Breast Augmentation

Serving the Advancement for Women's Health

Dr. Barnett expertly and discreetly addresses breast complaints. As both a Board certified general and plastic surgeon, she is qualified to deal with all breast related problems from benign ones to cancer and beyond. She is highly respected by her peers for her reconstructive skills. Dr. Barnett has particular expertise in implant related problems. Patients come to her from across the US for these typical problems.


Dr. Barnett brings her skills as a surgeon as well as her perspective as a woman to achieving your goals safely. She will listen carefully to your needs. She will explain why she recommends certain treatments so that you can be a willing participant in achieving your goals.


For example, she may recommend against a certain size implant due to your unique body structure, but she will thoroughly explain why she feels this way and will help you find the right compromise. She never delegates this job to nurses or assistants because she feels strongly that your education and understanding are as important as her surgical skills.


Implants:

Dr. Barnett uses only smooth saline implants. Why? Because of the many problems she has seen over the years with gel implants including ruptures. Gel implant ruptures are frequently undetected until problems arise.

If saline filled implants rupture, salt-water should not harm patients, as it is a major component of the body. Dr. Barnett is finding that saline implants rupture much less frequently than gels, particularly smooth salines. Additionally, she finds that they are less likely to get hard, which is the primary complaint about implants. They are especially less likely to get hard if they are placed under the muscle which is her preferred method.

Placing implants under the muscle means that they will have a more natural appearance and feel. There is a wide variety of incisions for placement of implants and Dr. Barnett will customize these to the individual patient. For more detailed information, please consult with the doctor.


Breast surgeries performed by Dr. Barnett:

Augmentation mammoplasties; reduction mammoplasties (standard and short scars); liposuction reduction; breast lift with or without implant reconstruction, expander/implant; autologous flaps including latissimus flap, TRAM flap, and FREE flap, as well as local flap.

Explants - Questions & Concerns

Q: Do you have En-Bloc and Capsulectomy skills and have you removed implants En-Bloc?

A: Yes, I perform En-Bloc removals however, in my mind that is an oncologic term in which the implant is removed in one piece with the capsule. If your implants are under the muscle and soft, it is virtually impossible to do an "en bloc" removal as the scar tissue is typically so thin that it tears when I retract it. Once it tears, the implant flops out so I usually remove it as it will not be in the way of my dissection and I can complete the capsulectomy. I do a complete capsulectomy but it may not be what I think of as an enbloc one.  

Q: How many explants have you done?

A: I have perfomed over 3,000 such surgeries 

Q: Are you committed to removing all capsule tissue from your chest?

  

A: I have left a tiny piece of capsule in perhaps two cases- once when a postage stamp size piece was adherent to a large blood vessel and nerve to the muscle. Since the piece was so thin, I could read through it, I did not feel it was worth damaging either to remove such a small piece. Another case the capsule ran up almost to the collarbone and again was so thin, i couldn't even pull it down. i stripped as much off the muscle as I could but probably left a small amount because it was not worth resecting more muscle to get it off.

Q: What kind of anesthetic is used during surgery?

A: These operations must be done under general anesthetic and Dr. Barnett requires a board-certified anesthesiologist to attend the cases to insure safety of patients

Q: Will I receive antibiotics during the surgery?

A: Dr. Barnett will not use antibiotics unless there is a clinical reason i.e. you tell me you get infections every time you have surgery, you harbor MRSA or i am doing flaps such as a lift.

Q: Will the stitches be dissolvable or do they have to be removed?

A: Dr. Barnett uses dissolvable sutures. 

Q: Do you send my implants/ capsule tissue to pathology?

A: Dr. Barnett sent the first one thousand for analysis/cultures and almost all returned normal so now she does not do such studies unless something does not seem normal or if the patient insists.

Q: Do you check lymph nodes for silicone and remove the worst ones if they are contaminated?

A: There will never be any way to clear your body 100% of silicone (even I who have never had any implants have a measurable level of silicone in my body) so I see no reason to remove any lymph nodes which are simply trying to do their job of protecting you from invaders unless there were something obviously wrong with the nodes. 

Q: Do you take pictures or video of the explant procedure?

A: I do take complete set of photos of the implants and capsules upon removal and you are welcome to these and any operative reports or paths/lab reports. Videos are difficult to take as the incisions are small and it is hard to see inside of them but i have had them done for a fee.

Q: Can I have a copy of my complete file including operative reports, pictures and tests?

A: Yes, they will be given to you at your first follow up meeting.

Q: Will you return my implants and capsule tissue to me?

A: You are the owner of the implants so they are yours if you want them; however, they are biohazards and need to be stored properly. If you are considering legal action and it is doubtful that you have any cause for legal action, then it is recommended that you not take possession of your implants as it can be argued that you tampered with them once you got them. It is better to store them with me or with an attorney if you have one than to take possession. They certainly should NOT be discarded as I believe there is a lot we can learn from them and have been asking the ladies if they would consider allowing me to have them for research in the future assuming no legal action will be taken.

Q: Will I have drains and what should I expect with drains?

A: I do not use drains unless I am doing a lift and they will be removed next day in our office.

Q: If a breast lift is required, what type of incision do you use if any at all?

A: I usually perform a lollipop scar for the lifts but must evaluate you first to see if one is even needed.

Q: Is there a deposit required and what happens with that deposit if I have to cancel or postpone?

 A: Yes, we do collect 20% of the surgery cost to hold your surgery date. It is refundable if you have to cancel no less than 2 weeks before scheduled surgery. 

Q: How long will it take for my breasts to heal and feel normal?

A: It DEPENDS. A simple capsulectomy without anything else can be healed very quickly but a lift could take 4-6 months to settle.

Q: Will there be follow up appointments and how many?

A: Typically, if you live in the area we would see you the next day, a week later and then usually at 6 weeks and then 3 months after that and so forth until everything is satisfactory. For my out of towners, obviously that may not work. Depending on your health and what we do, you may be able to leave the next day or J may want you to hang out several days.

BREAST SURGERIES PERFORMED BY DR. BARNETT

Explants

Reduction

Overly large breasts can cause some women to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active lifestyle. The emotional discomfort and self - consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain. Also known as reduction mammaplasty, this procedure removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts. 

Reconstruction

Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition. The creation of a new breast can dramatically improve your self - image, self -confidence, and quality of life. Although surgery can give you a relatively natural looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed. 

Implants

Breast augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts. Clinically referred to as augmentation mammaplasty, the procedure is used cosmetically to: Enlarge a naturally small breast, most commonly the result of heredity. Restore breast volume lost following pregnancy, as a result of breastfeeding or due to weight loss. Achieve better symmetry when breasts are moderately disproportionate in size and shape. 

Lift

A woman's breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from: pregnancy, breastfeeding, weight fluctuations, aging, gravity, and heredity. Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.