Breast Augmentation

Plastic Surgery for the Breasts: Breast Augmentation

Frequently Asked Questions:

What is breast augmentation?

Breast augmentation is a plastic surgery procedure to enhance the size and shape of a woman's breast. Many women choose to have breast augmentation for various reasons; the most common are listed below:

• Women who wish to have fuller breasts because their breasts are too small.
• Women who wish to correct a loss of breast volume after pregnancy.
• Women who wish to have perkier breasts and a better shape after pregnancy.
• Women who wish to correct asymmetry of the breasts.
• Women who wish to replace a previously placed breast implant.

What makes up breast implants and what different styles are there?

Breast implants typically contain a silicone shell and can be filled saline (sterile medical salt-water) solution or silicone gel. Breast implant manufacturers continue to produce silicone gel-filled implants but their use is restricted by the Food and Drug Administration. Styles of implants include differences in size, shape and consistency. Breast implant shape varies from teardrop to round. The consistency of breast implants can be smooth or textured. Which breast implant style is best suited for you depends on many factors. Dr. Guerra can help you to decide which breast implant style and breast implant size best suits your needs.

Breast augmentation surgery, how long should it take?

Breast augmentation procedures typically last 1 hour. When a breast lift is performed at the same time as breast implant placement, surgery may lasts up to three hours. However, it really depends on the individual patient, what type of placement for the breast implant and the form of anesthesia used.

After plastic surgery of the breasts, how will my breast implants feel?

Immediately after this type of plastic surgery and for the following 2 to 6 weeks your breasts will feel firmer than usual. Your breasts will also be swollen and full. Once your tissues have stretched to accommodate the size of your breast implants and as swelling resolves, your breasts will feel and act more natural. Several factors that may affect how your breasts feel after breast augmentation, including, placement of the breast implants, the breast implant's surface and breast implant filler material, and the amount of breast tissue over the breast implant.

How much recovery time is required after plastic surgery of the breasts?

Recovery varies from individual to individual. We attempt to make all of our plastic surgery patients as comfortable as possible after their plastic surgery procedure and we encourage our patients to be active within 24 to 48 hours after breast plastic surgery. Most patients can go back to work or social activities within a few days after their breast augmentation surgery. Exercise and other activities may need to be postponed for 3 weeks or more.

Is breast augmentation painful?

There is always some level of discomfort after breast augmentation. This is due to pressure in the tissues that develops after placing the breast implants in the breast. Larger breast implants generate more pressure. Therefore, the larger the breast implants, the more uncomfortable the patient will be and the longer the recovery. We go to great lengths to provide all of our plastic surgery patients with the best anesthesia possible during and after the breast augmentation procedure. Dr. Guerra is skilled at breast augmentation and can perform the procedure with minimal trauma, swelling and bruising. He has the utmost respect for your tissues and uses long-lasting local anesthetics, which will keep you comfortable for 6 to 12 hours after this plastic surgery procedure. We have not seen any difference in discomfort level with breast implantation either below or above the pectoral muscles. All discomfort can be easily controlled with prescribed analgesics and muscle relaxants.

How does the size of the breast implants get determined?

There are multiple factors that determine the ultimate size of your breast implants, including your desires for a certain size, shape and feel, your overall physique and the amount of breast tissue available on your chest to cover the breast implants. The happiest breast augmentation patients are those who receive breast implants that make their breasts proportional with the rest of the body. Dr. Guerra will listen carefully to your desires and together you and your plastic surgeon will develop a plan to make you as happy as possible with your decision to undergo breast augmentation. Breast implants are available in the office for you to try a certain size and we have plenty of before and after photos of women with different builds so that you can get an idea of what a certain breast implant size can do for you. In all, we attempt to make the decision of which breast implant size and breast implant shape best serves you as simple and as comfortable for you as possible.

What are the risks of getting extremely large breast implants?

The happiest breast augmentation patients are those who achieve a beautiful result with breasts that are proportional to the rest of the body. When women decide they would like an extremely large breast implant they take on several important risks not noted with the smaller breast implants. As we mentioned above, the larger the breast implant, the more uncomfortable you will be after breast augmentation surgery. Larger breast implants also are associated with a higher risk of capsule contracture (breasts becomes firmer than natural), never look and feel truly “natural” (extremely big breast implants may be easily felt through the breast skin) and create excessive pressure on the remaining breast tissue. After many years with this type of high-pressure, the remaining breast tissue “wastes” away.

What choices are there for breast implant placement and which one is the better choice?

Breast implants can be placed below the breast gland only (subglandular) and above the chest muscle or below the breast gland and chest muscle (submuscular). A breast implant placed under the breast gland alone can “lift” the minimally saggy breast and look more “bubbly”, like the breasts of many models and Hollywood personalities. There are 3 major advantages of submuscular breast augmentation; including, a more natural feel and look, with less chance of breast implant visibility (ripples) and palpability, the ability to obtain better mammograms, a reduction in the overall rate of capsular contracture (unnatural firmness of the breasts). A common myth states that subglandular implant placement results in faster recovery and less discomfort, but we have not seen a noticeable difference in our patients. Where the implant is ultimately placed depends on many factors including your desires and, most importantly, the amount of breast tissue thickness available to cover the breast implant. In plastic surgery patients with extremely thin tissues we strongly recommend submuscular breast implant placement to achieve, a more natural and beautiful result.

Where the sites of incisions and are there other sites that are more favorable to others?

Possible breast augmentation incisions include: periareolar (around the nipple); inframammary (within the crease beneath the breast); or axillary (below the armpit). Depending on a few factors, your breast augmentation incisions will be determined with help from your plastic surgeon. Typically, inframammary and axillary incisions are linked with less problems if you decide to breast-feed; although both do have a small visible scar. Periareolar placement will result with a less visible scar, but higher problems with breast-feeding.

How long is the recovery for the incisions?

After breast augmentation, the incisions will be healed within several months to a year. All plastic surgery patients should understand that the ultimate results of breast augmentation are not seen until after 1 year has passed since surgery.

What is the different between anatomic breast implants and round breast implants?

Anatomical or contoured breast implants are teardrop-shaped while round breast implants resemble an ellipse. Anatomic breast implants are advantageous in breast reconstruction and when there is very little breast tissue to cover the breast implant. These breast implants provide additional fullness at the bottom of the breast. Problems can result if the contoured breast implants roll and the fullness ends up at the top of the breast, requiring additional plastic surgery to the breasts. The round or elliptical breast implants provide fullness in all the breast quadrants, that is, after breast augmentation there will be fullness in the cleavage, upper and lower pole and the outer pole of the breasts. When the appropriately sized breast implant is placed using sound plastic surgery techniques a beautiful breast shape can be created. Dr. Guerra with his vast experience can help you choose the best breast implant to accomplish your goals with breast enhancement surgery.

What is different between textured and smooth breast implants and is one better?

A smooth surface has many advantages including less chance of breast implant rupture, less rippling, ease of handling and implantation. On the other hand, a textured breast implant can rupture sooner, can ripple easier, but can protect some plastic surgery patients who are at risk of early capsule contracture. In fact, textured breast implants were first developed to lower the rate of capsular contracture. The choice for you can be determined between you and your plastic surgeon.

What is rippling and how does it happen?

Rippling is the name of a phenomenon that occurs when waves in the salt water are transmitted across the breast skin surface. The saline (sterile salt water) in your breast implants behaves like any other body of water on this planet. If you have ever dropped a stone into a pond of water and noticed the waves that are created when this occurs, then you should easily understand how rippling occurs. These waves occur with every saline filled breast implant, but are usually only noticeable in plastic surgery patients with breast implants placed above the muscles that have relatively large breast implants, which are underfilled and who have small amounts of breast tissue for cover. One reason for a disappointing breast augmentation is rippling. Rippling usually requires revision plastic surgery and breast implant exchange into a submuscular pocket. Some patients may prefer silicone breast implants at the exchange procedure, which generally are not associated with rippling.

How long does breast enhancement last?

We do not expect any plastic surgery procedure to “last forever.” However, breast augmentation is extremely popular because it is a great plastic surgery operation that lasts a significantly long time and has made millions of plastic surgery patients extremely happy. Not meant to last forever, breast implants may over time need additional plastic surgery to remove and/or be replaced. On average, a breast augmentation procedure typically lasts about ten years.

Is it true that breasts make noises after breast augmentation?

Some plastic surgery patients describe a sloshing sound coming from their breast implants soon after breast augmentation. This occurs because a small amount of air gets into the breast implant when the breast implant is filled with saline. These tiny air bubbles are absorbed by the body and sloshing is usually only a temporary issue for most plastic surgery patients.

Does insurance pay for the cost of a breast augmentation procedure?

Breast augmentation is recognized world wide as an aesthetic plastic surgery procedure to enhance the appearance of the breasts. We are not aware of any insurance company, which covers the breast augmentation. In our practice, plastic surgery patients are responsible for all charges incurred while undergoing breast augmentation and not their insurance company.

Will my breast be more sensitive after breast augmentation?

Short-term the breast or nipple can have some increased or decreased sensitivity after breast augmentation. A few patients feel an enhanced sensitivity, others may feel a decrease, and a tiny amount of patients may loose all feeling in parts of their breast or nipple. Rarely are these situations permanent. Most improve after the breast stretches completely to accommodate the size of the breast implant. Loss of nipple sensation can affect intimate contact activities and arousal.

If I get pregnant, will my breast implants have an affect on me?

While this can be difficult to predict with great accuracy, in our experience, women who have breast implants will look better and sag less after pregnancy than women without breast implants. That is, it appears that the breast implants can “support” the breast tissue better when pregnancy occurs. Women with breast implants can usually breast feed normally and studies demonstrate that the level of silicone in mother’s milk is lower than in the milk we buy at the grocery store.

What are the risks concerning breast augmentation and mammograms?

All breast implants will block the mammogram x-rays and block the amount of tissue seen in mammograms. Subglandular breast implants block much more of these rays than submuscular breast implants. A special technique must be used in women with breast implants in order not to rupture the breast implant and to improve the results of the mammogram. Deposits of calcium may appear around the breast implant, especially, silicone breast implants, allowing a misreading. If this happens, a biopsy may be recommended to sort of the issue of calcification around breast implants.

What are the risks with breast augmentation?

With every sort of plastic surgery procedure there are risks involved. The chances of any serious side effects occurring with breast augmentation are always very low. Some of the risks include bleeding, infection, mammography interference, capsular contracture, breast implant deflation, and breast or nipple sensation changes. When these unwanted side effects occur, additional plastic surgery may be required in an attempt to correct or improve the situation. More plastic surgery does not guarantee an acceptable outcome for either the plastic surgery patient or the plastic surgeon.

What is a gummy bear breast implant?

Gummy bear breast implants are relatively new on the market and their used is restricted by the Food and Drug Administration. The feel of the substance is close to the texture of gummy bears and these breast implants are called “gummy bear” breast implants. Technically these breast implants are recognized as cohesive gel breast implants and are designed to feel more natural. The filler material inside the breast implant is a special type of silicone gel which “sticks’ together under various conditions, including when the breast implant is cut or ruptured. It is though that these breast implants will be less likely to leak even when rupture occurs. Dr. Guerra participates in an FDA approved study in which these types of breast implants can be used for plastic surgery patients who meet the study criteria.

Can fat injections be used for a breast augmentation?

Fat is a great soft tissue filler for facial aging. Fat injections are not a good alternative for breast augmentation. Fat grafting can lead to calcifications, which could be misdiagnosed as something more serious leading to breast biopsy and breast implant removal to identify the true cause of the calcifications.

What is symmastia?

Symmastia literally means “one breast from two” and occurs when a breast implant slides past the sternal bone and across to where the other breast is located. The two breasts look like one large and deformed breast. This problem is rare and has not occurred at the AB Guerra Plastic Surgery Clinic. This problem is seen when the plastic surgeon aggressively releases the pectoral muscle attachments to the sternal bone in an effort to bring the breast closer together.