Greer Plastic Surgery Wed, 09 Oct 2019 22:58:01 +0000 en-US hourly 1 Do Breast Implants Have to be Replaced? Thu, 26 Sep 2019 15:20:43 +0000 The post Do Breast Implants Have to be Replaced? appeared first on Greer Plastic Surgery.



The lifespan of a breast implant is a topic which should be on your mind if you are considering breast augmentation or breast reconstruction. You may be wondering: how long do breast implants last? How often do they need to be replaced? What happens to breast implants over time: do they sag or ripple?

Many women mistakenly believe that breast implants have to be replaced every 10 years. Although the average lifespan of a breast implant is 10-15 years, breast implants actually only need to be replaced if you have a problem such as implant rupture or capsular contracture. In the following blog post I’ll explain explain how to recognize an implant rupture or capsular contracture, and how often they occur. I’ll talk about treatment options, as well as how your breast implants may change over time.

Do you have to replace breast implants every 10 years?

When I see a patient for breast augmentation or reconstruction, one of the first things we talk about is the lifespan of a breast implant. Breast implants are not lifetime devices. Unless you have a fairly short life expectancy, you will need to have your breast implants removed or replaced at some point during your lifetime. 10 years is the magic number that often gets thrown around as the lifespan of a breast implant. But there’s nothing magic about the 10-year mark. Breast implants aren’t like an oil filter that needs to be changed every 15,000 miles. Unless you’re having a problem with your breast implants, there is no reason to change them out! I tell my patients their implants will last, on average, 10-15 years.

Why do breast implants need to be replaced?

There are two major reasons why breast implants would need to be replaced:

  1. Breast implant rupture
  2. Capsular contracture

Breast implant rupture

You may wonder what causes a breast implant to rupture. Although mammograms or trauma to the chest have been blamed, the most common cause of breast implant rupture is simply time. Breast implants wear out over time: eventually the shell cracks, causing a rupture.  The rupture rate does start going up after 10 years, which is where that number comes from. What happens when a breast implant ruptures depends on the type of implant it is.

Both silicone and saline breast implants have a tough, silicone outer shell. With saline implants that shell is filled with saltwater solution (saline). If the implant ruptures the saline is gradually absorbed by your body. With silicone implants the shell is filled with a thick silicone gel called cohesive gel. In the newer gummy bear implants the gel is so thick that it stays within the implant, even if the shell cracks. (Want to see an implant rupture in action? Head on over to my Youtube channel where I ruptured both a silicone and a saline breast implant to show you what happens.)  In the older generation silicone implants the silicone gel filling the implant was much thinner- about the consistency of honey. If you’ve ever heard about silicone traveling to the lymph nodes, it is usually with these older implants.

What percentage of breast implants rupture?

The rate of breast implant rupture varies by the brand of implant as well as whether the implant is above or below the muscle. The rate of rupture also increases over time. A rough estimate is that 1% of women will have a rupture per year the breast implant is in place. So after 10 years, 1 in 10 women will have a ruptured implant.

How do you know if a breast implant ruptures?

When a saline breast implant ruptures, you’ll know it’s happened because the breast will gradually get smaller as your body absorbs the saline. Silicone gel implants are a bit trickier. Because the silicone gel is so thick, it may stay contained within the breast capsule (called an intracapsular rupture). If this happens, you may have no idea that the implant has ruptured.

So-called “silent ruptures” are not dangerous. But because they do sometimes occur, the FDA recommends a screening MRI every two years beginning three years after the implant was placed. This test isn’t always covered by insurance, so many women opt to wait until they are concerned about a rupture to have the MRI done.

Implants may change in appearance or in the way they feel if they rupture. If this happens, your plastic surgeon will likely order an ultrasound or MRI to confirm the rupture. If you are no longer in contact with your original surgeon, don’t be afraid to follow up with someone new. Most plastic surgeons are happy to see you for breast implant concerns, even if we didn’t perform your original operation!

Capsular contracture

Capsular contracture is the other reason a breast implant might need to be replaced. Breast implants are a foreign body, and your body’s natural response is to form scar tissue around them. If the scar tissue becomes too thick, this makes the implant firm and possibly painful, a condition known as capsular contracture.

The actual incidence of capsular contracture is difficult to estimate, because it varies between implant types, whether the implant is above or below the muscle, and whether the implant was placed for cosmetic augmentation or breast reconstruction. In addition, capsular contracture isn’t an all-or-nothing phenomenon. An implant could be slightly firm but still look great, or it could be rock hard, distorted, and painful. The overall incidence is somewhere around 10%, and is higher in women who have had breast reconstruction or have a prior history of capsular contracture.

Capsular contracture is treated by removing the implants and the scar tissue around them. If new implants are placed, I move them to a new pocket (above the muscle if they were originally under the muscle, or vice versa). I will also treat capsular contracture with medications. In early cases this can nip the inflammatory process in the bud, preventing more scar tissue from forming. If given after surgery, medications such as Singulair can help prevent the capsular contracture from recurring.

What happens if you don’t replace breast implants?

As I mentioned earlier, breast implants don’t have to be replaced unless they rupture or develop a capsular contracture. If they haven’t ruptured and feel soft, you don’t need to replace them regardless of how long they have been in. But what happens if they rupture and you don’t replace them? Let me start this conversation by saying this isn’t something well-studied. There are no studies in which doctors leave ruptured breast implants in place simply to see what happens. So the information I’m giving you is a combination of anecdotal information combined with common sense.

With a ruptured implant I do recommend removal of the implant, whether it is silicone or saline. If a ruptured silicone implant is left in place, the silicone could cause inflammation that results in pain or the development of scar tissue (i.e. capsular contracture). For this reason, some insurance companies will cover removal of a ruptured silicone breast implant. Saline implants are less clear-cut however. Insurance generally will not pay for removal of a ruptured saline implant. This could be taken to mean ruptured saline implants do not cause problems. And anecdotally this appears to be true. But I still recommend removing the implant if it is ruptured.

In the case of capsular contracture, there isn’t a medical necessity to remove the implant, as long as it’s intact. But if the breast is hard or painful, most women will want to have the implant and capsule removed simply for comfort.

What happens to breast implants over time?

Breasts change over time, whether you have implants or not. Weight gain or loss will cause breasts to change size. Pregnancy and breastfeeding also cause changes in breast size and shape. And over time breast tissue shrinks and skin stretches, causing ptosis (i.e. droopiness). Breast implants can increase the amount of stretch on the skin, but the degree to which this happens depends on the size of the implant. The larger the implant, the more it will stretch the skin.

Why do breast changes over time matter? For two reasons. First, your breasts appearance will change as you age. Your breasts may drop lower (that pesky droopiness again!). Or as the tissue thins the implants may become more visible in the form of rippling. Second, if or when you have your breast implants removed, your breasts will look different than they did prior to breast augmentation. The changes are a combination of skin stretch from the implant and the natural changes breast undergo over time. Many women are totally fine with this. Others opt to have a breast lift (aka mastopexy) done at the time the implants are removed.

In Conclusion

We covered a ton of information in this blog post. We’ve explained why breast implants need to be removed or replaced. We’ve explained what happens if you don’t replace your breast implants. And we’ve also discussed how breast implants change over time. If you have breast implants from either cosmetic augmentation or breast reconstruction, I recommend seeing a board-certified plastic surgeon once a year for a quick exam to make sure your implants are intact and don’t have capsular contracture. Even if you moved away or your surgeon retired, find a new surgeon to follow up with: you can find a plastic surgeon at the American Society of Plastic Surgery website.


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Can You Have a Baby After a Tummy Tuck? Wed, 04 Sep 2019 13:19:26 +0000 The post Can You Have a Baby After a Tummy Tuck? appeared first on Greer Plastic Surgery.



Tummy tuck surgery was one of the top five most popular plastic surgery procedures performed in 2018, and the reason why is no wonder: who wouldn’t want a flatter, more toned looking abdomen? But, what happens if you have a baby after a tummy tuck? Can you even carry a baby after having a tummy tuck?

The answer is complicated. From a medical standpoint, tummy tuck surgery does not affect your ability to get pregnant or have a baby. On the other hand, pregnancy may have a significant effect on your tummy tuck results. Keep reading to find out why.

Before we delve into detail regarding having a baby after tummy tuck surgery, it’s important for you to understand why your stomach may not be flat. Once we understand that, I’ll explain what actually happens during tummy tuck surgery. Then I’ll explain how getting pregnant may affect your tummy tuck results and how long you should wait after pregnancy to have a tummy tuck,

How to Get a Flat Stomach

There are four separate causes of a stomach that isn’t flat:

  1. Loose skin. Both pregnancy and significant weight loss may result in loose skin, but this  loose skin will shrink up some over time. If you just had a baby or hit your goal weight, give your skin a full six months to shrink up. Any loose skin left after that time frame will likely require surgery to improve.
  2. Rectus diastasis. The rectus abdominis muscles are the two strips of muscle on the front of your abdomen which create the “six-pack”. They are connected in the midline by a sheet of tough connective tissue called fascia. When you gain weight or get pregnant, this fascia stretches out to allow the baby to grow (or to allow the fat to accumulate, which is decidedly less fun than having a baby).
    After the baby is born, or you lose the weight, the fascia will shrink up some. As with loose skin, this process takes at least six months, but often there is still some stretch left, creating a widened space between the muscles. (The word “diastasis” means widening.) So a rectus diastasis is literally a widening between the rectus abdominis muscles. And this is what causes your belly to look six months pregnant right after you had a baby.
  3. Subcutaneous fat. Subcutaneous means under the skin. So subcutaneous fat is the fat that you can pinch between your finger and thumb. Compare this to intra-abdominal (see below).
  4. Intra-abdominal fat. This is the fat inside your abdominal cavity, packed around your internal organs. Also known as visceral fat, intra-abdominal fat causes a hard, round belly (think beer gut). The fat feels hard because you’re actually feeling the abdominal muscles, which are pushed outward by the fat behind them.

Your flat stomach solution depends on the cause.

Let’s talk fat first. Liposuction can remove subcutaneous fat. So if subcutaneous fat is the only thing keeping your stomach from being flat, liposuction is a great option. But it’s not unusual to have more than one factor keeping your stomach from being flat. If that is the case, you’ll only see a partial improvement from liposuction.

An important point in this discussion is that liposuction cannot remove intra-abdominal fat. This fact often confuses people, so it may be helpful to think of it this way:

To remove fat that is behind your abdominal muscles — packed in and around your internal organs — would require us to literally open up your abdominal cavity and move all your organs around. Not safe, and not even really possible. The only way to safely remove intra-abdominal fat, in fact, is good old weight loss. On a side-note, losing weight reduces subcutaneous fat as well. But if you have that stubborn fat around the midsection that doesn’t respond to weight loss, liposuction may be a great option for you.

How do you know if you need a tummy tuck?

If your problem is loose skin and/or a rectus diastasis, and you don’t have a lot of excess fat, then a tummy tuck will get you that flat stomach you’ve been wanting.

Tummy tuck surgery (aka abdominoplasty) has two major components:

  1. Removal of loose skin
  2. Repair of rectus muscles to correct rectus diastasis

I find that very few people need only skin removal without a diastasis repair, and vice versa. And this makes sense — excess fat or pregnancy tend to stretch out skin and the abdominal muscles at the same time.

Tummy tuck surgery leaves a scar from hip-to-hip low on the abdomen and another scar around the belly button. The belly button (umbilicus) actually stays where it is, attached to the underlying abdominal muscles. Most or all of the skin below the belly button is removed. So if you have stretch marks over your lower abdomen, many of them come off with the excess skin. You can read more about the procedure on the American Society of Plastic Surgeons website.

A brief side note here: if you have extra subcutaneous fat as well as loose skin, your surgeon may recommend a two-stage approach. Liposuction first removes the fat, then six months down the road after everything is healed, a tummy tuck removes the loose skin and tightens the abdominal muscles.

Why not do liposuction and a tummy tuck at the same time? Aggressive liposuction compromises the blood supply to the skin. If you have a tummy tuck at the same time this can cause major healing problems (think death of the skin). It is safe, however, to liposuction the hips or waist at the same time as a tummy tuck.

Can You Still Get Pregnant After a Tummy Tuck?

Now that you understand what a tummy tuck involves and what it treats, we can talk about how tummy tuck surgery affects pregnancy and vice versa.

First, let me reassure you that abdominoplasty surgery does not affect your actual ability to get pregnant or carry a baby. Skin removal and muscle repair have no effect on your fertility. And there is no health risk to mom or baby.

But if you get pregnant after tummy tuck surgery you can expect some changes during and after pregnancy. You may find that the pregnancy doesn’t show as early. After all, those tightened abdominal muscles take time to stretch back out.

What about after pregnancy? Having a baby grow will stretch your muscles and skin back out. It’s impossible to predict how much they will stretch, and to what degree the skin and fascia will retract (shrink up) after pregnancy. But, pregnancy will essential undo much of what a tummy tuck accomplishes. If you get pregnant after having a tummy tuck, you may end up with new stretch marks, loose skin, or stretched muscles. For this reason, I advise patients to wait to have tummy tuck surgery until after they are done having children.

What if you gain weight after a tummy tuck?

Pregnancy has a pretty dramatic effect on the abdomen because babies simply take up a lot of space. In contrast, gaining weight doesn’t usually result in the same amount of stretch. But it can still affect your results, especially if you tend to gain weight in your midsection.

Removing excess skin does not prevent fat from accumulating in the skin that remains, and if you accumulate intra-abdominal fat, it will stretch out the rectus muscles, creating a new diastasis. Even if you lose all the weight you gained, your skin and abdominal muscles may not completely recover.

How long after having a baby can you have a tummy tuck?

As I mentioned above, you should wait to have tummy tuck surgery until after you are done having kids. But how long do you have to wait after your last pregnancy? It takes your body about six months to recover after pregnancy. (Are you noticing a theme here with the six month timeline?) Although you will likely feel fully recovered long before this, your skin and abdominal muscles are still shrinking up.

Six months is actually the minimum timeline, assuming you quickly lose all the pregnancy weight. In reality it may take a year or more to lose all the weight you gained during pregnancy. I recommend being at a stable weight for a full six months before having surgery — that loose skin will still be shrinking up if you are in the process of losing weight. The ultimate result, (how much your skin shrinks up) depends on your age, skin quality, and how much weight you gained in the first place.

What if you never lose the excess weight?

Simply being overweight doesn’t mean you can’t have a tummy tuck. But for the best results, I do recommend you be at a weight you plan to maintain. If you have a tummy tuck and then lose a lot of weight, you’re going to have loose skin afterward. You should also be within range of your ideal body weight, with a BMI of around 30 or less. This is because if you are significantly overweight, you likely have excess intra-abdominal fat, which means you won’t get a great result after tummy tuck surgery.

In Conclusion

If you’ve made it this far, you’ve learned quite a bit about tummy tuck surgery. You’ve learned that tummy tuck surgery (aka abdominoplasty) is great for removing loose skin and correcting a rectus diastasis (stretched abdominal muscles). If you have excess fat, however, you may need to lose weight naturally or have liposuction first to get an optimal result.

Tummy tuck surgery is cosmetic, and does not affect fertility. So it’s absolutely possible to get pregnant after a tummy tuck. But pregnancy will stretch the abdominal muscles and skin, affecting your results. For this reason, I recommend waiting until after you are done having children to have tummy tuck surgery done.

If you just had a baby, I recommend losing the baby weight and then waiting another six months prior to having surgery. If you’ve just lost a lot of weight that same six-month rule still applies. This is because your skin and abdominal muscles take time to shrink up after pregnancy and weight loss, and your result will be better if you let that process happen prior to surgery.

If you would like to see what results you can expect from a tummy tuck, check out these before and after photos. And if you’re in the Cleveland area and ready to take the next step, you can reach us at (440) 974-8577 to schedule a consultation.


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How often should you replace breast implants? Wed, 03 Jul 2019 16:07:29 +0000 The post How often should you replace breast implants? appeared first on Greer Plastic Surgery.



replace breast implants replace breast implants

Breast implants don’t last forever. If you have breast implants, you will need to have them removed or replaced at some time in your life. But how often should you replace breast implants?

Breast implants last an average 10 years.

But they’re not like the engine filter on your car, which must be replaced every 15,000 miles (or however often it is- I’m not a car person!). But after 10 years the rate of rupture increases. Some may last longer, some less time.replace breast implants

There are two reasons to replace breast implants:

Capsular contracture.

Capsular contracture happens when firm scar tissue forms around the breast. This can vary in severity from slightly firm to hard and painful. We (the medical community) think this is due to more inflammation than normal, which results in the body laying down more scar tissue. It’s more common if you have a hematoma after surgery, meaning bleeding collects around the implant. It’s also associated with bacteria infection, even if it’s a subclinical infection, meaning one with no symptoms.

In the earliest stages capsular contracture can sometimes be reversed with medications and massage. So if you have breast implants and notice that one side feels firmer than the other, it’s critical to see your plastic surgeon right away.

Once capsular contracture is fully developed the only effective treatment is to surgically remove the capsule and replace the implant.

Rupture of the breast Implant

Both saline and silicone breast implants have a shell made of silicone. Over time the silicone weakens, and eventually it ruptures. As I mentioned previously, this risk increases around the 10 year mark. Before that the risk is 1% per year, so in 10 years 10% of women will have a rupture.

Ruptured saline implants deflate as your body absorbs the saline. (We use the same saline to fill implants that is given through an IV if you are in the hospital). As the implant deflates, the rupture becomes obvious.

Ruptured silicone implants may be more difficult to diagnose because the silicone is a very thick gel. So it’s more like the implant cracks, than actually ruptures. Check out the video below to see what I mean:

If your silicone implants feel different or look different, or if you’ve had any recent trauma (like getting head butted in the chest by a toddler) then it’s worth getting an MRI to see.

What does it cost to replace breast implants?

Replacement is covered under warranty for rupture. Warranties vary by manufacturer, and some have a time limit. Some manufacturers also extend their warranty to cover capsular contracture. So call your implant manufacturer to get the details. (This is why it’s critical to save the little card the hospital gives you after surgery!)

replace breast implantsThe ultimate cost of replacing your breast implants depend on whether you simply remove the implants, replace the implants, or replace them and remove a thickened capsule. Costs could range from anything to $3000 – $8000 depending on the amount of time involved.

And if you’re ready to have your implants replaced, know that you may still have to have your implants replaced again in the future.

What if you aren’t having problems?

If your implants are intact and not painful, it’s totally okay to leave them in place. Most plastic surgeons are very happy to check in with you once a year and make sure everything is okay, even if they didn’t do the original implant surgery.

Dr. Greer is a plastic surgeon in Cleveland, OH. You can read more on her practice website at


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Which brow lift is right for you? Wed, 05 Jun 2019 16:05:23 +0000 The post Which brow lift is right for you? appeared first on Greer Plastic Surgery.



brow lift in Mentor OH types of brow lift

What exactly is a brow lift anyway?

What is brow lift?The goal of a brow lift is, quite literally, to raise the eyebrows. Our foreheads start to drop as well age (thanks gravity!) This makes the eyebrows drop down, which can make the eyes look older. In women the eyebrow should be slightly above the orbital rim- that ridge of bone right above your eye. In men the eyebrow should be at the level of the orbital rim. If your eyebrows are lower than this and you have excess skin over your upper eyelids, you may benefit from a brow lift.

What are the types of brow lift?

Open brow lift:

  • Often considered the “gold standard”.
  • Hides the incision back inside the hair line or just in front of the hairline, depending on how high your forehead is.
  • Removes the corrugator muscles- these are the muscles between your eyebrows that cause those little vertical lines when you frown. Botox works temporarily, but removing the muscles is a permanent result.
  • Smooths horizontal forehead lines by stretching the skin.
  • Elevates the brow by removing a strip of skin.
  • Has a fairly easy recovery: Most patients experience some bruising and have a headache the first couple days. It’s also common to have numbness over the scalp behind the incision which may take several months to go away.

Endoscopic brow lift:

  • Is considered less invasive than an open brow lift.
  • Uses five small incisions instead of one long one.
  • Also removes corrugator muscles.
  • Elevates the brow by anchoring it to the skull using suture or an Endotine device. The endotine is made of polylactic acid. It dissolves over 60-90 days, after the skin and scalp have healed in their new, higher position. This also smooths horizontal forehead lines by stretching the skin

Direct brow lift:

  • Excises skin just above the eyebrows.
  • Raises the entire brow. (Endoscopic brow lifts and open brow lifts also raise the entire length of the eyebrow. Contrast this with lateral and TransBleph brow lift below).
  • Does not address the “11s” frown lines because the corrugator isn’t removed.
  • Does not smooth horizontal forehead lines.

Lateral brow lift

  • Use a small incision over the lateral aspect of the forehead at the hairline
  • Is good for lifting just the lateral end of the eyebrow.
  • Does not smooth horizontal forehead lines.

TransBleph brow lift:

  • Uses an Endotine device placed through an upper eyelid (blepharoplasty) incision.
  • Is good for adding more arch to the eyebrow, and can adjust the center of the eyebrow.
  • Does not smooth horizontal forehead lines.

Which brow lift is right for you?

How do you know which type of brow lift is right for you?

Type of brow lift you needWhat type of lift you need depends on your problem areas and your hairline (for hiding scars). If you just need a little more arch to the eyebrows, a lateral brow lift may be perfect. But if you need to smooth horizontal lines, get rid of frown lines, and raise the eyebrows, than you’ll see better results from an endoscopic or open brow lift.

Most importantly: make sure you are seeing a plastic surgeon or facial plastic surgeon who is experienced in multiple techniques. I’ve seen non-plastic surgeons who only offer one type (often the lateral mini-lift) and it’s not right for all patients.

Dr. Greer is a plastic surgeon in Cleveland, Ohio. Her passion is helping moms regain their confidence by getting rid of sagginess, wrinkles, and stubborn fat using surgery, laser, Botox and fillers. Check out her website for more information, or to download a FREE copy of “The Busy Mom’s Guide to Plastic Surgery.


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Low self-esteem – causes and solutions Wed, 22 May 2019 16:07:33 +0000 The post Low self-esteem – causes and solutions appeared first on Greer Plastic Surgery.



low self esteem low self esteem

As a plastic surgeon, low self-esteem is always on my radar. In a previous post I discussed how patients with low self-esteem are often unhappy with their surgical results. But if surgery doesn’t help low self-esteem, what is the solution?

What is self-esteem?

Self esteem is the value you place on yourself, or your overall opinion of yourself — how you feel about your abilities and limitations. This is different than self-confidence, which is how you feel about your abilities.  You can have high self-confidence and low self-esteem.

What creates our self-esteem?

From the University of Texas at Austin University Counseling and Mental Health Center

Self-esteem develops from our successes, failures, and how we were treated by our family, teachers, coaches, religious authorities, and peers.low self esteem

Childhood experiences that contribute to healthy self-esteem include:

  • Being listened to
  • Being spoken to respectfully
  • Getting appropriate attention and affection

Childhood experiences that may lead to low self-esteem include:

  • Harsh criticism
  • Physical, sexual, or emotional abuse
  • Being ignored, ridiculed, or teased
  • Unreasonable expectations of perfection: People with low self-esteem often receive messages from parents, teachers, or peers that failed experiences (losing a game, getting a poor grade, etc.) were failures of their whole self

How do we improve our self-esteem?

Changing your thoughts is the key to changing how you feel about yourself. Our emotions are actually created from our thoughts, and fortunately we have some degree of control over our thoughts.

The first step is to become aware of your thoughts. Writing down a stream-of-consciousness for five minutes is a simple way to figure out what is going on in your brain.

low self esteemOnce you see your thoughts written down, you can challenge the negative thoughts.  Are you really lazy? Can you possibly think of a time in your life where you worked really hard? Or are you really stupid? Can you find examples to counter that?

Next, look for your strengths. For me,  comparing my singing voice to… well anyone really… isn’t a fantastic idea. Singing is not a particular strength of mine. Nor is throwing a football. But I do an awesome tummy tuck, and I bake some delicious cookies.

Be kind to yourself. We often say things to ourselves that we would never say to a friend. Also, avoid comparing yourself to others. On social media you’re seeing a carefully curated picture of someone’s life- it’s not reality. So comparing yourself to their best is like comparing what you look like in the mirror to a model’s heavily photoshopped fashion shoot. It’s not a fair comparison, and it doesn’t help you at all.

  • Good self care- taking care of yourself is really a sign of self-love, right? So performing actions consistent with good self esteem sends you the message that you are worth the care.
  • Volunteering: not only does it take you out of your own head, and give you a frame of reference for your own problems, but generally volunteering is something you can be proud of.

Don’t be afraid to ask for help if you have low self-esteem!

Our thoughts about ourselves are ingrained over a life-time. So don’t be afraid to call in expert help. Seeing a therapist can help you uncover negative thought patterns and change them, so that you can improve your self-esteem.


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Types of breast implant – which is best? Wed, 08 May 2019 16:02:11 +0000 The post Types of breast implant – which is best? appeared first on Greer Plastic Surgery.



types of breast implant types of breast implant

If you’re considering breast augmentation, it’s very important that you understand the different types of breast implant on the market.  Breast implants fall into two main categories: Silicone and Saline.types of breast implant

Silicone Breast Implants

Safety of silicone breast implants

Silicone breast implants have been on the market since 1961; they actually pre-date the FDA!   But because of concerns about safety, silicone breast implants have been studied more than nearly any other medical device on the market.  Silicone implants are composed of a silicone shell filled with silicone gel.

A full discussion of the safety debate would take up an entire book (and many have been written on the topic), so for now I’m just going to say that both types of breast implant are equally safe. And after studying tens of thousands of patients, we know that implants do not increase your risk for connective tissue disease such as lupus or rheumatoid arthritis.

Pros of silicone breast implants:

  • Silicone implants give a more natural feel compared to saline.
  • They are less likely to show rippling compared to saline.
  • Silicone implants come in different degrees of firmness, from soft to quite firm. Even the softer implants on the market today contain very thick gel which is more solid than liquid. So unlike the gel implants of the 1980s, the silicone is less likely to move outside the implant pocket.

Cons of silicone breast implants:

  • Silicone gel is so viscous that you can’t always tell if they rupture just by look or feel- an MRI may be necessary.
  • Silicone implants come in pre-filled sizes, so the size isn’t completely adjustable.types of breast implant

Saline Breast Implants

Saline breast implants actually came on the market slightly after silicone implants, in 1964. Silicone implants are composed of a silicone shell filled with saltwater solution.

Pros of saline breast implants

  • Saline implants are adjustable in size, so it may be easier to correct for breast asymmetry.
  • You will know if a saline breast implant ruptures because the saline reabsorbs and the implant deflates.

Cons of saline breast implants.

  • Saline doesn’t feel quite as natural as silicone.
  • Saline implants may show rippling, especially in thin patients.

Cost vs. breast implant type:

Silicone implants do cost a little bit more than saline implants, on the order of a few hundred dollars.

What about textured implants and anatomic implants?

Let’s wrap up with a quick review of the different types of implant shells. So far we’ve discussed what is inside the implant (silicone or saline). But implant shells come in both smooth and textured. Textured implants were quite popular initially because they have a lower risk of capsular contracture. But over the past few years we’ve discovered a higher association with a very rare type of lymphoma (only 600 cases worldwide associated with implants). For this reason, most surgeons I know have switched over to smooth implants only.

Implants also come in two shapes: round and anatomic (aka tear-drop). The anatomic implants can give a more natural appearance in very thin patients or after reconstruction, but they must be textured so they stay in place without rotating. So again, the use of anatomic implants has dropped way off.

I hope you found the discussion of different types of breast implant helpful. You can always find more on my website, or email me at if you have questions.


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Why would you have fat grafting to the face? Wed, 24 Apr 2019 16:02:08 +0000 The post Why would you have fat grafting to the face? appeared first on Greer Plastic Surgery.



fat grafting to the face fat grafting to the face

Fat grafting takes fat from one area of the body and transfers it to another. Fat grafting is commonly done to the buttocks (known as a Brazilian butt lift) and to the breasts. The face is another common location to transfer fat to. But why would you have fat grafting to the face?

Fat acts like a permanent filler.

Facial volume loss happens with aging. The tissue also droops with age. The end result? Volume loss over the temples and cheeks, and lines around the mouth. Fillers can improve these areas, but most are temporary and last a year at most.fat grafting to the face

Fat, on the other hand, is permanent. About 80% of the fat that we transfer to another part of the body will survive. Meaning no more paying for filler every six months to a year.

Fat also has stem cells.

Stem cells are cells that can turn into many different kinds of cells lines. As a result, fat grafting can have some results separate from adding volume alone. As an example,  I like to do fat grafting in tissue that has been treated with radiation to soften the tissue and reverse some of the radiation damage. The end result is better than simply adding additional volume.

Which is better- fat grafting or fillers?

Fat grafting requires a trip to the operating room, which is a lot more invasive than simply having a syringe or two of filler injected. It’s also less precise- fat grafting is good for adding over all volume, but not for smoothing a single wrinkle or plumping up the lips. So why do fat grafting to the face instead of simply adding fillers?fat grafting to the face

  1. I can add much more volume with fat than I can with fillers. I will often inject 20ml or more of fat in a session. This would cost $12,000 if we used fillers, and the result with fillers wouldn’t be permanent.
  2. The stem cells seem to give more of an improvement than simply adding volume.

So fat grafting is a great adjunctive procedure during a facelift since you’re having surgery anyway. But I usually don’t recommend it on its own. If you aren’t at the point where you need an entire facelift, you probably don’t need that much volume added either.  And if you do need overall volume added, but don’t want to have surgery, Sculptra is a great option. It stimulates your body to form more collagen, so the results are permanent. Sculptra is injected right in the office, and it’s very similar to fat grafting in terms of cost.

Another caveat- grafted fat increases in size if you gain weight. So you could theoretically end up disfigured if you gained a lot of weight after fat grafting. This is why I always recommend a conservative end goal!

Have questions about fat grafting? You can email me at

Dr. Greer is a plastic surgeon in Cleveland, OH. Her practice website is at



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Eye Lift Surgery in Mentor Thu, 18 Apr 2019 22:59:07 +0000 The post Eye Lift Surgery in Mentor appeared first on Greer Plastic Surgery.



Greer Plastic Surgery, located in Mentor, Ohio, is committed to giving every woman that extra boost of confidence she needs to conquer her day. Led by Dr. Greer, our team of highly-trained professionals use their expertise to deliver premium results to the Mentor and Cleveland area. Dr. Greer knows the struggles of being a woman and understands that sometimes life gets in the way of taking care of yourself. As you age, your eyes begin to look tired, saggy, and just not as bright as your inner-self. Luckily, Dr. Greer offers cosmetic procedures that can reverse the effects of time, resulting in a more youthful, well-rested appearance!

What is an Eye Lift Surgery?

An eye lift is a cosmetic surgery medically referred to as a blepharoplasty. This surgery involves tightening the skin on the upper and lower eyelids to achieve a more awake and alert look. The goal is to reduce puffiness, signs of aging, wrinkles, and sagging skin while maintaining a natural feel and relaxed aesthetic. Eyelid surgery can take anywhere from 30 minutes to 2 hours depending on the specifics of the surgery. Eye lift surgeries are low risk and high reward in terms of your satisfaction. You look at your face every day, and you deserve a reflection that’s smiling back at you.

Do I need an Eye Lift?

The eyelids and skin surrounding the eyes are often the first to show signs of aging, as the skin there is thinner and more delicate than the rest of your face. Because of this, you may find yourself feeling self-conscious or disconnected from your outward appearance. You may feel like your expressions always seem tired or upset and do not reflect how you truly feel. If you want a refreshed, opening effect, eye lift surgery is an effective remedy to counteract the signs of aging. Schedule a consultation with Dr. Greer to discuss your needs and see how her life-enhancing procedure can be tailored to meet your desired look.

How does an Eye Lift Work?

An eye lift is a relatively simple procedure. You are given the choice between an upper eye lift, a lower eye lift, or both. Dr. Greer will discuss the different effects of each procedure and which one is best suited for you. An upper eye lift surgery is effective if you feel like your eyes always look too tired or your expression tends to look sad and unhappy. This procedure involves an incision made in your eye crease through which Dr. Greer will extract a specific amount of fat and excess skin and adjust the muscles to create that lively look. Lower eyelid surgery is optimal for removing under-eye bags and puffiness. For lower eyelid surgery, Dr. Greer will create an incision on the outer edge of your lower eyelid, inside the eyelid, or beneath the eyelashes. From there, she will reposition or remove excess fat for a natural, younger-looking contour beneath the eye. During your consultation, Dr. Greer will explain each procedure thoroughly and address any concerns you may have. Dr. Greer will take as much as needed to make sure you are comfortable and well informed on what procedure you would like. So be sure to ask any and every question you may have during your consultation.

How much does an Eye Lift Cost?

The cost of an eye lift varies based on the complexity of the surgery and can be discussed during your first consultation with Dr. Greer. Her philosophy is creating customized treatment plans that best compliment your needs. At your eye lift consultation, Dr. Greer will provide you with a cost breakdown including the cost of the surgery facility, anesthesia, and eye lift procedure.

What is the Recovery Time for Eye Lift Surgery?

This is an outpatient procedure, meaning you get your eye lift and go home the same day. You may experience bruising that should subside in a couple of weeks. Dr. Greer will give you complimentary laser treatments to make the bruising resolve more quickly. You should only experience marginal discomfort following your eye lift and need pain medication for a couple of days. It’s up to you to choose when you feel well enough to return to work, but Dr. Greer recommends avoiding intense exercise or lifting more than 15 pounds for the first month following the procedure.

Plastic Surgeon in Mentor

Eye lift surgery is the next step towards becoming a better you, so let us at Greer Plastic Surgery help. Dr. Greer is a mom of three and has committed her practice towards helping women make small adjustments to their appearances that make big differences to their lives. She is Board Certified by the American Board of Plastic Surgery believes in using her practice to improve the lives of women in the Northeast Ohio area.
Greer Plastic Surgery is the premier practice for plastic surgery in Mentor, Ohio. Give us a call today at (440) 974-8577 to schedule your eye lift consultation.


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Breast Augmentation Thu, 18 Apr 2019 22:18:48 +0000 The post Breast Augmentation appeared first on Greer Plastic Surgery.


Breast Augmentation Surgery in Mentor Ohio

At Greer Plastic Surgery, we believe that every woman deserves to look and feel her best at any age. Greer Plastic Surgery is committed to providing premium services to the Northeast Ohio community by offering cosmetic surgeries with only one thing in mind: YOU.  Our highly trained staff works to create the results that you want, so you can live the life you deserve. If you want an experienced plastic surgeon who knows the importance of putting yourself first, reach out to Dr. Greer in Mentor, Ohio. Together, you’ll make the perfect pair.

What is Breast Augmentation Surgery?

A breast augmentation surgery enhances the shape, fullness, and size of the breasts to the patients liking by inserting a silicone or saline implant into the breasts. This is an outpatient procedure, taking roughly 1 – 1.5 hours. Dr. Greer understands and appreciates what makes you beautiful and uses her skills and expertise to enhance that beauty. Using the Mentor™ gel sizing system, Dr. Greer will guide you to the size and type of implant that best suits your lifestyle and desired aesthetic.

What types of Breast Implants are There?

You will have three options when choosing implants for your breast augmentation surgery. The choices are silicone, saline, and gummy. Each breast implant varies in weight, firmness, and material but can be tailored in size to give you the exact appearance you want. Dr. Greer will walk you through your options and explain the merits of each type of breast implant and which breast implant is best for your desired aesthetic. Implant material and implant size will all be carefully explained and discussed during your breast augmentation consultation with Dr. Greer.

(See More Before and After Photos)

No matter what your ideal breasts look like, Dr. Greer will assess your lifestyle, body type, and personal preferences to help you choose the perfect implant to meet your goals. Your satisfaction is her priority, and she will provide you with all the resources you need to make the best choice of implant material and cup size.  Before talking in person, you can read Dr. Greer’s thoughts on choosing the right breast implant size for you here. (

How does Breast Augmentation Surgery Work?

Once you have chosen an implant, you and Dr. Greer will discuss the merits of inserting the implant above or under the breast muscle. The implant incisions are commonly made in the breast crease, around the areola, or in the armpit depending on your needs. Dr. Greer will walk you through your options to see which method of insertion is best for you. She will explain the entire procedure in detail during your consultation to ensure your complete comfort and answer any questions you may have about breast augmentation.

What is the Recovery Process?

The recovery process for breast augmentation surgery is relatively small compared to the life-long investment you’ve made in your self-confidence. Dr. Greer works tirelessly to ensure an optimal level of comfort and ease for you following surgery. Most patients only need pain medication for a couple of days and can return to work within a week. The total healing time for this surgery is about a month. At that time, you can resume your normal fitness routine. Read here for Dr. Greer’s quick tips for a smooth recovery.

What is the Cost of Breast Surgery in Mentor?

Greer Plastic Surgery’s customized approach to clients means an exclusive plan of action just for you. Our price varies based on surgery location and type of implants. During your consultation, you will receive a breakdown of costs that includes the cost of the facility, anesthesia, and surgery. Elite services with affordability in mind are Dr. Greer’s priority, and this is reflected in her prices.

Plastic Surgery in Mentor Ohio

Breast augmentation surgery may seem intimidating at first, but Dr. Greer takes a personal interest in every one of her patients to ensure a level of comfort and trust unmatched in the plastic surgery industry. As a mom of three, Dr. Greer understands the importance of women putting themselves first. Dr. Greer is Board Certified by the American Board of Plastic Surgery and is passionate about helping strong women look and feel stronger.
Breasts are not a one-size-fits-all matter. When your breasts don’t reflect the inner you, it’s time to give us a call at (440) 974-8577.

The post Breast Augmentation appeared first on Greer Plastic Surgery.

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What is breast implant illness? And how do you treat it? Wed, 10 Apr 2019 16:07:26 +0000 The post What is breast implant illness? And how do you treat it? appeared first on Greer Plastic Surgery.



breast implant illness breast implant illness

What is breast implant illness?

Breast implant illness is a term used by women who have symptoms they attributed to their breast implants. But it’s not a true medical term. So far in the studies that have looked at women with these symptoms, there are no commonalities. So no labs that are consistently abnormal, and no symptoms that are common among all (or a large proportion of) these women.

But breast implant illness is a real thing.

Even though science hasn’t done a great job of defining breast implant illness, there are enough women experiencing symptoms that improve after removing their implants, we know something  is going on. I think the worst thing plastic surgeons could do is brush off these cases. Instead, we need to find out how best to help these women, and that involves figuring out exactly what is going on. To that end, the American Society of Aesthetic Plastic Surgeons has created a task force to study Breast Implant Illness.breast implant illness

Fibromyalgia was originally brushed off as a real disease because it was so hard to pin down in terms of common symptoms or lab test results. But now that we have a better concept of what causes fibromyalgia and what the symptoms are, we have done a much better job of helping patients live a better quality of life.

How do we treat breast implant illness?

Because every woman seems to have different symptoms and different (or no) lab abnormalities, how do we define the best treatment? Unfortunately we can’t. Some women do have an improvement in symptoms after removing breast implants, and some do not. Because the result is different for everyone, it’s currently impossible to recommend the proper method to remove implants. I’m hopeful that as Breast Implant Illness is studied more, we’ll have better recommendations based on scientific evidence to help these women.

It’s easy to be misled.

If you’re concerned your breast implants are making you sick, you may start with an internet search. But there is a lack of really good data telling us how to treat breast implant illness, and even what it is.

Does that mean you won’t find recommendations on the internet? No- of course not. There are many breast implant illness websites out there giving specific treatment recommendations. But unfortunately these recommendations are not based on science. One example: en-bloc capsulectomy for removal of implants to “cure” Breast Implant Illness.

En bloc capsulectomy removes the breast implant and all the scar tissue around the implant.

Sounds great, right? But performing an en-bloc capsulectomy on every woman who is concerned about breast implant illness raises several issues:

  1. There’s no proof it’s medically necessary. Because every woman has a different set of symptoms and a different response to removing her implants, it’s impossible prove en-bloc capsulectomy actually works.
  2. It is potentially dangerous. When implants are under the muscle, the capsule behind the implants is attached to the ribs and the muscles between them (intercostal muscles). Trying to peel this capsule off the bone can actually damage the underlying lungs. It’s hard to justify this risk if we don’t have a proven benefit.
  3. It’s often impossible. The capsule is scar tissue around the implant. If the scar tissue is very thick then it’s easy to remove. But some women don’t form thick scar tissue, so there’s literally nothing to remove.

What about the “experts” in Breast Implant Illness?

breast implant illnessSo why do some surgeons profess to be experts in treating breast implant illness and recommend en bloc capsulectomy? I can only speculate, as their recommendations are not based on scientific evidence. But women suffering from breast implant illness are a vulnerable population. They feel like their concerns aren’t always being taken seriously, and they desperately want to feel better. Which means they are at risk for being scammed.

Surgeons who “specialize” in Breast Implant Illness often charge women thousands of dollars out of pocket to remove their implants en-bloc. Yet there’s no medical proof that it’s necessary or that it even works.

As I mentioned above, I am confident that Breast Implant Illness is a real issue. But first we need to better characterize and define the illness. Then we can develop treatments that consistently improve symptoms. Until then, offering a surgical “cure” that is unproven and potentially dangerous is completely unethical.

If you have questions about this tope, please feel free to leave them in the comments or to email me at It’s an important topic, and I want to help spread accurate and correct information.

Dr. Greer is a plastic surgeon in Cleveland, Ohio. She helps women regain their confidence by getting rid of sagginess, wrinkles, and stubborn fat. Check out her website for more information, or to download a FREE copy of “The Busy Mom’s Guide to Plastic Surgery.


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