Ear Lobe Repair
July 7th, 2009
Ear lobe stretching is really nothing new, although it seems to be quite fashionable now. The tribes near the Ubangi River like the Suyas have been practicing lip stretching for centuries. They find the changes in anatomy to be physically attractive, while culturally consistent. The ability to stretch the skin is one of the remarkable aspects of the human body. The skin not only stretches, but also grows to accommodate stretching force. Similarly results of pregnancy, as it stretches a woman’s abdominal skin is the most familiar. Obesity essentially does the same thing, by gradually stretching skin due to significant weight gain. In many cases, when weight is then lost, stretched skin fails to regain its elasticity and often sags. These permanent changes in anatomy are the reasons why tummy tucks, thigh lifts and arm lifts are done.
Tissue expansion is the purposeful stretching of skin using a “medical saline filled balloon.” When extra skin is needed, plastic surgeons use this device to “grow” extra skin. Breast reconstruction done following cancer surgery is the most common use of this particular technique.
Earlobe stretching, like facial tattoos can become unwanted in western culture due to its cultural inconsistency or changes in current fashion fads. Notions of what is beautiful or desirable are constantly changing perceptions. As a person’s life and life situations change, requests to repair the purposeful ear stretching or remove the tattoo often arrive on my doorstep. Recently a patient with stretched earlobes requested a repair. They were to become employed in a rather conservative company. The stretched earlobe appearance made them feel uncomfortable in their new cultural setting. Repair was simple and easily accomplished, since the largest diameter inserted was no greater than an inch. Unfortunately, stretched areas larger than one inch can pose real reconstruction issues and more complicated surgery is needed to correct large holes made by stretching the skin.
Breast Implant Rippling
July 1st, 2009
A patient emailed me today about “rippling” of her breast implants. Her surgery was done in another office some 10 years ago. This has bothered her ever since, despite a revision surgery to correct the problem. She wants to have something done to reduce the rippling. There are several factors to consider.
Women frequently notice rippling of their breast implants. This refers to the undulation of the breast surface or breast skin above the breast implant. This is a result of fluid movement within the silicone shell. Erect posture and leaning forward seems to accentuate the condition. As the fluid shifts, it changes the shape of the implant from discoid to pear shape. The change in shape results in surface distortion of the implant which show up as rippling.
Women who have minimal breast tissue of their own, may notice this rippling more. Since they have only a thin layer of breast tissue and fat between the implant and the skin, the changes in implant surface are more noticeable. Weight loss may often include reduction in breast substance to reveal rippling or make it worse.
It seems the outer surface of the breast is affected by rippling the most. This is the area where the arm and elbow touch the chest and side of the breast. This location of the implant may only be covered by a thin layer of fat and skin. Larger diameter implants and lateral positioning of the implants toward the armpit, reveal larger portions of the implant into chest areas with less or thinner coverage. Rippling can be seen in the upper inner aspect of the breast. This is the decollete area. Placement of implants beneath the Pectoralis muscle has virtually eliminated this rippling.
Both saline (salt water) and silicone gel implants available in America can show some visible rippling. It is felt less when silicone gel implants are used. However, the most coherent silicone gel products, only available outside the US, may reduce or eliminate rippling of breast implants. Unfortunately, the coherent gel implants currently available in the US do not eliminate this rippling.
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