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New Hampshire Cosmetic Plastic Surgeon Discusses Silicone Breast Implants after Breast Augmentation becomes No. 1 Cosmetic Surgery Procedure

Silicone breast implants went through a long period of relative dormancy after a series of lawsuits prompted their removal from the market. Now, two years after the U.S. Food and Drug Administration approved them for use in breast augmentation and breast reconstruction procedures, cosmetic plastic surgeon Richard L. Zeff, MD comments on why he feels the FDA’s decision was correct.

(Vocus) April 2, 2009 -- The American Society for Aesthetic Plastic Surgery has just released a report finding that, after twelve years, breast augmentation is now the number one most-performed cosmetic surgical procedure in the U.S. Last year, more than 355,000 breast augmentations were performed, bumping liposuction to the number two spot. This trend coincides with the two-year anniversary of a decision that reshaped the field of breast surgery.

In 2006, the U.S. Food and Drug Administration approved the use of silicone breast implants in breast reconstruction procedures for patients of any age, and in breast augmentation surgery for patients aged 22 and above. This significant decision came in the wake of intensive clinical trials and rigorous studies to determine the safety of silicone implants after being pulled from the market in 1991. Dr. Richard Zeff, a New Hampshire cosmetic plastic surgeon, says that since the FDA approved the implants, the public comfort level has improved dramatically. “The FDA approved gel after a 14 year moratorium during which studies compared large numbers of women who have implants with a similar group of women who do not. Because there were no significant differences in the health risks demonstrated in these extensive studies, the FDA approved the gel. I’m very comfortable with their findings.”

Dr. Zeff says he typically uses the word ‘gel’ when describing silicone breast implants to patients because saline implants, the type that were still available for use during the silicone implant moratorium, also have a silicone exterior. “That alone is often surprising to some patients. Patients are also comforted by the fact that the newer implants are ‘cohesive’ so they hold together if cut or ruptured. They might bulge, but they won’t drip or run.” The issue of implant leakage was at the heart of the silicone implant controversy. Saline implant leaks are more noticeable because the breast often takes on a deflated appearance; whereas silicone implant leaks are not as easy to detect without an MRI or an examination by the plastic surgeon. However, today’s silicone gel implants are known for their strength and durability, and Dr. Zeff says, while he always explains the intricacies of both silicone and saline implants, the controversy over silicone implants may have actually helped in making patients understand that they are indeed safe. “For some patients there is still a residual fear based on memories of the controversy rather than on the facts. I try to explain the history and the facts. I feel that the controversy was constructive because it provided the opportunity to prove scientifically that gel implants are safe.”

Dr. Zeff feels that one of the major benefits of silicone ‘gel’ implants over saline is that they have a more natural look and feel. He says that he advises each of his New Hampshire breast augmentation patients on the basis of what their ultimate goals are, and what may best suit their individual needs. “The difference between gel and saline is much more noticeable in some patients than in others. I think they look at least a little more natural than saline but still youthful or perky. They definitely feel more natural in almost all patients. I try to be as objective as possible, but with women who are very thin, I feel more strongly about the benefits of gel. In particular, the risk of visible or palpable wrinkling or rippling is less likely with gel.”

Coinciding with the new study indicating breast augmentation as the number one surgical cosmetic enhancement procedure, Dr. Zeff says he’s also seeing an uptick in the number of silicone gel procedures at his New Hampshire breast implants facility. “I have been using progressively more gel than saline implants, and I believe it’s now more than 50% gel. Part of the reason is that women have become more comfortable with gel, making it easier for me to express my preference.”

What’s more, Dr. Zeff says his patients love the results.

Dr. Richard Zeff is certified by the American Board of Plastic Surgery and is a member of the New England Society of Plastic and Reconstructive Surgeons, the New Hampshire Medical Society, the American Society of Aesthetic Plastic Surgery, and the American Society of Plastic Surgeons. His office is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF), and is equipped with a fully operational surgical suite.

For more information on breast surgery in New Hampshire, Dr. Richard Zeff can be reached at 137 Portsmouth Avenue, Stratham, NH 03885 - (603) 684-2339, or via his website at


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