Everything You Wanted to Know About Breast Implants but Were Afraid or Ashamed to Ask

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Did you know that the most important factor in predicting your result with breast implants is the type of breasts you have before the surgery? I always check the breasts and make sure that we don’t have an unusual problem. Some breasts are very, very saggy and need a lift before doing implants. It used to be that the surgeons generally performed the lift and the implant at the same time, but opinion is shifting on this issue because the complications are so high if these two procedures are performed together. All kinds of problems, including nipple areolar area skin death, occur. And the general opinion now is that it’s better to do a lift in one procedure and wait four to five months before inserting an implant, if necessary.

Other breasts are different than the “standard model.” Some breasts are long and skinny, and these breasts deserve special treatment before performing the implant. Sometimes they need a reduction. Sometimes they need a procedure that makes them look more like normal breasts before doing the implant.

Another problem is the question of a person with slightly saggy breasts who might not want scars on her breasts. In this case, we offer a lift first, but many of these individuals like a fairly large implant, and this will lift the nipple to some degree. They accept a somewhat more “natural” look, which is a little bit saggy, rather than having scars on their breasts. We frequently insert these through the armpit, through an incision which for saline implants is only about an inch long or less.

There are many breast augmentations that are performed above the muscle and many that are performed below the muscle. The theory about the above-the-muscle implant is that it produces a smoother upper curve of the breast. However, if you have rather reasonably full breasts that aren’t too saggy, an over-the-muscle implant is much easier recovery process and produces a very predictable result in our hands. Additionally, below-the-muscle implants over the long term may produce several undesirable effects. These include the breast falling off of an implant that is riding high under the muscle, and while this is acceptable in some cases, in others it’s not. A second complication which is very common is over the two to three years after getting your implants below the muscle, the activity of the muscle pushes the implant down and out. So the implants become saggy sooner rather than later.

We always recommend good bras for our breast implant patients, and in particular, we like Bali brand “Minimizer” bras, which have broad straps and full support and full coverage. Stretchy, “sports-type” bras are generally not as good because they just don’t supply the support, even though perhaps some manufacturers and individuals think that they’re very supportive.

Each breast project is an individual effort based on your particular idea of the size that you want, and we size you very carefully in the preoperative period. Your breasts also determine what kind of result you’re going to get, and the surgical technique also is very important. We perform breast augmentations through the belly button, under the muscle, through the armpit, above the muscle, and also use areolar incisions at times where this is the best option or the patient wants this. The crease at the bottom of the breast can also be used as an entry point to insert the implant. However, this is probably less desirable in many cases because the scar is visible in a lot of situations.

So your consultation will take you through the process and we will check the size you want, tell you the limitations that exist because of your breast type, and make a recommendation based on your individual needs and desires.