Hugh Hefner’s Wife Was Not Poisoned By Her Breast Implants

ASPS surgeon takes aim at claim by wife of Playboy magazine founder that her breast implants caused her to be ‘poisoned’. Jack Fisher, MD, a key figure in debunking erroneous claims that breast implants cause systemic disease, uses science to refute Crystal Hefner’s declaration that her silicone implants directly led to symptoms of disease and other complications.

Crystal Hefner, wife of Playboy entrepreneur Hugh Hefner, recently elected to have her breast implants removed because she believed that they “were slowly poisoning her.” This was after she read Internet comments from people who shared similar symptoms and said implants were the problem, and after she believed she had chronic Lyme disease.

Science is not on her side. Not even close.

It’s okay that she did it. Breast implantation is a reversible process. If the devices are no longer providing benefit, if they become a source of worry or fear, or for any reason, they can be removed, ideally by an experienced surgeon working in an approved facility. An image of Ms. Heffner recovering suggests that she did just that.

But the important question for other women who may now be concerned is this: What is the source of information that drove her to this level of concern? If she has based her decision on the unsubstantiated belief that silicone polymers are toxic to humans, then her worry and fear is unwarranted.

False assumptions about silicone in medical devices, especially breast implants causing myriad diseases (more than 200 attributed) were commonplace in the early 1990s. Fortunately, we now have the results of dozens of well-run studies, which show no causal link between silicone exposure and any of the problems that Mrs. Hefner lists: aches and pain, fatigue, allergies, thyroid dysfunction.

We are told that Mrs. Hefner sought medical advisory, and was diagnosed with Lyme Disease. Apparently this was insufficient for her or her husband, who is on board with the decision based the shabbiest of evidence— 3000 listings on Facebook by people with similar problems. This sounds ridiculous enough, but it does not mean that other women won’t follow suit.

A bigger question is: What should several million women, who have breast implants, but no problems do? And, what about hundreds of thousands who have symptoms similar to Ms. Heffner, but do not have implants?

The breast implant issue was studied thoroughly by a panel of scientists selected by the Institute of Medicine of the National Academy of Sciences. Their report in 1999 was do not waffle. It declared that all claims about carcinogenic, mutagenic, teratogenic, or immunologic effects of breast implants were invalid.

No- breast implants do not cause cancer, genetic disorders, birth defects, or autoimmune and rheumatic diseases. The events leading up to the IOM report are documented in Silicone on Trial: Breast Implants, Regulation, and the Politics of Risk.

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Angelina Jolie’s Prophylactic Mastectomies

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

Jolie penned in New York Times about her prophylactic double mastectomy: “My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman,” she wrote. “Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much as I could. I made a decision to have a preventive double mastectomy.” Jolie has been praised in the media for having the courage to go through this procedure, and in addition being willing to share her story in order to encourage similar women with the BRCA gene to understand and manage their increased risk of developing breast and ovarian cancer.

Jolie understands cancer, her mother, actress Marcheline Bertrand, had breast cancer and died of ovarian cancer six years ago at the age of 56. Her grandmother died of ovarian cancer at age 45 and her Aunt just passed away from ovarian cancer at age 61.

Jolie reports that the procedure involved preservation of her nipples, removal of the breast gland and reconstruction of her breasts with implants. Like Jolie, everyday women who decide to undergo prophylactic mastectomies are likely to also be concerned about how they will look once the procedure is completed. A consultation with a plastic surgeon who specializes in breast reconstruction will provide information about options for reconstruction, whether the technique involves implants or the woman’s own tissue. Contemporary implants used in breast reconstruction are textured and anatomical (tear drop) shaped filled with cohesive silicone gel. By using this style of implant breast shape is optimised and longevity is maximized by the addition of Alloderm.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

Breast Reconstruction Surgery Planner Link

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

I came across this article written for the USA National Breast Reconstruction Awareness day two weeks ago, on behalf of the American Society of Plastic Surgeons, and wanted to share this with anyone facing mastectomy and breast reconstruction surgery.

“The treatment of breast cancer is a team effort. On the medical side there are numerous physicians, nurses, and other health care providers who know how to work together to provide the best outcomes for women with breast cancer. But, that’s not the only team. What about the home team, those who live with and support women undergoing these treatments. And more importantly, who educates this team about what to do and how to work together? Where is their playbook?

The ASPS is proud to announce the availability of the Breast Reconstruction Planner: Tips to Manage a Speedy Recover. This is a guide for a patient and her family and caregivers to help plan for and manage the recovery following breast reconstruction surgeries. And, it’s free to any and all who want to download it, which can be done at: www.BRAdayUSA.org/Planner.

This eBook contains the answers to a lot of questions that will come up during recovery, along with tips on things that you can do to prepare, and things that will make the whole process easier. Let’s face it: no woman is an expert on how to recover from breast cancer surgery when she begins the process of breast cancer treatment. It is the hope of ASPS that this guide will make the process of dealing with breast cancer less daunting, and lead to a better outcome.

If you or someone you know is dealing with breast cancer, share this link with them. It’s another way you can be on their team!”

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

Natural Versus Implant Breast Augmentation

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

“Natural” breast augmentation is performed by transferring fat to breasts from another part or the patient’s body. Fat transfer has been used in cosmetic and reconstructive surgery for a number of years. Initially used in facial cosmetic procedures it is being used more in cosmetic breast surgery to provide enlargement and avoiding the need for implants. It seems like a great idea but there are limitations to the technique and not every patient is a suitable candidate. Extra desire is created as the fat is harvested by liposuction from a prominent fat deposit, for example from the tummy or hips, so effectively the patient gets two cosmetic improvements at the same time.

In 2009, the American Society of Plastic Surgeons released a report detailing the use of fat transfer and injection for reconstructive and cosmetic purposes, offering guiding principles to surgeons and patients about the use of fat transfer for natural breast augmentation. The report noted that physicians and surgeons have been using fat transfer successfully for more than one hundred years to treat cosmetic defects, and that natural breast augmentation is just one way of applying these successful techniques. Lipoaugmentation of the breast is an appealing concept for patient and surgeon – soft, supple and natural and presumably safe, but is it?

Fat augmentation for breast enlargement remains highly controversial for a number of reasons:

– fat injected into the breast may calcify and interfere with future cancer surveillance through mammograms

– grafted fat contains stem cells and stimulatory substances that potentially can cause breast cancer to develop

– injection of fat into breast tissue can cause cyst formation and infection

– consideration needs to be given to the results and size of enlargement as the procedure is labour intensive, may require two or three sessions of surgery and anesthesia, plus the resulting expense is more than for an implant based breast enlargement

– cosmetic surgery journals suggest this procedure carries liability for the surgeon decades after the procedure due to the unknown factors listed above

Despite all of these concerns, fat transfer to cosmetically enlarge breasts is an appealing procedure. There needs to be more research showing success and safety before “natural” breast enlargement is accepted as a routine cosmetic surgery procedure. Until then, implant based breast augmentation remains the surgery of choice for cosmetic breast enlargement.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

Breast Lifting – Droopy versus Perky

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

Following my blog last week on breast reduction surgery I have had some comments asking about breast lifting. Breast lifting (also known as mastopexy) is a procedure to correct the changes of nipple position and breast shape that occur with time and recreate a youthful appearing breast. Theses changes can occur with aging, weight loss, pregnancy and following breast feeding. Generally the nipple descends and the breast mound droops (breast ptosis) as the breast skin loses elasticity. A good way to think of this is the breast skin acting like a bra supporting the breast gland. Just like an old bra that has lost its elastic nature the breast skin also fails allowing the gland and nipple to head south.

There are two main options to correct breast droop, either tighten the skin or expand the breast gland volume using an implant. This second option known is as augmentation-mastopexy and I will discuss in a separate blog as it is worthy of discussion alone. Mastopexy is a term that describes the goal of breast and nipple lifting which improves the breast shape but maintains the current breast size. There are however a number of surgical procedures to attain this goal, the choice of surgical procedure should be individually tailored to the patient’s breast shape, skin characteristics and desires. The most important issue is how drooped the breasts are, generally the more droopy the breast the more surgery is required and results in more scarring. Scarring can be limited from around the nipple alone, to around the nipple and a short scar on the lower portion of the breast, to a scar that includes the nipple, lower breast and in the fold itself. Only after consultation with a Plastic Surgeon will you know what the best option is for you. Minimal scarring is desirable but the overall goal of a youthful breast should not be compromised to keep the scar short. A longer scar on a youthful breast is better aesthetically than a shorter scar on a droopy breast.

It is worth remembering that once the breast has been lifted and returned to its youthful appearance then the changes can again occur slowly with time. Plastic surgery can turn the clock back but once the procedure is performed the clock will start ticking again. Having said this, a good quality and well chosen mastopexy should gain many years of satisfaction for the patient.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

Breast Reduction – Do Not Wait to Improve Your Quality of Life

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

Breast reduction surgery is one of the most common procedures I perform and becoming more popular over a wide range of patient ages. Historically referrals from family doctors was poor as the potential surgical gains from the symptoms of large breasts were poorly understood. Patients with large breasts (also known as mammary hypertrophy or mammary hyperplasia) suffer from a constellation of symptoms and concerns. Physically patients can experience neck and/or back pain, breast pain, rashes under the breasts, bra shoulder strap grooves, and may need to wear their bra to bed for support. Exercise is often difficult or impossible due to the breast mass being poorly supported or due to tight fitting swimming or gym gear. Patients also suffer socially due to the attention their chest gets when wearing fitted clothing, consequently they tend to wear loose clothing several sizes larger than their lower body and slump their shoulders forward to hide their breast size. Emotionally the prolonged psychological weight of having large breasts can be as bad as the physical symptoms. The key things are knowing that if you have large breasts your symptoms are typical, you are not alone and surgery is a very good option to consider. What you should expect to gain from breast reduction surgery are breasts that are smaller (shorter, narrower and less full), lighter, perkier and generally more youthful. You will also gain a new self-confidence and be able to wear normal bras, shirts, dresses, swimming and gym gear. Exercise will be achievable and your neck, back and breast pain should improve as will your posture. You will appear proportionate to your friends and family as well as appearing slighter in frame as your heavy upper body has been treated.

Patients who present for breast reduction surgery generally come in two age brackets, those that are 18-30 years before having a family and those 35+ years following a family. A small age difference I know but there are a couple of issues that patients need to be aware of. Like all plastic surgery procedures the post-operative result of breast reduction can be affected by a number of life factors from the day of surgery onwards. Pregnancy and breast feeding can affect the breast size, shape and gland density. So, in theory the result of breast reduction can be affected by pregnancy and breast feeding. However, I believe the overall the gains of having a breast reduction before having a family are immense and exceed any potential pregnancy changes. The second group of patients are post family and typically have been thinking about having a breast reduction for many years, almost universally my patients in this group comment following surgery that they wish they gone and had their breasts reduced years ago.

Surgery can be performed as a day procedure, or with a single night in hospital, as the post operative pain is usually quite mild. Recovery is faster than most patients expect and a commonly I need to tell patients to slow down their activities in the early days after surgery. I would expect that most patients are back to work or study and driving by 1 week after surgery.  The sense of physical and emotional improvement is immense making breast reduction one of the most satisfying plastic surgery procedures for patients and plastic surgeons alike.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

ALCL – Facts that Breast Augmentation Patients Need to Know

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

Anaplastic large cell lymphoma (ALCL) has been identified as occurring in a small number of patients with breast implants. ALCL is a rare type of non-Hodgkin’s lymphoma and is not a cancer of breast tissue. The US FDA is investigating this possible association and “believes that there is a low but increased risk of developing ALCL adjacent to the breast implant”. Approximately 60 cases have been identified throughout the world, which represents a fraction of the 5-10 million women who have received breast implants. It is estimated that the risk of ALCL for breast augmentation patients is between 1 in 250,000 and 1 in 1 million. Breast implants have been proven not to increase the risk of breast cancer; breast cancer can affect up to 1 in 7 women in developed countries. There is no association between ALCL and any particular breast implant brand, shell or whether the implant has saline or silicone fill.

Of the known cases of ALCL in patients with breast implants there are some warning signs that patients should be aware of. If a breast lump is detected or if one of the breasts becomes larger or tighter than the other then it is recommended that breast augmentation patients are reviewed by a Plastic Surgeon. An MRI scan may be ordered to assess the implant integrity and adjacent breast tissue for any abnormal lumps. If a seroma (a fluid collection around the implant) is suspected then an ultrasound scan can be used for documentation or used to aspirate any seroma fluid which can then be sent to the laboratory to test for the presence of ALCL cells. If  ALCL is suspected or confirmed with these investigations then implant removal with capsulectomy is recommended. The breast capsule is then sent to the laboratory for further testing.

There is, however, a slightly silver lining to this warning – ALCL developing around breast implants is a clinically indolent disease with a favorable prognosis that is quite distinct and different from systemic anaplastic lymphoma kinase–negative ALCL. Although some women underwent irradiation and/or chemotherapy after breast implant removal and capsulectomy for ALCL, more recent reports suggest that outcome and survival may be equivalent with only implant and implant capsule removal.

Prospective breast augmentation patients need to be aware of ALCL and discuss this with their Plastic Surgeon, patients need to be reassured that the risk is of developing ALCL is extremely low and that ALCL behaves in an indolent manner.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz