New recommendations can be seen here with regard to PIP breast implants.  PIP was a French breast implant company that was found to be using less than optimal silicone and therefore was investigated regarding health risks.  The link above explains the recommendation from the French Health Minister to have PIP implants removed because of inflammatory risks.  We have removed several of these implants and replaced them with Mentor implants which have been shown to be safer by the FDA and use only the highest medical grade silicone, sourced from NuSil Technology which is a local Carpinteria company.

We recommend all patients with PIP see a plastic surgeon for evaluation and recommendations- we are happy to make an appointment for all such patients.  Please call 805-969-9004 and speak to Danielle or Susanne to schedule a consultation with Dr. Lowenstein.

In the course of my discussions about creating the most natural appearing breast augmentations, I always review the reasoning that I use the dual plane technique with my patients.  A lot of information about breast implants can be found on the breast pages of my website, but I want to reiterate why this technique seems to give the best  and most natural breast contour.

The pectoralis muslce is a broad, flat muscle that extends from the proximal humerus, at the top of the arm near the shoulder, down to the breast bone and central rib cage.  Classically, breast implants have been placed either above or below this muscle.  Most often breast implants are currently placed under this pectoralis muscle because it tends to have a lower rate of complications.  This is called the sub-muscular position.  The disadvantage to putting the breast implant in this position is that the attachment of the pectoralis muscle to the rib cage and the breast tissue can tend to hold the implant in a relatively high position, giving the un-natural appearance of excess fullness, or a shelf, in the upper portion of the breast.

While some plastic surgeons will release the lower portions of the muscle in order to aid in preventing the breast implant from remaining high, the dual plane technique adds a further dissection releasing the lower portions of the breast from the muscle.  This allows the implant to fall into the relaxed breast tissue behind the nipple.  With the implant in this position, the apex of the breast implant lies where the best projection of the breast should be- at the region of the nipple.  The muscle remains to cover the upper portion of the breast implant, and creates a lovely transition from the breast apex to the upper chest wall.  The resulting tear drop form allows a very natural appearing breast augmentation, and a very happy patient.  Best of all, this dual plane technique retains a very low complication rate.

Feel free to come and have some further discussion on this breast augmentation technique, and be sure to review our photo gallery for some examples of woman who have had natural appearing breast augmentation with me in Santa Barbara.

There was a lot of coverage today of the news that a certain type of lymphoma has been found in a relative few women with breast implants.  Much of the coverage, as expected, lacked the actual information put out by the FDA.  My particular interest is in doing the right thing for my patients, and additionally making sure that my patients are well educated.

Please feel free to follow this link to FDA white paper that was released, which has an excellent explanation of the information that is currently available.  Some key points taken from the FDA report:

�According to the American Society of Plastic Surgeons, nearly four million breast implant procedures were performed in the United States from 1998 – 2009. The total number of implants worldwide is estimated to be between 5-10 million.�

�In total, the FDA is aware of approximately 60 case reports of ALCL in women with breast implants worldwide. The exact number is difficult to verify because reports from regulatory agencies and scientific experts often duplicate those found in the scientific literature.�

“Health care providers should be aware ALCL in women with breast implants is a very rare condition; when it occurs, it has been identified most frequently in patients undergoing implant revision operations for late onset, persistent seroma. The FDA does not recommend prophylactic breast implant removal in patients without symptoms or other abnormalities.�

�Because the risk of ALCL appears very small, FDA believes that the totality of evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.�

I encourage my patients and the general public to become as educated as possible on this as well as all aspects of any plastic surgery procedure that they are considering.  I am happy to review the pros and cons of any and all of the plastic surgery procedures that I perform in Santa Barbara.  If you are planning or considering plastic surgery, please feel free to come and have an educational, complementary aesthetic plastic surgery consultation with me to discuss any questions or concerns.

As many of you know, following Dr. Sheffield’s retirement at the end of last year, some gentle transformations have kept us busy at Montecito Plastic Surgery. New paint adorns the walls, and new furniture can be found throughout the office. This week, the finishing touches will be placed with new flooring in two exam rooms. Several new pieces of art will be received from the framers, and will be heading for our newly painted walls.

The hardest part, and yet the best part, has been that throughout this transition, we have remained clinically as busy as ever. Two and often three operating days per week have been filled through much of February by the ongoing interest in having plastic surgery in Santa Barbara by some old, but many new patients. I will be performing several face lift operations, rhinoplasty operations, liposuction, and breast augmentations in the coming weeks on both men and women from Santa Barbara and beyond.

We are thrilled at the response that patients have given on the new look to the office. It appears lighter, larger, and more aesthetic. Additionally, computers placed in each room allow increased access to the new electronic medial record, as well as plastic surgery imaging programs that aid in patient education. We couldn’t be more pleased with the enhancements to Montecito Plastic Surgery, and we invite you to stop by and see what all of the excitement is about.

With every breast augmentation patient in Santa Barbara, I go over the various types of breast implants, the various pockets that breast implants can be placed in, and additionally the different incisions that can be used to place the breast implant into the breast pocket.  With respect to this last issue, I think there is some helpful information that has recently been published.  (more…)

We are seeing more and more women come from Beverly Hills and Hollywood to have their plastic surgery in Santa Barbara.  I find this a very interesting phenomenon.  I’ve never been one to gawk at celebrities- I see them as people just like you and I, with very interesting careers.  (I have some friends, whoever, that I’m convinced only visit me both here in Santa Barbara and also at my home in Aspen because they like to see and be seen with the rich and famous.)  Personally, I feel that privacy issues are of ultimate importance, and as I refuse to divulge anything about my patients (more…)

It seems that more and more and more surgeons are performing breast augmentation in the same techniques that Dr. Sheffield and I have been proponents of for quite some time.  The dual plane breast augmentation seems to be gaining favor by many plastic surgeons around the country.  On of the most respected breast surgeons in the world, Dr. Dennis Hammond, is a friend who has been kind enough to participate on my panel at the ASPS meeting for two years running.  He and I additionally share responsibility for much of the educational program at the ASPS meeting pertaining to surgery of the breast, and I have the highest opinion of Dennis as a great, thoughtful surgeon and educator.  He is also a proponent of the dual plane approach for many patients, and like me, believes in an individualistic approach to breast augmentation and breast lifts.  Breast implants should be chosen on the basis of individual patient anatomy, including length and width of the chest wall and torso, as well as specific patient expectations. (more…)

I’ve just returned from the 2008 meeting of the ASPS- thousands of plastic surgeons converged in Chicago last weekend to discuss the latest trends in plastic surgery, as well as issues of patient safety and improving plastic surgery outcomes for patients around the country and the world. I had the pleasure of being involved with two of the most popular programs, one of which I’ve been asked to put together now for I think the 6th year running. We discussed issues ranging from wound care to breast augmentation, breast lifts, breast implants, body contouring, facelifts, and eyelid surgery. I had the opportunity to teach by sharing my thoughts, while hearing from some of the world’s experts about their recommendations and experiences. Having previously served on the Board of Directors of the American Society of Plastic Surgeons, I also had the great opportunity to see many of my friends from around the country, and help mentor some of the younger, up and coming plastic surgeons. On top of that, I got to do some shopping on Michigan Avenue, and have some fantastic Italian food. And then there was that amazing Chicago style hot dog at O’Hare airport….. ☺ I’ll try to include some of my thoughts about some of our discussions over the next few blog entries, and I’ll limit my thoughts to plastic surgery instead of pasta and hot dogs.

I’ve been given permission by one of my patients who came for breast augmentation in Santa Barbara to post a video of the transition between her pre-operative breast form and her post-operative breast form. This video is on our YouTube Channel, “videoplasticsurgergery” with several others.
-Dr. L

Deciding on any plastic surgery, especially breast augmentation, is a very personal decision and one not to be made casually or lightly.  Finding the right operation, and having it performed by the right surgeon, is key to increasing your likelihood of a long lasting and great result.  We have seen so many patients over the years, and the vast majorities have come to our office for plastic surgery in Santa Barbara for great reasons.  Here are 5 common reasons we perform breast implant surgery in Santa Barbara: (more…)