Breast Augmentation Questions

I’m 20 Years Old and Am Unsure if the Saline Implants I Get Will Be the Best Think for Me?

posted by ajimerson

Q:  I’m 20 years old, Caucasian, 5ft6 and 130 pounds. I’ve been looking into getting saline implants as I’m not 22 yet and cannot get the silicone. I’ve heard alot of bad things about saline and I’m hoping y’all can put my mind at ease. How common is rippling? And how natural will it look/feel? Also, I’ve heard that if you have smaller breasts, that you shouldn’t get a dramatic increase in bust size like say from 32A to a 32D. Is this true? Lastly, should I get it above or below the muscle? Thanks!

A:  You are correct that silicone breast implants are only approved for use at age 22 and older so right now saline implants are your only option.  Saline implants can give a nice, natural result.  I prefer silicone for women who are seeking a dramatic increase in breast size (like from an A to a D) and for women with a small amount of natural breast tissue.  I love the dual plane approach where the implants (saline or silicone) are placed partially under the muscle – this also helps me achieve a more natural appearance since the implants aren’t sitting right under the skin.  You should also be aware that your nipples are spaced far apart.  This cannot be corrected with breast augmentation and will probably be more noticeable.  Please also keep in mind that you have the option of having saline implants now and going up a cup size or two.  You can see how they look over the next 2 years and switch to silicone if you want at age 22.

Tear Drop Vs Round Breast Implants for Petite Build?

posted by ajimerson

Q:  Hi! I’m a 19 year old girl who is petite build, short about 150cm (4’9″), breast size about an A cup and is going to get Breast implants but I’m not sure which style to go for. I was told the tear drop as it is more natural and due to my petite built. I just wanted to know if I were to get round implants would it look that bad?

A: I only use round implants for breast augmentation. By selecting the correct volume and profile, they can give a very natural look. I always like to hold a round implant at the top to demonstrate that the saline or silicone inside sinks to the bottom with gravity.  This helps create more fullness at the bottom – like a natural breast. Unlike your natural breast tissue, breast implants move around in the pocket we create.  Tear drop breast implant manufacturers try to reduce this by “roughing up” or contouring the outside of the implant.  This texture encourages your skin and muscles to adhere to the implant and help hold it in place.  Either way, it creates problems.  If you skin doesn’t adhere to a tear drop shaped implant, the implant can rotate giving you an oddly shaped and asymmetric breast.  This can be visible even through clothing.  If your tissue does stick to the implant, this can lead to rippling and make the implant very visible under your skin.  In my opinion, tear drop shaped implants are best reserved for breast reconstruction.

Recommended Correction(s) for my Tuberous Breasts?

posted by ajimerson

Q:  Do I have a severe form of tuberous breasts? What would a good surgeon recommend I do to correct them and accomplish full, round A cup breasts? Can it be done under local anesthesia?

A: Based on your photo, I’m not convinced you actually have tuberous breasts.  A side view would give more information.  You may have some mild constriction of the base, but your areolas appear normal to me.  I think silicone breast implants would give you a lovely result.  While this could be performed under local anesthesia, I would recommend general anesthesia.  With general anesthesia you have excellent pain control and muscle relaxation – both of these help your surgeon place the implants in great position.

Should I Have Breast Implant Revision Surgery?

posted by ajimerson

Q:  I had breast augmentation 10/9/12.When I went for my consult I told her that I was thinking 300cc implants.She thought that was too big. She told me to try some sizers, up to 240-270cc and then we would talk.When she came back in the room we agreed on 240-270cc,then after the surgery I noticed that she had put in 210-240cc. She says that she will redo the surgery but I have to buy new implants.Shes discouraging me from doing anything more and says that its a good result. Im very disappointed.

A:  30 cc is one ounce or 1/8 of a cup.  This is not a very big difference in volume and is probably not worth going through another surgery.  I can certainly understand your disappointment since you and your surgeon discussed a certain volume beforehand, but surgery is as much art as science and sometimes we have to make adjustments once the procedure has begun.  Looking at your photos, I’m not sure your breasts would have accommodated a larger implant – your skin looks tight.  It may not have been possible for your surgeon to have inserted the slightly bigger implant that you all agreed upon beforehand.  You had surgery about 4 months ago.  I would suggest waiting another few months to let the implants settle.  If you decide that you want a significant increase in volume (a cup size or so), then meet with your surgeon.

I Want Silicone Implants Without a Lift, is my Ptosis Bad Enough to Not Recommend Implants Without a Lift? (photo)

posted by ajimerson

Q: I want silicone implants without a lift, is my ptosis bad enough to not recommend implants without a lift?

To lift or not to lift, that is the question . . . Forgive the pun!  I am asked this question almost daily – your issue is very common.  I think you would have the best cosmetic result with a combined breast lift and augmentation, but the choice is yours.  You do have breast ptosis (sagging), so the question is – are you OK with that?  You should understand that breast implants will NOT correct sagging.  I think a lot of women come to my office thinking that implants will raise the nipple but this is not so.  After implants alone, your breasts will be fuller, but the nipple will remain in the same position.  You have the option to start out with breast augmentation alone.  If you are satisfied, great.  If not , you can always opt for a mastopexy (breast lift) later.

I Am 5’4″ and Around 120-125 (Always) I Want a Breast Aug and a BBL. Do I Look As Though It Might Be a Benefit? (photo)

posted by ajimerson

Q:  I’m really invested in getting this procedure done but Im having the absolute hardest time gaining weight. O.O I’m naturally just not that into food but lately I have eaten more & think I have gained at least 2 pounds… YAYYYY! Is there a special diet I should be on to gain weight quickly? I’d like to know if it looks like ill need a tummy tuck as well? I really REALLY hope not because I scar like crazy! Also as far as I know 200-300 cc is not enough. Could I have more than I think? Thank you!

A: Based on your pictures, I don’t think you need a tummy tuck. Whether or not a Brazilian Butt Lift is the best option for you depends on how big you want your butt. I think you will love the effect of the liposuction on your tummy, but based on your current amount of fat, I don’t think you will end up with a huge butt.  If you are looking for a dramatic increase in size of your butt, you might consider butt implants alone or combined with fat grafting.  Some of my patients have had good success gaining weight by adding 1-2 cans of Ensure daily.

I would need to examine your breasts further – you may be a candidate for a breast lift, but it is hard to tell from your pictures.  If you opt for a breast augmentation alone (I know you are concerned about scarring), you should understand that this will not elevate the nipples (it won’t make your breasts perkier).

What All Needs to Be Done to Fix my Breast Assymetry?

posted by ajimerson

Q:  I have done so much research on breast augmentation and am ready to schedule a surgery.I want to make sure I am going with the right surgeon that has experience with breast assymetry.I would like to have 34D-DD as an end result, but i don’t know if this is possible with my left breast being MUCH smaller than the right. The left breast is an A while the right is a large C.I have read that removing breast tissue from the larger breast should be done, as well as a lollipop lift for nipple symmetry.

A:  Thank you for sharing your story and photos.  I think that your asymmetry can be improved through surgery on both breasts, but it is unlikely that any procedure or combination of procedures will make your breasts match exactly.    I would recommend placement of a tissue expander on the left (smaller) side and an implant on the right side.  Once both breasts are the desired size, I would do a second procedure to address nipple placement and areola size (a breast lift) on the right breast.  With this degree of asymmetry, I think two separate procedures are warranted to achieve the best result.

Replacement of Implants, Original Cancer and Radiation in 1985? (photo)

posted by ajimerson

Q:  I had lumpectomy & radiation in 1985. I got UM silicone implants in June 2011. Left radiated side 400cc, right 325cc. Easy recovery; no problems – left breast is nice but firmer & smaller and right is softer & lower. Not really noticeable in bra. Can I increase the left side rather than reduce the right w new implant? Can I lift the right w/o moving nipple? Will I always be asymmetrical regardless of what I do? I am 61 and really don’t want a big major surgery. Options? Opinions? THX!

A:  Thank you for your question.  I generally don’t perform fat transfer to the breast after lumpectomy.  There appears to be some capsular contracture on the smaller side.  This could be corrected in conjunction with placement of a larger implant on that side.  Lifting the larger side (mastopexy) would involve moving the nipple.

How Do Breast Implants Look if You Have Stretch Marks Before You Get Them Done?

posted by ajimerson

Q:  I have had 2 kids and it has caused a lot of stretch marks on my breasts? Does anyone have any pictures of their stories? Please help.. I want to get my done but I am nervous of the outcome

A:  Stretch marks are tricky and hard to predict.  Breast implants will certainly not remove your stretch marks, but some women do find that the marks are less apparent when the breasts are full and the skin is pulled taut.  It is possible to develop more stretch marks if the skin has to stretch over the implant.  I would suggest meeting with a board-certified plastic surgeon to discuss your concerns and your goals for your breasts.  He or she will be able to give you a better idea of what to expect after assessing your skin quality and determining how big you want your breasts to be.

Why Do So Few Surgeons Work in an Actual Hospital As Opposed to Their Private Surgery Centers?

posted by ajimerson

Q:  Am I wrong in wanting to be operated on in a hospital, even though these surgery centers are accredited? It just seems safter.

A:  Almost every board-certified plastic surgeon you will meet operates in at least one hospital.  Having hospital privileges is a requirement for most accrediting organizations.  There are several reasons why so many of us and our patients prefer surgery centers.  First and foremost is patient safety.  I run my own AAAASF-accredited surgery center which allows me to hand-pick the best nurses, anesthetists and other staff to help me take great care of you.  I have no control over who is working in the hospital.  Most surgery centers also have MUCH lower infection rates than hospitals.  The second benefit is cost.  Hospitals are expensive to run and that cost is passed on to you.  I have no influence on the anesthesia and facility fees that they will charge my patients.  I am much better able to control costs in my own center and I pass that savings on to you.  Additionally, I am able to offer better service in my own operating room than I am at a hospital.  I offer a variety of surgical dates and times and my staff is particularly attuned to your needs.  It’s equivalent to the service difference you would notice when comparing a fast food chain to a sit down meal at a family owned restaurant.