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Breast Implants
and
Breast
Augmentation
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"Thy two breasts are like two young roes that are twins,
which feed among the lilies"
Bible: Song of Solomon, 4:5
The fascination of both sexes with the female breast and the desire by women to have fuller breasts predates the writing of the Bible. Dating back to antiquity, the written records, paintings and sculptures of many cultures have idolized the shapely breast.
This universal breast fascination has continued despite the introduction of breast and body revealing clothes and our ever increasing media-driven familiarity with the female breast.
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Youthful full breasts have always defined femininity. But the pressure on women to have or, at least, present fuller chests began just before WWII, when movies, glamour magazines and advertisements, began to repeatedly featuring full-chested actresses and models. However, it was not until the early 1960’s that Plastic Surgery begun having the capability to correct this particular shortcoming of nature. The history of breast augmentation surgery is VERY interesting. (You can more of it on our HISTORY page).
Breast enlargement is a great operation. In most cases, it improves the appearance of the breasts and does away with
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| the insecurity and self-doubt that women with smaller breasts commonly have. In the past 30 years, nearly two million American women had undergone breast augmentation and the vast majority is very happy with their decision and would do it again. Breast enlargement surgery is the commonest cosmetic surgery procedure in Memphis and the Mid-South.
Small or mildly sagging breasts can be made perkier and larger by placement of breast implants. Breast implants consist of a silicone elastomer shell which is filled either with saline (sterile salt water commonly used for IV fluids) or with viscous gelatinous silicone gel. (see Mentor MemoryGelTM).
There are many different types of breast implants. In general, breast implants are classified based on their filler (saline vs. silicone), their shape (round vs. teardrop (i.e. anatomical or contoured)), their profile projection (low, moderate, moderate plus or high) and by the texture of their surface (smooth vs. textured).
You will have to decide on:
• Access Incision placement - (around areola (Periareolar), Breast fold (Inframammary), arm pit crease (Transaxillary)
• Implant Placement - Above pectoralis muscle vs. Under the muscle)
• Implant Filler (saline vs. silicone)
• Implant Shape (round vs. anatomical)
• Implant Surface Texture (smooth vs. textured)
• Implant Profile projection (low, moderate, moderate plus or high) and,
• Implant Volume / Weight (cc's)
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| In your consultation, Dr. Aldea and Dr. Eby will then help you through this maze of choices to choose the breast implant that is best for you based on your chest width, chest slope, breast cover and your desired breast size |
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| There are many options in breast augmentation without a single "best choice" which is universally applicable to all women. Each choice has its own advantages and trade-offs. Since each woman possess a unique combination of anatomy and long-term goals, Dr. Aldea and Dr. Eby strongly believe that to achieve success in breast augmentation, the procedure should be individualized and customized to each individual woman's circumstances rather than using a "one operation fits all" approach.
The key to a successful breast enlargement surgery is knowing your options and making a series of educated choices. After fully understanding all your options, you will arrive at your “best” implant/incision/placement choice.
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ACCESS INCISIONS AND IMPLANT PLACEMENTS
Breast implants are commonly placed through a small incision either around the nipple complex (periareolar), under the breast fold (inframammary), or through the armpit (trans-axillary). Some surgeons use the navel (TUBA) to place their breasts implants. Each incision has its advantages and Dr. Aldea and Dr. Eby will educate you as to which may best suit your goals. The breast implants may be placed either under the breast
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gland and over the pectoralis major muscle (center Right), or under the pectoralis muscle (far Right).
The plastic surgeon then creates a pocket, either directly behind the breast tissue or underneath your chest wall muscle. Implant placement behind the muscle (retro-pectoral) may interfere less with mammograms than if the implant is placed directly behind the breast tissue The choice of incision and site of implant placement depends on the patient’s goals and expectations.
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BREAST IMPLANT FILLER (Saline vs. Silicone)
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A few comments about silicone gel breast implants. Silicone breast implants were taken off the general American market in 1991 NOT because they were found to be unsafe but because the FDA thought they were “inadequately studied”. But silicone breast implants have several important advantages over saline implants. What many Americans do not know is that for this reason and despite their publicized former restriction, the FDA continued to allow plastic surgeons to use silicone gel breast implants throughout the moratorium period in the most challenging of breast cases, such breast reconstruction after cancer, in women with deformed chest walls, in those with little to no breast tissue to offer coverage and in women with severe breast sagging. (Makes one really wonder if silicone gel breast implants were really that “bad”, how could we still use them on anyone?) Between 1991 and 2006, breast implants were studied more extensively than any implant in the history of this country. Sad to say, because of plaintiff lawyers and their pervasive influence, our country’s resources were diverted to studying breast implants more than pacemakers, heart valves, defibrillators or artificial joints.
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On 11/17/2006, after the FDA found silicone gel breast implants to be “safe and effective” with no relation to autoimmune disease or cancer, the FDA removed its restriction on their general use.
Today’s silicone gel breast implants have better more resistant shells and are COHESIVE (The silicone filler in the implant keeps its shape and does not migrate even when the breast implant shell is punctured or cut). On the right is a transversely cut Mentor silicone gel breast implant maintaining its MemoryGelTM filler. (For a VERY impressive demonstration of what happens when a Mentor MemoryGelTM silicone gel breast implant is cut in two, please, click HERE or on the photo on the right).
BREAST IMPLANT SURFACE TEXTURE
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| Cut Mentor Silicone Breast Implant – Silicone Gel fill Stays Put |
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Textured breast implants were engineered to prevent their implant movement and rotation. Unfortunately, their mini-“Velcro” surface, which holds the textured breast implants in place, also results in their having both a higher risk of breast rippling and early deflation. Furthermore, textured saline breast implants cost and are firmer than smooth saline breast implants. Put another way, smooth saline breast implants have less visible shell rippling, feel softer and are cheaper than textured implants. Moreover, unlike anatomical implants, any sideways rotation on their part is not likely to affect the appearance of the breast.
BREAST IMPLANT SHAPE Many plastic surgeons prefer using round breast implants because create more fullness of the upper part of the breast and may enable better cleavage. Teardrop (anatomical or contoured) breast implants were originally developed to provide a more mature breast look. But, they cost more than round breast implants and require a textured surface to prevent their rotation or displacement. In the event that teardrop implants rotate, the breast shape will appear unnatural. A subsequent study determined that a round breast implant takes on the same shape as the teardrop implant when standing. The study also concluded that when lying down, the round breast implant appears more natural in appearance than the teardrop implant because it retains the teardrop shape and the round breast implant does not.
BREAST IMPLANT PROFILE PROJECTION (Low, Moderate, Moderate Plus, High Profile)
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To allow plastic surgeons more artistic versatility in breast augmentation, American breast implant manufacturer produce implants in three different profiles. (The profile being the height of the implant from its base to its roof). So two implants can have the same volume (in ccs) but with different profiles will make the augmented breast look VERY differently. High profile breast implants provide more projection (i.e. height) relative to their base footprint and are generally used in women with narrower chest who wish to have larger cups filling breasts.
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BREAST IMPLANT SIZE / WEIGHT / VOLUME (cc’s)
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| The most frequent dilemma women have is HOW to pick the breast implant size. When they see the large number of available implant choices, many frequently state:
“Doctor, I do not want to be big… I just want to be a full C” We hear this phrase in our office multiple times each day. After all, American women have become accustomed to equate and compare breast volume by bra cup sizes. Studies have reported that 70% of women wear the wrong bra and since bra cup volumes differ between the different bra manufacturers, this way of quantitating breast volume is very inaccurate and is at best a rough estimate.
How did we get here? The bra, as we know it, is really only 100 years old. In 1907 American Vogue was first to actually use the term "brassiere" (old French 'upper arm') in print. The first patent for a
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“Backless Brassiere" bra was filed on 11/3/1914 by Mary Phelps-Jacobs, a New York socialite, who designed it with her French maid. After a few years, she sold her patent to Warner Brothers Corset Company of Bridgeport, Connecticut for 1,500 dollars. Over the next 30 years, Warner made over 15 million dollars and have been producing bras ever since. The flat-chested boyish look was fashionable in the Flapper era that followed WWI and all the early bras flattened the breasts. The first bras with actual different bust sizes were produced in 1928 by the Maidenform Company founded by Russian immigrants Ida and William Rosenthal. In the 1930’s, showing breast shape, instead of flattening them, became popular. In 1935, Warner’s introduced 4 bra cup sizes (A to D), which has since been adopted by all bra manufacturers globally.
Most women favor and use only one or two bra manufacturers because their bras somehow “just fit and feel better”. Why is that? Breasts do not come in only seven fixed cup (A to F) sizes but in a huge range of in-betweens. So a breast that fits nicely in a Bali bra C cup may not fit as well in a C cup in a Goddess, Maidenform or a Victoria’s Secret bra. Bra manufacturers’ cup sizes differ from one another to accommodate this large variety of breast sizes. So, in picking a breast implant size, the use of bra cup sizes is at best a rough starting estimate.
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When presented with this reality the many breast implant choices, many women just retreat by “going big” - asking for the biggest implant they can get. However tempting this may be, doing so may become a very poor long-term solution. Let’s now consider the interaction and balance between the forward lifting of the breast by
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| the breast implants and the downwards gravitational pull by them. Both forces co-exist and are very well represented by the analogy of the balcony. (As a matter of fact, in French slang they refer to big breasted women as:” Il y a du monde au balcon” - there are people on the balcony…”).
We are all familiar with Shakespeare’s Romeo and Juliet's balcony scene.
“But, soft! What light through yonder window breaks?
It is the east, and Juliet is the sun.
Arise, fair sun, and kill the envious moon..” etc
The balcony on the far Left, in the figure below, in Verona, Italy, is purported to be Juliet Capulet’s (aka Giulietta Capuleti, in Italian) famous balcony. It is doubtful that the
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| weight of the 13 year old Juliet standing on this balcony would challenge this structure. Even if her young boyfriend/husband, Romeo, were to have joined her on this balcony, it is doubtful the balcony would have strained under their weights.
But what if instead of continuing their long feud, the Capulet and Motague families decided to make peace and celebrate their kids’ engagement on that balcony? Not good. Some creaking would be heard and felt. Obviously, not all balconies can hold the same weight load. Consider the other balcony on the near Left. Its supports are poor and it would have a hard time supporting ANY weight for a long time.
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The breasts are anchored to the chest by many fragile connective tissue suspension ropes called Cooper’s Ligaments. Once these ligaments have been stretched, the breasts will irreversibly sag (in medical slang - “Cooper’s droop”). The amount of inherent support a breast would give a breast implant would totally depend on the integrity of its Cooper’s Ligaments and the quality of the breast gland and overlying skin. Depending on the extent of breast damage (i.e. sun, UV, smoking etc) and thinning (as with aging), the breast may not be able to hold an implant in place and rapid breast sagging would result.
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| Multiple studies have documented the degree of breast sagging caused by lack of proper support. The repetitive bouncing invariably causes overstretching of the Cooper's with irreversible breast sagging. A study showed that the AVERAGE sized breast, when poorly supported, repeatedly moves an average of 3.5 inches in a 3D figure-of-eight and sustains 70-80 lbs. of force and with every step. Obviously, much higher displacements and stresses are sustained by large breasts.
In addition to causing rapid breast sagging, large implants commonly cause progressive thinning of the overlying breast tissues resulting in less breast coverage
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of the implant with greater visibility of the implant shell folds and appearance of ripples. (This is seen more with saline-filled implants, which are particularly prone to wrinkling, and much more when implants are placed over the muscle). Finally, large implants sometimes detach and lift the cleavage skin zone off the chest wall resulting in a “uniboob” (synmastia or symmastia) condition which is very hard to correct.
When choosing YOUR implant, ask yourself -
How many “people” could YOUR balcony hold and for how long?
Breast implants irreversible change the shape of the breast. You cannot have the breast you started with when the implants are removed. Choose your surgeon wisely - choose a member of The American Society of Plastic Surgeons. Remember, any surgeon can stuff any implant in almost any breast. It takes little skill and no artistry to stuff a large implant in a breast, collect a surgical fee and call it a day. (That is why you have ER doctors, gynecologists, even family practice doctors performing breast augmentations …). However, it does take experience, judgment and an artistic vision to know WHICH implants would look best in WHICH breasts. Therefore, in choosing your breast implants, choose wisely! For your sake, do not insist on large implants IF your breasts would not hold them for more than a few months. If you so insist, someone would readily accommodate your wishes regardless of the long-term irreparable consequences to you.
Breast Enlargement Procedure - Depending on the technique and implants used, the procedure usually lasts 1 to 2 hours and is done as an outpatient procedure. You may have temporary soreness, swelling, bruising, change in nipple sensation. You're likely to feel tired and sore for a few days following your surgery, but you will be up and around the same day.
Recovery – Dr. Aldea and Eby are extremely concerned for your well-being. To minimize swelling and post-operative pain, Dr. Aldea and Dr. Eby use a gentle breast enlargement surgery technique. In addition, they place a long-lasting pain relieving medication inside the operated breasts which nicely controls pain in most women. Any subsequent discomfort will then be easily managed by a pain medication prescribed by Dr. Aldea and Dr. Eby. Depending on your occupation, most women return back to work in less than a week and to more strenuous activities (including gym) in 3 to 4 weeks.
Implant Longevity - All man-made devices, airplanes, cars, roofs, tires etc, eventually fail. Breast implants are no exception and will eventually deflate and will need to be replaced. No one knows how long breast implants last. Although today’s breast implants – both saline and silicone gel – now have better envelopes than ever before and are more durable than earlier implants, eventually they will leak. They could leak the day after surgery or 25 years afterwards. Breast implants are not lifetime devices and any woman going into surgery should know that even without complications, her implants will likely need to be replaced once or even twice during her lifetime. (Click HERE for studies on MemoryGel™ Breast Implant rupture rates)
Potential complications of breast augmentation may be bleeding, infection, formation of noticeable scar tissue around the implants (capsule contracture) which may cause the breast to feel tight, undesired implant shifting or movement sideways or lower on your chest, palpable or visible waviness or rippling of the side breast skin or changes in nipple sensation. While the majority of women do not experience these complications, you should discuss each of them with your surgeon to make sure you understand the risks of breast augmentation.
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Picking YOUR BEST Breast Implants Dr. Aldea and Dr. Eby are the first and still the only Plastic surgeons in Tennessee who offer their breast augmentation patients a thorough consultation which includes a never seen before ability to see themselves digitally augmented with any breast implant on the US market.
You will be able to see yourself from every conceivable angle just as the world sees you and be able to pick the breast implant which is right for you with unmatched accuracy. To see and read more, please, refer to our 3D Scarless Virtual Breast Augmentation page.
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| You can get a good idea of the cost of breast augmentation charged nationally by ABPS board-certified Plastic surgeons, by checking the latest (2007) fee survey by the American Society of Plastic Surgeons of the professional fees charges by its members. (Please, check it on our Fees and Costs page). In addition, you may also visit THIS page on the website of the ASPS.
Dr. Aldea’s and Dr. Eby’s charges for a breast enlargement procedure are LOWER than these national fees (even when travel and lodging expenses are added) and extremely competitive with the charges by plastic surgeons within our own metropolitan Memphis area. Moreover, our office will strive to beat any comparable, written breast
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augmentation cost estimate from any plastic surgeon in Memphis. In addition, our office works with several financing companies which would make your breast augmentation surgery even more affordable.
But the actual dollar cost of breast augmentation is more than eclipsed by its REAL value to a woman. A breast enlargement invariably greatly improves appearance, makes women more attractive and turbo-charges their self-confidence. It is truly hard to put a price on the actual value of a breast augmentation.
Please, consult our SPECIAL OFFERS page for details on our time-limited Plastic Surgery savings for the holidays.
As many women know too well, being flat-chested in our society can be embarrassing and extremely socially limiting. But with current modern breast augmentation plastic surgery and new safer breast implant technology, you need not settle or resign yourself to remain flat chested.
Breast Augmentation surgery transforms lives. No wonder it is the most commonly performed cosmetic surgery in the country and locally. The positive transformation is immediate and our patients LOVE it! Breast enlargement transforms introverts into extroverts. Many of our patients repeatedly tell us just how thrilled they are with their new chests and new found confidence and sexuality. Unprompted, many tell us that the ONLY regret they had is not having had their operation sooner!
Please, see some patient feedbacks and be sure to also visit ourREVIEWS page and see for yourself what some of our patients said. Some other patient feedback may be found on Nicole's website. Comments such as these make Dr. Aldea and Dr. Eby extremely proud of what they do
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| Can Breast Augmentation Surgery answer your particular needs? Drs. Aldea and Eby are experienced breast experts who have performed hundreds upon hundreds of breast augmentations. Drs. Aldea and Eby are particularly honored to have physicians, nurses and other health care among the hundreds of patients who put their trust in them. Dr. Aldea and Dr. Eby are talented, board-certified Plastic surgeons who are committed to perfection and a determination to exceed your expectations. By using a customized analytic approach to each woman and the safest breast implants in the USA, they are able to offer their patients attractive naturally appearing breasts.
Call us today at (901) 752-1412 to schedule your consultation. We are confident you will not be disappointed!
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Additional Resources
• Dr. Aldea is a featured BREAST AUGMENTATION EXPERT on RealSelf.com
• To see a very instructive, step-by-step 3D demonstration of a breast augmentation procedure visit THIS PAGE at the American Society of Plastic Surgeons (ASPS) and choose the procedure(s) of interest to you.
• For more information – click HERE tio visit the American Society of Plastic Surgeons
• FAQ’s at the Mentor (one of the largest breast implant manufacturers) web site. Click HERE
• Before and After Pictures
You may see other Breast Augmentation Before-and-After images at the following locations:
• ASPS - click HERE
• ASAPS - click HERE
• Implantinfo - (Please, note that due to its multiple sources, photos may be subjective and not always accurate. However, the website makes a great effort to educate its visitors). Click HERE to visit.
• Comprehensive online resource on breast implant safety, please consult www.breastimplantsafety.org . (http://www.breastimplantsafety.org/). This web site presents the as the advantages and disadvantages of both saline breast implants as well of silicone implants. It also covers medical research, safety information, clinical trials, links to other informative Web sites and more.
• For more information and updates on silicone gel filled breast implants you may visit www.siliconegelimplants.com .
• For the position of the American College of Surgeons on the safety and availability of silicone gel filled implants please review www.facs.org/ahp/testimony/breastprostheses.html .
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Mentor wishes to reward confidence and loyalty in its breast implants.
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The company will reward women who referred friends to this practice if those friends subsequently had a breast augmentation with Mentor implants. Please, click on the LINK to find out more.
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Comparison of Mentor and Allergan-Inamed Breast Implant Warranties*
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| Standard Advantage |
Enhanced Advantage |
Confidence Plus |
Confidence Plus PLATINUM |
Cost |
Free
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100 dollars |
Free
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100 dollars |
| Enrollment |
Automatic |
(must enroll within 45 days of surgery) |
Automatic |
(must enroll within 30 days of surgery) |
Noncancelable
Lifetime Implant Replacement |
Yes |
Yes |
| Size / Style replacement |
Any size / Any style
(A charge may apply on implants with a higher list price than originals)
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Any size / Any style
(A charge may apply on implants with a higher list price than originals)
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| Duration |
10 years |
10 years |
10 years |
10 years |
Financial
Assistance
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Up to 1,200 dollars OR and Anesthesia costs
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Up to 2,400 dollars
- Up to 1,200 dollars operating room and Anesthesia costs
- Up to 1,200 dollars in Surgical fee costs
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Up to 1,200 dollars OR and Anesthesia costs
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Up to 2,400 dollars
- Up to 1,200 dollars operating room and Anesthesia costs
- Up to 1,200 dollars in Surgical fee costs
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| Implants covered |
Both Saline and Silicone implants
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Both Saline and Silicone implants |
| Contralateral implant replaced at same time |
Yes
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Yes
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Yes |
Yes
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Warranty does NOT cover implant removal due to
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1. Removal of intact implants due to capsular contracture, wrinkling or rippling
2. Loss of implant shell integrity resulting from reoperative procedures, open capsulotomy or closed compression capsulotomy procedures
3. Removal of intact implants for size alteration
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* NB – You are solely responsible for verifying the accuracy of this table. Cosmetic Surgery Specialists of Memphis, PLLC, its physicians and employees will not be responsible for any errors, misrepresentations, changes, or omissions in the contents of the tables. You should contact Mentor and ALLERGAN-Inamed directly for the latest information before relying on any of the information above.
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For your convenience, you can have this page translated into either Spanish, French, German, Italian or 8 other languages. All you have to do is choose the language you want this page to be translated to on the Right.
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Para su conveniencia, usted puede tener esta pagina traducida en Espanol u otros 10 lenguajes mas. Lo unico que usted tiene que hacer , es elegir "Spanish" decea en el menu de la derecha.
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This web site has been prepared to give you a basic understanding of this type of cosmetic procedure. If you want to learn more or have any further questions, please call us at (901) 752-1412 to arrange a consultation with one of our doctors. You will be under no obligation to undergo surgery by attending a consultation with either Dr. Aldea or Dr. Eby.
Please, call 752-1412 for your appointment today!
Cosmetic surgery is an investment in yourself.
An investment which could make a world of
difference in your outlook.
Peter A. Aldea, M.D. Patricia L. Eby, M.D.
Certified and Re-Certified by The American Board of Plastic Surgery
Members of the American Society of Plastic Surgeons
Fellows of The American College of Surgeons
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Cosmetic Surgery Specialists of Memphis, PLLC
6401 Poplar Avenue, Suite 360, Memphis, Tennessee 38119
Telephone (901) 752-1412
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