Cosmetic fillers: A popular choice for millions of Americans, but not without risks - including the rare possibility of blindness

By Claire Wolters, May 16, 2023

Although vascular occlusion is “extremely rare,” it can have extreme health consequences, says Constance M. Chen, MD, a board-certified plastic surgeon based in New York. She encourages doctors to have thorough conversations with patients before procedures and to intervene quickly if a procedure appears to have gone wrong. “Warning signs that a patient is in trouble after fillers include visual loss; red, painful or tender nodules; area of filler injection turns black,” says Chen. “Regardless, you should follow up after treatment so any issues can be caught and treated early.”

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Breast Reconstruction with Implants: Is it better to go above or under the muscle?

May 9, 2023

According to the American Society of Plastic Surgeons, 81% of women in the United States who undergo breast reconstruction after mastectomy use breast implants. As opposed to natural tissue breast reconstruction, implant-based breast reconstruction does not involve surgery on any other part of the body outside of the breasts. Patients do not have to worry about scars elsewhere on the body or additional healing and drains. In addition, the actual operation is shorter and more straightforward and does not require complex microsurgical skills. Thus, implant-based breast reconstruction is an easier surgery for both the patient and the surgeon.

One common problem with implant-based breast reconstruction, however, is that women often experience chronic pain and tightness after surgery. Usually, this is caused by breast implants placed under the pectoralis muscle - known as subpectoral breast implant placement. Since the pectoralis muscle lies flat against the chest wall, the muscle is routinely cut at its attachment to the sternum so that it can be lifted to make room for the tissue expander or breast implant. Despite this, the breast implant is a tight fit because there is no anatomical space for it under the pectoralis muscle. Additionally, when the pectoralis muscle is flexed, it pushes the implant down and out - both deforming the implant and pushing the breast implant into the armpits. Over time, the breast implants may move farther apart creating widened breasts.

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Cellulite Will Never Totally Go Away, But There Are Some Ways To Lessen It

By Marica Laing, May 6, 2023

Do you have a foam roller gathering dust in the corner of your room? If so, it's time to dust that bad boy off. "Foam rolling may cause some swelling, which can give the illusion of a smoother appearance on the skin, but it does not actually change the fibrous bands that cause the pockets of fat to bulge," plastic surgeon Constance M. Chen also shared.

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Moldy breast implants may have caused this woman’s depression and joint pain

By Lisa Marie Basile, Apr 12, 2023

Constance M. Chen MD, board-certified plastic surgeon and breast reconstruction specialist, says patients with BII may present with a wide range of symptoms, including “brain fog, joint aches, hair loss, swelling, visual changes, fatigue, strange body odors, skin changes such as rashes or discolored skin, nail changes (such as thick or black fingernails resistant to any antifungal treatments), breathing problems, heart palpitations, and distorted taste buds.” 

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Understanding Nipple Reconstruction Alternatives after a Mastectomy

April 11, 2023

The objective of breast reconstruction after a mastectomy is to recreate new breasts to help a patient feel whole and normal after surgery. The traditional mastectomy resects the nipple-areola complex and leaves a woman with a straight line scar across her chest. New mastectomy techniques preserve the nipple-areolar complex so that no nipple reconstruction is needed. Nipple-sparing mastectomies allow a better aesthetic result because the entire skin envelope of the breast is preserved. Not all breast surgeons are trained to perform nipple-sparing mastectomies, however. When the nipple-areola complex is resected, it is possible to reconstruct the nipple and the areola as part of the breast reconstruction.

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Breast Surgery May Be Utilized Due to Cancer or for Cosmetic Reasons

By Meg Walters, Mar 14, 2023

"Someone might get breast surgery for any number of reasons," said Constance M. Chen, M.D., a board-certified plastic surgeon and breast reconstruction specialist in New York City. "Usually, the reasons will either be cosmetic or medical. Cosmetic reasons for undergoing breast surgery include changing the size, shape and symmetry of the breasts. Medical reasons include cancer and infection."

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New study explores omission of radiation in older women with breast cancer

By Lisa Marie Basile, Feb 24, 2023

Constance M. Chen, MD, a board-certified plastic surgeon and breast reconstruction specialist, shares some thoughts. “While women have traditionally received radiation therapy after lumpectomy, it is an option to decline radiation therapy after lumpectomy—as long as women understand that they have a higher chance of having another breast cancer in their breast but they don’t have a higher chance of metastasis or dying.” Some patients will be willing to accept the risk of local recurrence, Chen says. That’s if they don’t want to undergo the effects of radiation therapy. Also, she says, “If they do have a local recurrence of breast cancer, they can undergo another lumpectomy or mastectomy without worrying that they are at a higher risk of dying.”

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Natural Tissue Breast Reconstruction for Thin People

By Dr. Constance M. Chen, Feb 23, 2023

Autologous tissue breast reconstruction creates soft, warm, and living breasts from a woman’s own body tissue, and many consider it to be the gold standard in breast reconstruction. Despite this, many thin women report that they have been told that their only option for breast reconstruction is implants because they do not have enough fat to undergo natural tissue breast reconstruction. Why are thin women being turned away? Even among specialists, many plastic surgeons are primarily familiar with the abdomen as a donor site for breast reconstruction—and many thin women have minimal abdominal fat. Breast reconstruction using abdominal flaps, such as the TRAM or DIEP flaps, transfer fat, skin, and blood vessels—and in the case of the TRAM flap, the rectus abdominis muscle, too—from the lower abdomen to the chest to build the new breast, and they are the most common options for autologous tissue breast reconstruction.

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Breast reconstruction specialist Dr. Constance M. Chen on comfortable apparel choices for women after breast surgery

February 23, 2023

For more than 100,000 American women who undergo mastectomies each year, it is important to be as comfortable as possible during the postoperative period. Pain and tenderness, swelling, surgical drains and other sequelae from surgery should guide the choice of bras and other post-mastectomy clothing, says plastic surgeon and breast reconstruction specialist Dr. Constance M. Chen.

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What To Do About Unacceptable Breast Implants

In October 2021, the FDA announced a series of changes to help ensure that women considering breast implants have a clear picture of what implants involve before undergoing surgery. The changes include new labeling requirements, updated screening recommendations, and selling implants only to facilities that outline their potential risks and benefits.

“While breast implant surgery is safer today with improved implant technology, there are still potential risks involved,” explains Constance M. Chen a NYC-based plastic surgeon specializing in restorative breast surgery. “Women should be well-informed about the pros and cons of the procedure and what they can expect in the coming months and years with breast implants.”

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Common bumps on the areola, Montgomery glands can sometimes get clogged, and may need treatment if they get infected.

By Elizabeth Millard, Feb 2, 2023

IF YOU’VE EVER noticed small bumps around your nipples, and wondered if they were pimples, you may have been noticing Montgomery glands. These oil glands, which appear as small raised dots on the areola (the dark circle around the nipple) usually look like goosebumps, according to Constance Chen, M.D., a plastic surgeon and breast reconstruction specialist in New York City. Montgomery glands may become more enlarged in some circumstances, such as pregnancy, and then go back to normal size without causing a problem. But if bacteria gets into the gland, they can cause a clog and infection. Here, experts share tips for keeping inflammation and infections away, as well as your options should a blockage occur.

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Nipple-Sparing Surgery is Safe for Women with Gene Mutations

By Constance M. Chen, MD, MPH, Jan 2023

Women with a genetic mutation predisposing them to breast cancer face a terrible choice: to lower their cancer risk to an acceptable level, they must lose their natural breasts. Fortunately, however, preserving their nipples—an integral part of the breast and a woman’s body image—is possible for the vast majority of those who undergo a preventive mastectomy as long as they find a breast surgeon with the skill set to do this type of specialized mastectomy.

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Using Fat Grafting for Breast Reconstruction

By Cconstance M. Chen, MD, MPH, Dec 2022

For women who want natural tissue breast reconstruction but cannot or do not want to undergo flap surgery, another option is fat grafting. One reason a woman might not be a candidate for flap surgery is due to a clotting disorder that will cut off the blood supply to the flap. Or she may be a smoker or a user of nicotine in another form, which significantly increases the risk of flap failure, wound healing problems, and infection. Other recreational drugs, such as cocaine, will also prevent a successful flap surgery. Or a woman may have significant medical comorbidities that can make a long operation unsafe such as obesity, diabetes, or heart or lung issues. Finally, some women may simply not want the extensive scars that come with cutting out tissue from one part of the body and transferring it to the chest to create a breast.

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Breast Cancer: Researchers Say It’s OK to Pause Long-Term Treatment for Pregnancy

By Eileen Bailey, Dec 13, 2022

“This research is encouraging for young women who have had hormone-positive breast cancer and are committed to starting a biological family,” said Dr. Constance M. Chen, a plastic surgeon and breast reconstruction specialist in New York City.

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Nipple-Sparing Surgery is Safe for Women with Gene Mutations

For women with a genetic predisposition to breast cancer, it is shocking to learn that you carry a gene mutation that dramatically increases the chance you will develop breast cancer at some point in your life. Perhaps just as shocking is learning that your best way to prevent breast cancer is to undergo a double mastectomy that changes your body forever. For these women, one way to optimize survival while preserving breast shape is to undergo nipple-sparing mastectomies. Sparing a woman’s nipples has been shown to be safe to preserve life while minimizing deformities, says Dr. Constance M. Chen, plastic surgeon and breast reconstruction specialist.

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Can Drinking Milk Increase My Breast Size?

By Rachel MacPherson, Dec 2, 2022

"Drinking milk does not make your breasts grow," said Constance M. Chen, a board-certified plastic surgeon and breast reconstruction specialist in New York City. "Gaining weight makes your breasts grow, just as it makes the rest of your body grow."

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Using Fat Grafting for Breast Reconstruction

Fat grafting is an innovative form of breast reconstruction3 that avoids both the artificiality of breast implants and the scarring and complexities of flap surgery. A form of natural tissue breast reconstruction, fat grafting is an option for women with the time and patience to accept its limitations.

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Heads Up, Here’s the Link Between Breast Cancer and Moles

By Leah Emily Minoza, Nov 21, 2022

Constance Chen, M.D., a breast reconstruction specialist in New York City, explained that hormones, particularly estrogen, are theorized to play a significant role in the number of moles a person can develop. The higher your estrogen levels, the higher your risk of having moles and developing breast cancer. However, Chen clarified that more studies are needed to understand how estrogen links to moles and breast cancer.

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What Side Effects or Risks Are Common After Breast Reduction Surgery?

By Gabrielle Kassel, Nov 10, 2022

According to Constance M. Chen, MD, a plastic surgeon and breast reconstruction specialist in New York, you can generally expect scarring around the nipple-areola complex and a vertical scar at the bottom of your breast.

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The Best Bras And Post-Op Products For Mastectomies

By Tessa Flores, Oct 26, 2022

Dr. Constance M. Chen, a board-certified plastic surgeon and breast reconstruction specialist based in New York City, said that when shopping for postoperative undergarments, which are often covered by insurance, it’s important to take breast swelling into consideration. A bra that might fit well in the operating room might become too tight as you heal. Chen also said that the kinds of bras used for postoperative situations will depend on whether or not long-term goals of reconstruction are in a patient’s future.

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