Unlike diamonds, breast implants won’t last forever. Both saline and silicone implants wear out or “rupture” over time, but at no “exact” time. The older the implant, the more likely it is to fail.

Implant failure doesn’t mean that you are going to necessarily have problems, like pain or contracture (excessive firmness). Saline implants will deflate when worn out (obviously noticeable). Silicone implants, however, maintain their shape even when they have failed–and despite what you think you heard from your friend or learned with your Google search, ruptured silicone implants are not likely to make you ill.

I recommend that you consider replacing your breast implants every 20 years or so, even if you are not experiencing problems. If you have symptoms like pain or contracture, you may even want to avoid expensive CT/MRI scans that some doctors recommend, and simply elect to change them out (and save yourself from the radiation exposure). The results of any test will unlikely change the fact that you need to exchange your implants.

I know it’s hard to elect to have a surgical procedure when you are doing “fine,” but there is a fun factor in having “new” implants as well as the element of peace of mind.

Robert Caridi, MD

I would guess that over half of the patients seen in my office are taking antidepressants—a surprisingly high number to some. It would seem intuitive that those patients taking “happy pills” would be more satisfied with their procedure results. Or, maybe those who are not taking antidepressants are simply not satisfied no matter what.

It is common for patients to experience a “letdown” after cosmetic plastic surgery. It is seen about two weeks after the procedure and is more common when a patient has plastic surgery of the face. This letdown after surgery is quite different from true depression. The former is temporary while the latter lasts for a longer time.

This “letdown” or catharsis is quite normal. It happens after many big events in a person’s life, like a wedding or the birth of a child, because emotions run so high in anticipation of the outcome. Perhaps in plastic surgery “letdowns,” it’s the antidepressants that keep patients from this low period.

All Board Certified Plastic Surgeons want the best for their patients and strive to make them happy. Trying to determine those who are best suited for plastic surgery is challenging (I often think that this is the hardest part of being a plastic surgeon!), so having a good relationship with your surgeon and making sure that you have realistic expectations will help ensure that you are satisfied with your plastic surgery investment.

As a general rule, from my experience, a happy patient before surgery is a happy patient after surgery, antidepressants or not.

Robert Caridi, MD

I see three groups of patients who use shoulder shrugging as a “defense mechanism” (something an individual does to protect themselves against something that creates anxiety).

1. Women with particularly small or large breasts.
2. Women who are taller than average.
3. Men that suffer from Gynecomastia (the development of fullness or extra breast tissue in a male chest).

For women with small or large breasts and for men suffering from Gynecomastia, this defense tactic is used to hide and draw attention away from the chest area – the source of anxiety. In tall women, poor posture or shoulder shrugging simply makes them appear shorter.

A breast augmentation or reduction is an alternative for those who are anxious about the appearance of their breasts (this includes men too. Read my article on Gynecomastia to learn more).  As always, sitting up straight, keeping your shoulders back and keeping your chin up will dramatically enhance your appearance to others.

Do you think you have poor posture? Do you know someone who uses shoulder shrugging as a defense mechanism? Do you have a “secret” to keeping good posture?

Robert Caridi MD

But now, the popularity of facial procedures has made the proverbial “About Face.” I have seen a 20 percent increase in requests for plastic surgery of the face within my practice.

Why is this so? Well, for one thing, non-invasive procedures certainly sound good, but the benefits are minimal and the cost high. Patients have begun to see the long-term results of these procedures – hardly any difference at all! In fact, not only do these non-invasive procedures offer only minimal improvement, but they have also harmed some patients and have given all elective cosmetic procedures a bad name.   

Despite what the tabloids and over-sensationalized media would have you believe, procedures like face lifts, nose jobs, eye jobs, brow lifts and neck work can offer tremendous, natural looking benefits, when performed by the expert hands of Board Certified Plastic Surgeons.

Are you sitting on the fence when it comes to plastic surgery of the face? Do you worry about “alien” looking results? Are you concerned that you won’t look like you?

It might just be the time to visit with your Board Certified Plastic Surgeon and learn more about your options and what you can reasonably expect. I think you will be pleasantly surprised!

Robert Caridi, MD

When it comes to body self-image, this statement couldn’t be closer to the truth. Women are pretty darn harsh on themselves and men think that they are “studlier” than they actually are.

Why is this? Without going into the deep psychosocial analysis and boring you to tears, I suggest it has a lot to do with the perceived role women and men have in our society (and this is changing!).

Here are some interesting facts that you might consider when you come to your own opinion:

1. Over 90 percent of my patients are women.
2. The number one cosmetic procedure for men is a Rhinoplasty (nose job).
3. The number one cosmetic procedure for women is a Breast Augmentation.
4. The number of women and of men that are considered to have Body Dysmorphic Disorder (BDD) are almost equal (based on the first fact, you would think that women would far outnumber men!).
5. About 10% of patients seen in plastic surgery offices are considered to have Body Dysmorphic Disorder.

The best “spin” I can put on this debate is that each sex can learn from the other; men could spend a little more effort taking care of themselves and women should think about cutting themselves a little bit of slack!

Robert Caridi, MD

Aside from the impressive drawings, what I immediately noted was the unique shape of the women’s breasts. They are all narrow, moderate in size, and quite projected—“ultra perky” would describe it best. Yet in those days, breast implants didn’t exist (they weren’t invented until 1964). There was simply no way that a natural breast could possibly have that shape!

Being a leader in breast surgery, my practice is a reflection on current trends and patient preference. Right now, all the rage is “Varga Girls” type breasts. It’s all about “higher, tighter and perkier.” High profile breast implants (the narrow and tall variety) help provide for this shape. Often, a “breast lift” is also needed to get that “Vargas” look.

Which breast shape do you prefer? Do you even like the “Vargas” shape? And why do you think current trends have changed in favor of the “Vargas” breast?

Robert Caridi, M.D.

Then there is also the group in between consisting of those women who simply don’t like the shape of their breasts. “The size is ok, I just don’t like the way they look.”

We all seem to want what we don’t have. We just need to make sure that when we have a choice of size, we don’t go to the opposite extreme.

Hence, we have two very common plastic surgery procedures:  a breast augmentation and a breast reduction. I consider both “happy” surgeries as most patients are very pleased when their breasts are “normal” sized after either of these procedures.

Breast reduction patients almost always prefer, and benefit from, smaller breasts. If the breasts are left too large, they will more than likely wish they were smaller. Breast augmentation patients are at times tempted to choose a size that is simply too large, with some patients regretting their choice of such large implants. I always preach moderation when it comes to breast implant size.

What breast size do you prefer? Are you happy with your breast size? If you have had a breast augmentation or reduction, can you share some of your experience with us?

Robert Caridi, MD

No wonder patients are afraid. If, supposedly, every plastic surgery encounter results in breasts that are way too big, noses that look artificial, eyebrows that are in the middle of the forehead and lips that are from a large mouth bass, you can’t blame them!

So why is it that I end up scratching my head in disbelief? Why is my world view so different from the rest? From my perspective, as a leading provider of cosmetic plastic surgery in Central Texas, I simply don’t see these outcomes. What I see from reputable Board Certified Plastic Surgeons is excellent work and satisfied patients. When I do see “weird stuff,” it is almost always from non plastic surgeons.

So, in the end, “Plastic Surgery Gone Right” is much closer to reality than people have been led to believe. Probably the main reason why the media portrays plastic surgery the way they do is because sensational headlines are far more likely to attract your attention (and money). Are the headlines keeping you from considering plastic surgery?

Robert Caridi, MD

The Internet is full of advice, for sure, but clever marketing can create illusions for even the sharpest researcher. Sometimes, this deceptive marketing trick can make it seem like a doctor is the answer to all your concerns with plastic surgery. Unfortunately, more often than not, this is not true.

Here is my “Top 10 Check List” of suggestions for making good decisions regarding your plastic surgeon:

1. Make sure your doctor is Board Certified by the American Board of Medical Specialties (ABMS)
2. Make sure your doctor has enough years in practice to be very experienced (ten years is good)
3. Make sure your doctor has the right credentials (quality University, Medical School, and Residency programs)
4. Make sure the procedure you are selecting is one of your doctor’s areas of expertise.
5. “Meet and greet” your doctor. Schedule a consultation and get a feel for your doctor.
6. Check with the Medical Board for serious disciplinary actions.  See how many lawsuits your doctor is involved in.
7. Check Online reviews, such as CitySearch and Google Local, for consistent comments, favorable or unfavorable.
8. Check the quality of the doctor’s website, and look at his/her work in the before and after photos.
9. Patient and Doctor referrals are always a great way to learn about your doctor’s reputation.
10. Learn from patients who have been treated by the doctor and ask them about their experience and results.

Robert Caridi, MD

I have seen these changes many times before in my career. Although plastic surgery is no “ticket” to happiness, it can be quite beneficial, if performed on people who use it in a constructive way. No, it won’t solve all your problems or reduce all the stress in your life, but it can be just what is needed to help you “switch gears,” or take that turn down the pathway to a healthier and happier lifestyle. It’s fun and professionally fulfilling to see this woman wearing a beautiful, fitted dress and telling me that she didn’t have this figure “when I was sixteen.”

Plastic surgery is hardly about what some people would think.  It’s not about being unable to accept your age, or looking for the Holy Grail or Fountain of Youth. It’s not about surgically healing your body dysmorphia or becoming a plastic surgery junkie. It’s simply fulfilling your desire to look as young as you feel.  It’s nice to stand in front of the mirror and actually feel good about your reflection. Life is short and it can also be sweet. Sometimes plastic surgery can be that little added sweetener in your life!

Robert Caridi, MD