After several years of controversy regarding silicone breast implants, current scientific evidence has not been able to determine any correlation between implants and systemic disease in humans. Because of this, silicone gel implants are back on the market in the United States (and they have been in constant use in other countries). Women now have a clear choice between silicone and saline implants when choosing implant surgery.

Advantages of silicone implants

Gel implants offer the advantage of a much softer, more natural feel and oftentimes, appear much more similar to a natural breast. A key benefit is that only a very slim chance exists for rippling of the skin with silicone implants, making them a great answer for thin patients with less of a subcutaneous layer. Also, silicone implants typically last longer without needing to be replaced.

Disadvantages of silicone implants

One of the silicone gel implant’s small disadvantages is that it requires a bit of a larger incision (5 cm versus 4 cm); this generally makes the inframammary approach the necessary surgical technique. A ruptured gel implant is also harder to detect, which is why women are encouraged to undergo regular MRIs to check for a ruptured implant. Finally, gel implants are somewhat more expensive.

If you live in the Philadelphia, Pennsylvania area, Dr. David Bottger can help you explore which implant type would best meet your needs. Please contact the office of Dr. Bottger at 610.520.1929 today to schedule an appointment.

The appearance of a woman's nipples is key to the overall look of her breasts, and many women undergo nipple restructuring procedures either as a part of or related to breast augmentation surgery, a breast reduction or a breast lift.

Some women are dissatisfied with the size of their nipples in relation to their breasts. A variety of studies have set out to determine the ideal size of the areola and nipple in relation to the rest of the breast, but in actuality, the correctness of nipple size is determined by what a woman feels comfortable with. Dr. Bottger offers women the option of having large nipples reduced in size through nipple reduction surgery.

The surgical techniques used to reduce nipple size include removal of only the top portion of the nipple, which is then sutured with small incisions. Another nipple reduction technique removes a cylinder of skin from around the nipple, then inserts the nipple into the breast tissue and closes the skin with sutures.

Nipple sensation generally remains normal following a nipple reduction, and breast feeding capability is not impacted.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about nipple reduction techniques, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Women’s right and left breasts are often different in size and shape. Usually, a woman can notice these differences herself, but they are not very apparent to others. If the size difference becomes apparent suddenly, women must first explore whether or not a growth of some kind in one breast may be causing it to appear larger than the other. A visit to the doctor is essential to rule out any breast masses that might be causing the size differential.

If a breast mass or cyst is ruled out, the rule-of thumb to determine the severity of the differential is that most breast size differences are under a bra cup size and as such are not in need of surgical correction. However, if you believe your breasts vary more than one cup size in volume, you may wish to have a consultation with experienced cosmetic surgeon Dr. David Bottger. He can help you evaluate the need for corrective surgery.

The factors that influence breast appearance are size, breast shape and breast and nipple position when a women is in an upright position. Surgery to correct breast asymmetry may mean that one or both breasts are surgically treated; correction could involve breast reduction of one or both breasts, or augmentation of one breast in deficient areas and reduction in size of the other. Sometimes breast sagging can be treated while Dr. Bottger corrects the size difference.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about surgery to correct breast asymmetry, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Procedures to augment the breast are designed to enhance the shape and size of the female breast. If breasts sag, a procedure called a breast lift can be utilized in concert with a breast augmentation to achieve optimal results.

Typically breast augmentation surgery is performed in one of two ways. When initiating breast augmentation surgery, Dr. Bottger makes a small incision in a concealed area and a saline or silicone gel implant is positioned behind the breast. Depending on the patient and Dr. Bottger’s decision after consultation, the implant may either be inserted above or below the muscle. The time it takes for a patient to resume normal activities after breast implant surgery is dependent upon the type of procedure utilized.

Dr. Bottger helps his patients make informed choices on the many factors to consider surrounding the breast enlargement procedure, including:

• Size
• Contour
• Type of placement
• Incision type
• Silicone or saline implants

A patient’s body type and personal goals influence these decisions—as can Dr. Bottger’s recommendations based on his years of professional experience. Dr. Bottger can also make you aware of what to expect from breast augmentation surgery, including recovery period, risks and more.

If you live in the Philadelphia, Pennsylvania area and would like to learn more about breast augmentation, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Women today can choose from different implant types when they elect to undergo breast augmentation surgery. Typically that choice involves silicone versus saline implants.

Advantages of Saline Implants
Saline implants have some advantages over silicone/gel implants. One advantage is that a smaller incision is required for saline implant placement; thus, more incision options present themselves. Since saline implants are filled when they are placed, any asymmetry of the breasts can be addressed at the time of placement by raising or lowering the amount of fluid in the implant.

Disadvantages of Saline Implants today
Some of saline implants’ disadvantages can involve a much more firm feel and an appearance that can sometimes seem less natural. Also, rippling that is apparent to the eye and by touch can sometimes occur with saline implants and be quite considerable. The problem is very unlikely to develop with silicone/gel implants. Thin patients are more likely to experience this effect.

If you live in the Philadelphia, Pennsylvania area and would like to explore which implant type would best meet your needs, please contact the office of Dr. David Bottger at 610.520.1929 today to schedule an appointment.

Non-invasive cosmetic surgery is popular both for its effectiveness and its short or non-existent downtime. Halloween is really the beginning of the holiday season and if you would like to quickly improve your appearance before Thanksgiving, you have many choices in how to do it.

Injectables are among the "lunchtime" treatments you may have heard about, which give immediate results. We offer several very effective injectable fillers. They each work differently, but in general they all create volume beneath the skin which smoothes the skin surface.

As we age the body produces less collagen - a fibrous protein which helps support the skin. Elastin is another natural protein and gives elasticity to the skin. The skin's middle layer, the dermis, has a matrix of collagen and elastin like scaffolding. Collagen and elastin are abundant in youthful skin but their reduced production is a contributing cause to wrinkle-formation as we age.

Injectable fillers provide increased volume which substitutes for the loss of collagen and elastin. The results last six months or perhaps longer. We offer Restylane(R) and Radiesse(R) which smooth out frown lines, nasolabial folds and other wrinkles around the mouth and cheeks. We also offer Juvederm(tm) which is effective in smoothing out the fine lines which form around the lips, as well as other fine lines on the face.

BOTOX(R)
BOTOX(R) is an injectable, but not an injectable filler. It does not work by providing volume beneath the skin. Instead, it temporarily paralyzes the muscle where it is injected. It blocks the nerve messages traveling from the brain which tell the muscle to contract, and this prevents the muscle from contracting for as long as the BOTOX(R) is in effect.

Most often it is used for frown lines and horizontal forehead lines, although it can also be used around the mouth. Repeat treatments can "retrain" the muscle to some extent. If you have a series of BOTOX(R) injections, not only does the skin remain smooth for lack of muscle contraction, but also the muscle remains relaxed for all that time. This may break an old habit of frowning or squinting which has caused the wrinkles.

You can see some Before and After photos in our BOTOX(R) Gallery.

Injectables, whether dermal fillers or BOTOX(R), can rejuvenate the face and give you a refreshed, more wide-awake look. Treatments last only about 15 minutes and are done with local anesthetics.

If you would like to know more about the injectable fillers we offer or about BOTOX(R), please call or email our cosmetic surgery office to schedule a personal consultation.

Breast augmentation can be a life-changing event giving you a tremendous boost in self-confidence, but it is not something to rush into. There are important choices to make in planning your surgery and they require some thought. Dr. Bottger will discuss all the options with you and make his recommendations. For best results it's important that you also understand these options and why one is better than another in your particular case.

Type of implant
You can choose saline or silicone gel implants and each has advantages and disadvantages. The choice will take into account your lifestyle, surgery goals, size of implant desired and other factors that need to be discussed with Dr. Bottger.

Location of the Incisions
There are four choices for where to make the incisions, all of which will hide the resulting scars well. Dr. Bottger offers three of these choices which you can read about on our Incision Options page.

Implant Size
Implants are not sized like bras, as 34B, 36C, and more. They are sized according to the number of cubic centimeters of fill they contain. Silicone gel implants come pre-filled. Saline implants are inserted empty and then filled; they can also be adjusted later. But they still have certain sizes according to the maximum volume of saline solution they can safely hold.

Implant Shape
Breast implants can be round or shaped like a pear. It depends on what sort of look you want, how much cleavage, how large your breasts are already, and other factors which you can discuss with Dr. Bottger.

Implant Placement
Your breast implants can be positioned either beneath the breast tissue but over the pectoral muscle, or beneath both. Again there are several aspects to this decision and it is an individual matter you can work out with Dr. Bottger.

For more information, please refer to the Before and After Photos of some of our patients and our Breast Augmentation Questions page.

If you would like a personal consultation about breast augmentation, please contact our cosmetic surgery office today.