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| Dr. Joel Aronowitz |
Dr. Joel Aronowitz: “Want to talk implants? Here we have
them. So silicone was invented in like 1950s and implants were invented in
1960. They were used starting in 1962, invented in Houston, Texas where
everything is big and they were a big success ever since and the implants are
very similar to the original ones. Silicone shell on the outside and either
silicone or saline on the inside.”
Bridget: “The texturing on the outside was designed so that
they wouldn't get hard but we don't use anymore.”
Dr. Joel Aronowitz: “Correct. You never really liked it
though right?”
Bridget: “Never was a big fan. These are what?”
Dr. Joel Aronowitz: “Yeah these are not implants though.
These are sizers so you can see what we'll do.”
Bridget: “Uh-huh. Here.”
Dr. Joel Aronowitz: “Am I embarrassing?”
Bridget: “No not at all.”
Dr. Joel Aronowitz: “I didn't look to be honest which I
think is. So these are used for a patient to get a sense of how big the implant
will be because it's hard to get, it's hard to tell from the shape implant. So
now a small implant roughly 200 cc's this will give you one increased cup size.
Okay. So for every 200 cc's it's roughly one cup size. Okay. And then and then
an implant shaped like this is a shaped implant but 90 some odd percent of
implants are going to be round and round implants though can have differences
in size but also you see how the shape is different so as you fill the implant
up more and more it becomes rounder and rounder so you get more projection but
you also it gets firmer and firmer so an implant like this that's a moderate or
low profile implant meaning it's not as round.”
Bridget: “Projection. You get less projection but it's
softer.”
Dr. Joel Aronowitz: “Right. So for a woman who needs that projection
because the shape of her own breast is isn't requires it you need a higher
profile implant it's also kind of a preference and then size this is a larger
implant larger this is 600 cc's. Wow can I see that? I don't think you're older
than that. You can see that one. This is actually these are nice. All right go
ahead. Oh this is a saline implant we're pumping it up with air to show you.
Why do you hold it up? So there's an injection tubing there's a little port
right here I'll put it back in for you and and this little valve allows you to
fill it up in surgery. Right and in surgery it well I gotta take it out to fill
it up. You have to unplug it. This is a one-way valve so the saline can't get
out while you're filling it up.”
Bridget: “Exactly. Have you taught me that it's you know how
it works?”
Dr. Joel Aronowitz: “Yeah. See and you just keep you go
saline and then you. And then when you lose track of how much saline you put in
you start all over. And you have to keep track because they have to be even. They
don't have to be but it makes for a lot happier patient. I'm just saying. I
know. So now we've filled this up with air not saline but it's filled it's
filled with saline which is just salt water. So two kinds of implants silicone
filled and saline or salt water filled. If the difference is that this will be
lighter and this will be heavier. This will be a more expensive implant. This
will be a less expensive implant not necessarily for the surgery but the
implant itself is less expensive. If this leaks you will go flat. You won't the
saline doesn't hurt you. If this leaks if this ruptures the silicone is still
contained within the scar tissue capsule so you won't have any difference in
size. Other than that any differences. This is more natural feeling. If you
talk to a person you'll feel this more. What are the problems with breast implants?
Implant gets super hard. A capsular contracture like that feel that implant
very hard. What do you do? Basically it's a surgical problem. You surgically
remove the implant release the capsule and then replace the implant with the
same implant or a new implant. What if the implant gets infected? The pocket
gets infected, the breast is hot, it's red, it's painful. What do you do? Take
out the implant. Wash it out. Wash it out and don't put the implant back in
usually for a few weeks until everything is all healed up. Correct. What do you
do if the implant the saline leaks? Yeah what do you do if all of a sudden you
have a deflated breast?”
Bridget: “You come on in and we need to replace that broken
implant. Sorry I cut you off.”
Dr. Joel Aronowitz: “That's so sad when that happens.”
Bridget: “I know and I cut you off but I...”
Dr. Joel Aronowitz: “You could do that.”
Bridget: “I know I feel rude but... What other problems can
there be?”
Dr. Joel Aronowitz: “What do you do when an implant is just
too big? They still look good. They're still but the breasts have started to
sag. The woman maybe has gained a little bit of weight and has a little more
weight in her breast. Years have gone by and these implants are hanging and causing
pain. You need a lift. How do you do a lift?”
Bridget: “You tailor tack the breast up.”
Dr. Joel Aronowitz: “Yeah you do right. So then it's down
here and it gets up here. That's very scientific medical terms. Maybe you take
the implants out and put fat in. Maybe you don't even need an implant at that
point.”
Bridget: “I know. What do you do if the implant is older
than 10 years old?”
Dr. Joel Aronowitz: “If it's causing you no issues and you
still are happy with them you can leave them. If they're older than 10 years
old and they're causing any of the issues we've previously discussed then you
can replace them.”
Bridget: “You can replace them but they don't have a time limit,
right?”
Dr. Joel Aronowitz: “No I mean the companies usually say 10
years but if they're 10 years it's not like a hard knock 10 years. Did you like
that answer?”
Bridget: “I didn't understand the hard knock.”
Dr. Joel Aronowitz: “I mean like a hard rigid line.”
Bridget: “I understand that but a knock is like fine 10
years you don't need it. You want to hold the big one again?”
Dr. Joel Aronowitz: “She likes that one.”
Bridget: “Other than that I think you did great.”
Dr. Joel Aronowitz: “Did I?”
Bridget: “Yeah.”
Dr. Joel Aronowitz: “What is the name of the man that
invented the buskin plan? We should remember him because he's since passed away
but he was. What's his initials?”
Bridget: “FG. Frank. Frank. I want to say like juror
something. Frank Jarrell. Frank Jarrell in Houston Texas.”
Dr. Joel Aronowitz: “Very good.”
Bridget: “Thank you.”
Dr. Joel Aronowitz: “And so we should give Frank Jarrell credit for a major advance. Dr. Frank Jarrell. He was a resident when he did that. Wow. He was a resident and that's really interesting. Yeah and not only were women able to have a reliable augmentation but if you think about it back in the day before 1962 you didn't have any breast reconstruction you just had mastectomy and a woman who had a mastectomy or even a portion of the breast removed or had asymmetry naturally she had no reasonable alternatives. All the alternatives were terrible and with the invention of the modern breast implant those women had a chance for a much more normal appearance. So thank you Frank Jarrell and thank you everybody direct from Aronowitz land where we are using a lot of implants still we're doing fat grafting to the breast but we're also doing implants for breast reconstruction for breast augmentation and all and just for playing with them. All right you can hold the big one for a minute and we want to say goodbye from Aronowitzland we look forward to seeing you again soon everything is just great here and we hope you have a wonderful day.”
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