What’s Trending in Breast Augmentation

Join Plastic Surgery Practice Co-Chief Editors Alison Werner and Keri Stephens as they talk to Anna Steve, MD, FRCSC, a breast specialist at the famed Neinstein Plastic Surgery in New York City. Known for her “elegant” approach to breast surgery, Dr. Anna, as her patients call her, prioritizes a minimal scar approach to breast augmentation and advocates for limiting patient downtime.

In this podcast, Dr. Anna reveals why it’s important for plastic surgeons to speak openly about breast implant illness with breast augmentation patients and how the “bigger is better” adage seems to be changing—particularly in New York City. She also shares how fashion can affect plastic surgery trends.

Finally, Dr. Anna shares what excites her most about working in a private practice setting post fellowship training.

Podcast Transcript

Keri Stephens:

Hello and welcome to the Plastic Surgery Practice Podcast a part of the Medqor Podcast Network. My name is Keri Stephens, and today I’m joined by my co-host, Allison Werner. And we are the co-chief editors of Plastic Surgery Practice Magazine. Today we are talking to Dr. Anna Steve, a board certified plastic surgeon and practitioner at Neinstein Plastic Surgery in New York City who specializes in breast surgery. We wanted to learn about Dr. Anna’s unique approach to breast surgery and what trends she’s currently seeing in the field. Dr. Anna, thank you for joining us today.

Dr. Anna Steve:

Thanks so much for having me.

Keri Stephens:

Yeah. Can we just start, we would love to hear about your background, how you got into plastic surgery, and just a little bit about that.

Dr. Anna Steve:

Of course. So plastic surgery to me is so unique, and I always say that it really resonates with me that if you really find your true passion and what you really love, you never really work a day in your life. And that’s how I feel about plastic surgery. That’s how I felt about it the first time I saw it. It’s such a unique surgical subspecialty in that you’re always giving something back, whether it’s restoring aesthetics, restoring form and function. Surgery is so often taking something away, removing something that’s broken, and plastic surgery is like the polar opposite. So it’s a really unique niche in that way, and that’s really what drew me to plastic surgery and then what keeps me enjoying my practice so much from day to day.

Keri Stephens:

Awesome. And so you started at Neinstein Plastic Surgery in July. What led you to that practice post your residency?

Dr. Anna Steve:

Neinstein Plastic surgery is really unique in the sense that it’s one big team working towards a common goal. Everyone from the surgical techs to the nursing staff to the front desk to my fellow surgeons, Dr. Neinstein and Dr. Chris Funderburk are really all working towards the same goal. And I think that’s so unique in a private practice. Often everyone in private practice is working in their own silo, and I think it’s unique that we have such a team-based approach and such a unique team-based culture. At Neinstein plastic surgery, I grew up in a pretty small town. I have pretty humble beginnings in a prairie town in Canada. And so I really feel like Neinstein plastic surgery was my way of finding a little bit of a small town niche in the big city because it is really a small family feel to our office. And I think patients really appreciate that about their experience when they’re navigating the surgical process and the preoperative care and the postoperative care, which plays such an important role in surgery. And that’s really what drew me to the practice. Okay.

Alison Werner:

Well, let’s switch gears a little bit. Your bio says you focus on optimizing a woman’s sense of self and femininity through sophisticated breast surgery. Can you talk a little bit about what this means to you?

Dr. Anna Steve:

So for me, this means that really it’s about meeting the patients aesthetic goals. So I like to start the conversation by hearing the patients story, get an idea of what her goals are, and then see if I can come up with a surgical plan that meets those goals in a safe way. And that’s, I think, where the idea of the unique femininity for that patient comes from. And then with respect to breast surgery, breast surgery is kind of my wheelhouse at Neinstein plastic surgery, so they hired me as the cosmetic breast specialist. And so I’m primarily focusing on a wide range of breast surgeries, breast augmentation, two breast breast reconstruction, breast revisions, breast reduction, breast lifts. And by focusing on a hyper sub-specialized area, I think it really allows you to become sort of really a master of that very narrow field. And we’re finding that a lot of people are really, really liking the sub sub-specialize care, so much so that there are requesting combo cases.

So for a traditional mommy makeover, patients are coming requesting Dr. Neinstein, for instance, to do the abdominal portion of the procedure and myself to do the breast portion. So it’s been a really nice collaboration that way for us to be able to, again, really focus on that team based approach and sort of meet the requests of the patients and do some combo cases or hybrid cases. So that’s been really unique. We didn’t necessarily plan for that, but that’s kind of the way that things have started to unfold with how things have gone since I’ve joined the practice. So that’s been fun.

Keri Stephens:

Awesome. And as someone with breast implants myself, I’m impressed by the fact that your breast surgery patients can get back to exercising so quickly post surgery. I know for me, I had to wait at least eight weeks, nine weeks. You use a special technique to allow this.

Dr. Anna Steve:

I think one of the differences is using a medication called Xpro. So the Xpro medication works for 72 hours. So in terms of pain control, it really does manage pain well. And I just use Tylenol and Advil and the postop recovery period, which really limits the side effect profile. I liked women to take two weeks off of high intensity cardio and four weeks off of chest heavy exercises like chest presses or pushups. And I really think a lot of the approach to longer periods of time off surgery are really, they’re seated mostly in tradition. If you don’t question what the traditional approach was, there’s a tendency to just continue to go back to doing the same thing over and over again. And what I’m finding with my patients is they feel really well, they’re anxious to get back to doing the things they were doing before, and they’re not encountering any problems when they’re getting back to doing those things earlier.

And so I think it’s actually a really important part of the recovery process to encourage early movement, early return to your normal everyday life because surgery doesn’t necessarily have to be this big scary thing. That’s a huge pause on your life, especially breast surgery, breast surgeries are fairly straightforward. The recovery can be fairly streamlined and I’m finding that at least the population that I have tends to get back to what they’re doing pretty quickly. So limiting downtime has been important. Also, my own story is I’m a working mom and a lot of my patients are working moms too, and they just can’t afford a lot of downtime. I’m always trying to think of ways that I can improve the post-op process so that we can get patients back to safely living their life again.

Alison Werner:

You also prioritize a minimal scar approach to breast augmentation. How do you go about this?

Dr. Anna Steve:

There’s a couple of techniques. So I like to hide the scar in the bra line or the breast fold. You might hear this also called the inframammary incision or hiding it in the IMF. And then I like to keep the scar between three centimeters and four centimeters long. The way that we insert a large breast implant through that tiny incision is by using something called a Keller funnel or a no touch technique. So the implant actually goes into a funnel that looks sort of like something that you use to like ice a cake and you squeeze the breast implant in through the tiny incision through the Keller funnel.

Keri Stephens:

Since you are a breast specialist let’s talk breast implant illness, I mean, it’s something we have heard so much about. It’s been in the news. I mean, the FDA now has a black box for breast implants. And how do you massage your patients fears regarding this? And have you seen an influx of patients looking to explants?

Dr. Anna Steve:

So I think it’s an important conversation to have with any woman who’s considering breast implants. I talk about breast implant illness with all of my patients considering breast implants, and I tell them what we know. There’s women who are experiencing symptoms like headache, fatigue, autoimmune diseases that they feel might be related to their breast implants, especially on the timeline that the breast implants went in is similar timeline to when they started to feel those symptoms. And I think it’s logical that if you’re having symptoms that you think are related to the implants, that the implants come out.

And I think it’s an important conversation to have with all patients that are considering breast implants. I also think that it’s important while we’re just figuring out exactly whether or not there is a strong association between breast implants and those things, that women who come in with those symptoms and are requesting implants, that you caution them that there’s a possibility that removing the implants may not improve the symptoms. So I think both are important pieces of the conversation. I have seen few women who have been requesting breast implants being removed. The primary reason for that is actually that they got large implants when they were in their early twenties and now styles have changed, fashion’s changed, and they don’t want to be quite so heavy chested. So they’re wanting to downsize their implants. And many of those women are actually still choosing to put new implants back in just a much smaller style of implants.

And we have newer technologies that give us the ability to do that. We can change the size of the implant and have better control of the pocket that contains the implant by using some new technologies like AlloDerm or GalaFLEX, special materials to create an internal bra to suspend that smaller implant within that large space. And so the other way that we can sort of combine the smaller implants with the larger pocket is to start mixing in some fat grafting and things like that. So it’s fairly rare to see women so far in my practice that are having symptoms that they feel are related to their implants and want them out. But I have had a few patients requesting implants out for that reason. The primary reason tends to be more the styling and women who are choosing to have other implants put back in.

Alison Werner:

Yeah. Well, speaking to that, what trends are you currently seeing in breast surgery?

Dr. Anna Steve:

So with respect to the trends, definitely sizing is a main one. So I would say the words that many women use to describe the type of look that they’re going for to me is like a natural elegant look. And it might seem like a bit of an odd thing to request a natural looking breast implant, but it’s actually actually an achievable result. So I’m using a lot more small volume implants, lower profile implants to achieve that aesthetic. And I think fashion dictates a lot of that. I also find that the New York trends seems to be that, and a lot of the implants that are being put in, maybe in LA or California are a little bit higher profile. So I am having some woman come from LA and California or Florida who say, I’m not really into the trend I’m seeing here. I kind of want the New York look. So those are the things that I’ve noticed since I started practice here specifically.

Alison Werner:

Okay. I’m curious, you talked earlier about the fact that, you just joined Neinstein’s practice in July, and I know you finished your fellowship, your second fellowship recently. Coming into the private practice situation. What excites you about the future of being in this business or this world?

Dr. Anna Steve:

That’s a great question. I think that the most exciting thing is being in a city like New York where there is so many highly motivated people. I have never met patients quite like this before in my practice, where they’re super high achievers and they have specific goals and they’re willing to do whatever it takes to meet those goals and whatever it takes in the post-op recovery process to optimize their results. And it’s really nice to be at the pulse of all that energy. And New York is really, I think, the center of the world in a lot of ways, but the type of people that work here and the type of clientele that I’m seeing, they’re just such amazing patients because they really, they are goal setters and high achievers, and that makes their surgical results and their recovery and everything just really next level.

Alison Werner:

Dr. Anna, thank you so much for that. This has been really informative. And to our listeners, be sure to check back soon on the Medqor Podcast Network for the next episode of the Plastic Surgery Practice Podcast. And in the meantime, to catch up on the latest industry news, please check out plasticsurgerypractice.com. Until next time, take care.

Published at Tue, 18 Oct 2022 21:11:13 +0000