A lot of women ask if they can breast feed after Breast Augmentation Surgery. The answer is a resounding yes. For the vast majority of women who have a breast augmentation, breastfeeding is no more difficult with implants than without. In fact, some women who have breast fed with and without implants say that breastfeeding with implants is easier! 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 have 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.
Can implants achieve some 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: 1.) Implants take up some of the slack in loosened skin thereby increasing the volume and decreasing the saggy look. 2.) 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 passes, because the weight stretches the skin, elasticity is lost with age and 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, but more so if you wear a properly fitting bra regularly. A patient cannot expect to go without a bra for the rest of their life once they get implants. Especially with larger cup sizes as you will be returning to your plastic surgeon's office consulting for a breast lift.
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 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 a more palpable result. hence thin-skinned individuals often opt for under placement. And also may meet the criteria to receive Silicone-filled implants.
Will I have stretch marks after my breast augmentation? How can I keep this from happening?
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. 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. It must be said that applying topical Vitamin E may have been the advice of yesteryear but according to new dermatological studies, topical Vitamin E can cause contact dermatitis and exacerbate scar appearance in some patients. Incidentally, Bio Oil with the new breakthrough ingredient PurCellin Oil is recommended 2 weeks post op with the addition of manual compression exercises beginning immediately to prohibit capsular contracture (CC). The stretch marks are caused by an abrupt expansion of the tissues. When the expansion is very gradual stretch marks are practically non existent. We suggest massaging Bio Oil or Shea Nut butter (if you are not allergic to nut oils) into the tissue beforehand and after until your skin is no longer tight feeling.(Do not rub Bio Oil on the scar until after 2 weeks of healing). But still 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. 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.
Is there much pain associated with breast augmentation? How bad will it hurt?
Although pain thresholds vary, breast augmentation pain is dependent upon the implant placement, incision placement and if you choose to take your medication on time, every time. You can also cause yourself more pain by not abiding by your surgeon's instructions and over-exerting yourself. Many patients report that their discomfort is described as pressure or muscle soreness. Some patients will feel a shooting pain described like being pricked with a needle from inside, this is the nerve endings re-attaching and is only temporary.
Should I wait to get my implants until after the weight loss to get the breast augmentation?
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 sag 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?
No, although it is a matter of choice for each woman. Many patients have the surgery before having their children. Most of those patients have breast fed without a problem. If the surgery is done with the incision in the axilla (armpit) and the implants are placed under the large pectoral muscle, an approach favored by many surgeons, the entire breast remains above the area of surgery and above the implant so that there is no interference with the milk glands and their connections to the nipple. In most cases, stretching or sagging is no greater with implants than in women who do not have implants. Therefore, this does not have to be a reason for a woman to put off enjoying the benefits of a breast augmentation until after having her children. Of course, if a woman is actively attempting to get pregnant, and it is a priority, it would make sense to wait until after the breast augmentation by is born and she has stopped nursing. Like all choices surrounding whether to get implants and the timing of breast augmentation surgery, this is a very personal decision.
How big should I go?
This question is probably one of the most often-asked. 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. It is entirely up to you. You will have to "wear" them from here on out. Just remember that most women say, "I wish I would have gone bigger."
Am I too old/young for Breast Augmentation?
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, many older women of all ages have got 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. Below are some testimonials from women in their 40´s....you decide! For all you ladies who are in your 40's and 50's (or older!) and think you're too old for a breast augmentation...I'm 4 months post-op now, having undergone my breast augmentation. I am 47 years old and had seriously questioned my motives and sanity before finally committing to the surgery. I have always been athletic, slim, petite and youthful both in appearance and attitude. But... as gravity (and motherhood) took its toll, my once-perky little 34 A breasts began to sag and deflate. How I hated looking in the mirror! My stomach is flat, my butt is curvaceous, my body is toned... but there wasn't a damned thing I could do about my breasts. Except.... wait a minute! I could do something about my breasts!!! And I decided to go for it. I got lovely, perky little 34 B breasts, and I am SO happy I did it. For any woman trying to decide whether or not she is TOO old for Breast Augmentation surgery... consider the fact that we're all living well into our 70's and 80's now... if you get the surgery in your 40's or 50's... think of how many years you still have to enjoy your body! (And my hubby certainly doesn't mind either!) GO FOR IT! I am a middle aged woman of 47, I have just had a breast augmentation and I feel great! Don't let "age" stand in the way - it's just a number. I see a much younger, happier and shapelier person possessing a great deal of pride looking breast augmentation at me from the mirror. Even my wardrobe has gotten "younger"! I am 48, soon to be 49, had my 2nd breast augmentation last March, getting ready for a possible redo in February to go to silicone. I don't think it is ever too late, if it is something you want and know you will benefit from. It can truly change your outlook on life, give you confidence, and make shopping for clothes and lingerie a whole new world. I know it has done all of that for me - and more! It's never too late to feel more of a woman than you ever have in your life.
Do birth control pills cause breast tissue growth?
An increase in estrogen/progesterone, be it from the normal onset of puberty, supplements, contraception products, pregnancy, etc. all cause a subsequent increase in breast size. If you are planning on taking birth control pills or receiving the "shot", 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 (plural of areola, the disc of darkened skin around the nipple in the center of the breasts) is very common and sometimes unavoidable. This can create more sag in breasts that are already saggy although the stretching is from the pressure of a tight breast envelope. If you have less tightness, you will usually experience less stretching. it may not happen over night, but it will happen over time. 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 (although Gore-Tex sutures can stretch) around the areolae to keep them from stretching again.
How much is breast augmentation going to cost me? What about if I need a revision?
Your breast augmentation price that we quote you will include, operating room costs, anaesthesia, medications, overnight stay in the hospital. See our Prices and Packages, or send us your enquiry, for a personal quote. If you are in need of a revision, this will be discussed case by case with the hospital and surgeon, in most cases revisions are free - unless you have just decided that you wish you had gone bigger. So please talk to us about revision stipulations before your surgery and we will answer all your questions beforehand.
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. Of course, there is the risk of Capsular Contracture (the 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 an 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 been 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). Also, there are the risks of disappointment in size. A lot of women wish they would have gone bigger. 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.
Under vs Over Augmentation - which is best?
Few questions seem to create more confusion or controversy among both patients and surgeons than whether the implant should be placed above the muscle or below the muscle. The first problem is that there is no best answer for any one person. Each person´s own physical characteristics may make the choice for one woman or her surgeon entirely different than the choice for another. Another problem is apparent confusion about the medical terminology that applies to this issue. Subglandular - this means placement of the implant above the pectoral muscles but below the mammary gland. Technically, all implants are subglandular because implants placed below muscle are also below the mammary gland. However, this term refers to placement just below the mammary glands and above the muscle. This placement is also referred to as retroglandular or submammary. Subpectoral - often loosely referred to as "submuscular," subpectoral means placement of the implant below the pectoralis major muscle. In subpectoral placement, the implant is only partially submuscular due to the nature of the pectoral muscle under which the implant is placed. The lower half of the implant is not covered by muscle in this type of placement. This placement is also referred to as retropectoral. Submuscular - although many refer to subpectoral placement as "submuscular," fully submuscular placement actually means placing the implant under not only the pectoralis major muscle (covering the upper portion of the implant) but also under related muscles at the lower half of the implant. Subfascial - Another option instead of over OR under the muscle is called "subfascial" has recently been reported (pronounced like "fashion" without the "n"), which is a sort of compromise between the two. Although it is thin, the faschia is usually substantial enough to provide a layer behind the breast and in front of the implant. Advantages and disadvantages: Capsular contracture. Many surgeons believe, based upon clinical studies regarding placement of the implant and contracture rates, that placing the implant below the pectoralis muscle (subpectoral) or fully submuscular, reduces the rate of capsular contracture (review separate FAQ on Risks) when compared to above the muscle placement of the implant. Keep in mind that there is not total agreement as to whether this is truly the case. One alternative that has been suggested to prevent capsular contracture is the textured implant which, even if placed above the muscle, is also supposed to reduce the rate of capsular contracture. Whether this is true is also the subject of some debate. Furthermore, many believe that textured implants are more likely to create visible rippling. Rippling - in women with little breast tissue, subpectoral or fully submuscular placement is likely to reduce the chances of visible rippling of the implant. This should be true regardless of the originating reason for the rippling because the implant is partially or fully covered by muscle, in addition to breast tissue. Mammography - although technology increasingly makes better breast imaging possible with and without implants, placement of the implant below the muscle is thought generally to improve mammography by making it less likely that the implant will prevent proper imaging of all of the breast tissue. Subglandular (or above muscle) placement, on the other hand, is thought to be more likely to interfere with imaging. Sagging - in most fully submuscular placements and potentially in subpectoral placement as well, many surgeons contend that the implant is better supported than in subglandular (above muscle) placement, resulting in less sagging of the augmented breast in the long term. Appearance. Initially, and especially with silicone implants, implants were predominantly placed above the muscle (subglandular). Most surgeons can agree that in the ideal case where a woman has adequate breast tissue to disguise the implant and assuming no rippling or contracture, above the muscle placement would result in the most likely natural looking result because the implant is behind only the tissue itself, the tissue that is being augmented and which will take on the augmented shape. In women with adequate or a lot of breast tissue, subglandular (above muscle) placement is likely to yield the most natural looking result. Women who work out with weights complain of an unusual appearance while working out with implants that are behind the muscle as the muscle can contract the implant into a distorted shape. In most women with average to little breast tissue, under the muscle placement can help to avoid the "fake" look of implants that are apparent because they are closer to the surface. A potentially more natural look for over the muscle placement is mostly true in women with any significant sag or droop (ptosis) of the breast tissue. Because the pectoralis muscle tends not to sag, placement of the implant behind the muscle means that the implant is likely in these women to be higher on the chest than sagging breast tissue, which will tend to look like separate tissue hanging from the firmer, higher mound of the implant. Because of this, in cases where subpectoral or submuscular placement is desired (read on for the reasons this might be so), many surgeons will recommend a mastopexy (breast lift) in conjunction with a subpectoral or submuscular augmentation when there is significant droop. Due to most of the factors listed above, most surgeons prefer under the muscle placement, whether subpectoral or fully submuscular, but again, the patient´s physical characteristics will affect the decision as well as the surgeon´s preference.
What is involved in a breast lift?
Sagging breasts, medically known as breast ptosis, is a bothersome condition to many women. The most common reasons for desiring correction include breast sagging which is a sign of aging and inability to go "braless" . Essentially breast ptosis indicates that the breast is falling on the chest as well as rotating downward (see pre-operative example below and left). Plastic surgeons usually divide ptosis into degrees to describe various amounts of the descent of the breast. The basic criteria for ptosis frequently accepted by most plastic surgeons looks at the relative position of the nipple areolar complex (NAC) and the fold under the breast known as the inframammary fold (IMF). Remember that the fold is essentially stationary as the breast is falling. Therefore, if the nipple areolar complex is above the level of the IMF there is no sag. When the NAC is at the same level or slightly lower than the IMF this is known as first degree ptosis. If the NAC is 2-3 cm below the fold this is second degree ptosis and if the NAC is lower and pointing toward the floor (rotated 90o) this is third degree ptosis. Other important relative measurements include the distance from the notch in the top of the sternum (breast bone) to the nipple and the distance from the areola to the IMF. There are two other conditions that need to be mentioned and distinguished from ptosis. The first is an empty sac syndrome. Here there is a loss of volume of the breast while the skin envelope remains the same size. The breast appears empty and is often confused with ptosis, but the NAC and IMF are in the correct relationship. The procedure to correct an empty sac syndrome is to fill the breast with an implant. The second condition is called pseudoptosis. Here a large percentage of the breast volume is at or below the level of the NAC creating a hollow in the upper part of the breast. In this condition the relationship of the NAC to the IMF is acceptable and again the usual solution is an implant to acquire some volume in the part of the breast above the NAC. One important thought involves the common misconception that the placement of an implant will alleviate sag (the larger the implant the more sag that will be removed). Such is not the case. The procedure used to correct breast ptosis is called mastopexy (breast lift). There are options for breast lifts, mastopexies. In general the operations will require that the NAC is relocated into the proper position and the extra skin is removed. In the classic operation the NAC is lifted in the appropriate position by leaving it attached to the surrounding breast tissue with the outer layer of skin removed known as a pedicle. The pedicle is a bridge of tissue left intact for the purposes of maintaining blood supply. Removal of the excess skin either vertically and/ or horizontal involves excision of "darts" of skin. This process will result in a scar completely around the nipple, vertically from the nipple to the IMF and along the IMF. The scar will resemble the configuration of an anchor. This is called the inverted "T". This operation permits for a large amount of adjustability and can handle the most significant amount of ptosis. Obviously one of the major drawbacks to this procedure is the amount of scar present on the breast. The appearance of all scars is an individual characteristic related to your genetic makeup. There are variations of the inverted "T", for example, it is possible in situations with less vertical amount of skin to limit the scar to around the nipple and vertically from the NAC to the IMF thus resembling a lollipop. The other major category of operations is known as a periareolar mastopexy because the scar is located only around the entire NAC. Essentially a ring of skin around the NAC is removed and gathered together similar to a purse string pocketbook. This procedure is somewhat limited in that it cannot be used with larger amounts ptosis, or excess skin. Also if the permanent suture breaks at any time and skin pulls back to the larger circle creating a giant areola necessitating the surgical placement of another "purse string" suture. Like the purse string pocketbook when you pull on the strings the pocketbook closes but the skin puckers as it gathers. This puckering can be permanent. Finally this procedure results in flattening of the cone of the breast as the pressure is applied to the NAC. In cases where the NAC is a little low and there is minimal to no excess skin a crescent of skin can be removed from above the nipple. When approximating the edges of the crescent the NAC is positioned slightly more superiorly. Remember that no mastopexy yields a permanent result. Similar to a facelift, a breast lift will eventually sag again. On the other hand the recurrent sag may take a long time to occur. If there is a desire to have a larger breast then an implant can be added to the surgery and performed at the same time as the lift. However, as noted above a mastopexy and augmentation are not interchangeable operations.
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