AnnaLynne McCord flaunts her flawed results

Now let’s look at the case of Adriana Lima, the Brazilian born model. She is most well known as a Victoria Secret Angel and as a spokesmodel for Maybelline cosmetics but she also is a supermodel, actress and has graced the covers of countless magazines for more than ten years. Since 2005, she has been ranked in the top five of Forbes’ lists of the 20 highest-earning models in the world.

Looking for some good and interesting material to write about, I came across a recent photo shoot of her in a bikini that was posted online which caught my eye (actually both of them). I thought to myself: “Aha. She’s the one that I’ve been looking for!” Who knew that she was so famous?

Now about breast implants and a more tasteful breast augmentation. Below is a photo of her “aug” natural. Before plastic surgery.

Adriana Lima au natural - before breast implants

Pretty. Has potential. Not much money or fame – yet.

Now, after a very nice breast augmentation.

Adriana Lima, supermodel, after breast augmentation

Her breasts are relatively “natural” in appearance rather than being disproportionately or grotesquely large. In clothes (this is a bit of a stretch!), she has good symmetry, cleavage, projection and her breast implants are situated at the same height on her chest.

Worthy of fame and fortune.

My only gripe has nothing to do with her breast enlargement. It has to do with her emaciated, pseudo-anorexic appearance. Look at those ribs and her extremely skinny body!

If you would like to schedule a complimentary consultation with me or obtain additional information on breast augmentation surgery 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

What can be done to either recoup or obtain that youthful, perky and sexually attractive shape?

Clearly, a breast lift (mastopexy) with or without implants (breast augmentation) will provide the rejuvenation of the breasts with lifting, recontouring, tightening and even adding volume. This can be facilitated employing incisions that range either from one just around the areola to an anchor shape one that also involves a vertical and horizontal component. Unfortunately, many women are very apprehensive about these incisions which ultimate become “scars” and want to avoid them at all costs.

A question that I am frequently asked and which many women have as also evidenced by myriad postings online is: “Can I just get much bigger implants to avoid having to do a breast lift?”

Often, women either know other women who have pursued this approach or they were told this in consultation with other physicians, many who either didn’t have the experience, sensibility or training regarding this issue or lowered their standards in order to “close the deal” and perform the surgery. It is unfortunate that these physicians, quite often not plastic surgeons, wouldn’t do what was in the best interest of their patients just to make a buck (or lots of bucks).

Personally, I will either do what is right for my patients or won’t perform the surgery. It’s all about principles. Period!

Now, why is placing too large an implant in the breast in order to avoid having to do a breast lift a very bad idea?

Let me explain this briefly. The skin is already thin (or thinner) with decreased elasticity (stretchiness) with breast ptosis. Placing an even larger implant than is ideal will stretch out and thin the skin even more. Added to this, many of these physicians recommend that the best way to counter the drooping breast skin is to directly stretch it out by placing the implants above the muscle. What eventuates is that the breasts descend at a more accelerated pace lower on the chest and abdominal wall. The granny breast caricature (no offense to grandmothers)!

Not a pretty picture!

Ultimately, the only treatment of this would be a complex reconstruction that would require an anchor shaped scar (which may or may not have been originally recommended) and possibly one or two procedures. The skin will be much thinner and less elastic than it would have been had the appropriate procedure been performed initially. The final outcome, after spending at least double or more the amount of money than it would have originally cost, will always be significantly inferior to what it could and should have been. Add to this the extra down time, discomfort, inconvenience, etc. and you should easily conclude that not pursuing the correct procedure was a very poor choice.

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

The title associated with the picture was “AnnaLynne McCord Gets Something Off Her Chest”. The writers might have thought this was a cute phrase as they were referring to her recently acquired cleavage through breast augmentation surgery. Unfortunately, their phrase “Off Her Chest” was the exact opposite of what was done. Actually, the more precise description should have been “AnnaLynne McCord Gets Breast Implants For Her Chest”.

You might have recognized immediately that the photo was indeed of AnnaLynne McCord from “90210” but having never watched “90210”, I didn’t know. It took some googling to discover exactly who she is. What I learned is that she may be more than just another beautiful face (and body) – having some acting talent (though again I wouldn’t know that first hand). She does apparently devote a tremendous amount of her time to charities which is more than most Hollywood narcissists do … and that is an admirable endeavor.

However, she does need to devote a little more time and discretion about the clothes that she selects and some things which I will now discuss.

You may be wondering why I am writing about a voluptuous actress on my plastic surgery website, posting a revealing photo and even tossing in some nice comments about her. Well, here is the reason:

Her breast augmentation results as seen in this and other photos are … well, very unacceptable! And to make matters worse, she is brazenly flaunting what I consider to be a suboptimal outcome. Of course, both the less than ideal results and the ostentatious display of them are not a rare phenomenon in Hollywood.

No matter who my patients are, normal every day women or Hollywood actresses (I do have experience in this department), I would NEVER knowingly accept this inferior result in my own patients.

Yes, there are many women on whom it is impossible to obtain great, ideal or even very satisfactory breast augmentation results for a variety of reasons. However, in AnnaLynne’s situation, based on her photos prior to surgery, this did not appear to be the case.

So what am I seeing in the photo?

There is a striking difference in the shape and projection of the left versus the right breast implant with the left one being less projecting. This is independent of the asymmetrical position of her shoulders. Whether or not they are situated at the same vertical height can’t be ascertained by this one view. However, her revealing dress seems to accentuate the substantial disparity between sides – never a good thing.

My philosophy has always been that a breast augmentation is more than just inserting breast implants and trying to obtain a particular cup size. It is a procedure that MUST be performed with precision and this starts right in my office during the consultation. There is a very comprehensive examination that includes not only an assessment of the size of the breasts but also other issues such as their shape, location on the chest wall, asymmetries, skin tone, etc. Sizing is also done but this doesn’t end in the office. I also evaluate various sizes and styles of breast implants during surgery and will use what will give my patient the best possible results based on what the goals are.

You most likely aren’t an actress and probably will never be a movie star, but I sure want to make sure that the excellence of results from your breast augmentation will be what these famous actresses would have wanted (but didn’t receive) as their outcome.

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

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

Breast augmentation is the number one cosmetic surgical procedure that women undergo. It is also among the top two in overall satisfaction with 94% stating that if they had to do it all over again they would still make the same decision. That is an amazingly high number particularly in light of all the risks and complications that plastic surgeons must discuss with their patients prior to this breast enlargement surgery.

One of these risks in breast augmentation and one which I review in detail with my patients is the occurrence of numbness of the nipples and the breast skin in general. How common is numbness of the nipples? Is it temporary or permanent?

As with many surgical procedures where incisions are made and the skin elevated (lifted), there will be some postoperative numbness, albeit usually transient, and such is the case with breast enlargement surgery. Right after surgery, the skin of both breasts can/will be somewhat numb which is also compounded by the initial swelling. Over a period of a few weeks, most if not all of this will resolve in a majority of women; others can take several months. There is a very small percentage of women who may take a year or more for their sensation to return.

The incidence of permanent loss of sensation of the nipples as identified by several studies is around the 3 – 5% range though in my practice, it is extremely rare. This risk is influenced by many factors including surgical technique, skill of the surgeon, incision location and breast implant size. Incisions placed around the areola have a substantially greater risk of resulting in temporary and permanent numbness than those placed through one situated either in the lower breast crease (inframammary fold) or the armpit (axillary approach). Breast implants that are disproportionately large in relation to the chest wall and starting breast size also elevate the risk.

For more information on breast augmentation surgery in Scottsdale or on any other plastic surgery procedure that I perform or to schedule a free 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 is often on the mind of women who are contemplating undergoing a breast augmentation in Scottsdale and are also planning on having children in the future is “will my getting breast implants have an effect on my ability to breast feed?” This actually is a very good question that has a positive answer which I will share with you in one word:

No!!

Let me explain this to you in a little more detail.

When breast implants are inserted for a breast enlargement using either the inframammary (lower breast crease) or transaxillary (armpit) approach, there is no need to disrupt any of the breast tissue whether or not they are placed in front of (submammary) or behind the muscle (submuscular). When a periareolar (around the areola) incision is employed, there is actually a disruption of some of the ducts in the process of creating a pocket for the implants whether or not they are placed above or below the muscle. Even with this approach (where dissection traverses some breast tissue), most of the ducts and their connection to the areola and nipple still remain intact.

Over the years, many of my breast augmentation patients have had children some time after their surgery and I am unaware of anyone who was unable to breast feed. Of course, there are women who do not have breast implants and who are unable to breast feed.

If you would like more information on breast augmentation surgery in Scottsdale or breast implants or for any other plastic surgery procedure that I perform, please feel free to contact my office at 480-451-3000. At that time, we would also be happy to schedule you for a complimentary consultation with me.

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

The same goes for the expression that “she has killer boobs”.

This weaponized breast/bra approach will definitely capture the attention of airport security.

Our world is being threatened by religious forces of evil and hatred that are twisting and perverting scientific, technological, aesthetic and medical advances for destructive purposes. This is not unlike many previous groundbreaking advances such as controlled nuclear fusion and fission that can be employed for peaceful purposes like nuclear power plants or for war and lethal uses as in annihilative nuclear weapons.

Now it seems that even a breast augmentation can be used for nefarious purposes.

What is the world coming to?

What is this all about?

Islamic terrorist groups are seeking to use implantable explosive devices that won’t raise suspicions and are nearly impossible to detect, allowing the terrorist to effectively evade security in order to wreak havoc on airplanes and elsewhere. Breast implants are the ideal readymade device to accomplish these nefarious acts. They are large enough to hold a highly lethal amount of explosives that could predictably blow a plane out of the sky. Pectoral and buttock implants are other possibilities that also would not raise much suspicion.

How can this be done?

The implants, which normally may be filled with saline can instead, be filled with an explosive such as PETN which is stabile until a chemical reaction is initiated. This reaction is simply precipitated by injecting the chemical trigger into the implant at the desired time which is accomplished by puncturing the skin with a sharp device that contains the element. The object can be modified and disguised to appear as a nondescript pen. All the terrorist has to do is just pull out the device and stab himself/herself to initiate the lethal reaction. This can be performed anywhere on the plane: while sitting in a seat, in the restroom or even near the cockpit.

The only good news about this is that if you had an “irrational” fear of flying before, it is at least not so irrational any longer.

Finally, to paraphrase a slogan from the 60′s so as to apply it to breast augmentation surgery: Make love, not war!

For more information on peaceful uses of breast implants or on breast augmentation surgery, please feel free to contact my office at 480-451-3000.

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

Silicone breast implant

There have been considerable technological advances in the design and construction of silicone breast implants since their early days. They are made with much thicker, stronger and durable outer shells that are filled with a very cohesive silicone gel – almost like taffy. The result is that they will withstand much more and last longer on average compared to previous versions.

But, they will not last forever?

Of course not!

The FDA in 2006 recommended (not mandated) that women who have silicone implants inserted for a breast augmentation in Scottsdale or breast reconstruction should have an MRI (magnetic resonance imaging) three years postoperatively then every other year afterwards. There was no specific data supporting their recommendation, however. Given the expense of an MRI which often may not be covered by a woman’s insurance plan, is this a prudent recommendation? Is it worth the money?

A retrospective study was performed at the University of Michigan and published in the March 2011 issue of the Plastic and Reconstructive Surgery® journal which examined 21 previous studies that had evaluated MRI’s and their ability to detect silicone implant rupture. The findings of the combined data were quite interesting and enlightening.

What was confirmed was that MRI’s were fairly accurate in detecting implant rupture but this wasn’t the whole story. In those women who presented with symptoms related to their implants, MRI’s were 14 times more likely to detect a rupture than in those who were asymptomatic. Looking at this from a different angle, the MRI’s were less helpful in women who had no symptoms.

Given that silicone gel implants on average last in excess of 10 years, can one justify the expense of repeated MRI’s as a screening tool for implant rupture (and breast evaluation) in otherwise asymptomatic women at least during this period of time compared to a routine screening mammogram for cancer?

With the present technology and the findings from this study, the answer is probably not. Mammograms and or ultrasounds (which are less accurate in the detection of implant rupture) should be performed for routine breast cancer screening. If there is evidence or a suspicion of an implant rupture, then an MRI can be considered or performed.

For more information on silicone gel breast implants, breast enlargement surgery in scottsdale, breast reconstruction or for any other plastic surgery procedure that I perform please feel free to call my office at 480-451-3000. A consultation can be scheduled at that time as well.

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

What are these implants called and how are they different?

Even more important: Are they available to use here?

The silicone breast implants that I am referring to have been labeled “gummy bear” implants because in some ways they have characteristics of the candy after which they were nicknamed. I’m sure that this doesn’t include  taste though someone probably has already checked this aspect out. The major way that these silicone implants differ from earlier versions is that the gel is highly cohesive and form-stable which means that it resembles taffy rather than a viscous gel and maintains a stable shape.

These implants have been used in breast enlargements elsewhere since the early 1990’s. Extensive research on these implants has been performed both in this country and internationally but unfortunately they have not been cleared for broader usage here yet by the FDA (Federal Drug Administration) although their approval may be imminent. (Note: Plastic surgeons in the United States have been under the impression for the last several years that FDA approval was imminently forthcoming … but we are still waiting.)

There are a few advantages of these form-stable silicone implants (as well as some disadvantages) over the present day cohesive gel silicone implants. They will last longer in general and there will be virtually no potential of “gel” migrating elsewhere. The risk of developing capsular contracture appears to be lower, somewhere around 3% versus 5 – 10% or more with the standard silicone implants.

The cost for these implants are yet unknown though they are expected to be significantly more expensive than the present day silicone implants. This may affect their popularity and selection to some extent. Ultimately, several factors will play a role in deciding which type of silicone implant would be the best choice.

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

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

Rarely, will I ever place breast implants above the muscle and when I do, it is usually as an exchange for someone who has had reasonable results with their implants situated in this location. Body builders are another exception.

It is amazing to me that there are still many physicians who place a majority of their patients’ implants in a submammary pocket. Many of these happen to be non-plastic surgeons who find that performing the procedure is easier this way and therefore dismiss or ignore important aesthetic issues and outcomes.

Over the years I have seen countless poor results from saline implants placed above the muscle in women of all ages, a situation which is exacerbated by those with thin skin. Even more disheartening are those women in their 20’s who have sustained permanent damage by what I consider to be very poor “choices” by their surgeons.

The following video illustrates one such individual who is in her mid 20’s. Note the severe static and dynamic rippling, skin stretching and very poor cosmetic appearance.

Video of Saline Implants Above Muscle

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

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

ALCL is quite rare, being diagnosed in 1 out of every 500,000 women in this country annually. Its annual incidence with the primary location being the breast is an infinitesimal 3 in 100 million. The total number of women with breast implants reported to have this disease is somewhere between 34 and 60 worldwide out of an estimated 10 million or more women who do have breast implants.

To put this into perspective, the average yearly risk of primary breast cancer in American women is 123 per 100,000 which translates into 123,000 per 100 million women or 41,000 times more common than ALCL. In other words, this is nothing to lose sleep over.

The particular form of ALCL that has been found in women who have breast implants is fairly “benign” and not very difficult to diagnose once suspicion is raised. Those who have been diagnosed with this disease presented with the onset of pain, a palpable mass in the breast and a sudden enlargement in size secondary to a fluid accumulation known as a seroma. The average time of occurrence following implant placement has been around 8 years.

Treatment has been found to be straightforward and completely curative. This “simply” involves the removal of the capsule which forms around the implant and which is the location of this tumor. Although several of these women had new implants reinserted, studies will need to be performed to determine the advisability of this. There have been no reported deaths in any of the women who have been diagnosed with ALCL and there is no indication for chemotherapy or radiation therapy.

In summary, though anaplastic large-cell lymphoma (ALCL) has been found in a few women who have breast implants, no definite association has been established. The disease is extremely rare and seemingly “benign” in course, easily diagnosed by symptoms, completely curable and not associated with any deaths. For more information, you can check out the FDA’s report on this as well the American Society of Plastic Surgeons website.

If you have any questions regarding this news or any other questions regarding cosmetic or reconstructive breast surgery or any other plastic surgery procedure that I perform or to schedule a complimentary consultation, please feel free to call my office at 480-451-3000.

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