Frequently Asked Questions: Breast Surgery & Implants

June 27th, 2016 | Breast

1. Breast Lift vs. Breast Augmentation: How to tell which breast surgery is needed?

Many patients ask a question whether they need a breast augmentation or a breast lift. Still others ask whether they need a combination of the two breast surgery.

The purpose of a breast lift is to tighten loose and sagging breast tissue. It redistributes the volume of the tissue from the low position to a higher position to create cleavage and fullness of the breast. Mastopexy or breast lift does not change the volume of the breast at all. The breasts sometimes look full due to the fact that they are in a higher location and the cleavage is accentuated.

Conversely, an implant increases the volume of the breast. When the volume of the breast is increased, for some there is a correction of the drooping of the breast.

Some patients require a combination of these Breast Surgery procedures. They require lifting of the breast but also require volume enhancement of the breast. These patients cannot get enough of a lift with an implant alone. Using the implant alone for a lift will require some patients to have a volume that is greater than the desired volume in order to achieve the lifting effect.

2. Can breast implants lift slightly sagging breasts?

For specific patients with minimal sagging who desire volume enhancement an implant placement alone can provide a minimal to moderate lift. Our surgeons at Houston Plastic Craniofacial and Sinus Surgery will be able to advise you if you are a candidate for this.

3. How do I choose a breast implant size that’s right for me?

The two major factors that determine the correct implant size for a patient are her natural breast base measurement and her desired breast “look.” The breast base measurement is important to avoid an overly unnatural appearance after augmentation. But as in all procedures the patient’s desire is taken into consideration with her measurements to together help her achieve her goals for her breast contour.

4. Can I have breast implants if I’m planning to have kids in the future?

Breast implants do not preclude having children in the future. Careful discussion with your surgeon will determine the implant placement technique that is best for you. That being said pregnancy and the resultant effect on the breast can have dramatic changes on the breast and can result in either enlargement of the breast, streaking to the breast, or drooping of the breast. These changes will be present irrespective of whether or not you have had implants in the past.

5. Can I breast feed if I have breast implants?

Often for patients who plan on having children in the future and want to preserve their breast feeding ability an inframammary approach for breast implant placement is chosen. This allows for excellent implant placement and avoids the breast tissue entirely therefore not affecting the milk production.

6. What is the best shape of implants to achieve more natural looking results?

Shaped implants are fortunately used by the surgeons at Houston Plastic Craniofacial and Sinus Surgery. We have embraced all types of implants including the anatomic “gummy bear” implants. These implants for many people will result in a natural appearance and have a more profound effect. The surgery itself is significantly different in the fact that patients with the textured anatomic implants will have their final postoperative result much sooner than those patients with smooth silicone or saline implants. This is because the textured implants do not drop as much as the smooth implants, therefore the initial placement is closer to the final desired location. Furthermore, anatomic implants have  a more natural appearance. A patient will often choose a shaped implant if she desires to have a look that has a more natural and less operated appearance.

7. Do silicone implants harden over time?

Less than 10% of implants placed under the muscle will develop a firm or hard scar capsule that can cause the breast to be firm, oddly shaped or painful. There is no way currently to predict if this will happen. If it does occur, further surgery will be needed to correct it, and most of the time it will not reoccur.

8. Do breast implants need to be replaced over time?

No. Unless issues occur there is no specific time recommendation to replace implants. Most implant manufacturers provide a 10-year warranty that will cover issues due to implant failure. However after the warranty expires replacement is not required unless indicated for a specific reason.

9. What can I expect during breast augmentation recovery?

Most patients recover rather quickly from breast augmentation. This procedure is typically done in the Houston Plastic Craniofacial and Sinus Surgery ASF certified operating room. This procedure is also usually performed via a sedation technique avoiding the risk, discomfort, and prolonged recovery associated with endotracheal anesthesia. Adequate local anesthetic is placed during the procedure, which not only facilitates the intraoperative procedure but also allows for postoperative pain control. Most patients are discharged as soon as 15 minutes after the procedure is completed due to the lack of significant side effects associated with this type of anesthesia.

On average patients are back to normal activities within two to three days and can be back to exercise and vigorous activities within two to three weeks. There is typically minimal bruising and discomfort and no special dressings are necessary due to the specialized individualized intraoperative technique.

10. What is your advice for exercise after breast augmentation?

At Houston Plastic Craniofacial and Sinus Surgery, we feel that excellence in the operating room obviates the need for a significant amount of postoperative manipulation including massage. Patients should begin their normal activities approximately two to three weeks after surgery and can resume all preoperative exercises including heavy weights and strengthening exercises within four weeks after surgery.

11. Will breast implants give me a natural cleavage?

At Houston Plastic and Craniofacial Surgery significant attention is placed towards accentuating the cleavage with breast augmentation. It is absolutely critical that the implants are placed in a central location and not extremely laterally as patients with implants that are too far lateral have significant dissatisfaction with their breast augmentation. Significant effort and time is placed in order to get medial cleavage, which yields to the highest postoperative satisfaction.

12. Silicone vs. Saline: Which breast implant is safer? Or are there any other safe options?

A silicone shell surrounds both silicone and saline implants. Saline implants are filled with sterile salt-water while the silicone implants are filled with a thick silicone gel. Both implants have an equal safety profile and the decision to use one over the other is up to the surgeon and patient’s Breast Surgery preference. For some women augmentation can be safely achieved without the use of an implant and instead with fat transfer Breast Surgery. This method of augmentation is not as predictable but works well for women desiring a modest augmentation with minimal (sagging).

13. What are the risks of breast implant?

Like many surgeries breast implants include the risk of infection, bleeding (hematoma), fluid collections (seroma) and scarring. Specific to breast augmentation surgery capsular contracture (hard scar encapsulation), implant leakage, rippling, asymmetry and nipple sensation changes can occur. At My Houston Surgeons we provide excellent care with a focus on safety to reduce these risks as much possible.