A brief transcript excerpt from a YouTube interview (Aug 2, 2018) where Dr. Anderson discusses breast implant practice: challenges placing implants in very thin patients, the trend toward above-the-muscle placement, differences between round and anatomical (teardrop, textured) implants and when each is used, risks of smoking on wound healing due to vasoconstriction, and capsular contracture (hardening of the scar capsule) as an implant complication.
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A lot of women that are getting breast implants are really, really thin, so that's why they're getting them. So if they're really thin, there's just no way to put them above the muscle. But it's definitely moving in the trend of going above the muscle.
So what's the difference? I saw you said something about like, smooth, rough, and then how you can like, shape them.
Shaped implants. I can't shape them, but they come out of the box shaped as opposed to a round implant there. It's a teardrop shape, so it has a more natural silhouette. It looks like what a breast should look like. So those are textured and they're anatomical shaped. And those are primarily what I use for reconstruction. And if I look at a patient and they are. If I'm relying on the implant for volume, just volume, I can go with a round implant. If I'm relying on it for volume and shape, then I go with an anatomical shaped implant.
Okay. And something. Okay. So it said you can't smoke before. What's the medical reason?
So we think that smoking interferes with wound healing. Right? Doctors, like, we're bad people. I tell my dad to stop smoking. Every day smoking pipe. I tell him every day to stop smoking. He's like, show me the data that says a pipe's gonna make me have health problems. But nicotine and the. It's probably the tar and the other stuff that are in cigarettes affects your ability to heal a wound. Right. And like in a. Something that I rely on. Vascularity, breast reductions or tummy tucks. If you insult the body, like surgery is an insult, right. And you are relying on a blood supply. And then you introduce nicotine or what's in a cigarette. The vasoconstriction that happens can cause wound healing. Like, basically not enough blood flow will get to whether it's the nipple for breast reconduction or. Or whether it's the central area for a tummy tuck. And tissue will die because of. No, no. So like noses and facelifts. I mean, my God, Kulak would literally die if she thought you were smoking before her facelift. Because if there's any vasoconstriction, you can lose like all of the skin. Like all of this where your incision is along. A facelift can die. It's devastating. And it happens. Yeah.
Okay.
Vascularity, vascularity, wound healing.
Also. What's this? Is that on your website?
That's that hardening of the implants. So that's that. We didn't know why it was. It happened a lot early on. A lot of women just accepted it. They'd come into the office with capsular contracture 20 years ago, and the surgeon would be like, all right, I'll just pop it. And they would press on them so. So soft, hard, that it would break up that scar tissue. Probably like puncture, you know, break the implant, too. Knuckleheads. I don't know what they were thinking, but now we just know it's capsular contracture. The scar tissue around an implant's getting hard from.
