PRS Journal Publication

The Three Breast Dimensions: Analysis and Effecting Change

Sir

I read the article by Dr. Hall-Findlay, “The Three Breast Dimensions: Analysis and Effecting Change” (Plast Reconstr Surg. 2010; 125:1632-1642) and appreciate her documentation of changes to the breast following augmentation. Her review of 20 cases confirms that the distance from the sternal notch to the nipple increases by more than 2 cm even as early as 1 month postoperatively. This confirms my observations of over 25 years that subpectoral and subglandular placement of implants increases ptosis. This is very evident when an inframammary incision is used and the scar ends up superior to the fold. With a subglandular pocket, gravity is the deforming force. With a subpectoral pocket, the pectoralis major muscle contraction adds a deforming force of inferior and lateral displacement to gravity.

A submuscular pocket avoids this deforming force. Incorporating the serratus anterior with the pectoralis major helps prevent lateral and inferior migration of the implant. I have reviewed 20 of my own patients with a minimum of 4 months’ follow-up for measurements and have found an increase in the sternal notch-to-nipple distance on average of 0.4 cm. The average of the implants was 400 cc, larger than those used by Dr. Hall Findlay. When using smaller implants and when I did not lower the inframammary fold, there was no increase in the distance.

I agree with Dr. Hall-Findlay that we should measure our patients, which should make managing their expectations easier. Unfortunately, I rarely obtain records on patients seeking second opinions who have even had preoperative measurements and virtually never have had postoperative measurements. I often see patients who had ptosis and were talked into having large implants, which not surprisingly resulted in increased ptosis. DOI:10.1097/PRS.0b013e381fad608.

Lawrence Neal Gray, M.D.
Atlantic Plastic Surgery
100 Griffin Road
Portsmouth, NH 03801

Atlantic Plastic Surgery Finds Coolsculpting Effective Non-surgical treatment removes stubborn fat

Portsmouth, NH – Dr. Mark Ballentyne, Dr. Lawrence Gray and Dr. Brannon Claytor of Atlantic Plastic Surgery Center have found that patients are highly satisfied with CoolSculpting as a safe, non-invasive way to noticeably reduce localized areas of fat. Dr. Mark Ballentyne, said, “We have had this new, non-surgical treatment for a long enough period of time now that our patients are seeing their results clearly and they are quite happy. Back fat, love handles, isolated belly fat and saddlebags are responding well to Coolsculpting treatments”. Both women and men like this fat reducing treatment because it requires no needles, no cutting and has no downtime.

Dr. Gray states, “We are finding so much success with this patented cooling technology for fat reduction that we have purchased the two newest heads available. Our new flatter head accesses a greater amount tissue the selected area, such as the abdomen, which may have previously required more than one treatment. The second new head has a better curve for fat reduction on the hips.

Dr. Claytor reports that, “Many people exercise and follow a healthy diet, yet have persistent areas of fat. People who are good candidates for Coolscupting treatment have a generally healthy weight with a body mass index of less than 30, but have at least an inch of pinch-able fat. I always emphasize the importance of a healthy and active lifestyle, but the vast majority of people who inquire about Coolsculpting have specific areas of fat that have troubled them for a long time.

Coolsculpting has shown significant results in clinical studies for removing fat without the potential risks of damage to nearby tissues. Approved by the FDA, this cool technology is based on a large body of research that has shown that fat cells are more susceptible to cold and can be selectively and permanently destroyed. This new Coolsculpting technique of freezing fat is pain-free and reduces fat bulges by as much as 20-25%.

CoolSculpting works by gently cooling unwanted fat cells in the body, bringing about a natural, controlled elimination of fat cells. One to two months after the procedure, cooled fat cells begin the process in which the cells begin to shrink and are reabsorbed into the body through the lymphatic system. Approximately two to four months after the coolsculpting treatment, patients begin to notice significant results in the treated areas. The body continues to naturally and gradually eliminate the cooled fat cells, reducing the thickness of the fat layer. Visit our website at atlanticplasticsurg.com to learn more about the complete range of plastic surgical procedures or call Atlantic Plastic Surgery Center at 1-800-633-6860 for additional information.

About Atlantic Plastic Surgery Center:

Atlantic Plastic Surgery Center is the practice of New Hampshire plastic surgeon, Dr. Lawrence Gray, since 1985. Dr. Gray is nationally and internationally recognized as the inventor of the scarless breast reduction, a revolutionary procedure that eliminates scars associated with the older, traditional method of breast reduction. He has a large following of satisfied patients from across New Hampshire, the United States and a number of foreign countries, who have sought him out for breast augmentation and scarless breast reduction. Dr. Gray has taught at educational conferences for the American Society for Aesthetic Plastic Surgeons and is the only member of the International Society of Plastic Surgeons from New Hampshire. Dr. Mark Ballentyne is a highly skilled physician who has been Director of Medical Aesthetics at the Skin Wellness Center since 2003. Dr. Ballentyne is board-certified by the American Academy of Family Practice Physicians, is licensed to practice in New Hampshire and will be fully certified by the Board of Aesthetic Medicine in September 2011. He has established a strong reputation for his talent in administering dermal fillers, BOTOX® Cosmetic and Dysport injections, and Fraxel laser treatments. He is a national trainer for Allergan™. Dr. Brannon Claytoris board certified in plastic and reconstructive surgery, as well as in hand surgery. Dr. Claytor is a fellow of the American College of Surgeons, offering patients a high level of skill, outstanding training and commitment to excellence in cosmetic, reconstructive and hand surgery. He completed an additional year of training in breast microsurgery, oncologic reconstruction and hand microsurgery at Washington University in St. Louis, Missouri and was on the teaching faculty of the Lahey Clinic Medical Center.

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