YOUR COMPLETE GUIDE TO BREAST ENHANCEMENT

EDUCATIONAL BOOKLET

1 MODEL DEPICTED SODERSTROM SKIN INSTITUTE & MEET OUR SKIN DIMENSIONS BOARD CERTIFIED LOCATIONS PLASTIC SURGEONS PEORIA JAMES M. JEFFRIES III, MD, FACS 309.674.7546 & TODD M. GERLACH, MD Spa 309.691.9381 4909 North Glen Park Place

PERU 815.224.7400 Spa 815.224.6409 2200 Marquette Road

MORTON 309.263.7546 Spa 309.291.0404 410 Maxine Drive

GALESBURG 309.344.5777 60 S. Soangetaha Road

NORMAL JAMES M. JEFFRIES III, MD, FACS 309.268.9980 Dr. Jeffries is Board Certified from the American 2100 Jacobssen Drive Board of Plastic and has over 25 years of experience. He graduated from Lycoming MOLINE College in Pennsylvania with a bachelor’s degree 309.277.0772 in biology and received his medical degree from 1302 7th Street New Jersey .

IOWA Upon completion of medical school, Dr. Jeffries CLINTON was enlisted as a commissioned officer for the 563.242.3571 U.S. Penitentiary in Leavenworth, Kansas. He then completed his internship in general surgery 2027 S. 21st Street at New Jersey Medical School and University DAVENPORT Hospital where he also completed both his 563.344.7546 general surgery and plastic surgery residencies. Spa 563.355.0600 1800 E. 54th Street Dr. Jeffries worked in private practice providing reconstructive and cosmetic surgery services MUSCATINE before joining Soderstrom Skin Institute in 2012. 563.263.2113 He is a diplomate of the American Board of Plastic 2300A Park Avenue Surgery, a member of the American Society of Plastic Surgeons, and a fellow of the American College of Surgeons. Dr. Jeffries is a member of the Peoria Medical Society and has served as its President. 2 TODD M. GERLACH, MD Dr. Gerlach is Board Certified from the American Board of Plastic Surgery JENI MOLLY and has over 20 years of experience. He attended college at the University of California at Riverside, graduating with a bachelor’s degree in biochemistry. LET US HELP FIND THE FIT Dr. Gerlach then moved to to pursue his dream of becoming a THAT'S RIGHT FOR YOU! physician at the Chicago Medical School. HIGHLY TRAINED NURSES, He completed his general surgery MOLLY AND JENI, WILL residency at Mount Sinai Hospital, followed by plastic surgery training at GUIDE YOU THROUGH THE the Cleveland Clinic Foundation. Dr. DECISION-MAKING Gerlach also completed fellowships in PROCESS AT YOUR microsurgical replantation CONSULTATION. and hand surgery at U.C. Davis Medical Center.

After his formal education, he started and served patients in the greater Los a private practice providing plastic and Angeles region. He is a diplomate of the reconstructive surgery for patients in American Board of Plastic Surgery and the suburbs of Chicago. In 2005, he a member of the American Society of relocated back to Southern California Plastic Surgeons. 3 WHAT GIVES A BREAST ITS SHAPE? The breast consists of milk ducts and glands, surrounded by fatty tissue that provides its shape and feel. Beneath the breast is the chest muscle (pectoralis major muscle).

Implants are used to make the breast larger or to restore/replace breast tissue. Factors such as pregnancy (when milk glands are temporarily enlarged), rapid weight loss, and the effects of gravity as you age combine to MODEL DEPICTED stretch the skin, which may cause the breast to droop or sag. However, it is important to note that implants are used to make the WHEN CHOOSING A SURGEON breast larger. The implants alone may not adequately lift the breast, or correct the FOR BREAST AUGMENTATION, effects of pregnancy, weight loss, or skin stretching. Additional procedures may be YOU SHOULD FIND OUT THE recommended at the time of the breast ANSWERS TO THE FOLLOWING augmentation, such as mastopexy, to help QUESTIONS: achieve improved breast lift.

How many breast augmentation implantation procedures do they perform per year? FATTY TISSUE

How many years have PECTORALIS they performed breast MUSCLES augmentation procedures?

What types of implants does MILK DUCTS the surgeon primarily use AND GLANDS (saline, silicone)?

Are they board certified, and, if RIBS so, with which board?

Did they complete a residency in plastic surgery from a recognized and accredited program? WHAT ARE YOUR COSMETIC GOALS? Your decision whether or not to get breast What is the most common implants should be based on realistic complication they encounter expectations of the outcome. There is no with breast augmentation? guarantee that your results will match those of other women. Your results will depend on many individual factors, such as your overall health (including age), chest structure, breast/nipple shape and position, breast asymmetry, skin texture, healing capabilities (which may be slowed by radiation and chemotherapy treatment, smoking, alcohol, and various medications), tendency to bleed, prior breast surgery, surgical team’s skill and 4 MODEL DEPICTED

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experience, type of surgical procedure, referred to as breast augmentation. Or and type and size of implant. you may need to have a previous breast augmentation corrected or improved, TYPES OF IMPLANTS which is called revision-augmentation. There are 2 FDA-approved options — We are here to assist you in making saline and silicone filled implants. These an informed decision about breast options allow your surgeon to utilize augmentation or revision-augmentation the best type of implant to achieve your surgery, and to help answer some of desired effect. the questions you may have about the procedure and about breast implants in SALINE general. The saline implant comes from the manufacturer as an empty silicone shell. Who is eligible for Silicone-Filled Breast At the time of surgery, saline (salt water) Implants? is placed into the implant through a Breast Implants have been approved self-sealing valve. The FDA requires by the FDA for the following uses that a woman be at least 18 years old to (procedures): receive a saline filled breast implant. • Breast augmentation for patients at SILICONE least 22 years old. Breast augmentation includes primary breast augmentation A silicone gel-filled breast implant is to increase the breast size, as well an implant shell of silicone elastomer as revision surgery to correct or (rubber) filled with silicone gel used to improve the result of a primary breast increase the size of your breasts. This is augmentation surgery.

PHOTO COURTESY OF SIENTRA® 5 • Breast reconstruction. Breast reconstruction includes primary COMMON INCISION SITES reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast TRANSAXILLARY abnormality. Breast reconstruction also includes revision surgery to PERIAREOLAR correct or improve the result of a primary breast reconstruction surgery.

MULTIPLE PROFILES. INFRAMAMMARY HUNDREDS OF OPTIONS. Based on your body structure and aesthetic goals, we will help you INCISION SITES choose the right profile and size (cc) for a customized result...from a subtle There are 3 common incision sites: change to a dramatic difference! around the nipple (periareolar), within the breast fold (inframammary), or under What does Gummy mean? Gummy the arm (axillary or transaxillary). describes the consistency of the silicone gel. This gummy like gel sticks together THE FUN PART! YOUR CONSULATION and has the tendency to hold its shape. AND TRYING ON SIZERS We offer multiple types of gummy gels. Forget Cup Size! Since bra Each implant has a different level of manufacturers differ, and women’s cohesivity or what surgeons may refer body shapes are all unique, using cup to as gumminess. sizes as the way to choose the size of an implant can be confusing and not always predictable. During the consultation, PLACEMENT OF IMPLANT your surgeon and team will listen to your The breast implant can be placed either goals, complete measurements and find partially under the pectoralis major the best fit for you. Finding the ideal cup muscle (submuscular) or on top of the size happens along the way! muscle and under the breast glands (subglandular). You should discuss CONTRAINDICATIONS with your surgeon the advantages A contraindication is a condition or and disadvantages of each implant circumstance that, if present, means a placement. procedure should not be done. Breast implant surgery should not be performed in: • Patients with active infection anywhere PLACEMENT OF IMPLANT in their body, because the implant will make the infection much harder to SUBGLANDULAR SUBMUSCULAR treat should the infection move into the breast. • Patients with existing cancer or pre- cancer of their breast who have not received adequate treatment for those conditions, because radiation and chemotherapy treatments may increase the risk of some complications seen with breast implants. Also, breast implants may interfere with radiation or chemotherapy treatments. 6 MEET YOUR SURGICAL TEAM The Peoria Ambulatory Surgery Center staff works closely with our Plastic Surgeons and their team. The surgery center JEANINE VALERIE KATIE KATHY staff are specially trained and certified for outpatient surgical care. Special attention is given to patient safety from the pre- operative to post-operative stage of your procedure. CHRISTY ZAIDA SAMMIE KATEY

• Women who are currently pregnant in our fully accredited surgery center at or nursing, because surgery may Soderstrom Skin Institute in Peoria, Illinois. interfere with the safety of the pregnancy/nursing. Since breast Benefits To The Patient Include: augmentation is an elective surgery, it • Free parking with easy first floor access should be postponed until you are no longer pregnant or nursing. • Cost savings • Safe, private setting for comfort and security OPERATION & POST PROCEDURE • Physician anesthesiologist available • Consultation, surgery and follow-up at THE OPERATION the same location The operation is performed in our • Specialized nursing staff and entire fully accredited day surgical facility cosmetic surgery team under general anesthesia with a skilled anesthesiologist in attendance. • Accredited by the Accreditation The actual surgical time will vary Association for Ambulatory Health depending on the amount of surgery Care, Inc. necessary for each patient. In general, the operation requires 2 hours or less POST PROCEDURE BANDAGES of surgical time. Steri strips will be placed over the incisions. You may shower after 48 hours PEORIA AMBULATORY being careful not to saturate the steri SURGERY CENTER strips. These may come off after a few These procedures will be performed days, but typically stay in place until your follow up appointment. A small amount of drainage is normal in the first 24 – 48 hours after surgery.

A sports-type bra will be placed on you for comfort following surgery. This should be worn for comfort only, it will not help to shape your breasts. Do not wear any other type of bra (i.e. underwire) for approximately 12 weeks or more following surgery. 7 BREAST ENHANCEMENT RESULTS

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WORKING STITCH REMOVAL REMOTELY FROM The sutures which are buried beneath YOUR HOME the skin will all absorb on their own and do not require removal. It is important DURING THIS TIME that you do not travel out of state for CAN BE APPROVED two weeks after surgery, so that we can BY THE SURGEON be sure you are healing as expected ON A CASE BY CASE following the breast surgery. BASIS. CHANGES IN EMOTION & PAIN Most patients do have some pain and discomfort immediately following surgery. We will be here to support you in this journey. You must remember that before you see the improvement you are expecting, you will go through a standard postoperative period in which you will look quite swollen and bruised. This will be followed by another period of time when you may look strange to yourself (this varies considerably with each individual). It can take up to 12 weeks before the implants are settled where they are supposed to be. In some patients there is a temporary period of slight emotional depression immediately following the surgery while you are anxiously awaiting your final results. This is quite normal and should not alarm you. Fortunately, this period usually passes 8 MODEL DEPICTED rather quickly. Always check with your surgeon and clinical team where they surgeon before resuming vigorous can be reached at any time. The only exercise, including aerobics. bad question is the question not asked!

GOING BACK TO WORK POSSIBLE COMPLICATIONS* You will need to take a week off of work Complications can occur from any type to rest and recover from the procedure. of surgery. Those that occur in cosmetic Working remotely from your home during breast surgery are most often minor in this time can be approved by the surgeon nature. These may include, but are not on a case by case basis. During that time, limited to the following: we advise no heavy lifting over 10 pounds. • A hematoma is a collection of blood Following up with your physician and under the skin which usually occurs care team because we care about you, right after surgery. In about 2% of all we ask that you are seen periodically breast augmentation operations, this for the 6 months post procedure to must be removed in the immediate track your progress. The typical plan is postoperative period. This may as follows but could vary by case: require an additional operation. • Infection may occur in 1 – 2% of • 1 Week Post Procedure breast augmentations. If this involves • 2 Weeks Post Procedure only the incision, antibiotics may • 1 Month Post Procedure clear it up. If, on the other hand, the infection is deeper around the • 2 Months Post Procedure implant, the implant will require • 6 Months Post Procedure removal. Symptoms include: fever, vomiting, diarrhea, dizziness, fainting, We welcome all questions that may sunburn-like rash, deep seated pain. come up along the way. You will be Replacement of the implant may given contact information to your occur at a later date in approximately

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ACTUAL PATIENT OF SODERSTROM SKIN INSTITUTE & JAMES M. JEFFRIES, MD, FACS 9 BREAST ENHANCEMENT RESULTS

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ACTUAL PATIENT OF SODERSTROM SKIN INSTITUTE & JAMES M. JEFFRIES, MD, FACS

4 – 6 months post infection. Surgery result in additional scarring, or loss may be necessary to determine if it is of breast tissue. Factors associated safe to replace the implant. with this include: smoking, infection, • Changes in nipple and breast sensation steroid use, chemotherapy/radiation, can either increase or decrease or excess hot/cold therapy. following surgery, it may even result in • Capsular Contracture may occur. A no feeling. These changes are usually capsule of fibrous tissue forms around temporary, but can be permanent. the implants as part of the body’s These may also affect breast feeding natural response to a foreign material. or sexual response. While in the majority of women this does not significantly alter the feel of the breasts, in approximately 5% of women the hardness may cause NICOTINE USE POST-SURGERY WILL sufficient discomfort or deformity of INTERFERE WITH YOUR RECOVERY the breasts and may require additional surgery to correct. AFTER SURGERY. • Nicotine use post-surgery will interfere with your recovery after surgery. Adequate blood flow is necessary • Rupture/Valve defect can occur. If in a for your incisions to heal and can be saline implant, the solution will absorb problematic. Poor scar formation, into your system with no adverse exposed implant, pneumonia are effects. You will notice a change in the among some of the most common size and shape of your implant over complications – refrain from using a period of a few days. If in a silicone nicotine post surgery! implant, you may need to have an MRI to determine a true rupture. Your implants are not a lifetime device. • Delayed wound healing or necrosis Revision surgery, consisting of removal is the death of cells or tissues. This and/or replacement of your implants may delay or prevent wound healing, may be required at any time. Revision

10 runs between 25% and 30% for all breast WANT TO SEE MORE? enhancement surgical procedures. You will be given a brochure outlining the CHECK OUT BEFORE & AFTERS AT warranty information after your surgery. SODERSTROMSKININSTITUTE.COM *Based on the results of the Allergan Core Clinical Study for the first 10 years after implant surgery. There were 455 Primary Augmentation patients and 147 Revision-Augmentation patients enrolled. surgery may also be indicated to achieve long term satisfaction with cosmetic results. Revision surgery is SODERSTROM VIP CLUB not included in the original cost of the Many of our patients decide to join our initial surgery and will be at additional VIP Club so they can have the most cost, including surgeon’s fees, to the savings not only on the procedure patient. It should be noted that the but also on other cosmetic services national rate for revisional surgery or and products post procedure. Visit other additional enhancement surgery SoderstromVIP.com for details.

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We hope you have enjoyed reading our booklet outlining breast augmentation as much as we have enjoyed putting it together. Because we are proud of our work, we would love for you to view our online gallery of Before and Afters at SoderstromSkinInstitute.com.

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