FITNESS BODY WORK
M : DR . JUGENBURG , WHAT CAN A POTENTIAL CLIENT EXPECT FROM YOU OR ANY OTHER SURGEON ?
J : I begin by obtaining a complete medical history and a clear understanding of what the client is hoping to achieve . I then create a customized approach to suit their needs , goals and lifestyle . I ask patients to bring photos of breasts they like and dislike to help me understand their preferences . For something so industry specific , like competitive women ’ s fitness and bodybuilding , I take pectoral strength and function into account ; I have to consider the lifestyle . Furthermore , I believe that the discussion about going over or under the muscle is extremely important ; I prefer to go over the muscle as it is advantageous to avoid animation deformity in such athletes , while I prefer to go under the muscle for most other patients .
M : WHAT ARE THE KEY DIFFERENCES FOR GOING OVER OR UNDER THE MUSCLE ?
J : Most people will warn you that going over the muscle will look fake , especially when one is very lean . Fact is , when you are in competition shape and have large implants , you won ' t fool anyone by simply placing them under the muscle . Best thing to do to avoid a ' fake ' look is to avoid high profile implants and implants that are too wide or too narrow for your existing breast tissue . An implant should be small enough that your natural breast tissue hides it . If you have no natural breast tissue , a smaller round implant under the muscle ( dual plane ) or an anatomic ( teardrop ) shaped implant over the muscle will give you the most natural looking result . In fact , at the latest cosmetic surgery meetings , surgeons talking about sub glandular implant placement ( over the muscle ) are the hot topic in breast augmentation these days - so when friends tell you under the muscle is the only way to go , tell them you know better .
M : WHAT TYPES OF IMPLANTS ARE OF- FERED AT YOUR CLINIC AND WHAT DO YOU PREFER ?
J : Unlike most cosmetic surgeons who offer only silicone implants , we offer them all ; I don ’ t believe there is one perfect implant . Each has its own pros and cons and each patient would benefit from a different approach – tying back to understanding what each client is trying to achieve . We offer saline implants as well as IDEAL IMPLANTS ®, also referred to as ‘ structured ’ implants . It is a multi-shell structure with an inner and outer lumen , both filled with saline . Saline implants definitely have their benefits – I am able to enter through a tiny incision so small it looks like a wrinkle . I have also developed a new technique that allows me to go through a 2cm incision and complete the procedure in less than 20 minutes !
There is also an element of texture to the implants ; they include :
Smooth Implants - they ripple less , and have a lower risk of delayed seroma formation , but tend to be less stable and are more likely to displace over time .
Textured Implants – these implants move less , but do display more visible rippling and have an elevated risk of delayed seroma formation . These are currently falling out of favour in North America , but are still common throughout Europe and Asia .
M : WHAT ABOUT INCISION PLACEMENT ?
J : There are quite a few ways to have an augmentation – your optimal implant will depend on anatomy , desired look and functional requirements . There is no “ one best ” solution . That being said , the breast fold incision is the most common due to its versatility . It allows for the placement of all implant types , sizes and shapes , and allows the surgeon to go both over and under the muscle .
14 MUSCLE MEMORY | APRIL / MAY 2018