Breast Implants -- Through the Armpits

When M.A. starting thinking about getting breast implants, she remembered a co-worker who once had the same procedure. (M.A. asked to remain unidentified for medical privacy.)

A 30-year-old, single working mom of a seven-year-old son, M.A. watched as the co-worker searched the Internet for just the right Las Vegas plastic surgeon with impressive training and the best possible before and after pictures of his work.

Before M.A. had a child, she was a full D cup. But child birth and nursing naturally cause changes in the body, and her bust line shrunk to a full C and then to a full A.

“Breast augmentation was something I wanted to do just for myself”

Breast Enlargement

"Breast augmentation was something I wanted to do just for myself," says M.A. who, inspired by her friend's experience, turned to the Internet. There, she found a discussion group that explained what breast augmentation was like from the very first consult to final healing. She also watched each and every episode of Dr. 90210 with a hungry eye.

Moreover, M.A. has a special medical consideration and kept an eye out for a Las Vegas plastic surgeon who has some extra experience with her particular condition.

"My ethnic background is Philipino and I know from past experience that my scars will be keloid." (Read more about scar revision.)

Keloid scars result from an overgrowth of tissue at the site of a surgical incision or other skin injury. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can be lighter or darker than the surrounding skin. (Read more about keloids.)

"Due to the keloid scarring, the surgical incisions to place the implants could only be in my armpits where they would be hidden," she says.

Breast Augmentation Photos

Patient M.A. at age 29 before her breasts implant procedure (left), and three months after the procedure (right), M.A. is a full D cup.(Photos, courtesy of Dr. Cambeiro, M.D.)

Breast Implant Surgery

Being ever the wise consumer, M.A. arranged consults with several Las Vegas plastic surgeons. Her continuing research kept bringing her back to information about a board certified Las Vegas plastic surgeon, Arthur Cambeiro, M.D., who appeared to be the only local board certified plastic surgeon with patients who were also subject to keloid scarring. She saw a second surgeon and made a non-refundable deposit on a breast enlargement.

"While waiting for the appointment, I continued researching and was constantly referred back to Dr. Cambeiro," she says. "Eventually, I decided to go with him, even though I had to forfeit the deposit with the second surgeon."

After the procedure, M.A. was delighted with the results. However, the keloids did, as expected, develop on her incisions.

Breast Surgery

M.A. chose saline breast implants, placed under the chest muscle, and inserted through the armpit (this method reduces the visibility of scaring). She had the procedure on a Friday and returned to work the following Tuesday, wearing loose, flowing clothing. She reports feeling pain only in her back from sitting up while sleeping during recuperation. It was such an effort to get back up after reclining, she decided to just sit on her couch for a while.

“I continued researching and was constantly referred back to Dr. Cambeiro”

"Even though I wanted breast enlargement, I'm still shy and modest and did not want to show off my new bust line with a plunging neckline and the like," she says. "Happily, nobody at work noticed I had the enhancement done."

Next, Dr. Cambeiro worked over the next year to lessen the appearance of her keloid scars and made sure that they were even with the rest of her skin. Untreated keloids scars almost always bulge above the surface of the surrounding skin.

"The scars are now just a little darker and rougher than the rest of my skin but are completely hidden," M.A. says. "The people who've seen me in a bathing suit, and knew me before I got pregnant, tell me the implants are just the right size for me and that I look totally natural.

"I couldn't be more pleased!"

Malaria

The Facts on Malaria

Malaria is a parasitic infection spread by Anopheles mosquitoes. The Plasmodium parasite that causes malaria is neither a virus nor a bacterium - it is a single-celled parasite that multiplies in red blood cells of humans as well as in the mosquito intestine.

When the female mosquito feeds on an infected person, male and female forms of the parasite are ingested from human blood. Subsequently, the male and female forms of the parasite meet and mate in the mosquito gut, and the infective forms are passed into another human when the mosquito feeds again.

Malaria is a significant global problem. There are approximately 216 million cases of the disease worldwide, killing about 655,000 people every year. Malaria is prevalent in Africa, Asia, the Middle East, Central South America, Hispaniola (Haiti and the Dominican Republic), and Oceania (Papua New Guinea, Irian Jaya, and the Solomon Islands).

Each year, up to 1 million Canadians travel to malaria-endemic areas. This results in 350 to 1,000 annual cases of malaria in Canada.

Although the parasite has progressively developed resistance to several older antimalarial medications, there are still many safe and effective medications both for treatment and prevention.

There are four species of the Plasmodium parasite that can cause malaria in humans: P. falciparum, P. vivax, P. ovale, and P. malariae. The first two types are the most common. Plasmodium falciparum is the most dangerous of these parasites because the infection can kill rapidly (within several days), whereas the other species cause illness but not death. Falciparum malaria is particularly frequent in sub-Saharan Africa and Oceania.

Causes of Malaria

You can only get malaria if you're bitten by an infected mosquito, or if you receive infected blood from someone during a blood transfusion. Malaria can also be transmitted from mother to child during pregnancy.

The mosquitoes that carry Plasmodium parasite get it from biting a person or animal that's already been infected. The parasite then goes through various changes that enable it to infect the next creature the mosquito bites. Once it's in you, it multiplies in the liver and changes again, getting ready to infect the next mosquito that bites you. It then enters the bloodstream and invades red blood cells. Eventually, the infected red blood cells burst. This sends the parasites throughout the body and causes symptoms of malaria.

Malaria has been with us long enough to have changed our genes. The reason why many people of African descent suffer from the blood disease sickle cell anemia is because the gene that causes it also confers some immunity to malaria. In Africa, people with a sickle cell gene are more likely to survive and have children. The same is true of thalassemia, a hereditary disease found in people of Mediterranean, Asian, or African American descent. (See the article on "Anemia" for more information.)

Symptoms and Complications of Malaria

Symptoms usually appear about 12 to 14 days after infection. People with malaria have the following symptoms:

• abdominal pain
• chills and sweats
• diarrhea, nausea, and vomiting (these symptoms only appear sometimes)
• headache
• high fevers
• low blood pressure causing dizziness if moving from a lying or sitting position to a standing position (also called orthostatic hypotension)
• muscle aches
• poor appetite

In people infected with P. falciparum, the following symptoms may also occur:

• anemia caused by the destruction of infected red blood cells
• extreme tiredness, delirium, unconsciousness, convulsions, and coma
• kidney failure
• pulmonary edema (a serious condition where fluid builds up in the lungs, which can lead to severe breathing problems)

P. vivax and P. ovale can lie inactive in the liver for up to a year before causing symptoms. They can then remain dormant in the liver again and cause later relapses.P. vivax is the most common type in North America.