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Frequently asked questions
about Breast Augmentation.
What are the risks of Breast Augmentation?
Although extremely rare, it is possible to bleed post-operatively resulting
in another surgery to control and drain the collected blood. You could develop a
post-operative infection and need to have the implant removed, the infection dealt
with and still have to wait for several months before an additional surgery can
be performed to re-implant. Loss of sensitivity is common, although temporary. Permanent
sensation loss in the areola (nipple) area or breasts, in general, can and may happen.
There is also the possibility of developing a Seroma which is a mass caused by the
accumulation of serum fluid within a tissue or organ. Or a Hematoma which is a localized
mass of blood that is typically confined within an organ, tissue, space, or potential
space and may be a result from a broken blood vessel.
There is a risk of Capsular Contracture (the evil scar tissue encapsulating the
implant, hardening around and squeezing the implant). This rarely ever goes away
on its own. Nor does it tend to lay dormant after a revision surgery is performed.
It may happen due to bacteria on the implant, surgical implements or airborne and
the body attempting to place the foreign body as far away from itself as possible.
Or it may develop after injury. If this happens, you can develop pains, hardening,
deformity and deflation of the implant. It sometimes even happens again after the
surgery to remove the scar tissue has be performed.
There is a chance of rippling (wrinkling or indentations from the implant) being
apparent, especially when one has no breast tissue and chooses to go over the muscle.
It is possible that the implant can shift and push through layers of tissue, showing
through the skin. The implant can deflate or rupture from an injury or from wear
and tear from an improperly under filled implant (even your breathing motions can
cause creasing in the implant causing it to weaken at these creases). Even an overzealous
doctor performing a mammogram can rupture your implant. You can have a complete
deflation within several hours if it is an un-encapsulated saline-filled implant.
If it is a silicone gel-filled implant, you may not know for months or years. Of
course either way, they will have to be replaced. Then there is always a risk of
hematoma and scarring. Also, difficulty in early breast tumor detection is possible
when you have either silicone gel (more pronounced) or saline-filled silicone shelled
implants.
There is also the risk of disappointment in size. A lot of women wish they would
have gone bigger. Realize that when you are doing the rice test that they will have
to add a little more to make up for the tissues and/or muscle flattening the implant
a little if you choose the submuscular placements. When you pre-operatively try
on the larger bras and fill them out a bit, they are on top of your body, probably
lifted, as well, by an under wire. Take this into account and communicate with your
doctor, the results you really want.
There is also the disappointment in the implants not lifting the breasts as you
would like. This is not a breast lift this is an augmentation. If it is lift you
want as well as augmentation, get them both. After your augmentation surgery, the
breasts will be heavier than what you are accustomed to. The heavier weight will
speed up the sagging process especially if you go around braless all of the time.
There is the possibility of extrusion of the implant, breast tissue atrophy from
the force exerted by the implant. This is according to the F.D.A. and you can read
the info on their site by visiting: Breast Implants: An Informational Update.
Can a woman breastfeed after Breast Augmentation?
The answer is yes.
A lot of women ask if they can breast feed after Breast Augmentation Surgery.
For the vast majority of women who have BA breastfeeding is no more difficult with
implants than without.
Breastfeeding is a growing concern with patients who have had Breast Augmentation
surgery. In previous years, women who received implants were married and had
already finished with childbearing. However, more and more single women, and
women who have not finished or even begun childbearing are having the surgery.
In 1992, the first report of a Silicone Illness hit the media. At that time
there was fear that breastfeeding with silicone implants would endanger the child. There
has been studies performed to show this not to be the case. The main reason
being that the silicone molecule is too large to pass into the milk ducts.
Particularly with the belly button approach, the breast tissue and ducts are not
disturbed, cut or affected. The procedure literally takes place under all of the
breast tissue, not going through it. There is no evidence that silicone from the
implant shell enters the milk.
However, with other incision locations and techniques other than the TUBA and trans-axillary,
it is quite possible to disrupt the mild ducts and lines resulting in blocked ducts
during a pregnancy. This has been known to happen with a peri-areolar technique
resulting in additional surgery to unblock the milk ducts.
Can implants achieve lifting of sagging breasts?
Although implants do not lift up a sagging breast, they do help mildly sagging breasts
appear less saggy. They do this in two ways:
- Implants take up some of the slack in loosened skin thereby increasing the volume
and decreasing the saggy look.
- Implants, to a mild extent, rotate the lower portion of the breast upward, making
the breasts appear less saggy.
For moderate or severe sag, a lifting procedure or a lifting procedure with implants
is usually performed.
Do breasts with implants experience sagging over time?
All breasts relax as time goes by. This is because:
- the weight stretches the skin
- elasticity is lost with age
- the amount of breast tissue often decreases as the person gets older.
These three factors mean that breasts can be expected to relax and sag whether or
not there are implants present.
The implants add some weight to the breast, which may increase the rate of relaxation,
and yet implants and surrounding scar tissue can provide some internal support for
the breasts.
The overall result is that usually the breasts sag less - more so if you wear a
properly fitting bra regularly.
Will my implants feel like natural breasts?
This issue depends much upon a few factors:
Pre-existing tissue: The more natural tissue you have pre-operatively,
the more of a chance you have of feeling "natural" post-operatively. However,
if you have Cohesives or overfilled saline implants, regardless, your breasts will
feel firmer than natural breasts.
Overfill amount: Too little volume will give you ripples, too MUCH
volume will cause firmness and rippling. Discuss overfill amounts (percentages)
with your surgeon pre-operatively.
Implant filler: Saline reportedly feels less natural than silicone
gel or Hydrogel-filled implants.
Implant surface: Smooth-surfaced implants are thinner than textured-surfaced
implants. Although very slight, patients having had both often report that
they can feel a difference.
Implant placement: You may hear that unders look more natural than
overs - when in fact, all cases are different. Overs actually move more naturally
than unders but may have a pronounced upper pole fullness (especially in overfilled
implants). Unders tend to "jump" and twitch when you use the pectorals during
every day movements and working out. This may be a matter of opinion and preference
rather than an effect which produces a blanket statement.
Thickness/thinness of skin: The thicker and springier your skin
the less the implant edges will be felt. Thinner skin allows more a more palpable
result. hence thin-skinned individuals often opt for under placement.
Should I pre-medicate before I have dental work, once I've had
my Breast Augmentation?
Some may consider this a controversial subject and scoff at the idea of
a bacteria-induced infection or case of Capsular Contracture (CC).
When an individual has dental work, even a routine cleaning, plaque and bacteria
are released from their holds and introduced into the blood stream via your gum
tissue. The gums are often lacerated, even slightly, during dental work creating
a 'doorway' in which bacteria may enter.
When a significant amount of bacteria is present in the body, they will seek out
weakness in the body to stronghold themselves and replicate. Any foreign presence
within our bodies (i.e. breast implants, lip implants, hernia repair mesh, etc.)
is a prime target for these infectious intruders.
Although it is not technically proven that dental work and Capsular Contracture
(CC) are related there are increased instances of CC thereafter.
NOTE: It is even cautioned to those with pacemakers and aorta catheters to take
antibiotics when going to the dentist so mammary implant recipients should be no
different.
Will I have stretch marks after my Breast Augmentation? How
can I keep this from happening?
The stretch marks are caused by an abrupt expansion of the tissues. When
the expansion is very gradual stretch marks are practically non existent.
An individual's elasticity varies.
Some patients develop stretch marks from growth spurts during puberty, muscle tissue
gain from weight lifting and pregnancy. Some individuals never develop stretch marks
and still others are very prone to them.
Mature stretch marks are very difficult to remove. You can tell a stretch mark
is mature by the age of course and by the color - which is usually white.
Deep fissures which are purple in color can scarcely be removed with treatments
short of excision. This means that those microdermabrasion treatments that
you have been getting are probably going to do nothing but empty your pocket book.
The white marks CAN be darkened using a flesh-colored pigment implanted using micropigmentation.
There is still no successful treatment for the removal of stretch marks. Some swear
by Shea nut butter, others, olive oil. Some swear by Retin A as a solution to the
red lines that may develop in the early stages of stretch mark formation. Ask your
surgeon before doing anything other than what he or she instructs. There is no guarantee
that stretch marks will not develop but medical science has faith that a proven
method of removal will be discovered, eventually.
Is there much pain associated with breast augmentation?
Many patients report that their discomfort is described as pressure or
muscle soreness. If you should experience any discomfort that seems out of
the ordinary, contact your surgeon.
Although pain thresholds vary - breast augmentation pain is dependent upon the implant
placement, incision placement and medication.
You can also cause yourself more pain by not abiding by your surgeon's instructions
and over exerting yourself.
Should I wait to get my implants if I am considering weight
loss?
Although you may wish to get your implants at any time, if you are considering losing
any significant amount of weight (15 lbs. and up) be prepared to notice sag if you
lose breast tissue.
If you have very small breasts and get implants then lose weight, there shouldn't
be a significant problem with sage since your breast envelopes were not large to
begin with. You could safely lose the weight and suffer no ill effects to your breasts
if this is the case.
Should I wait to get my implants until after having
children?
Although you may wish to get your implants at any time, if you are considering having
children within the next year or two, it is advisable to wait since the effects
of weight and breast tissue gain and loss will affect the appearance of your breasts.
However, if you plan on waiting on having children you should know that a postpartum
lift is possible.
How big should I go?
This is totally up to you!
- if you are asking what is the average size - C and D's are pretty common.
- if you are asking what size would help balance YOUR figure - try the hip-bust ratio.
Say for instance if your hips are 36 inches, your breasts can be 34 to 36 inches
and up (around) and you will look more like an hourglass as opposed to a pear.
Am I too old or too young?
Although there is no set age, it is best to wait until your breasts have finished
developing. You can better determine this with your OBGYN if you are a longstanding
patient of his or hers. This can vary and although you may think you have finished
maturing by 18 or 19 - your breasts will continue to go through changes well into
your early twenties.
The youngest is usually 18 although in special cases of pronounced asymmetry and
reconstruction - prostheses can be used on persons younger than 18. These younger
cases are very specific.
On the other side of the spectrum, women in their late 60's who have gotten breast
implants. When we are older the only thing that may stop us from having breast augmentation
surgery is general health so be sure to have a physical to see if you are in good
health to properly heal and handle the anesthesia factor.
How can I tell my family?
How you tell (or if you choose to tell at all) is up to you. All families will react
differently.
You can begin to tell them how you feel regarding your appearance, about your lack
in breast size making you feel less feminine, etc.
Make a list of the reasons you want breast augmentation, go over these reasons in
your head.
Let your family know how you feel, they may not be completely supportive at first
- but they usually come around.
Should I tell people at work?
If you choose to tell people at work, it is your business. Do not feel that you
must.
However, if you choose to tell your boss (or coworkers) you are having female surgery,
or whatever pops into your head - do know you have to stick with that story.
Many women tell their bosses or take their vacation time off and tell them absolutely
nothing upon return. I
f you are worried about them being able to tell, work up to it with padded bras
and Curves or have it during winter when big, bulky sweaters are common. If you
wear suits it is easier to hide, although if you were significantly flat-chested
be advised that hiding C's or D's or anything significantly more than you had before
is going to be difficult.
What type of anesthesia should I choose?
The type of anesthesia is usually not your choice. Depending on your particular
case, your surgeon will make the decision.
Do birth control pills cause breast tissue growth?
An increase in estrogen/progesterone causes a subsequent increase in breast size.
If you are planning on taking birth control pills be advised that there are
other side effects than simple breast growth.
If you smoke you shouldn't take the pill, if you have circulation problems or high
blood pressure, you shouldn't take the pill. There are many contraindications and
considerations involved with this.
Please see your OBGYN for more information and a complete exam before you take any
type of hormonal supplement.
Will my areolae stretch after augmentation?
Stretching of the areolae is very common and sometimes unavoidable. This
can create more sag in breasts that are already saggy although the usually stretching
is from the pressure of a tight breast envelope. If you have less tightness, you
will usually experience less stretching.
In persons with peri-areolar lifts and areolar reductions - some surgeons use permanent
sutures which are usually made from prolene, mersilene or even Gore-Tex around the
areolae to keep them from stretching again.
I went on several consultations and every doctor had
a different opinion of what would be best for me. What should I do?
All surgeons are different, hence different opinions. Don't expect every surgeon
to agree, but do expect to have to do your own research as well to better understand
what techniques and options can get you what you want.
Do remember that you are not the doctor and to listen, to take notes at your
consultations and reflect upon each surgeon's recommendations.
I have fibromyalgia(or multiple sclerosis, etc), is
it safe for me to get implants?
This is up to you and your primary care physician, although I have friends who have
both disorders and breast implants, nothing has gotten worse (or better) since the
implantation of their prostheses many years ago. The FDA released information
stating that the IOM concluded that implants do not cause nor contribute to disorders
such as these.
It must be said that those predisposed to have disorders may experience the onslaught
of such after having been exposed to high levels of stress, trauma, surgery, foreign
bodies, infections, high blood pressure, accidents, etc.
I have Poland's Syndrome (pectus excavatum, pectus
carinatum, etc) and have been told breast implants will help me look "normal" -
is this true?
Many patients with Pectus Excavatum and Carinatum have gotten breast implants to
give the illusion of a normal chest conformation. Patients with Poland's syndrome
have also gotten one implant or two different sizes when there is considerable asymmetry
involved with their disorder. In any case, please seek out a surgeon who is well-experienced
in cases such as these.
Should I try BRAVA or Breast Enlargement Pills before
choosing to undergo BA with breast implants?
As far as breast enlargement supplements, all supplements are not regulated by the
FDA - only their preservatives and food dyes are regulated, these herbal supplements
are not the exception. Please be careful when purchasing these items. Some of them
contain herbs that are contraindicated with other medications or herbal supplements
and can even cause heart palpitations or nervousness. Just use your best judgment
when taking something like this and go over the ingredients list. Remember that
'if it sounds too good to be true, it probably is'.
How much is breast augmentation going to cost me? What
about if I need a revision?
This definitely depends upon your region, surgeon can range from $2,500. to $10,000.
and up. Prices may vary due to region, surgery bids, the newness of practice,
marketing ploys, the occasional "special", demand of surgeon, etc. These prices
may or may not include, operating room coasts, anesthesia, lab work medications,
and more so be sure to ask beforehand and get it in writing.
If you are in need of a revision there is little else you can do if nothing was
determined beforehand, but pay the fees and move on. So please determine revision
stipulations beforehand and get this in writing as well. Such things as CC,
infection and others are usually not covered (although some surgeons do cover this).
Surgeon error should be covered at the surgeon's expense so please review the practice's
revision protocol before booking your surgery. It is better to prepare for
the worst and hope for the best than be hit by an avalanche of additional postoperative
fees in your time of misfortune.
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