regarding the treatment of gynecomastia or any other cosmetic surgery procedure, please contact my office at 480-451-3000.

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

Posted in Male breast reduction (treatment of gynecomastia) | Comments Off

Do Silicone Breast Implants Lower Your Risk for Developing Breast Cancer?

You must be thinking that there has to be a typo here. If anything, from all the news media palaver in the past, it is the opposite that must be true. Actually, this is the right question and it does have an unexpected answer.
Silicone breast implants have been subjected to more scrutiny and studies over the years than any other medical device. Several of these looked at any possible association of the long term presence of silicone breast implants with the development of breast cancer by evaluating large numbers of women over many years. The results were shocking but consistent: there is a statistically lower risk of developing breast cancer in women who have had these implants long term. This finding has been reconfirmed by many studies in diverse locations around the world.

The most recent research published in January 2009 in the International Journal of Cancer revealed the results of a epidemiological study of over 6200 Swedish and Danish women who had a mean duration of implantation of over 16.5 years with thirteen percent having them in excess of twenty five years. The findings identified a statistically significant reduction of risk of developing breast cancer of 27%. Previous studies conducted in the United States have shown decreased risks as high as 37 to 53%.

Why women with silicone breast implants have a lowered risk of developing breast cancer is unclear and has been the subject of much conjecture. However, this is fantastic news both for women who are considering a breast augmentation and those who already have silicone implants. When discussing breast enlargement with my patients, I try to put this all in perspective. I do not tell them that if they elect to have silicone breast implants, their risk for breast cancer may be decreased. Instead, I let them know that at a minimum there is no evidence that having silicone breast implants will increase their chances for developing breast cancer.

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

Posted in Breast augmentation, Breast cancer, Breast implants, silicone implants | Comments Off

Is a Breast Reduction Covered by Insurance?

A breast reduction with removal of a significant amount of breast tissue is considered by most plastic surgeons and patients to be a reconstructive procedure. Hoping to have the surgery paid for by their insurance, many find out that either this is not a covered benefit of their specific insurance plan or that they do not meet the criteria for surgery authorization.

What are the criteria that insurance companies require that you meet? These will vary from plan to plan and often are very stringent and difficult for many women to meet. You may need to have your symptoms explicitly documented such as neck, back and shoulder pains, negative effects on your posture, limitation of activities, skin rashes and even deep grooving of your shoulders from your bra straps. Some also mandate that you need to be below a specific weight for your height, have completed an extended course of physical therapy which did not resolve your symptoms, and that your plastic surgeon expects to remove a volume of breast tissue per side that exceeds a certain weight in grams. Letters from your primary care physician and other healthcare personnel strongly recommending this procedure are often needed as well.

If a breast reduction is not a covered benefit or your insurance company has denied authorization for the procedure, it may not be the “end of the world”. You still can elect to undergo the surgery but will have to pay for it out of your own pocket. Many of my patients do pursue this course of action because the symptoms from large breasts are so uncomfortable and limiting and the surgery is so effective in addressing them.

My office can help you to make this procedure a more affordable reality. We have package pricing available that significantly discounts your costs over what you would otherwise face in a hospital setting. For payment, not only do we accept several credit cards but we also offer you financing options from several companies that may meet your specific financial needs.

You can call my office at 480-451-3000 to obtain further information regarding a breast reduction or other procedure, insurance issues, financing options, or to schedule a consultation.

Steven Turkeltaub, M.D.
Scottsdale and Phoenix, Arizona

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Breast Implants in Breast Augmentation: How Long Do They Last?

If you have breast implants, don’t you wish that they would last forever? Although this would be wonderful, they are not lifetime devices and will probably need to be replaced sometime in the future. Many of my patients here in the Scottsdale, Glendale and the Phoenix area are under the impression that breast implants need to be replaced every ten years. Fortunately, this is not the case. The silicone gel implants manufactured today are much better than previous generations. There have been many technological and manufacturing improvements including a thicker and more durable outer shell that is virtually impermeable to any silicone migration. T

hey also are filled with a much more cohesive silicone gel. As a consequence, it is possible for many silicone gel breast implants to last 20 to 30 years or more. In an ongoing prospective scientific study overseen by one of the silicone implant manufacturers, Allergan, it was noted that there is a rupture rate of 2.7% at 4 years after breast enlargement surgery.

Saline breast implants deflate, on average, much earlier and at a significantly higher rate as compared to silicone implants. This has been borne out by my personal experience of over twenty years at the Arizona Center for Aesthetic Plastic Surgery. Textured saline implants do not fare nearly as well as the smooth surfaced ones.

There are many other factors that can influence the lifespan of the implants aside from whether they are silicone or saline. Some of these include the presence or absence of surface texturing, size of the implant, manufacturer of the implant, size and location of the incision for insertion, surgical technique, mammograms and trauma. Each one of these issues can be discussed in more detail during your consultation.

Breast enlargement is extremely rewarding for the vast majority of women who have had the procedure. Just realize that although the breast implants are generally quite durable, they typically will not last forever.
For much more information or to schedule a thorough consultation for a breast augmentation, breast lift with implants or other cosmetic procedures, you can contact Dr. Turkeltaub at 480-451-3000.

Smooth(left) and textured(right) silicone implants

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Does A Breast Reduction Lower the Risk For Developing Breast Cancer?

A breast reduction involves the removal of a significant amount of breast tissue. Intuitively, it would seem that with less volume, there would be less tissue available to degenerate into a cancer in a particular individual. This indeed has been borne out in through medical research. The decreased risk of developing breast cancer following a breast reduction has been documented in several medical studies as being somewhere between 28% and 50%. The women who benefitted from this lowered risk were over the age of 40 at the time of their surgery. To date, no discernible affect was identified in women under 40 years old.
This statistical finding is great news. It is one more positive piece of information for women considering a breast reduction. For women who have an increased risk of developing breast cancer and are considering prophylactic breast tissue removal, this is not an appropriate treatment as a significant amount of breast tissue remains. A procedure such as a subcutaneous mastectomy or total mastectomy would be more appropriate.

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The Importance of Breast Implant Size for Breast Augmentation

The number one issue facing women when electing to undergo a breast augmentation is selecting the proper sized breast implant. This is a truly a much more complex problem than one would think. You know that you want to be larger but how large? Do you want to be a “C”? A “small D”? A “full C”? Do you want to be proportionate, a little larger than proportionate or very large?

Unfortunately, these are all very subjective, personal and not standardized. What may be proportionate for one person would be way too small for another. A large “C” for one woman may be another’s “D”. Overly large breasts to one woman may be considered balanced to another. Further compounding the confusion is that there is no standardization of cup sizes among bra manufacturers. One company’s “C” bra may be identical in fit with another company’s “D” sized bra.

In my experience, I have found some useful approaches to assist my patients in better determining the size that they are seeking. Trying on a variety of implants in the office can provide some facsimile of a three dimensional result although the true shape and size will be different. Judging their responses to various elements then allows me to better ascertain what they desire. They are also shown photographs of a diversity of patients with varying cup sizes. Many patients bring in pictures of breast shapes and sizes that they like from the internet or magazines which can further help. However, there are limitations due to clothing, air-brushing, perspective and the two dimensionality of the pictures.

Combining all this information and input along with some intuition, I can determine reasonably well what my patient is looking for. During surgery, all this information assists me in making the final decision on the most desirable implant size. If there is any question about the size, I will elect to go larger rather than smaller. This approach is usually makes everyone happy.

These a a few different sizes of Silicone implants

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