My name is Thomas P. Trevisani, Sr. I’m a board-certified plastic surgeon, been board-certified since 1983. I’ve been practicing in Winter Park Florida since 1981, and have had the pleasure and honor of treating over 10,000 patients. Over the years at Celebrities Choice an additional category of breast surgery has developed: Correction of previously unsatisfactory results, breast augmentation, breast lift, breast reduction all have inherent complications. A variety of problems can occur even in the best of hands, with the best intention surgeon in patient. It takes a plastic surgeon who has seen many types of outcomes, feels confident in his skills to address the evaluation of those less than optimal outcomes, and also has acquired over the years the confidence to correct them as best possible. This patient had had a breast augmentation many years ago. She then subsequently made a less than optimal decision to go larger, and in this case, in someone else’s hands, she was over augmented, so her breast implants were above 600cc, which for her height and weight was excessive. What that does, is sets the patient up for breast tissue loss, because these large implants apply an internal pressure to the surrounding tissue, and she developed a very severe capsular contracture, which deterred her from feeling good about herself. So first of all I urged her to give her my opinion as to what needed to be done, urged her to return to her original surgeon, she felt that was completely impossible to do, then outlined a plan of action to restore her to her optimal anatomy and her best looking breasts, which included: Step one, remove these implants, get them out and leave it there for two, three, four months, whatever it took for her tissue to regain as much of a normalcy as was available under the present circumstances. Now that’s a very traumatic decision for a women to make; to have implants for quite some time, and then to be told they’ll have to come out. The feelings of loss that are associated with that are very profound, so it’s not taken lightly.
“Feet together, shoulder’s back. Perfect, just relax…”
On the day of surgery we see her in the pre-operative holding area where any last minute questions are addressed, and I usually have the patient standup with the nurse in attendance, and I go through the markings and the exact measurements and drawings that need to be done in order to guide us during the operative procedure. Whenever a patient presents with this type of situation, they may likely have had a parietal areola, or an incision around the areola, which is a member – the dark tissue around the nipple, or they may have had an inframammary incision from a previous procedure, so with this lift and reinsertion of implants, we can remove all those other scars, get rid of all the existing scars, provided they fall within the new operative site. Then what I do is inject the area with local anesthesia that’s long lasting, in conjunction with a vasoconstricting agent, this gives us an opportunity to then have a patient free of pain upon awakening, and also give us a minimal bleeding during surgery. So the next stage was then to remove the excess skin, so mastopexy after removal then gets us the opportunity to assess what volume is there, in her case the volume was inadequate, which is often the case with women with lifts who may want to be larger, and to exceed the volume they have intrinsically. And now we insert the optimally determined, pre-operatively determined silicone gel implant under the muscle, close the wound, and give her the best size, the best shape that she could possibly achieve under these circumstances. I use exclusively Allergan implants, the natural line of breast products by Allergan is the best, and that’s what I recommend exclusively for my patients. I think everyone felt very fulfilled that we’ve been able to take this women through a very difficult phase in her life, very emotional, I mean there were a lot of tears along the way with this particular patient, to get her to place where she’s now comfortable, and happy, and fulfilled with her plastic surgery procedure.