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In this episode of the podcast, Dr. Sam Fuller and Dr. Dan Butz take on one of the most commonly discussed yet poorly explained concerns women bring up in consultation: the area of fullness along the outer breast near the armpit, affectionately and infamously nicknamed the “chicken nugget.” It is the spot that peeks out of bras, resists workouts, and often surprises patients who thought breast surgery would magically make it disappear. With a mix of surgical insight and candid conversation, the doctors unpack what this area really is and how best to treat it.

The episode begins with anatomy. Drs. Fuller and Butz explain that lateral breast fullness is not a flaw or a mistake. It is often a normal extension of breast tissue called the axillary tail, sometimes combined with subcutaneous fat. This matters because not all “nuggets” are created equal. Some are primarily fatty, soft, and responsive to contouring. Others contain true glandular breast tissue that behaves very differently than fat and will not reliably shrink with weight loss, exercise, or nonsurgical treatments. Understanding what lives in that space is the foundation for choosing the right solution.

From there, the discussion moves into treatment options, starting with liposuction. Liposuction can be an excellent choice when the lateral fullness is mostly fat. It is minimally invasive, uses small incisions, and allows for smooth contouring that blends nicely into the side of the breast and chest wall. Recovery is typically quicker, swelling settles over weeks, and scars are usually discreet. However, liposuction has limitations. It cannot effectively remove dense glandular breast tissue, and aggressive suction in this area carries risks such as contour irregularities, tethering, or skin laxity if not done thoughtfully. As Dr. Fuller emphasizes, liposuction works best when anatomy and expectations are aligned.

The conversation then shifts to direct excision. For patients whose “chicken nugget” is primarily breast tissue rather than fat, surgical excision may be the more definitive option. This approach physically removes the tissue rather than relying on suction, making it more predictable for dense or fibrous areas. The tradeoff is a scar, usually placed strategically in the natural crease of the armpit. Dr. Butz explains that while many patients are initially scar-averse, they are often more satisfied long-term with a flat contour and permanent result than with incomplete improvement from liposuction alone. Excision also allows for pathology evaluation when appropriate, adding an extra layer of reassurance.

Drs. Fuller and Butz spend time comparing the pros and cons of each approach, emphasizing that there is no one-size-fits-all solution. Liposuction offers smaller scars and faster recovery but may under-treat true breast tissue. Excision offers completeness and durability but comes with a visible incision and slightly longer healing. In some cases, a hybrid approach may even be considered. The key, they stress, is individualized planning and honest preoperative discussion.

This episode is equal parts education and empowerment. Whether you are considering breast surgery, have already had a procedure, or have simply wondered why that area never seems to cooperate, this conversation sheds light on a common problem and the thoughtful surgical strategies available to address it.

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Season 3 of the Fuller Butz Podcast opens with a comprehensive look back at our 2025 predictions, separating what truly moved the needle in plastic surgery from what failed to gain traction. This “Wrapped” episode serves as both a retrospective and a roadmap, grounded in real-world clinical experience, patient outcomes, and evolving technology.

We begin by revisiting one of our most confident and ultimately successful predictions: the launch of the FDA-approved Motiva breast implant. Throughout 2024, we discussed the growing momentum behind Motiva’s design philosophy, data-driven development, and global track record. In 2025, that prediction came to fruition with FDA approval, and its entry into the U.S. market has already begun reshaping conversations around implant technology, safety, and patient choice. We break down what makes Motiva different, from surface technology to consistency and responsiveness, and discuss how FDA approval validates years of international data. More importantly, we explore how this approval expands options for patients seeking a more natural feel and long-term reliability, while raising the bar for innovation across the implant space.

Another major “hit” from our 2025 forecast was the continued success and broader adoption of the internal bra. Once viewed as a niche adjunct, internal bra technology has become a mainstay in breast surgery for surgeons focused on long-term shape, support, and durability of results. We discuss how internal bra use has matured from early experimentation into refined technique selection, improved materials, and clearer indications. From revision cases to primary lifts and augmentations, internal bra support has proven its value in reducing bottoming out, improving upper pole stability, and enhancing longevity.

Not every prediction, however, came to pass. We take an honest look at AlloClae, a product we believed might gain stronger momentum in 2025. Despite theoretical advantages and early interest, AlloClae did not achieve widespread adoption or consistent clinical enthusiasm. We discuss possible reasons, including cost, handling characteristics, outcome variability, and surgeon preference, emphasizing why it’s important to continually reassess emerging technologies against real-world performance. This segment underscores a recurring theme of the episode: innovation alone is not enough. Adoption depends on reliability, reproducibility, and clear benefit to both surgeon and patient.

Looking ahead, we turn our attention to 2026 predictions, starting with the Preserve system from Motiva. We discuss why Preserve represents a potential next evolution in breast implant surgery, focusing on tissue preservation, surgical planning, and alignment with modern patient priorities.

Beyond devices and implants, we expand the conversation to areas we believe will see significant advancement in 2026: compression garments, postoperative care, and nutrition. We predict a move toward smarter, more patient-specific compression solutions that improve comfort while maintaining effectiveness. In postop care, we anticipate greater integration of multimodal recovery strategies, emphasizing mobility, lymphatic support, and data-driven protocols.

This episode sets the tone for Season 3 by reinforcing what the Fuller Butz Podcast does best: thoughtful analysis, honest reflection, and forward-thinking discussion grounded in real practice. As we close the chapter on 2025 and look ahead to 2026, the message is clear. Progress in plastic surgery is rarely about a single breakthrough. It’s about consistent refinement, better decision-making, and putting patient outcomes at the center of every prediction and every procedure.

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https://samfullerplasticsurgery.com/

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In this educational and empowering episode, board-certified plastic surgeons Dr. Sam Fuller and Dr. Daniel Butz dive into one of the most common questions they hear from patients: "Do I need a breast lift, a breast augmentation, or both?" If you've ever stood in front of the mirror wondering how to restore volume, perkiness, or shape to your breasts, this episode is tailor-made for you.

We break down the anatomy and aesthetic principles that guide our surgical decisions, helping patients better understand what each procedure is designed to accomplish. A breast augmentation and a breast lift are not interchangeable—and understanding the core difference is essential to getting the results you want.

We begin by walking through breast anatomy and the natural aging process, including how pregnancy, weight changes, gravity, and genetics affect skin elasticity and glandular volume. This leads into a deep discussion on the goals of breast augmentation—adding volume, fullness, and upper pole projection—versus the goals of a breast lift, which include reshaping, repositioning the nipple-areolar complex, and removing excess skin to restore a youthful contour.

Next, we dive into how we evaluate patients during consultation:

• Is the nipple below the inframammary fold?
• Is there volume loss or deflation?
• Is the breast tissue dense or soft?
• Are the patient’s goals focused on size, shape, lift, or all of the above?

We’ll talk through real-world examples and how we tailor recommendations based on body type, age, future plans (like pregnancy or weight loss), and surgical risk tolerance.

Dr. Butz and Dr. Fuller also weigh the pros and cons of each surgery, including:

• Scarring and incision types
• Recovery time
• Longevity of results
• Implant risks (rupture, capsular contracture)
• Lift-only limitations (no added volume or upper pole fill)
• When it’s best to combine both procedures for maximum impact

We also touch on common misconceptions—like the myth that implants alone can lift a sagging breast, or the idea that a lift always results in a “flattened” look without implants. Spoiler alert: it’s all about planning and technique.

If you’ve ever felt overwhelmed by the idea of choosing between a lift and an augmentation, this episode will leave you feeling educated, reassured, and empowered to take the next step. You’ll walk away with practical knowledge and a better understanding of how we, as plastic surgeons, customize surgical plans to help each patient achieve their unique goals.

Whether you're postpartum, post-weight loss, or just looking to restore confidence, this episode will help you understand what’s possible—and what’s right for you.

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