Breast Augmentation FAQS

 

Many patients are concerned with the length of recovery from plastic surgery and what that recovery will be like.  They want to get back to work as soon as possible or be able to get back to their life without being restricted as soon as possible.

The 24 hour recovery protocol allows you to be doing just about anything the next day.  With a rapid 24 hour recovery breast augmentation using the natural feeling gummy bear breast implants from Sientra, you will not need any narcotics after surgery and will not be limited in any way.  You are not healed so you likely be a little stiff and sore for a day or two but the 24 hour protocol makes that very tolerable.  You will be able to get back to a desk job, lift children, drive and even get back to light work outs within a day or two.  There are no special bras and no massage with these implants and this method.  

 

 

This is a frequent concern of women who are preparing for a rapid recovery breast augmentation.  As long as you follow the post-operative protocol of MEAT or motion, exercise, anti-inflammatories and treatment if required, the answer is NO.  That is not quite true since anti-inflammatories are in fact a pain medication. Narcotics, commonly prescribed after surgery, are not necessary however and in fact can cause nausea, drowsiness and constipation.  These problems can actually delay your recovery.  In most cases, with the MEAT protocol, with just a basic over the counter anti-inflammatory medication like Aleve is all that is required.  The secret is motion.  We get patients moving, stretching and exercising within 2 hours of their surgery and they say when they stop moving is when they hurt a little.

A Keller Funnel is a used by surgeons to place breast implants in the breast augmentation pocket without having to touch the implant.  Using a Keller funnel has been shown to help to greatly reduce the problem of breast implant capsule contracture.  This video shows exactly how a Keller funnel is used.

 I’ve lost 115lbs and my breasts have gone from 44DDD to 34B

Congratulations on the weight loss. That is quite a size change. Your question about fat grafting or a fat transfer is a common one. Most women seek the fat transfer solution to augment their deflated breasts because they have areas of unwanted fat. At the same time they would to regain some of their lost breast size back. Their thinking is why not just transfer the fat to a place where they want the volume? After all it’s a natural solution. They do not understand that fat transfers to the breast, while a viable surgery will only add about 150 cc of new tissue per surgery at the most. This is because a lot of fat must be harvested. The harvested fat is then processed, and some volume is lost. When the processed fat is injected only about 30% to 85% survives depending upon the individual. This all makes fat grafting very unpredictable. There are cases in which more fat survives on one breast as compared to the other further complicating the predictability of fat grafting to the breast. In the end, if you want to bigger than 150 cc then it is another surgery with all the same inherent risks and expense.
Almost always, in your situation, we turn to breast augmentation with breast implants. The new 5th generation breast implants are not only safe but the gummy bear breast implants from Sientra feel very much like natural breast tissue after about 6 months.

This is a very common question but unfortunately there is no good answer because the bra industry does not have a size standard.  What is a DD with one brand or store may be an E, a D or even a C+ in another brand or store.  Ultimately what most women want to know is how they can get a breast size that they like or one that fits their frame. 

Probably the best way to choose a size before breast augmentation surgery is to try on breast implants in a tight-fitting sports bra.  This way you can pick a size that you will be happy with.  Many surgeons do this for you because one of the main reasons for breast augmentation reoperation is dissatisfaction with the size of implant that was picked for the patient by the surgeon.  This way the surgeon can avoid the problem of you not liking your size after surgery.

Sizing is also very different with the type of breast implant.  With the highly cohesive, natural feeling, gummy bear implants from Sientra, we first pick the width of the breast implant based on the width of your breasts.  This allows the implant to sit right under your breast tissue as close to the middle as possible without producing symmastia or “unna boob” and as far out to the side as possible without causing “side boob”.  The volume or size of the implant is then determined by the projection.  With Sientra breast implants, we have an algorithm that helps us decide on the best implant to suit your desires and body shape to get you the best result possible.

Sientra breast implants also work very well when placed above the muscle without increased capsule contracture or rippling which is an advantage for athletic women.   When a breast implant is placed below the pectoralis muscle there is a significant risk of causing a breast implant animation deformity.  Animation deformities are distortions of the breast with flexion of the pectoralis muscle.   These deformities are common with submusclar breast augmentations.

If you are athletic and regular do yoga, you may also consider a 24 hour recovery breast augmentation.  That way you could be back to doing yoga within days of your surgery.  Sientra implants help with this as well since there is no massage or special bands that are needed with these implants.

 

With a 24 hour, rapid recovery breast augmentation, you will be able to return to work and doing things like go back to exercise class within a few days of your surgery.  The rapid recovery protocol is designed to get you back to your normal life as quickly as possible and at the same time reduce the risks from the surgery.  You will not be healed, meaning that you may still be a little sore but you can easily get back to work in 4 or 5 days and get out to the beach within a couple of days after your breast augmentation.  We use the new natural feeling gummy bear implants from Sientra, which allow the placement of the implants above the muscle to not only speed your recovery but also reduce your risk of capsule contracture, implant animation and rippling.

 

 

 

 

 

 

 

Lateral displacement and animation deformities occur after a breast augmentation when smooth breast implants are placed below the pectoralis muscle.  This is relatively common with smooth silicone and saline implants since most surgeons who use these implants will use the submuscular technique to try to avoid a breast implant capsule contracture.   

A simple way to correct lateral displacement and/or animation deformities secondary to submuscular breast implant placement, is to remove the implants and then place textured implants in a new pocket above the muscle, essentially abandoning the first breast augmentation.  The natural feeling gummy bear implants from Sientra are textured and are perfect for this kind of breast augmentation salvage procedure.  The new breast augmentation can be done with a 24 hour rapid recovery technique so there in minimal down time.

Pregnancy and nursing can stretch out the breast skin significantly.  However, your breast skin has returned to close to its original shape/size and your breasts do not have much sagging then breast augmentation will not be affected by breast implants.  Most women who have nursed, have lost some shape and as a result I typically use Sientra’s natural feeling, tear drop shaped, gummy bear implant to help restore your shape.

To achieve the optimal breast augmentation result with not only good size and shape, but without any of the complications that accompany breast augmentation, including capsule contracture, breast implant animation, rupture and rippling, you need to start with a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery who does a lot of breast augmentation.  In addition, hopefully that surgeon also uses Sientra breast implants since the medical studies show that these implants have the lowest incidence of capsule contracture, implant failure and rippling.  In fact, Sientra just came out with their new implant warranttee that puts all other manufacturers to shame. 

It is also important that you first doing some sizing with implants in a bra so that you decide what size of implants you like.   Your surgeon should carefully measure your chest dimensions and then chose an implant that is appropriate for your measurements and approximates the size that you like.  The new shaped, natural feeling, gummy bear implants have a flat back and sizing in the old conventional way is no longer a good method to determine implant size.

Finally, the results from the newer gummy bear implants, are much more natural looking.  They also allow for the use of a rapid recovery protocol that requires no narcotics and gets you out enjoying your new look the next day. 

The safety profile of silicone breast implants is the same as saline breast implants.  There are a couple of considerations that many potential breast augmentation patients and surgeons do not think about though. 

The first is that the gummy bear silicone breast implants generally feel better than saline breast implants.  In fact, the gummy bear breast implants from Sientra feel essentially like normal breast tissue after a few months.  Conversely, saline implants often feel like a bag of water rather than breast tissue. 

The second thing to consider is that saline implants have a relatively high incidence of rupture which requires a second surgery and that added expense not to mention the risk of a surgery.

I frequently replace ruptured saline implants in women who have these implants for some time and every patient loves their new gummy bear implants, frequently saying, “I would never go back to a saline breast implant!  These Sientra breast implants are so much better”.

This woman describes her experience and the differences between silicone breast implants and saline breast implants:

Breast augmentation complications are, in part, related to technique.  Surgeons who use meticulous dissection techniques including the so called “no touch” technique which include the use of a Keller funnel, will have fewer complications.  Surgeons who utilize the 24 hour rapid recovery protocol also have a lower complication rate.

The complication of breast implant capsule contracture can be further reduced if your surgeon uses Sientra breast implants since these implants have been shown to have a significantly reduced capsule contracture rate over the breast implants of other manufacturers.  In fact, the rate is so low that Sientra now has a 20 year warranty for capsule contracture in addition to their lifetime failure warranty.  This alone makes these breast implants second to none.

This is a good question as a lot of patients do not understand that implant sizing is not like it used to be.  In the past, breast implants were essentially round balls that, as they got bigger they got wider or increased in diameter as the volume went up.  Different profile breast  implants were then introduced that had either a more flat shape to the breast implant (low profile) or more round shape (high profile).  This allowed us to consider different volumes with similar diameters of implants.  

When we talk about implant size, in general, we say that 100 to 150 cc difference in breat implant size represents a cup size change.  Estimating cup size is also a problem since bra sizes and cup size are not standardized in any way.  A Victoria Secret C cup is more than likely to be a B cup in another brand.

What is most important, is what you like and what looks good on you for your frame.  Now with the natural feeling gummy bear shaped implants we have a number of considerations including volume, shape, projection or profile, height and width of the implant.

With the gummy bear implants from Sientra, width of the implant is the most important measurement.   Today, we use your breast base width and then use trial implants  under a sports bra to determine what you like and what looks good on you.  We then get very specific in terms of implant width, height, projection and shape to give you the best possible result.

These implants have many advantages over other implants as well including lower capsule contracture rate, far less rippling in thin patients in addition to feeling more natural.  We can also place these implants above the muscle to avoid the complication of animation of the implants when the muscle is flexed.  This allows for a 24 Hour Rapid Recovery protocol as well.

Bra sizes are a difficult subject since the bra industry does not standardize cup size.  Consequently, it is very hard to definitely say that a 300 cc breast implant will change your breast cup from an A cup to a C cup. 

As I have mentioned in other question, the best way to figure out what size of breast implant will work for you, and thus answer this question, is to trial breast implant sizes in a bra.  This process incorporates the fact that the natural feeling gummy bear breast implants have a flat back, and as a result, your measurements become very important.   As opposed to regular silicone breast implants which are more round than gummy bear breast implants, your chest wall and sizing then becomes much more about your overall size (height and weight) and specific chest measurements such as breast width, nipple to inframammary fold distance and nipple to sternal notch distance.  Once we have those measurements, the next step is to put you in a sports bra and trial implant sizers so that you chose the size and we have an idea of what you want from your breast augmentation.  From there, using implant size charts we can pick a size and shape the suits your chest measurements and approximates the size you liked when you were trying on breast implants.

The main reason why women have their breast augmentation redone is because they did not like their size and almost always that is because their surgeon picked the size for them. 

If you do not know about gummy bear implants, especially Sientra implants which now have the best warranty on the market by far and also have been shown to have the lowest rate of complications associated with them read more here.

The so-called flex deformity or animation deformity occurs when a breast implant that is placed under the muscle deforms into an unsightly shape when the pectoralis muscle is flexed.  This does not usually occur when an implant is placed above the muscle. 

The best chance to achieve the optimal result  for a breast augmentation for you with not only good size and shape but without any of the complications that accompany breast augmentation including capsule contracture, breast implant rupture, rippling and breast implant animation, you need to start with a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery who does a lot of breast augmentation.  In addition, hopefully that surgeon also uses Sientra breast implants since the medical studies show that these implants have the lowest incidence of capsule contracture, implant failure and rippling.  In fact, Sientra just came out with their new 20-year implant warranty that puts all other manufacturers to shame.

It is also important that you first doing some sizing with implants in a bra so that you decide what size of implants you like.   Your surgeon should carefully measure your chest dimensions and then chose an implant that is appropriate for your measurements and approximates the size that you like.  The new shaped, natural feeling, gummy bear implants have a flat back and sizing in the old conventional way is no longer a good method to determine implant size.

Finally, the results from the newer gummy bear implants, are much more natural looking and can be placed above the muscle to avoid breast implant animation or pectoralis flexion deformity.  They also allow for the use of a rapid recovery protocol that requires no narcotics and gets you out enjoying your new look the next day.  

Breast implant associated ALCL or anaplastic large cell lymphoma, is a very rare lymphoma that can occur around any type of implant, not just breast implants.  It is true that that the incidence ALCL is higher with textured implants, but that incidence is still very low.  In addition, the incidence is even lower with the less aggressive textures like Sientra implants.  In fact, Sientra, and Silamed, the international manufacturer of the same implant, have had only a couple of cases of ALCL worldwide as compared to other implant manufacturers who have a more aggressive texture surface.  Patients with smooth walled implants are not immune to developing ALCL either although smooth walled breast implants have the lowest incidence of breast implant associated ALCL or BIALCL.

If you have Sientra breast implants in place, you should simply be vigilant for any problems with your breasts.  ALCL usually occurs 7 to 12 years after the implants were placed and the presentation is normally one side becomes very swollen.  Treatment is very successful if the diagnosis is made correctly. 

Sientra recently increased their warranty to 20 years and provides financial support if you have a problem.  With most manufacturers you have to pay to get something similar in terms of a warranty and they only go for 10 years, so Sientra’s warranty amounts to a free 20-year insurance policy for any problems with your breast implants.

In short, Sientra makes the best breast implant on the market today.  Even though they are textured, they are still very safe.  Your chances of having other life-threatening problems in the future are significantly higher than your chance of developing ALCL.

This is a great question since there are a lot of women who are adverse the scars and potential complications that a lift would add to a breast augmentation wonder the same thing.  Adding volume to your breasts will give at least the illusion of a lift.  If a shaped gummy bear implant is used, you should get a nice result.

Sientra’s natural feeling gummy bear implants are tremendous for dealing with breasts that are a little lower than usual and that have been deflated by pregnancy. They have the lowest complication rates (capsule contracture and rupture) and also have the best implant warranty in the industry, by far.

Your situation is not that uncommon.  Many women who had implants when they were younger decide years later that they want to go smaller or just get rid of their implants all together. 

Removing implants is surprisingly straight forward and can be done under local anesthesia with no down time if they are not ruptured and if you have saline implants, it is a very simple procedure.

If you were extremely small to start with you may want something instead of going without.

In your case, at 5’9 and 120 pounds it is unlikely that you will have enough fat to get a reasonable result with fat grafting. In addition, it often takes two surgical sessions to achieve a noticeable or reasonable result.  You might consider a small natural feeling gummy bear implant as many women love these after having a saline implant. 

Here is an article on a “mini boob job” that you might find helpful.

While most plastic surgeons will suggest a mesh or dermal matrix plus a new implant and pocket, the simple, yet highly effective way to solve your problem is to use Sientra’s natural feeling, shaped, textured gummy bear implants above the muscle.  There are many reasons why this works and is better, but it is easiest to have you take a look at this video testimonial by a patient with an animation deformity who had the same question after she experience a failure of her saline breast implants.

 

There are certainly a lot of opinions as to what the best breast implant is to get a natural look and reduce the risk for rupture and therefore further surgery.  From your question, I believe that you want a natural feeling and looking breast augmentation and you are looking for a implant that will reduce of having a problem and having to redo your breast augmentation in the future.  You have been considering the Ideal Implant.

Let’s take a look at the science and throw out the opinion.  Considering at the core study data, the Ideal implant is a saline implant that is prone to rupture at a rate of 4.7% for all breast augmentation procedures.  These implants also have a capsule contracture rate of 11.5%.  While the ideal implant study does not look at surgery to address animation or muscle flexion deformity, many smooth implants are placed below the muscle to avoid capsule contracture and as a result there is a moderately high likelihood of that happening if you have the Ideal implant placed below the muscle.

The numbers for a problems with Allergan and Mentor silicone breast implants are clearly not as good as the numbers for the Ideal implant in terms of complications in the core studies.  However, the numbers are much higher with the Ideal implant as compared to Sientra implants. 

Sientra’s highly cohesive or gummy bear implants have the lowest rupture rate of all implants at 2.5% and ruptures are almost inconsequential since these are implants are gummy bear or highly cohesive and the silicone gel will not “leak”.  The capsule contracture rate has been reported as high as 6% with Sientra’s complete implant line and drops to below 4% with their textured breast implants.  In addition, the textured implants can be placed above the muscle to avoid the muscle flexion deformity I mentioned and having to cut the muscle which reduces your pectoralis strength (no one talks about this).

This is a good question since so many women ask the same thing.  While surgeons vary, and each seems to have a different routine for when to start wearing regular bras and when it is okay to get sized, the answer is pretty standard with Sientra breast implants.  Because these implants are the natural feeling gummy bear implants that can be place in the more natural position above the muscle, you can be sized and start wearing a regular bra of your choice when ever you feel like it.  I use the 24 hour recovery and I have had many women out shopping for bras and sizing for bras the next day.

This is a good question for a tough problem.  There are many “fixes” for implants that have problems such as malposition, sliding, symmastia, rippling, capsule contracture, bottoming out and asymmetry. 

I have found that a good starting point is choosing the best implant available on the market.  Like many other problems in life, starting with the best available product goes a long way to either deal with or mask many concerns or problems.  For this reason, I use Sientra breast implants.  They have a 20 year warranty, the lowest capsule contracture rate of all implants in the industry and their naturally feeling gummy bear implants come in many shapes and sizes to help your surgeon match your goals.  Sientra’s textured implants can also be placed above the muscle to avoid muscle animation deformity.  The Velcro effect of the textured surface allows the use of much different sized implants than conventional breast implants without having to use internal slings or bras such as an acellular dermal matrix.

I have used these implants in many revision breast augmentation surgery cases with excellent success. 

This is a good question for a tough problem.  There are many “fixes” for breast implants that have problems such as malposition, sliding, symmastia, rippling, capsule contracture, bottoming out and asymmetry.

I have found that a good starting point is choosing the best implant available on the market.  Like many other problems in life, starting with the best available product goes a long way to either deal with or mask many concerns or problems.  For this reason, I use Sientra breast implants.  They have a 20 year warranty, the lowest capsule contracture rate of all implants in the industry and their naturally feeling gummy bear implants come in many shapes and sizes to help your surgeon match your goals.  Sientra’s textured implants can also be placed above the muscle to avoid muscle animation deformity.  The Velcro effect of the textured surface allows the use of much different sized implants than conventional breast implants without having to use internal slings or bras such as an acellular dermal matrix.

I have used these implants in many revision breast augmentation surgery cases with excellent success.

Many plastic surgeons, and almost all non-board certified plastic surgeons will recommend placing breast implants under the muscle or using a dual plane approach. This is because, for the most part, they are attempting to avoid the complication of breast implant capsule contracture. However, considering the medical science, using an implant that produces very little capsule contracture, and thus above the muscle placement without worry about capsule contracture makes more sense to me. Let’s examine all of this. The so-called flex deformity or animation deformity occurs when a breast implant that is placed under the muscle deforms into an unsightly shape when the pectoralis muscle is flexed. This does not usually occur when an implant is placed above the muscle. You may hear some surgeons suggest going under the muscle for better cancer surveillance but with the new digital mammograms this is no longer an issue with breast implants. The best chance to achieve the optimal result for a breast augmentation with good size and shape for a woman’s individual body and goals but without any of the complications that accompany breast augmentation including capsule contracture, breast implant rupture, rippling and breast implant animation, you need to start with a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery who does a lot of breast augmentation. In addition, hopefully that surgeon also uses Sientra breast implants since the medical studies show that these implants have the lowest incidence of capsule contracture, implant failure and rippling. In fact, Sientra just came out with their new 20-year implant warranty that puts all other manufacturers to shame. Finally, the results from Sientra’s natural feeling, textured gummy bear implants, are much more natural looking and can be placed above the muscle to avoid breast implant animation or pectoralis flexion deformity. They also allow for the use of a rapid recovery protocol that requires no narcotics and gets you out enjoying your new look the next day.

This is an interesting question because many patients only think of the cost for a procedure and how nice it would be to tack on a trip or vacation to an exotic place to have their surgery rather than the many implications.  

Some of the things to consider are:

1.      Many countries do not regulate specialty training and therefore you have no idea if the surgeon performing your procedure is properly trained.

2.      If there are issues with your surgery or treatment, it would be difficult for you to pursue a case. You may not have legal rights and may not be able to receive compensation for a mishandled surgery.

3.      Patients who travel abroad for medical treatment risk returning with complications or infections that require costly treatment, costly both on a personal and societal level.

4.      Will you receive adequate follow-up care in the foreign facility?  It’s important to understand that your hospital or clinic stay may be cut short, and you might not get the follow-up care you need.  What will you do if you have a serious infection or complication and can’t get the medical facility to treat you?

5.      Long air travel flights may increase your risk of blood clots. Plus, the combination of surgery and being stressed or fatigued following long multi-time zone airplane flights can make the risk even higher.  It has been shown that traveling can increase your risk of infection and complications after surgery.

6.      What implants will they use is another concern.  Here in the US surgeons have access to Sientra breast implants that have been proven to be the strongest implants available with les capsule contracture problems and with an incredible 20 year warrantee; just to name a few of the benefits.

Remember, breast augmentation is a decision for life and you have the best available to get a life long result right here in America.

Your photos show that you have very normal breasts with no signs of tubular or tuberous breast. Tuberous breasts are not simply small or underdeveloped breasts.  The effect of the condition on the appearance of the breast can range from mild to severe, and typical characteristics include: enlarged, puffy areola, unusually wide spacing between the breasts, minimal breast tissue, sagging, higher than normal breast fold, and narrow base at the chest wall.

If you want larger, more full breasts you would need a simple breast augmentation.  I would recommend Sientra’s gummy bear breast augmentation performed with a 24 hour rapid recovery protocol.

Both breast implant companies make a great implant and there is little to chose between them.  However, I believe that Sientra implants have a couple of advantages.  The first is Sientra implants feel almost like your own tissue at 3 to 6 months and women who have Sientra breast implants rave about how natural they feel.  The second is that Sientra’s gummy bear implants come in many shapes and the classic tear drop shape can provide your breast with not only volume but improved shape as well.  And finally, the warranty that Sientra offers is far superior.  Their implant warrantee covers capsule contracture and 20 year coverage for failure that includes funds for surgery, without having to pay extra. I have written a link to a two part article about why Sientra implants are so good that  you may enjoy.

As you do your research, make sure you look for surgeons who perform 24 hour rapid recovery breast augmentation as this will help you return to the gym much faster if you are athletic.  It also reduces your overall complication rate.

Breast augmentation is a very complicated subject for patients as well as for surgeons, especially when they delve into the details.  While many women and some surgeons focus on technique and placement, this is far less important than the type, shape and size of breast implant that is chosen for you.  The right implant can contribute to lifting your breasts and can also do a nice job of shaping them. 

The best implants on the market in terms of feel, strength are the shaped, naturally feeling gummy bear implants from Sientra would be great implants for you.  In addition, they have an unbelievable 20-year warrantee which is essentially a free insurance policy for your breast implants that no other company can match.

Make sure you seek out surgeons who are members of the American Society of Aesthetic Plastic Surgery to get the best chance of having a surgeon who can offer you all of the options and will know how to take care of complications that might occur down the road.  In addition. Look for someone who offers a narcotic free 24 hour rapid recovery breast augmentation in order to reduce complications and get you back to your life quickly.

 

 

The term dual place breast augmentation is simply a technique and term that plastic surgeons use to describe how the muscle is treated during your breast augmentation.  There should not be an additional charge for one technique over another.  The most important thing to consider in any breast augmentation is first your safety and second the implant and its safety profile.   

Make sure that the surgeons you are seeing are truly plastic surgeons.  There are many surgeons from different specialties who are board certified, call themselves plastic surgeons, but they are not certified by the American Board of Plastic Surgeons.  One way to know is to find a surgeon who uses Sientra breast implants, since Sientra will only sell their implants to truly board certified plastic surgeons.

Dark circles are usually caused by shadows from deep hollows under the eye.  These can usually be treated with a filler into the tear troughs and hollows.  While many injectors will inject the cheeks attempting to correct problems like the tear trough, this approach often fails as the filler is too far from the problem.  The other concern that many injectors of products like Juvederm or its cousins like Vobella is that they are worried about creating a blue hue or Tyndall effect.  For this reason, I like using Bellafill which will last at least 5 year and does not cause these problems as you can right in the tear trough and get great results.

Sometimes there is a component of dark skin in the same area and this can be treated in a number of ways depending upon the problem.  You can see many patients who we have treated with Bellafill for dark circles under the eyes here.

Your question is an interesting one because it is really a reflection on human nature.  Let me explain.  Your breast implants appear to be serving you well.  You have a good size and shape for your body.  The implants are in a good position and they have obviously served you well and should continue to serve you well for years to come.  Yet, you are clearly thinking about doing something with your breast implants because you have heard about breast implants and, in particular, Allergan’s textured breast implants, causing cancer, anaplastic large cell lymphoma (ALCL). 

With the implants you have, your risk of developing ALCL is one in thirty thousand (1:30,000) over the rest of your lifetime.  Now, if you develop ALCL that is obviously a problem but the chances of that are very, very small.  Put in perspective, the chance you die of heart disease over the rest of your lifetime is 1:3; a car accident 1:45 and a plane crash 1:4000. 

When I say your question is interesting, I mean that we often do not put everything into perspective when we consider certain actions.  While I am sure you can find someone who will be willing to remove your breast implants for you, there is certainly no need and the vast majority of plastic surgeons would advise against it for the reasons I have outlined.

What you should do is continue to monitor your breasts routinely for breast cancer, the kind we are all familiar with, and at the same time be aware that if you do develop a problem related to ALCL and your implants that the presenting symptom is large swelling of the breast that occurs over a few weeks.  If that occurs, you should then see a board certified plastic surgeon near you who can properly and accurately diagnose the problem and then guide you through the appropriate treatment. 

With respect to the age of your implants, there is a myth on the internet that you should change your implants ever 10 years.  Your breast implants are warranted for life so again, there is no reason to change something that is not broken.

This is a great question, but it pertains not only to body builders but to any woman who has a low BMI and therefore little if any “coverage” for her breast implants.  The main concern is animation of the breast and the only way to avoid this is with implants over the muscle.  This, in turn, can lead to rippling of the implants.

For these reasons, and many others, I use Sientra’s natural feeling, gummy bear, shaped breast implants for breast augmentation in women similar to you.  Very simply, they have the lowest capsule contracture rate of any implant on the market as well as the lowest amount of rippling. 

You can also have these implants with a 24 hour rapid recovery so that you can be back in the gym very quickly.

 

You appear to be an excellent candidate for a breast augmentation.  Always remember as you do your research to make sure you seek out a plastic surgeon who is certified by the American Board of Plastic Surgery and preferably a plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery.  This gives you the best chance of getting a great result. 

Remember that you have options with your breast augmentation.  You might seek out a surgeon who uses the 24 hour rapid recovery technique to minimize complications.  I would also recommend that you choose a surgeon who uses Sientra breast implants as they are the new natural feeling gummy bear implants and have been shown to have the least complications of all implants.  Sientra also has by far the best warrant in the industry.  There are many other reasons why Sientra implants are so good and I written an article about them that talks about why Sientra implants are so good.

Here is a video on 24 hour recovery breast augmentation. 

A great question because women often ask this when they are considering breast augmentation.  Most breast augmentations are done in women who have not had a pregnancy.  The women who have breast implants are usually very glad that they have them after their pregnancies since there is a tendency to lose breast volume after a pregnancy and after breast feeding.  Your breasts after a breast augmentation should continue to look good as long as you do not gain more than about 25 to 30 pounds during your pregnancy.  Any more weight gain than that carries with it the possibility of stretching the skin of the breast out and compromising the result.

Breast feeding after pregnancy should not be an issue as we normally do not cut any of the ducts and in fact rarely even see your breast tissue during a breast augmentation since breast implants are placed completely below the breast itself. 

 

As you do your research make sure you consider a 24 hour rapid recovery breast augmentation with no narcotics using the natural feeling, gummy bear breast implants from Sientra.  Sientra’s shaped implants will give you a great natural look and they have absolutely the best warranty on the market with the lowest complication rate.  

 

No, being skinny does not make breast augmentation dangerous at all and most women who get breast implants are quite fit with very little breast tissue.  That is the reason they decide to have breast augmentation.  Your concerns about being top heavy are well founded, especially if you see a surgeon who makes the breast implant size decision for you rather than you trying different size implants in a sports bra and making your own decision. 

I would also recommend the shaped, natural feeling, gummy bear implants by Sientra which have the lowest complication rate and by far the best warranty of all breast implant manufacturers and here is an article on why they are so good.

This is a very common question among women with similar breasts.  It appears that you have simply lost volume in your breasts that need to be replaced in order to restore your breasts to a more full and perky look.

When a breast implant is placed under your breasts, the nipple/areola complex is pushed out and although the distance between the nipple and the clavicle does not change but the nipple will come up in the vertical.

I always recommend for patients Sientra’s natural feeling, gummy bear breast implants for patient who have breasts like yours as they will help your shape as well.

Here is a case of a breast augmentation before and after photo that shows the lift that can be achieved with implants alone.

Breast augmentation bras generally are simply sports bras that are front opening.  These bras make it easier to get in and out of during the first few days after your breast augmentation.  It is the breast augmentation bra we use for the 24 hour recovery breast augmentation.  When Sientra breast implants, especially their natural feeling gummy bear breast implants, a hand in glove pocket technique for the breast implant is used so the implant stays put and does not need ongoing support. Therefore, there is no need to wear a bra after the first few days following a breast augmentation. 

Breast augmentation bras generally are simply sports bras that are front opening.  These bras make it easier to get in and out of during the first few days after your breast augmentation.  It is the breast augmentation bra we use for the 24 hour recovery breast augmentation.  When Sientra breast implants, especially their natural feeling gummy bear breast implants, a hand in glove pocket technique for the breast implant is used so the implant stays put and does not need ongoing support. Therefore, there is no need to wear a bra after the first few days following a breast augmentation. 

Yes. With Sientra’s natural feeling gummy bear breast implants, after the first week or so of recovery, you can wear a push up bra, a sports bra or no bra.  I use a 24 hour rapid recovery breast augmentation technique that allows patients to be out the next day and back to the gym within days.  Those patients wear only a sports bra for a few days and then what ever bra they want or no bra at all.

This is a good question.  The problem and concern with saline breast implants is that they will eventually leak and need to be replaced.  This is the reason that the manufacturers of saline breast implants offer a very limited warranty for their product now.  In addition, repeated surgeries are not necessarily safe and the problem of having to deal with the expense of revision breast implant surgery on a sudden or unexpected basis is of concern to many patients.  

Patients also fear silicone breast implants thinking that their implants have no silicone but in fact the shell of a saline breast implant is filled with saline but the shell is made of silicone rubber just like a silicone breast implant which is filled with silicone gel.  The good news here is that the silicone gel now is cohesive, meaning that even if there is a break in the shell, it will not leak.  More importantly, with a company like Sientra, the shell is the strongest and least likely to rupture of all the breast implants according to comparison testing and the gel for these implants is highly cohesive so it is really like a gummy bear candy, it will deform but it will not leak. 

Breast augmentation recovery does need to be long, arduous or painful. We use a 24 hour rapid recovery breast augmentation protocol that involves the acronym MEAT which stands for motion, exercise, anti inflammatories and treatment, which in the case of breast augmentation means heat like hot showers.  Motion and exercise is the real key however.  Since the breast implant sits either above or below the pectoralis muscle, exercises like over the head arm raises and stretches along with brisk walking swinging your arms will keep the muscle moving and greatly reduce any discomfort.  We also use Aleve after as it seems to be better than any other anti-inflammatory medication or narcotic for breast implant surgery.

 

I hope helps.

This is a very common breast augmentation question but I always remind patients that the difference between the breast implants you are considering is just 30 cc or 2 tablespoons.  The best way to decide on a size is to place trial breast implants under a tight fitting sports bra.  That way you can chose a breast implant size range that suits you. 

Make sure you research the subject of breast implants very carefully as there is a lot of information that you should be aware of such as:

·        The implant with the lowest capsule contracture rate.

·        Gummy bear breast implants.

·        Rapid recovery breast augmentation.

·        ALCL and breast implant illness

·        Above or below the muscle pros and cons.

 

I always recommend that you make sure you see a Board Certified Plastic Surgeon who has access to implant like Sientra breast implants.

Here is another link to information on the best breast implant

This a great question, especially why every doctor would not offer it.  The rapid recovery breast augmentation has been around for years.  It has been refined to a no drain, no narcotic 24 hour rapid recovery breast augmentation and I have extended the same protocol to tummy tucks, breast reductions, breast lifts and facelifts.  Many surgeons are just leary of trying something new, especially if what they are doing is working and their patients are not demanding the new technique.

The surgery is not shorter, but in many cases it is refined to be less invasive.  A rapid recovery is mostly a post operative protocol that uses motion right after surgery, and anti inflammatories.  It has been shown to reduce many complications as well. 

Rapid recovery plastic surgery is discussed on this page.

There is no particular way that you should sleep after a breast augmentation. If a 24-hour rapid recovery, no narcotic breast augmentation protocol is used, there are no restrictions on how you sleep, what you do, or the bra you wear (or not wear). You should be back to almost all of your normal activities and habits within 24 hours. You will, of course, not be healed, an over activity may be a little sore as might sleeping on your stomach, but you are in no way restricted. Here is a video testimonial of one woman’s experience with the 24 hour recovery breast augmentation.

A number of women as well as surgeons fret over breast implant sizing for breast augmentation but it does not have to be difficult if the principles are understood.  The first consideration is that the number one reason for re-operation on breast implants is size and the reason is almost always because the surgeon picked the size.  To avoid this complication, it is best if the patient picks the size for themselves.

This is accomplished by trialing breast implant sizes in a tight sports bra.  Following that, an implant in chosen as close to the breast width as possible that is a similar size to what you have chosen.  Projection is what is used to achieve that size the patient likes and keep the width close to what the patient’s chest can accommodate. Using the natural feeling gummy bear implants usually gives the surgeon and patient enough choices to get the desired results.

Make sure you chose a surgeon who uses a rapid recovery breast augmentation technique to minimize complications and your down time.

With a 24 hour recovery, no narcotic breast augmentation, there is no difference in the pain or the recovery time between a breast augmentation below the muscle or above the muscle. 

Most plastic surgeons certified by the American Board of Plastic Surgery, have access to Sientra breast implants and these implants have a low incidence of capsule contracture.  As a result, most plastic surgeons who use Sientra implants have shifted to placing breast implants above the muscle.  This also has the advantage of avoiding the problem of breast animation or flex deformity that can come with a below the muscle placement of breast implants. 

Another advantage of above the muscle is that there is less bleeding, the breast tissue can be draped over the breast implant.  This results in a more natural looking breast augmentation. 

Sientra breast implants have the best warranty, by far, of any of the other implants available, feel more natural and have less rippling since they are the most cohesive of all the gummy bear breast implants available today. Here is an article about the many advantages of these breast implants.

While there are many approaches to post-operative care.  The trend these days is to use a rapid recovery breast augmentation protocol that uses motion, exercise, anti-inflammatories and treatment of the surgical site with heat (warn showers) rather than use pain medications that have many untoward side effects including potential addiction and drug diversion, all of which is so prevalent in the news,  This new protocol is far more effective than pain medications and not moving or resting after surgery.  It comes form the new sports medicine techniques and allows you to be back doing most things in under 24 hours.  My patients are routinely back to work the next day with only Aleve or Tylenol. 

Similarly, postoperative antibiotics are rarely prescribed for breast augmentation.  It has been clearly shown that one dose of intravenous antibiotics just prior to surgery combined with intraoperative antibiotic washes and a no touch breast augmentation technique is far superior to postoperative infections   

The rapid recovery breast augmentation protocol has also been shown to reduce many other post breast augmentation complications as well.

Your question is a common one among women seeking a breast augmentation after pregnancy.  Most plastic surgeons now use an incision in the fold under your breast to help reduce complications like capsule contracture.  The most natural feeling breast implant on the market is Sientra’s natural feeling gummy bear implant.  This implant has minimal wrinkling and as a result can be placed above the muscle to reduce the risk of breast animation deformity and with a shaped or tear drop implant a beautiful breast shape can be achieved in women who have very little breast tissue or have lost breast shape after breast feeding.  Your concern about recovery is also common.  A 24 hour, no narcotic rapid recovery breast augmentation will minimize your recovery and with this protocol, the lightest anesthesia possible is used for your surgery so you do not have to worry about what is very scary for many women.

There are many ways to correct your elongated nipples and the best technique for you will really depend on your surgeon’s preference since all of the techniques result in very high patient satisfaction and low complication rates.