Dr. Bottger Blog

Breast Lift vs. Breast Augmentation

2009-06-29T07:58:00.000-07:00

Breast lifts and breast augmentation are two separate cosmetic surgery options to help women enhance, enlarge or contour their breasts. Sometimes these procedures are used in conjunction to achieve the desired results and sometimes only one procedure is necessary.

Breast Lift

A breast lift can help reverse the effects of aging, pregnancy or weight loss. Over time and after such major life experiences, the skin of the breasts can lose elasticity and succumb to gravity leaving breasts that sag or droop. Also called mastopexy, a breast lift involves the removal of excess skin and the repositioning of the nipple to reshape the breasts. The breasts will be perkier, firmer and look more youthful; however, they will not be larger in size.

There are two different types of incision methods that can be used for the breast lift procedure, depending on the severity:

• Donut, which results in an areola scar only
• Vertical, which results in a scar that circles the areola and extends vertically to the fold of the breast

Breast Augmentation

Breast augmentation, also called augmentation mammaplasty, is used to enlarge and reshape a woman’s breasts. Typically, this procedure alone will not correct sagging breasts, although there are always exceptions.

Women who choose breast augmentation have many important choices to make, including:
• Saline or silicone implants
• Size and shape of the implants
• Incision location
• Placement of the implants on the chest

If you would like to enhance or enlarge your breasts and would like to know which procedure might be right for you, please contact Philadelphia breast surgeon Dr. Bottger today for a free consultation.

Realistic Expectations for Plastic Surgery

2009-06-29T07:56:00.000-07:00

Plastic surgery can help both men and women change physical attributes about themselves that they find undesirable. Before embarking on any type of cosmetic surgery, the patient should discuss his or her final outcome expectations with the surgeon so everyone has a realistic understanding about the surgery possibilities and limitations.

Women considering breast augmentation surgery should have open and honest discussions with the surgeon regarding:

Size, shape and texture: There are different types of implants available, and each will look and feel differently.
Scarring: Depending on the incision location, the incision scars may or may not be visible.
Recovery time: Patients should wait 3 weeks to resume strenuous activity, and the breasts may not be fully healed and shaped until several months after surgery.
Replacement: Implants do not last a lifetime, and the average lifespan is 10 years. It is possible that the implants may need to be replaced due to deflation or other complications.
Sagging: A breast lift may be necessary to correct sagging breasts. Typically breast implants alone will not fix this problem.

Breast augmentation is an invasive surgery that carries potential risks and complications. Patients should be fully aware of these risks before making the important decision to undergo surgery.

If you are considering breast augmentation surgery and would like to meet with board-certified plastic surgeon Dr. David Bottger to discuss your expectations, please visit our “contact us” page for a free breast implant expectations consultation. We serve patients in and around Philadelphia, PA and all of Delaware.

Importance of Honesty with Your Plastic Surgeon

2009-06-22T07:57:00.000-07:00

It is for a patient’s own safety that plastic surgeons ask a variety of screening questions and/or do medical testing prior to performing surgeries. By understanding each patient inside and out, the surgeon has a better chance of reducing any risks or complications that can occur.

Surgeons should inquire about:

• Medical history: Plastic surgeons should be fully informed about patient’s medical history in order to determine which type of surgery, if any, is appropriate and safe for the patient.
• Psychological disorders: Mental illnesses, such as Body Dysmorphic Disorder, can give people warped self-images, making them poor candidates for plastic surgery. These individuals may believe that the surgeries will make them happier, when in actuality the surgeries may have the reverse effect.
• Substance abuse: Individuals with substance abuse problems may suffer from depression and undergo plastic surgery for the wrong reasons. The healing time for these patients can also be greatly lengthened, adding to the patient’s depression and despair.
• Medications: The surgeon should know about all medications the patient is taking prior to, during and after surgery. Even herbal medications and vitamins have been known to cause complications and delay or prevent proper healing.

The more honest you are with your surgeon, the better chance you have for a successful surgery and desired outcome.

If you would like to discuss plastic surgery options and live in the Philadelphia or Bryn Mawr, Pennsylvania area, please contact cosmetic surgeon Dr. David Bottger today for a plastic surgery consultation.

Choosing the Right Breast Implant Size

2009-06-12T07:53:00.000-07:00

Some women may be surprised to learn that silicone and saline breast implants are not created with bra cup sizes in mind. Because there is no absolute industry standard among bra manufacturers on cup sizes, it would be virtually impossible for implant manufacturers to create a D-size implant, for example, that perfectly fit every D-size bra on the market.

Breast implants are classified by the volume of saline solution or silicone gel that is injected into the implant shell. Breast implants range in size, depending on how large the woman would like her breasts to look. Typically, implants range in size from 250cc (cubic centimeters) to 1200cc with 350cc being one of the most popular implant sizes.

Each woman’s own unique body type will determine how much saline or silicone will be necessary to create the desired breast size. A 350cc implant on one woman may have a completely different effect on a different woman. However, as a rule of thumb, each 150cc-175cc of implant may increase a woman’s bra size one cup.

Pennsylvania and Delaware-area cosmetic surgeon, Dr. David Bottger, is experienced in helping women determine the right breast implant size for their body shape, breast shape, lifestyle and final expectations. If you would like to learn more about the different methods used to select the right implant size, please contact our office for a free breast implant sizing consultation.

Benefits of Plastic Surgery in the Spring

2009-04-28T15:39:00.000-07:00

Springtime is a time of renewal as people begin to shed their heavy winter clothing and start to enjoy the beautiful sunshine. Just as the trees and flowers embark on their blooming and growth patterns, so do many people elect to have cosmetic surgery procedures during the spring months.

Why is spring cosmetic surgery so popular?

We all know that once spring has sprung, summer is close behind. Summer is equated with lighter, smaller clothing options, revealing bathing suits and outdoor gatherings with family and friends. By undergoing plastic surgery in the spring, patients will be prepared to look and feel their absolute best during the summer months.

What types of springtime surgeries are popular?

Virtually any type of plastic surgery can help people gain or regain self-confidence and feel more comfortable in their bodies. Dr. Bottger routinely provides a variety of cosmetic surgery procedures to patients in the spring including:

Liposuction
Tummy tucks
Breast augmentation/lifts
Male and female breast reduction
Thigh or arm lifts
BOTOX® or facial fillers
Laser skin resurfacing
Facelifts or other facial procedures

If you are interested in reshaping or enhancing any part of your face or body, please contact Philadelphia, New Jersey and Delaware cosmetic surgeon Dr. Bottger for a plastic surgery consultation.

Breast Augmentation and Mammograms

2009-04-26T15:51:00.000-07:00

Any time you schedule a mammogram appointment, one of the first questions the office should ask is whether or not you have breast implants. This is an important question because breast implants can affect both the mammogram results as well as how the mammogram is performed.

Problems surrounding mammograms on implants

Tumors can be hidden from view by implants
Cancerous changes may go undetected
There is a slight risk of implant rupture
The images may be difficult to interpret

All women should get yearly mammograms after age 40. However, if you are considering breast augmentation and you are under age 40, it may be beneficial to have an early baseline mammogram to ensure that the pre-operative breasts are healthy. These baseline pre-implant results can be compared with future mammogram results on the breasts with implants. This may help radiologists detect any inconsistencies or tumors that would have otherwise been missed.

With our without implants, mammograms are one of the best ways to identify early stages of breast cancer and help increase a woman’s chance of survival.

To learn more about breast implants and mammograms, please contact Philadelphia, Pennsylvania, New Jersey and Delaware cosmetic surgeon Dr. Bottger for a free breast augmentation consultation.

Find Your Perfect Size

2009-04-24T15:49:00.000-07:00

Women considering breast augmentation have many different decisions to make prior to surgery. Detailed consultations with an experienced cosmetic surgeon like Philadelphia, Pennsylvania cosmetic surgeon Dr. Bottger will help patients determine:

• Which type of implant to use: silicone or saline
• Where to place the implant: under the breast tissue or under the chest wall/pectoralis muscle
• Where the incision will be placed
• What size of implant to choose

Because each woman is unique and has different expectations for the final result following breast augmentation, finding the perfect breast implant size is not an exact science. However, Dr. Bottger utilizes a variety of methods to help guide each patient toward making the right decision.

Methods

• Before and after photos: Dr. Bottger has performed breast augmentation on hundreds of patients with different body types. Viewing photos of similar bodies can help new patients get an idea of how the surgery will enhance their own bodies.
• Measuring breast dimensions: These measurements will show what size(s) of implants will be most aesthetically pleasing on the new patient’s body frame.
• Implant sizers: Different sized implants placed in bras are worn by the patient to simulate how the new breasts will look in regular clothing.

In short, there is no “perfect” breast implant size. If you are considering changing your appearance through breast augmentation, please contact our office today for a breast enlargement consultation.

Difference between Plastic and Cosmetic Surgeons

2009-04-21T15:47:00.000-07:00

Most people use the terms “plastic surgery” and “cosmetic surgery” interchangeably. The American Society of Plastic Surgeons explains that “the word ‘plastic’ in ‘plastic surgery’ does not mean ‘artificial,’ but is derived from the ancient Greek word ‘plasticos,’ which means to mold or give form.”

The umbrella term “plastic surgery” encompasses both cosmetic surgery as well as reconstructive surgery. These terms can be defined as:

• Cosmetic surgery: elective procedures that a person chooses to alter his or her outward appearance. Examples include breast augmentation, liposuction, tummy tucks, injectable fillers, etc.
• Reconstructive surgery: necessary surgical procedures to help improve or restore normal functions or create a normal outward appearance for a person. Examples of reconstructive scenarios include cleft-lip, hand or other deformities; growths; lacerations; etc.

Unfortunately, virtually any doctor can hang a plastic surgeon sign on his door and perform these intricate surgeries, even though he or she has not undergone the proper training and received the appropriate certifications.

Before undergoing any type of plastic surgery procedure, do your research. Make sure that the surgeon you choose is:

• Certified by the American Board of Plastic Surgery
• A member of the American Society of Plastic Surgeons
• A member of the American Society of Aesthetic Plastic Surgery

Philadelphia, Pennsylvania cosmetic surgeon Dr. Bottger is a board-certified cosmetic surgeon who has helped hundreds of patients achieve the face and body they desire. If you would like to learn more about the different cosmetic surgery options available, please contact our office for an initial cosmetic surgery consultation.

Liposuction

2009-03-30T10:05:00.000-07:00

Deposits of stubborn, excess fat can make an otherwise confident person feel insecure about his or her appearance. When diet and exercise programs fail to help a person achieve the desired body contours, liposuction is a viable alternative.

Liposuction involves making small incisions in the body to insert a small tube (cannula) and suction out excess fat. There are a variety of different liposuction methods available, including methods which utilize ultrasound waves or power-driven cannulas to help break up the fat prior to its removal. Dr. Bottger generally utilizes the standard suction method combined with a tumescent technique to constrict blood vessels and reduce bleeding to produce excellent results.

It is important to note that liposuction does not tighten loose skin and it does not improve cellulite.

Is liposuction only for the stomach area?

No. Liposuction can be performed on many different areas of the body, including the:

• Abdomen
• Thighs
• Hips
• Waist
• Knees
• Back
• Arms
• Neck
• Calves
• Ankles

If you have been considering liposuction and would like to know if you are a good candidate for this surgery, please contact Philadelphia, Pennsylvania cosmetic surgeon Dr. Bottger to arrange a free liposuction consultation.

Tummy Tuck

2009-03-20T09:24:00.000-07:00

Most men and women desire a flat, toned tummy. Unfortunately, this physical trait can be hard to come by, especially for women who have experienced the effects that pregnancy can leave on their midsections. If you have been struggling with sculpting your abdomen, despite healthy eating habits and regular exercise, a tummy tuck (abdominoplasty) procedure might be the answer.

Mini Tummy Tuck

A mini-abdominoplasty is performed only on the lower abdomen, below the navel. Even though it is sometimes called a “scar-less” tummy tuck, it is still necessary to make a small incision to remove excess skin and fat deposits. There is generally no need for belly button repositioning with this procedure. Candidates for this procedure are those who have a slight abdominal pooch.

Full Tummy Tuck

The more common full abdominoplasty procedure helps to remove excess fat and skin throughout the entire abdominal wall. The abdominal muscles are also tightened as a result, creating a firmer, more desirable profile. Liposuction is often combined with abdominoplasty to ultimately create the desired body shape.

When performed by a skilled, knowledgeable surgeon like Philadelphia, New Jersey and Delaware cosmetic surgeon Dr. Bottger, tummy tucks are a safe, effective way to enhance your body. To arrange a tummy tuck consultation, please contact our office today.

Gummy Bear Implants

2009-03-11T09:21:00.000-07:00

Cohesive gel breast implants, commonly referred to as gummy bear implants, are a type of silicone gel implant for breast augmentation that is firmer and thicker than regular silicone. As its nickname implies, gummy bear implants are soft, firm, pliable and strong. (However, they are not bear-shaped or multicolored.)

Advantages

Gummy bear implants have some advantages over regular silicone and saline implants, including:

• Cohesive gel is more stable and durable.
• If the implant is ruptured or cut, the gel will not ooze but will stay in place and the implant will retain its shape.
• The consistency is more like breast tissue than saline implants.
• Capsular contracture (scar tissue compression that can lead to tight, hard breasts) is less likely to occur in non-ruptured implants.

Disadvantages

Although the disadvantages are few, patients should be aware that:

• A larger surgical incision is required for implant placement.
• The implant cannot be inserted through the belly button as in transumbilical breast augmentation.
• The initial cost is higher than with regular silicon or saline implants.

If you would like to learn more about gummy bear implants, please contact Pennsylvania, New Jersey, and Delaware cosmetic surgeon Dr. Bottger to arrange a consultation and learn which type of implant is right for you.

Breast Augmentation Facts

2009-03-06T09:17:00.000-08:00

Breast augmentation, also known as augmentation mammoplasty, can enhance and enlarge the size and shape of a woman’s breasts. This surgical procedure has become very popular for a variety of women who:

• Want to reconstruct their breasts following a disease or accident
• Wish to balance the size or shape of their breasts in relation to their body size
• Simply want larger breasts

Breast Surgery Facts

Before undergoing breast augmentation, it is important to be aware of and fully understand all of the facts about breast enlargement surgery.

• Types of augmentation: saline or silicone gel
• Type of surgical procedure: invasive outpatient surgery which requires small incisions
• Anesthesia type: general
• Implant location: implants can be placed either above or below the pectoralis muscle
• Average cost: $3,000-$10,000
• Average procedure length: 1-2 hours
• Average recovery time: 1-2 weeks
• Possible risks: implant rupture; capsular contracture resulting in hard, tight breasts; infection; rippling; sensation loss
• Augmentation lifespan: most breast implants will last, on average, for 10 years; however, this varies greatly from woman to woman

If you are considering breast augmentation and would like to learn all of the facts, please contact Philadelphia cosmetic surgeon Dr. Bottger to schedule your initial breast enlargement consultation.

Maintaining Breast Health Before and After Surgery

2009-02-23T11:42:00.000-08:00

Mammograms and self breast exams are central to maintaining good breast health—both before and after any type of breast enhancement surgery. Following the age of 40, a screening mammogram is strongly recommended every one to two years, taking personal risk factors into account.

Make Sure to Get Routine Mammograms

Patients should be aware that depending on how breast implants are placed, they can to some extent decrease the effectiveness of mammogram procedures. This makes mammograms even more important, however, as research strongly indicates that mammograms effectively screen for breast cancer—even when women have had their breasts augmented. Tell the nurse, technician, or doctor performing the mammogram about your implants before the screening.

Take Time to Locate an Experienced Facility

Once you have obtained your implants, it is important that you take the time to identify a breast screening facility where large numbers of mammograms are performed each year. The population of women screened should include a substantial group of women who have had their breasts augmented. Radiologists at the facility should have experience interpreting mammogram results on women who have implants, as this is a somewhat more complex process. If you have had silicone implants placed, an imaging exam (MRI) should be performed three years after implant placement and every two years after that to look for any possible ruptured areas on the implants.

If you live in the Philadelphia, Pennsylvania area and are considering a breast enhancement procedure, please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

Choosing the Right Implant Size & Implant Cup Size

2009-02-16T11:40:00.000-08:00

Choosing the right implant size and implant cup size is a critical decision to avoid additional corrective surgeries down the road. Dr. Bottger works hard to assist his patients in selecting the right implant initially because more surgeries mean additional unnecessary risks. The vast majority of patients are delighted with the outcome of their breast augmentation surgery; however, if women do elect to have a second surgery, the reason typically centers around breast implant size.

Dr. Bottger carefully discusses what breast size is actually sustainable for each patient’s unique frame and skeletal structure. Skin tone is also involved in the determination. Some patients may not have enough flexibility to their skin to manage the larger implants.

You can help make a decision on breast implant size by taking stock of daily activities that may be affected by your enlarged breasts. You can also help by collecting pictures of women who have a similar build to you, but with breasts that think are attractive. You should consider trying on clothes that you like with a bra stuffed with different volumes of dry rice. ¾ cup of rice is about 185 cubic centimeters (cc, the unit used to measure the size of breast implants), approximately the amount the American Society of Plastic Surgeons estimates will take most women up one bra cup size.

Only a careful examination by Dr. Bottger can make certain that a patient’s frame and skin type is appropriate to your desired breast implant type. Visualization methods are good to help you get your mind clear on what you are looking for, but don't get your heart set on anything before talking to a board-certified plastic surgeon.

If you live in the Philadelphia, Pennsylvania area and would like to properly prepare for implant placement with a skilled and experienced cosmetic surgeon, please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

Reconstructive Breast Surgery

2009-02-09T08:50:00.000-08:00

Reconstructing a woman’s breast or breasts following a mastectomy is quite common these days. Many women feel the procedure helps them feel more whole again after the trauma of cancer. Two methods are typically used to restore the breast: implant reconstructions and restorations using the patient’s own tissues.

Implant Type Restorations

Dr. Bottger creates a breast mound by using an implant. Saline or silicone implants are placed under the skin and pectoral muscle to build a new breast.

Restorations with the Woman's Own Tissue

Using tissue from the abdomen, back, buttock or upper thigh, Dr. Bottger creates a new breast in this manner. Abdominal tissue is the most common source, and the procedure is called the T.R.A.M. flap.

Breast reconstruction techniques differ in how complex the procedures are, length of procedure and time until full recovery. Each patient should review these issues with Dr. Bottger so that the most appropriate method can be chosen. Most women find the breast reconstruction procedure very satisfying and a contributing factor to their healing and well being following breast cancer.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about how you could benefit from breast reconstruction surgery, please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

A Breast Lift Can Restore a Youthful Look

2009-02-02T08:46:00.000-08:00

Over time, gravity can take its toll even on the most pert figure, bringing about considerable drooping and sagging. Pregnancy, diminished skin elasticity and weight loss can all add to this effect.

Today’s breast lift procedures can do wonders toward restoring your original appearance—or towards improving your current look. One key advantage of a breast lift procedure is that you can couple it with building up your breasts through breast augmentation or reducing their size through breast reduction. This way you can achieve exactly the look you want.

The breast lift, or mastopexy procedure, requires Dr. Bottger to place the nipple and breast tissue on a higher level at the breast fold level, considered the ideal positioning for breast appearance. Dr. Bottger then contours the skin beneath the nipple to create a new breast shape. Breast implants can be employed at the same time for enlarging the breasts; this will be the patient’s personal decision and will also be based on the amount of breast tissue that is present to work with.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about what a breast lift procedure might offer you, please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

Help for Inverted Nipples

2009-01-26T14:40:00.000-08:00

Around ten to twenty percent of women have some degree of what are known as inverted nipples. Health risks are not a concern to those impacted, but for new mothers wishing to nurse, the condition can obviously be troublesome, and some women do not like the appearance of their inverted nipples.

Inverted nipples are connected to breast tissue beneath them by connective tissue bands. A loosening or breakage of these connections can again cause the nipple to protrude.

For women with mildly inverted nipples, sometimes called "shy nipples," many nonsurgical options exist. Solutions may involve bringing the nipple out with ice or other stimulating procedures. Pregnant women who are preparing their breasts for breast feeding can use an implement called a breast shell that is placed inside the bra; breast shells are plastic discs that have a hole in the middle where the nipple is allowed to protrude. A dome covers the disc to let air circulate underneath, coaxing the nipple to pull outward.

Cosmetic surgeon Dr. David Bottger also assists women with this condition if other methods fail. Surgical intervention can definitely improve the appearance of the nipples, but may not improve a woman's chance of breastfeeding.

If you live in the Philadelphia, Pennsylvania area, Dr. Bottger can help you decide the best procedure to treat your inverted nipples. Please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

Incision options

2009-01-16T14:38:00.000-08:00

One of the decisions you will make when you elect to have breast implant surgery is what type of incision to have. A consultation with Dr. Bottger will help you make the best choice. Incision type is based on a few key factors:

The type of breast implant you choose
Your personal preference
Your unique physical characteristics

Inframmary

This incision along the fold under the breast and is one to two inches long; the scar is well hidden and this procedure works with all types of implants.

Periareolar

The periareolar incision creates a scar on the areola’s lower border. This fine scar is generally almost invisible. This is often not the best method for patients with small areolas.

Axillary

The axillary incision is in the armpit where an endoscopic system is used to create the pockets that will hold the implants.

If you live in the Philadelphia, Pennsylvania area, Dr. Bottger can help you decide on an incision type that will best meet your needs. Please contact Dr. Bottger’s office at 610.520.1929 today to schedule an appointment.

Relief from Pain and Embarrassment with Breast reduction

2009-01-09T14:36:00.000-08:00

Many women with overly large breasts experience discomfort, health problems and chronic pain and embarrassment from their breasts. Their bra straps may dig into their shoulders and moisture may accumulate under the breasts, creating constant irritation. They may experience breathing difficulties and an inability to participate in certain sports. Unwanted attention may also be a part of their daily lives, along with chronic back, neck and shoulder pain.

A Proven Solution

Breast reduction procedures have become more and more common and provide a tried and tested means of surgically reducing breast size while eliminating all of the difficulties of overly large breasts. Dr. David Bottger performs many such procedures in his Philadelphia area clinic.

A Great Outcome

The procedure to reduce breast size typically requires that excess breast tissue be excised and breast skin made more taut; the result is that the breasts become smaller, less heavy and more firm. The surgical techniques Dr. Bottger uses will give you a natural-looking breast shape and reduce pain in the shoulders, back and neck due to breast size and volume. The most frequent reason for breast reduction is relief from physical pain rather than cosmetic enhancements, but often, the surgery will improve the outward appearance of the breasts.

If you live in the Philadelphia, Pennsylvania area, Dr. Bottger can help you determine if breast reduction surgery is right for you. Please contact the office of Dr. Bottger at 610.520.1929 today to schedule an appointment.

Silicone Implants: Advantages and Disadvantages

2009-01-02T14:34:00.000-08:00

After several years of controversy regarding silicone breast implants, current scientific evidence has not been able to determine any correlation between implants and systemic disease in humans. Because of this, silicone gel implants are back on the market in the United States (and they have been in constant use in other countries). Women now have a clear choice between silicone and saline implants when choosing implant surgery.

Advantages of silicone implants

Gel implants offer the advantage of a much softer, more natural feel and oftentimes, appear much more similar to a natural breast. A key benefit is that only a very slim chance exists for rippling of the skin with silicone implants, making them a great answer for thin patients with less of a subcutaneous layer. Also, silicone implants typically last longer without needing to be replaced.

Disadvantages of silicone implants

One of the silicone gel implant’s small disadvantages is that it requires a bit of a larger incision (5 cm versus 4 cm); this generally makes the inframammary approach the necessary surgical technique. A ruptured gel implant is also harder to detect, which is why women are encouraged to undergo regular MRIs to check for a ruptured implant. Finally, gel implants are somewhat more expensive.

If you live in the Philadelphia, Pennsylvania area, Dr. David Bottger can help you explore which implant type would best meet your needs. Please contact the office of Dr. Bottger at 610.520.1929 today to schedule an appointment.

Techniques to Reduce Nipple Prominence

2008-12-31T08:22:00.000-08:00

The appearance of a woman's nipples is key to the overall look of her breasts, and many women undergo nipple restructuring procedures either as a part of or related to breast augmentation surgery, a breast reduction or a breast lift.

Some women are dissatisfied with the size of their nipples in relation to their breasts. A variety of studies have set out to determine the ideal size of the areola and nipple in relation to the rest of the breast, but in actuality, the correctness of nipple size is determined by what a woman feels comfortable with. Dr. Bottger offers women the option of having large nipples reduced in size through nipple reduction surgery.

The surgical techniques used to reduce nipple size include removal of only the top portion of the nipple, which is then sutured with small incisions. Another nipple reduction technique removes a cylinder of skin from around the nipple, then inserts the nipple into the breast tissue and closes the skin with sutures.

Nipple sensation generally remains normal following a nipple reduction, and breast feeding capability is not impacted.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about nipple reduction techniques, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Correcting Asymmetric Breasts

2008-12-26T08:17:00.000-08:00

Women’s right and left breasts are often different in size and shape. Usually, a woman can notice these differences herself, but they are not very apparent to others. If the size difference becomes apparent suddenly, women must first explore whether or not a growth of some kind in one breast may be causing it to appear larger than the other. A visit to the doctor is essential to rule out any breast masses that might be causing the size differential.

If a breast mass or cyst is ruled out, the rule-of thumb to determine the severity of the differential is that most breast size differences are under a bra cup size and as such are not in need of surgical correction. However, if you believe your breasts vary more than one cup size in volume, you may wish to have a consultation with experienced cosmetic surgeon Dr. David Bottger. He can help you evaluate the need for corrective surgery.

The factors that influence breast appearance are size, breast shape and breast and nipple position when a women is in an upright position. Surgery to correct breast asymmetry may mean that one or both breasts are surgically treated; correction could involve breast reduction of one or both breasts, or augmentation of one breast in deficient areas and reduction in size of the other. Sometimes breast sagging can be treated while Dr. Bottger corrects the size difference.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about surgery to correct breast asymmetry, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Breast Augmentation

2008-12-21T08:14:00.000-08:00

Procedures to augment the breast are designed to enhance the shape and size of the female breast. If breasts sag, a procedure called a breast lift can be utilized in concert with a breast augmentation to achieve optimal results.

Typically breast augmentation surgery is performed in one of two ways. When initiating breast augmentation surgery, Dr. Bottger makes a small incision in a concealed area and a saline or silicone gel implant is positioned behind the breast. Depending on the patient and Dr. Bottger’s decision after consultation, the implant may either be inserted above or below the muscle. The time it takes for a patient to resume normal activities after breast implant surgery is dependent upon the type of procedure utilized.

Dr. Bottger helps his patients make informed choices on the many factors to consider surrounding the breast enlargement procedure, including:

Size
Contour
Type of placement
Incision type
Silicone or saline implants

A patient’s body type and personal goals influence these decisions—as can Dr. Bottger’s recommendations based on his years of professional experience. Dr. Bottger can also make you aware of what to expect from breast augmentation surgery, including recovery period, risks and more.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about breast augmentation, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Saline Implants: Advantages and Disadvantages

2008-12-16T14:09:00.000-08:00

Women today can choose from different implant types when they elect to undergo breast augmentation surgery. Typically that choice involves silicone versus saline implants.

Advantages of Saline Implants
Saline implants have some advantages over silicone/gel implants. One advantage is that a smaller incision is required for saline implant placement; thus, more incision options present themselves. Since saline implants are filled when they are placed, any asymmetry of the breasts can be addressed at the time of placement by raising or lowering the amount of fluid in the implant.

Disadvantages of Saline Implants today
Some of saline implants’ disadvantages can involve a much more firm feel and an appearance that can sometimes seem less natural. Also, rippling that is apparent to the eye and by touch can sometimes occur with saline implants and be quite considerable. The problem is very unlikely to develop with silicone/gel implants. Thin patients are more likely to experience this effect.

If you live in the Philadelphia, Pennsylvania area and would like to explore which implant type would best meet your needs, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Get Ready for the Holidays with Injectables

2008-11-06T10:17:00.000-08:00

Non-invasive cosmetic surgery is popular both for its effectiveness and its short or non-existent downtime. Halloween is really the beginning of the holiday season and if you would like to quickly improve your appearance before Thanksgiving, you have many choices in how to do it.

Injectables are among the "lunchtime" treatments you may have heard about, which give immediate results. We offer several very effective injectable fillers. They each work differently, but in general they all create volume beneath the skin which smoothes the skin surface.

As we age the body produces less collagen - a fibrous protein which helps support the skin. Elastin is another natural protein and gives elasticity to the skin. The skin's middle layer, the dermis, has a matrix of collagen and elastin like scaffolding. Collagen and elastin are abundant in youthful skin but their reduced production is a contributing cause to wrinkle-formation as we age.

Injectable fillers provide increased volume which substitutes for the loss of collagen and elastin. The results last six months or perhaps longer. We offer Restylane(R) and Radiesse(R) which smooth out frown lines, nasolabial folds and other wrinkles around the mouth and cheeks. We also offer Juvederm(tm) which is effective in smoothing out the fine lines which form around the lips, as well as other fine lines on the face.

BOTOX(R)
BOTOX(R) is an injectable, but not an injectable filler. It does not work by providing volume beneath the skin. Instead, it temporarily paralyzes the muscle where it is injected. It blocks the nerve messages traveling from the brain which tell the muscle to contract, and this prevents the muscle from contracting for as long as the BOTOX(R) is in effect.

Most often it is used for frown lines and horizontal forehead lines, although it can also be used around the mouth. Repeat treatments can "retrain" the muscle to some extent. If you have a series of BOTOX(R) injections, not only does the skin remain smooth for lack of muscle contraction, but also the muscle remains relaxed for all that time. This may break an old habit of frowning or squinting which has caused the wrinkles.

You can see some Before and After photos in our BOTOX(R) Gallery.

Injectables, whether dermal fillers or BOTOX(R), can rejuvenate the face and give you a refreshed, more wide-awake look. Treatments last only about 15 minutes and are done with local anesthetics.

If you would like to know more about the injectable fillers we offer or about BOTOX(R), please call or email our cosmetic surgery office to schedule a personal consultation.