Breast Augmentation | Dr. Forley
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Archive for the ‘Breast Augmentation’ Category


Sunday, October 22nd, 2017

The nipple can become enlarged and droopy following pregnancy and breast feeding. It may remain in that condition despite a gradual decrease in the size of the breast after nursing is completed.  A nipple reduction can both reduce the size of the nipple and make it appear more uplifted. This is especially important to consider when deciding on breast augmentation so that the appearance of the breast will be enhanced by a more proportionate nipple dimension.

Breast Augmentation and Nipple Reduction

Breast Augmentation and Nipple Reduction

Breast 2

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Saturday, December 3rd, 2016

Source: Crisalix

Dr. Forley is pleased to introduce the Crisalix 3D imaging simulator tool to assist you in visualizing the potential outcome of a variety of procedures including breast augmentation, facelift, nose surgery, body contouring, and injectable fillers. The simulation can be done remotely or as part of your in-office consultation with Dr. Forley. This imaging tool is also an excellent way of communicating your desires visually to Dr. Forley.

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Monday, June 29th, 2015

Natrelle INSPIRA™ breast implants were recently FDA approved for enhancing the size of the breasts and are now available as an added choice in breast augmentation surgery. They have a higher fill ratio of silicone gel for a given implant dimension and thereby provide added fullness to the volume deficient breast. During the consultation, Dr. Forley will listen to your desires when discussing size preferences for your breasts. He will carefully measure the dimensions of both breasts to assist in determining which style and size implant will provide the desired outcome. Crisalix, a 3 dimensional simulator tool, will be used to enable you to visualize the possible outcome that can be achieved with each potential implant option to help you in finalizing your selection.



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embrace® Advanced Scar Therapy

Saturday, October 19th, 2013

Achieving the most favorable scar appearance after surgery is dependent not only on the quality of the repair performed at the time of surgery but also on the mechanical forces that affect healing during the post-operative period. Control of the natural tension of skin during wound healing has been shown to minimize hypertrophic or thickened scars after procedures such as tummy tucks or breast surgery. Until now, none of the scar treatment modalities commonly used have been able to regulate wound tension in a manner that will impact on the final appearance of the scar.


embrace® Advanced Scar Therapy, a new FDA-cleared technology that helps reduce tension on the healing scar, enables us to enhance the results of surgery for our patients. The treatment involves the application of an adherent, water resistant elastic sheet that is stretched and applied to either side of the scar. Skin tension is actively reduced during the healing process due to the contraction of the device following its application. It is comfortable to use and normal activities, including showering and exercise, can be performed during the 8 week treatment course. Clinical studies have consistently demonstrated the efficacy of this device when compared to untreated scars.

embrace effect

Dr. Forley is now offering embrace® Advanced Scar Therapy to his surgical patients and will discuss its use with you during your consultation.

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Monday, November 26th, 2012

The Keller Funnel™ is a soft, sterile device made of nylon that plastic surgeons use to deliver silicone gel breast implants into the pocket created for an augmentation or reconstruction procedure. It was launched in 2009 and its addition to breast surgery has enabled the use of a shorter incision due to the ease with which the silicone gel implant can be introduced into the pocket.


The Keller Funnel™

Shorter incisions are possible because of the mechanical advantage provided by the lubricated funnel during implant insertion. The Keller Funnel™ gives surgeons the ability to place the incision in a variety of locations including: periareolar (around the nipple), inframammary (under the breast fold), and axillary(under the arm) with less visibility. Longer incisions that might be required for larger size implants can be shortened when the Keller Funnel™ is used.

During your consultation, Dr. Forley will discuss the advantages of using the Keller Funnel™ and how it provides the following benefits:

  • Shorter incision lengths
  • No touch technique in which the implant does not come in contact with the skin
  • More choices for incision placement
  • Reduced force on the implant and incision


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Monday, June 25th, 2012

The purpose of a mammogram is to identify abnormalities or changes in breast tissue. Screening mammograms can detect these abnormalities at an early stage resulting in potentially better therapeutic options and possibly less aggressive treatments.

The Mayo Clinic recommends a three-tiered screening mammogram approach:

  • Breast health awareness, which includes a woman becoming familiar with her breasts in order to identify breast abnormalities or changes, and to inform her doctor of any changes that may need further evaluation
  • Clinical breast exam performed by a health care provider and recommended annually
  • Screening mammography beginning at age 40

This approach is consistent with the recommendations of the American Cancer Society. A 2009 study, by the U.S. Prevention Services Task Force that recommended waiting until age 50 to begin screening mammography remains controversial.

MAMMOGRAPHY & BREAST IMPLANTSWomen with breast implants should continue to have mammograms. It is important to let the mammography facility know about breast implants when scheduling a mammogram. The technician and radiologist must be experienced in performing mammography on women who have breast implants. Implants can hide some breast tissue, making it more difficult for the radiologist to detect an abnormality on the mammogram. If the technician performing the procedure is aware that a woman has breast implants, steps can be taken to make sure that as much breast tissue as possible can be seen on the mammogram. Implant displacement views are used and involve positioning the breast tissue in front of the implant as it is pushed back against the chest wall.

X-ray vs. Digital Mammogram Techniques

All mammogram images are captured using X-ray technology. During a traditional mammogram, the results are then viewed on X-ray film. Digital mammograms rely on those same X-ray images, but they are stored on a computer and are analyzed using specialized programs.

Digital mammograms are said to offer better results for:

Women <50 years of age

Women with dense breasts (more tissue, less fat)

Women before or <1 year into the menopause cycle

With either method, you’ll be put through the same steps. Your breasts will be flattened or compressed. While you stand still holding your breath, a technician will take X-ray images. The entire process should last about 15 to 20 minutes.

A woman’s risk of developing breast cancer increases, as she gets older. The risk of breast cancer, however, is not the same for all women in a given age group. Research has shown that women with the following risk factors have an increased chance of developing breast cancer:

  • Advancing age – most important risk factor
  • Personal history of breast cancer
  • Family history of breast cancer
  • Radiation exposure to the chest
  • Obesity
  • Starting menstruation before age 12
  • Beginning menopause after age 55
  • Having your first child after age 35

However, a majority of women who develop breast cancer have no family history or risk factors.

If you’re concerned about screening mammograms, talk to Dr. Forley or your primary care doctor and learn what’s right for you based on your individual risks. It’s important that the two of you work together to develop a screening plan.

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Thursday, March 29th, 2012

Many difficult problems that can occur with breast surgery have been helped with the introduction of Strattice™, a biologic tissue support layer or matrix used to reinforce weakened tissues and enhance natural tissue regeneration.

Bottoming Out

Bottoming Out

Copyright © 2009 – 2012 LifeCell Corporation.

A lengthened nipple-to-inframammary fold distance due to skin stretching after surgery, and the breast pocket dropping lower than desired, can result in the nipple appearing to sit too high on the breast. A droopy or sagging appearance is produced when the skin below the nipple looks stretched and disproportionate in relationship to the overall size of the breast size. By attaching the Strattice™ internally to the fold, and chest muscle, the breast can be positioned in the desired location to correct this problem.

Fold Malposition

Fold malposition is a condition in which the fold under or lateral to the breast fold has become displaced. These folds give the breasts definition and help maintain the shape and position of the breasts. During breast augmentation surgery, a pocket is carefully created under the breast tissue. Breast folds act as important markers for the surgeon when creating the pocket and help to determine the surgical outcome. Loss of skin

Fold Malposition

Copyright © 2009 – 2012 LifeCell Corporation.

elasticity or a breakdown of pocket boundaries can occur over time due to the aging process and gravity. The inframammary fold, lateral fold, or both may be affected. The breast pocket may drift to the outside of the chest or appear to have dropped and will no longer be in the original desired position. Dr. Forley may recommend the use of Strattice™ to redefine the fold location inferiorly or laterally. This will support and hold the breasts in the desired location and achieve breast symmetry.


The normal appearance of breasts features a natural space between the breasts, which is defined by a gentle fold, referred to as the medial fold. The medial fold separates the breasts, giving them shape, form, and what is often referred to as cleavage. Even if the breasts are naturally large in size or have been enhanced, a degree of separation helps to give each breast definition. Symmastia is a condition in which the breasts sit too close


Copyright © 2009 – 2012 LifeCell Corporation.

together or possibly even touch one another. It can occur following breast augmentation surgery if the breast pocket created was made slightly too large, the breasts have migrated out of their original position, or the fibrous tissue which creates the medial fold becomes weak or stretched. Strattice™ may be used to reinforce and support existing weak or inadequate tissue to restore the natural separation between the breasts.

Wrinkling and Rippling

Wrinkling and Rippling

Copyright © 2009 – 2012 LifeCell Corporation.

The quality of the skin that envelops the breast tissue significantly influences the shape and appearance of the breasts. There is natural and hereditary variation in the amount of elasticity and thickness of each person’s breast skin, which affects the overall appearance of the breasts. A rippled appearance may also occur if the breast augmentation pocket exceeds the optimum size needed to maintain the position of the breast implants. If the breasts migrate out of their original position because the breast pocket is too large, the appearance of rippling may occur on the breast skin where volume is deficient. Many women who have either minimal body fat or thin skin may experience this less than desirable condition, simply known as breast rippling and wrinkling, following breast augmentation surgery. Dr. Forley may consider reducing the size of the breast pocket and using Strattice™ to help provide additional support. Strattice™ is placed at the bottom of the breast to reinforce weak or inadequate tissue, which can help reduce the presence of wrinkles and ripples on the skin surface.

Capsular Contracture

Capsular Contracture

Capsular Contracture is an unpredictable condition that may occur when naturally forming scar tissue surrounding the breast implant continues to increase in thickness. As thickness increases, it squeezes the implant causing tightness, firmness, and changes in breast appearance. Capsular contracture may occur in one or both breasts and may vary in degree and severity. Discomfort and changes in breast appearance may require additional surgery. Some corrective surgical outcomes may include partial or complete removal of the capsular scar tissue. Strattice™ reinforces weakened and inadequate tissue, which can help Dr. Forley to support and position the breasts in the desired location while allowing re-establishment of natural boundaries.

Augmentation Mastopexy

Augmentation Mastopexy

Copyright © 2009 – 2012 LifeCell Corporation.

Augmentation mastopexy is a breast surgery procedure that enhances both the position and size of the breasts by adding volume with an implant and lifting the breast tissue that has sagged. Women who have lost a significant amount of weight, including those whose breast tissue has changed following childbirth and breastfeeding, are candidates for augmentation mastopexy.Thin, weakened  tissues that may be insufficient to support the bottom part of the breasts can be reinforced with the use of Strattice™. During augmentation mastopexy surgery, Dr. Forley creates incisions using standard surgical techniques and then sutures Strattice™ to the chest wall and pectoralis major muscle to reinforce the breast pocket and help to keep the chosen implant in position. Removal of excess tissue and lifting of the breast is performed after this initial procedure has been completed.

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Wednesday, March 21st, 2012

Revision procedures are sometimes required to improve the results of breast surgery or handle problems that might develop following surgery. Recent clinical evidence has demonstrated the value of using a biologic tissue support layer or matrix to reinforce weakened tissues and enhance natural tissue regeneration. Strattice™, a sterile sheet of porcine dermis from which the cells have been removed, is now being used by Dr. Forley to provide not only the reinforcement of thin, sagging tissues, but a scaffold-effect to support new cell growth. The long-term success of revision procedures of the breast has been enhanced with use of this technique.


Copyright © 2009 – 2012 LifeCell Corporation

Clinical Uses for Strattice™

  • Reinforce the desired position of the breast
  • Redefine the location of the fold under the breast by providing support inferiorly or laterally
  • Correct complications that may occur after breast implant surgery, such as bottoming out, fold malposition, and symmastia
  • Minimize the need for the use of additional muscles to provide a supportive covering layer in the breast
  • Reinforce thin breast tissue when implant ripples and wrinkles are present
  • Correct capsular contracture or hardening of the breast after implant surgery
  • Aid in augmentation mastopexy to enable a stable, long term breast lift

Copyright © 2009 – 2012 LifeCell Corporation

In Part 2, we discuss in more detail how Strattice™ has provided a way to handle each of these clinical situations.

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Saturday, October 1st, 2011

The General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee to the Food and Drug Administration (FDA) met in August 2011 to discuss and make recommendations on issues related to silicone-gel filled breast implants. Dr. William Maisel, chief scientist for the Food and Drug Administration’s Center for Devices, re-confirmed the FDA judgment that silicone-gel implants are safe and effective for their intended use in breast augmentation.


The FDA placed restrictions on the use of silicone-gel implants in 1992 due to concerns about a possible link to autoimmune disease such as rheumatoid arthritis and lupus. Clinical trials conducted over the next decade failed to show any evidence of an increased incidence of these conditions in women with breast implants. In November 2006, supported by scientific evidence, the FDA removed the 1992 restrictions on the use of silicone-gel implants made by Mentor and Allergan. As an additional safety measure, the FDA required companies to conduct decade-long studies of their implants’ performance. The FDA has also looked at the studies conducted to gain approval, which have longer and better follow-up than those launched after the 2006 decision. Other studies published in the scientific literature and reports of adverse events helped complete the picture, Maisel said.

When considering both current and future post approval study designs for silicone-gel implants, the panel discussed methodologies and strategies that could increase compliance with follow-up. As discussed in a number of questions about methods and data collection, the panel felt that a breast implant registry of all women who receive the device may provide a means to answering many of the longer term and real world questions, in particular the questions associated with rare adverse events.

The FDA and the Devices Panel consider MRI as the gold standard for evaluating breast implants for evaluation of rupture. However, a 2006 requirement for regular MRI follow up studies following breast augmentation was deemed by the panel to be expensive and unnecessary. Dr. Forley advises his patients to return for annual follow up exams. They are also encouraged to see Dr. Forley in the interim if there is any change in the appearance or feel of the breasts after surgery.

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