What Treatment Options Exist For Correcting A Capsular Contracture After Breast Augmentation?

What is a Capsular Contracture?

Capsular contracture is a rare, but concerning complication of breast augmentation. While breast augmentation continues to be one of the most common aesthetic procedures undertaken in the USA, capsular contractors can and do occur. Capsular contracture refers to a process where your body forms an abnormally hard shell around your implant, causing pain, discomfort, and loss of the breast shape. While this complication is obviously concerning, we routinely treat this unfortunate complication at our facility for all types of patients. As with all types of plastic surgery, treatment of this problem begins with defining the problem and how it specifically effects you.

4 Stages of Capsular Contracture

Grade I Capsular Contracture

To begin, all breast implants cause creation of a capsule. The magnificent machine that is the human body recognizes the presence of a foreign body internally. It then creates a soft capsule around the breast implant that is completely organic and physiologic. This capsule is actually quite helpful for both patient and plastic surgeon, as it creates a permanent “home” for the breast implant. This type of capsule is considered a Grade I capsule. No treatment or surveillance is necessary at this stage. This is actually what both patient and plastic surgeon want to have. Grade I breast is normally soft and appears natural in size and shape

Grade II Capsular Contracture

When the capsule begins to thicken up, and the implant feels slightly firmer, but does not change its overall shape, the capsule is then considered a Grade II capsule. The good news is that surgery is usually NOT indicated. In these instances, we treat the capsule through medical and mechanical means only. Lymphatic massage, ultrasound therapy, and the use of Zafirlukast can often reverse thickening at this stage, and salvage your augmentation. Grade II breast is a little firm, but appears normal.

Grade III Capsular Contracture

The next stage of capsular contracture involves continued hardening of the implant capsule, but now the hardening has changed the overall shape of your implant and/or breast. Grade III breast is firm and appears abnormal. This type of contracture is considered Grade III, and is obviously extremely distressing to women, but it can be treated!! Treatment involves a careful balance of medical and surgical management, and as always, it relies upon wide open communication between our staff and you. In this stage, the capsule has created a mechanical compression of the implant. These patients do require surgical revision. As always, the type of surgery used is individualized to the patient, and we have a number of different approaches to choose from:

    • Partial Capsulectomy – This procedure involves removal of only a portion of the capsule. This is our least common procedure for treatment of contracture, but it does play a role for some patients who have a focused area of scar contracture. Typically, this type of procedure is done on patients who have not had appropriate unilateral descent of their implant. Surgery involves removing only the offending area of capsule. Post-operatively, patients are started on lymphatic massage and medical therapy. In appropriately selected patients, this treatment is very effective, but not all patients are candidates for this approach. We do not use surgical drains with this procedure.
    • Total Capsulectomy – This operation removes the entire capsule and all associated scar tissue with your existing implant. Once the implant and capsule are removed, a new implant is placed after the entire area is irrigated with a triple antibiotic solution. This type of procedure may also require a breast lift be done simultaneously, depending on the shape and size of the breast.
    • Neopectoral Pocket – This operation uses the abnormal capsule to our advantage! In this procedure the capsule is meticulously dissected free from the surrounding breast tissue and muscle. Once this is complete, the capsule is then collapsed down to the chest wall and oversewn to provide more projection and volume to the new implant. This is a fantastic approach to contracture, and it provides some of our best results. Unfortunately, a small 8mm surgical drain is required on each side for this procedure. The drain usually removed between days 3-5 after surgery. This is a highly specialized procedure that we perform.
    • Implant Plant Exchange with Strattice – There is a great deal of long-term clinical data that suggests that implants placed above the muscle may have more capsular contracture than implants placed below the muscle. If you have an above the muscle implant with contracture, the treatment of choice is total capsulectomy, removal of your current implant, and placement of a new implant beneath the muscle with a Strattice sling. This procedure is our most common form of revision, as it provides a soft, natural look to your breast. Strattice is a type of biologic mesh that revascularizes once inside your body. It essentially becomes part of the breast structure, providing a permanent internal support bra for your implant in its new position.
  • Implant Removal Only – This is a very viable approach to treating contracture, and while most clients wish to save their augmentation, many do not want to keep their implant. Removal of the entire implant without capsulectomy can be done with local anesthesia only. In this approach, the capsule is left behind, but it will commonly soften up over time. In cases where it continues to be hardened, secondary capsulectomy can be used at a later date to reduce internal scar burden.

Grade IV Capsular Contracture

The last stage of capsular contracture, Grade IV, involves a permanent dull throbbing pain, and commonly, a sense that the breast feels cooler to the touch. As with Grade III, your treatment options are the same. Patients again are maintained post-operatively on maximal medical therapy (massage, Zafirlukast). Use of total capsulectomy with Strattice sling is very common in this group. Grade IV – the breast is hard, painful to the touch, and appears abnormal

In summary, there are multiple treatment options available for women who have experienced capsular contracture of their breast implants. Treatment options vary from non-surgical treatment options to implant removal. Capsular contracture does not necessarily require permanent removal of the implant.

Have You Asked Yourself The Right Questions Before Your Breast Lift Surgery?

It’s quite normal for someone expecting a breast lift surgery to seek out as much information as possible concerning the procedure. However, while you seek answers from professionals and other sources, you might forget to ask yourself some critical questions concerning your operation.

Sometimes, you might overlook really sensitive self-evaluations concerning your true motivation for seeking surgery. If you don’t critically analyse such personal aspects, you might never be truly satisfied with the results of surgery.

1. Why Do You Really Want the Surgical Operation?

If you are not concisely clear about the exact reason for seeking surgery, you wouldn’t know which particular operation you need.

Perhaps, you might not be too sure whether you just want to improve the perkiness of your boobs or you also need to improve their size. In this regard, you should realize that a breast uplift would only improve perkiness; whereas, an augmentation surgery would be the option to take for a fuller appearance.

Therefore, if you go for a lifting procedure, you should be very comfortable with the size of your boobs. Otherwise, you might find yourself going for follow-up surgery just to get in some implants, when this might have been done altogether in one operation.

Fortunately, expert surgeons can help you visualize the expected results of surgery so that you can actually have a feel of what you will get. This should help clear your mind on your expected goals.

2. What Led You to this Decision?

The underlying reason for seeking surgery would also play a key role in the satisfaction you get from surgery. You definitely need to have legitimate reasons, especially since the operation would have long-lasting effects, which you cannot easily undo if you change your mind afterwards.

You shouldn’t base your reasons on other people, like trying to get the appearance of well-known celebrities. Basing your decision on flimsy fashion trends is also not advisable, since such trends can easily change.

Your decisions should be based on improving your physical appearance or improving your own self-esteem.

Indeed, a study carried out at the Boston’s Children Hospital revealed that corrective breast surgery would be instrumental in combating poor emotional well-being and low self-esteem in teenage girls who had asymmetric breasts. This study uncovered the fact that the effects of having uneven or abnormally large breasts had the potential of significantly affecting the mental health of teenage girls. Hence, the legitimate need for surgery.

3. How Will You Deal With Scars?

The fact that surgery would involve some extent of incision means that you will have a bit or scarring. For sure, such scarring wouldn’t be too visible, since modern surgical techniques greatly minimize the extent of incisions during surgery.

However, it may be that you would be involved in certain activities, whereby you wouldn’t want even that little bit of scarring to be visible. Therefore, you might need to re-schedule your operation to a later date.

You would need to make a similar consideration regarding breastfeeding and pregnancy. Have you finally decided that you won’t have any more children? If you haven’t, it would be better if you delay the operation until later.

Breast Augmentation: Complications Caused By Breast Implants

Whether you have a silicone or saline implant, which are the main types of implants used in breast augmentation, you face possible risks and complications that are likely to occur either in the early stages of surgery or during the latter stages. As much as the result of surgery may be quite appealing, it doesn’t mean everything would always go smoothly. On the contrary, augmentation procedures may have various complications.

Here are some of the complications you are likely to encounter:

During the Early Stages

Some issues that may arise during the early stages include:

Infections

Cosmetic surgeons normally use an antibiotic in order to avoid any infection that may occur when an individual decides to have an implant.

Some of the symptoms that show you are infected are itching of the nipple, redness and swelling of the breasts. Without appropriate preventive measures, such infection is one of the complications that is likely to occur.

Hypertrophic scars

This is the kind of scar that normally occurs on the skin as a result of surgery. Such scars are normally puffy, red and always stand out on the skin. The scar is likely to affect an individual who has undergone augmentation of the breasts. Fortunately, the percentage of individuals affected by such a scar is low, but it’s still a complication that is likely to occur.

Implant exposure

The implant can get exposed through an open wound that occurs when wounds separate and in turn expose the implant. This might require corrective surgery to close the wound back to the way it was.

Late Complications

These are the late or latter complications that are likely to occur:

Leakage or breast implant rupture

Breast implant rupture is a common complication that normally occurs with saline breast implants. When it ruptures, you can easily notice the symptoms of such rupturing.

With regard to silicone breast implants, it’s not that easy to detect any symptom that the implant has ruptured, which might pose certain health risks.

Imbalance of breast sizes

The sizes of your breasts may differ, with one breast being a little bigger than the other. This, in turn, forces an individual to go back for another surgery in order to restore balance in breast sizes.

Breast imbalance occurs when implants are not placed in the correct position or they start sagging, so they have to be corrected through surgery.

Loss of breast sensation

Surgery might affect sensitivity of the nipple; hence, you might not be able to experience any kind of sensation around the nipple. Fortunately, not every woman who undergoes this surgical procedure ends up losing breast sensation. A good number of people who have undergone surgery still maintain sensitivity of their breasts.

Despite such risks of complications, you can reduce your chances of developing such adverse effects by enlisting the services of a competent plastic surgeon. Such a surgeon would have extensive experience handling numerous surgical procedures, which would enable him/ her to easily identify and prevent potential complications.

Breast Lift: Myths Vs Facts

Are you new to surgical cosmetic procedures and do not know whether what you have been told is myth or fact? Here are a few misconceptions that surround breast lift surgery that have been proven to be simply myths.

1. Chest Exercises Will Keep Your Breasts From Sagging

Fact: Exercises will help improve your pectoral muscles, which are found beneath the breasts, but they will have no effect on the positioning of your breasts. Breasts tend to sag as a result of various factors such as age, weight fluctuations and heredity. Breasts are made of fatty cells and contain no muscles. Hence, chest exercises may improve the appearance of breasts as a result of exercising the pectoral muscles underneath, but there is no way to prevent sagging save for a surgical procedure.

2. High-Impact Exercises such as Running Will Cause Sagging of Breasts

Fact: There is very little research available on this particular matter; however, there has been no known link between high-impact exercises and sagging breasts. You are advised to wear a sports bra during exercise as this will help prevent a sore chest caused by your breast moving around too much. You are more likely to develop sagging breasts as a result of overexposure to the sun as compared to high-impact exercises.

3. Getting Breast Implants Will Make Your Breasts Perky

Fact: Plastic surgery is different for everyone as each person has his/ her specific needs. Different breast procedures have different results. For instance, breast augmentation will increase the size of your breasts, but may not necessarily make them perkier. However, a lifting procedure combined with breast augmentation may help your breasts look perkier.

4. Your Cosmetic Surgery Results Will Last Forever

Fact: Breasts will sag for a number of reasons such as weight, age and hereditary. A procedure involving lifting of the breasts will only cheat the clock for a few years; however, there is no way to prevent the ageing process. Breasts sag as skin loses its elasticity, and eventually its firmness. In as much as you cannot expect your breasts to look younger a few years after the procedure, they will look better than they would have had had you not done the procedure.

5. Fat Transfers Make Your Breasts Immune to Weight Fluctuations

Fact: The fat cells in your breasts are affected by weight loss just like the fat cells in other parts of your body. In as much as a breast procedure will make your breasts look youthful, there is nothing you can do to prevent the effect weight fluctuations will have on their appearance. You can prolong the results from your procedure by maintaining a constant and healthy weight.

6. Creams and Supplements Can Replace Breast Procedures

Fact: Do not fall into the trap of various products on the market, claiming that they can magically enhance the shape, size and beauty of your breasts. Because sagging is caused by natural elements such as the skin losing its elasticity, no amount of miracle portion will reverse that.

Signs Of A Botched Breast Augmentation Surgery

There is often a certain level of fear among patients who wish to undergo augmentation surgery, especially if it is their first time. There are always questions on whether the results will be as expected or whether they would need corrective surgery. A failed attempt at increasing breast size is what most patients fear.

How do you know whether your surgery was a success or not? Here are signs that your surgery was botched.

1. Excessively Firm Implants

Do your implants feel natural to you? Are they too firm, and not soft and supple? Usually, the first sign of a botched breast surgery attempt is implants that feel too hard. Your surgeon may have used poor quality implants, instead of using the more popular silicone implants. If this is the case, you may want to have the implants removed and replaced with better quality ones.

2. Ruptures And Leaks

Although rupturing of implants can accidentally happen, they are usually a sign of a botched surgery. Silicone and saline implants are known to rupture every once in a while. These ruptures are often caused by a simple mistake a surgeon makes. If there is a leakage in your saline implants, then you will notice them shifting and changing shape over the course of a few days. Despite the fact that silicone ruptures are known to happen, they are harder to detect. Signs of a silicone implant rupturing are unusual breast lumps, soreness, swelling and aching.

3. Problems With Implant Positioning

Sometimes surgeons make the mistake of positioning one breast significantly higher than the other one. If you have noticed this problem, it’s important that you notify your surgery immediately to discuss ways in which it can be corrected. This is a problem that is also found in breast lift procedures, and would require corrective surgery.

4. Differences In Size

If, after having implants inserted, you notice that one breast seems bigger than the other, you should notify your surgeon immediately. This mistake occurs when the surgeon uses two different-sized implants, or does not take into account the size and shape of the breast prior to surgery. Unless you want to walk around with unevenly sized breasts, you will need to undergo corrective surgery as soon as possible, and preferably get it done by another surgeon who’s better qualified.

5. Wrinkled Skin

If you notice any kind of wrinkling around the implant, then you should notify your doctor immediately. It may be a sign that your implant is leaking. Your skin should be smooth and wrinkle free. If that is not the case, then you need to have a doctor look at it.

6. General Sickness

A botched breast augmentation surgery can also present itself through a high fever, excessive scarring, constant pain, hardening of breasts, as well as inflammation and itching.

If you have any of these signs, it’s important that you see a doctor immediately who will advise you on the kind of treatment you need, and whether or not you require corrective surgery.

Hidden Costs Of Breast Lift Surgery

Because plastic surgery is elective, and not entirely necessary, costs almost always fall on the patient. It’s also common knowledge that cosmetic surgery is rather expensive and most patients are required to pay some percentage of the money upfront.

In as much as you may be prepared to pay for the procedure, are you aware of some of the hidden costs of plastic surgery? Here are some of them:

Money

According to the American Society of Plastic Surgeons, as of 2014, a breast lift costs on average $4,377. Even if you may be given a figure of how much the surgery would cost, there is no true way of determining the exact figure. This is because of all the things that you may be charged for which will not be included in the initial quote.

For instance, your consultation may be charged separately from surgery. You may also be required to pay for the prescription medication you’ll be given to deal with pain and reduce the risk of infection. Furthermore, it will be more costly for you if you experience complications which require you to be taken to hospital.

Because of these issues, it’s always advisable that you have a little bit of extra money to use, just in case of any hidden cost you may not be aware of.

Time Off From Work

Some people fail to take into account the fact that they’ll not be able to go to work for several days following the procedure. Most companies don’t allow their employees to take sick days off for a surgery that they elected to have. For the number of days you’re unable to work, your employer may choose to deduct this from your salary.

If you own a business, you need to consider that you may not be in the best shape to conduct business as you normally would. You could instead hire someone to oversee your business for a few days, or you could decide to close it down temporarily. Each of these options will cost you money.

Long-Term Health

In as much as plastic surgery is done to enhance a person’s appearance, it can have adverse effects on health. Hence, it’s important that you go for general check-up to determine whether you are physically capable of undergoing surgery. You should make sure your doctor has chosen an implant that is safe and that he/ she will use anaesthesia that is medically acceptable.

Relationships

You shouldn’t be surprised that plastic surgery can affect your relationships. It does have a way of changing how you feel about yourself, as well as how you view others.

If you were not comfortable in your body before, now you are. This will affect your relationships in many ways; for instance, you and your partner may even experience a new level of intimacy as a result of your new-found confidence. Also, people may respond to the positive and confident new look you possess, and they too will begin to treat you with respect.

Calm Redness Relief Moisturizer Normal to Oily

Jar Packaging:No
Tested on animals:No

If you have extra-sensitive skin that’s also oily or acne-prone, chances are you’ve had trouble finding a moisturizer that fits your needs. Fortunately, Paula’s Choice has you in mind with their Calm Redness Relief Moisturizer for Normal to Oily. A sheer gel-cream, it provides just enough hydration to suit those with its namesake skin type, and, like all formulas from the brand, is fragrance free.

Packaged in a plastic squeeze tube, its lightweight texture feels pleasant on skin and dries quickly without leaving a residue behind.

A look at its formula reveals that it takes its “redness relief” claims seriously. Licorice extracts, allantoin, beta-glucan and willow herb, just to name a few of its ingredients, provide both antioxidant and anti-inflammatory benefits to skin. There is a good dose of these (and other) soothing agents contained within the Calm Redness Relief Moisturizer. What it doesn’t contain are heavy oils or other emollients, which is evident from its sheer feel on skin. (So light, in fact, that it layers well under a sunscreen, or over serums and other treatments.) Of course, since this moisturizer is for sensitive, redness-prone skin, we love that it doesn’t contain a single ingredient known to cause redness-worsening irritation.

Your skin will also benefit from the ample free-radical protection and soothing effects of its antioxidant blend, and reparative ingredients like sodium hyaluronate.

Calm Redness Relief Moisturizer for Normal to Oily earned its rating thanks to its formidable range of beneficial anti-redness and antioxidant ingredients as well as its pleasant gel texture that’s ideal for its intended skin types (even if you’re also prone to breakouts). If you count yourself among those with oily to combination extra-sensitive skin (whether you’re battling rosacea, redness or a “finicky” complexion), this moisturizer may be the perfect choice for your needs.

Pros:

  • Sheer, hydrating texture is ideal for combination to oily skin.
  • Blend of anti-redness and reparative ingredients makes it suitable for extra-sensitive skin.
  • Layers well and dries without leaving a residue on skin.
  • Fragrance free.

Cons:

    • None.

CLAIMS
Calm Redness Relief Moisturizer for Normal to Oily Skin has a soothing, lightweight formula that instantly calms and hydrates sensitive, reddened skin so it can quickly look and feel better. Antioxidants, anti-irritants and cell-communicating ingredients work to help sensitized, reddened skin behave more normally (more like young skin!) while skin-identical ingredients prevent moisture loss and help maintain skin’s barrier so it becomes smoother and more resilient.

INGREDIENTS
Water (Aqua), Cyclopentasiloxane (silicone/skin-conditioning agent), Glycerin (skin-repairing ingredient), Butylene Glycol (water-binding agent), Bis-Phenylpropyl Dimethicone (silicone-based skin-conditioning agent), Glycyrrhiza Glabra (Licorice) Root Extract, Allantoin (anti-irritants), Beta-Glucan (anti-inflammatory antioxidant), Dipotassium Glycyrrhizate (licorice-derived anti-irritant), Epilobium Angustifolium (Willow Herb) Flower/Leaf/Stem Extract (anti-irritant), Phenyl Trimethicone, Dimethicone (silicone-based skin-conditioning agents), Dimethicone/Vinyl Dimethicone Crosspolymer (silicone-based texture enhancer), Sodium Hyaluronate (skin-repairing ingredient), Arctium Majus (Burdock) Root Extract (plant anti-irritant), Camellia Sinensis (Green Tea) Leaf Extract (anti-inflammatory antioxidant), Laminaria Saccharina (Algae) Extract (water-binding/soothing agent), Vitis Vinifera (Grape) Seed Extract (antioxidant), Panthenol (skin-repairing ingredient), Sodium Acrylate/Sodium Acryloyldimethyl Taurate Copolymer (film-forming/thickening agent), Hydroxyethylcellulose (thickener), Isohexadecane (dry finish solvent), Sodium Carbomer (gel-based thickener), Polysorbate 80 (emulsifier), Ethylhexylglycerin (skin-conditioning agent), Phenoxyethanol (preservative).

Peekee Bar

Jar Packaging:No
pH:6.50
Tested on animals:No

It’s official, Drunk Elephant knows a thing or two about what makes a great bar.  Well, of the cleansing variety, that is, because their interesting and unique Pekee Bar has certainly redeemed this category of skincare products.  Eschewing the negative qualities of most bar cleansers (wait for it), this mild, water-soluble formula works well for most skin types—including the sensitive and acne-prone.

Before we continue, we’ll explain why bar cleansers tend to be the wrong choice for keeping your skin healthy. The classic bar soap is formulated via a process that results in an alkaline (high) pH, which is irritating to naturally acidic skin. Bar cleansers also use fatty ingredients that keep it from rinsing easily, which can lead to dull-looking skin.  The combined result is that such formulas are often damaging to skin over the long term, keeping your skin in a cycle of sensitivity and potentially making conditions like acne worse.

Happily, Pekee Bar avoids these faults by evolving beyond the standard soap-making process (using lye and solid fats). This formulary feat was so surprising that weren’t certain exactly how Drunk Elephant did it—so we reached out to the brand and founder Tiffany Masterson explained their approach.

“High pH, residue and irritation were among my must-not-have characteristics for these bars, so I opted for a mild syndet (‘synthetic detergent’) over a soap detergent.  I combined the surfactants Sodium Coco-Sulfate and Disodium Lauryl Sulfosuccinate with a natural binder, to make up the syndet formulation.  We use wheat germ starch to bind the bar’s ingredients together.  [Drunk Elephant’s] bars are not what you would call a traditional “soap” product.”

The result is a fragrance-free bar cleanser that behaves like a liquid on skin—leaving no residue and contains no irritating ingredients.  (We feel like there should be a mic drop right there, but we digress.)

Aside from the mild cleansing agents, there is also the inclusion of moisturizing ingredients and anti-irritant ingredients.  As mentioned before, this works well for most skin types—the amount of moisture is slight, and rinses cleanly.  (Those with very dry skin may prefer a more emollient cleanser.)  We found that, despite it being a mild formula, it easily removed both sunscreen and makeup.  For those Clarisonic users out there, this worked well with the cleansing tool (we would recommend lathering up you face before using the Clarisonic, rather than directly applying the bar to the brush head).

This reviewer had long since dismissed bar cleansers as a hopeless category of products due to their frustratingly common drawbacks and overall lack of advancement.  However, Drunk Elephant’s Pekee Bar is a genuinely impressive innovation, and for that feat, earns our top recommendation.  Though it seems pricey given its size, it goes a long way—you can expect one bar to last for 2-3 months of twice-daily use.

Drunk Elephant is one pachyderm that knows its way around your dermis. (Sorry.)

Pros:

Uses mild cleansing agents, yet removes sunscreen + makeup easily.

Innovative formula that avoids the common skin-damaging issues of traditional bar cleansers.

Works well for most skin types.

Fragrance free.

Top Cosmetic Dentists & Top Cosmetic Dental Professionals

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Cosmetic Dentist Dr. Michael Adler, Colorado Dentist, has achieved graduate designation in the area of Cosmetic and Neuromuscular Dentistry at the renowned Las Vegas Institute for Advanced Dental Studies (LVI). Dr. Michael Adler is one of the few dentists to achieve this designation.

This honor is acknowledged by doctors once they have successfully completed LVI’s CORE curriculum. The core curriculum consists of an advanced program of hands on, real patient courses that teach comprehensive dental care from aesthetics to occlusion.

What is Neuromuscular Dentistry? Neuromuscular dentistry focuses on the muscles of the head and neck and where they are “comfortable.” If they are uncomfortable, this can cause an unnatural pressure in the jaw joint (TMJ). Because of this, one might be experiencing a myriad of unpleasant symptoms such as muscle tension or ongoing headaches. More importantly, this person may not attribute these symptoms to being a bite problem.

By finding where the muscles are comfortable and building your bite to this position, Dr. Michael Adler can alleviate symptoms that are related to your bite. While some dentists arbitrarily pick a location for the final restoration when attempting to improve a smile and bite, Dr. Michael Adler uses a scientific method known as Neuromuscular Dentistry to produce exceptional results. In short, he provides comfort and function along with a beautiful smile and now Dr. Michael Adler has become one of the few nationally accredited dentists providing this valuable service.

LVI Global is the ultimate teaching center in dentistry at which dentists from around the world advance their skills. In the world of dentistry, LVI is to dentists what Microsoft is to computer technology – the clear leader in the field. While some dentists are still using outdated processes, Dr. Michael Adler’s, Boulder LVI dentist, advanced training offers patients the best care possible. Dr. Michael Adler provides less invasive dentistry and better aesthetic results. Moreover, working only with the highest quality dental labs reinforces the delivery of top-level care. That coupled with advanced clinical skills results in a smile that is natural, beautiful and most importantly, healthy.

About Dr. Adler

Dr. Michael Adler, Boulder Cosmetic Dentist, brings the power & wisdom of scientific research, and diverse life experience to his practice. A graduate of: the University of Michigan, Dr. Adler was a research biochemist at Stanford University prior to completing his dental degree at Georgetown University. Serving as a Lieutenant in the United States Public Health Service, he provided dental care and patient education. Dr. Adler was awarded a prestigious commission by Surgeon General Dr. C. Everett Koop. Dr. Adler has been in private practice since 1990.

Dr. Adler is committed to lifelong ongoing training, assuring his patients the best dental care available on the planet. His postgraduate training has been extensive, including studies on the topics of neuromuscular dentistry and smile design at the nationally renowned Las Vegas Institute for Advanced Dental Studies. Dr. Adler is certified to provide Invisalignâ„¢ (invisible braces) orthodontics to his patients, as well.

33 of the Best Beauty Buys — Shop the Aussie All-Stars

Every brand has a hero product — the one that gains cult-like status and sometimes becomes more well-known than the brand itself. Here in Australia, one of our most famous beauty exports is paw paw ointment (Lucas Papaw, we’re looking at you), but there’s countless other five-star offerings made in our very own backyard.

We’ve already looked at the top 20 natural brands we have, and so to celebrate Australia Day tomorrow, we’re showcasing the best Aussie beauty all-stars — and we’ve even plucked out the hero product from each brand for you, too. We’re talking serious cult-status, so have a look and see how many of them you already own, or simply click to buy to get them into your hot little hands and onto your body.

— Additional Reporting by Justine Dunton-Rose