General Breast Implant FAQs

 

Can a woman breastfeed after breast augmentation?

Can implants help lift sagging breasts?

Do breasts with implants experience sagging over time?

Will my implants feel like natural breasts?

Will I have stretch marks after my breast augmentation? How can I keep this from happening?

Is there much pain associated with breast augmentation?

Should I wait to get my implants until after I've lost weight?

Should I wait to get my implants until after having children?

How old do I have to be to have breast augmentation?

What type of anesthesia should I choose? Which is safest?

Will my areolae stretch after augmentation?

I went on several consultations and every doctor had a different opinion of what would be best for me. Now I am confused! What should I do?

What about augmentation with my own fat? Isn't this a better idea?

I have Poland's Syndrome (or pectus excavatum, pectus carinatum, etc.) and have been told breast implants will help me look "normal". Is this true?

What are the risks of breast augmentation?

Breast Implants (specific)

Can saline-filled implants harden?

What are the differences between smooth and textured breast implants?

What are the differences between round and contoured breast implants?

How long can I expect my implants to last?

How many cc's make a cup size?

Will the implant burst when I get my next mammogram?

Do breasts with implants experience sagging over time?

Breast Implant Placement FAQ

Should I go over or under the muscle?

Breast Augmentation Recovery FAQ

How long should I wait after surgery until I resume exercising?

How long before my implants drop and fluff?

How long before they soften up?

How soon can I go back to work?

My nipples are too sensitive and are constantly erect. What can I do to ease this?

 

Can a woman breastfeed after breast augmentation?
Breastfeeding is a growing concern with patients who have had breast augmentation surgery. First there was the question of whether a woman could physically nurse after implants because the surgery can result in cut or damaged milk ducts. Then, when the first reports of silicone illness hit the media in 1992, there was concern that breastfeeding with silicone implants would endanger the child. Studies have shown that this not the case because the silicone molecule is too large to pass through the duct. Read more about breastfeeding with implants.

With the transumbilical breast augmentation (TUBA) approach, the breast tissue and ducts are not disturbed, cut or affected. The procedure literally takes place under the breast tissue, not through it. However, with other techniques it is possible to disrupt the milk ducts, making breastfeeding impossible. This is a particular concern with the periareolar technique, which involves an incision around the areolae.

Whatever technique is used, breastfeeding after breast augmentation is a possibility, not a guarantee. That is why doctors advise women who have not completed their families to postpone breast surgery until they have.

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Can implants help lift sagging breasts?
Although implants are not designed to lift up a sagging breast, they do help the breasts appear less saggy. They do this by filling some of the slack in the loosened skin, thereby increasing the volume and decreasing the saggy look. Implants also help by rotating the lower portion of the breast upward, making the breasts appear less saggy. For moderate or severe sag, however, a breast lift procedure, with or without implants, is usually performed.

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Do breasts with implants experience sagging over time?
All breasts relax as time passes because the weight stretches the skin, elasticity is lost with age, and the amount of breast tissue often decreases as the person gets older. These three factors mean that breasts can be expected to relax and sag whether or not there are implants present. The implants add some weight to the breast, which may increase the rate of relaxation, and yet implants and surrounding scar tissue can provide some internal support for the breasts. The overall result is that usually the breasts sag less, particularly if the woman regularly wears a properly-fitting bra.

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Will my implants feel like natural breasts?
This issue depends upon a few factors. The more natural tissue you have preoperatively, the greater the chance that you will have natural-feeling breasts postoperatively. However, if you have cohesive silicone or overfilled saline implants, your breasts will feel firmer than natural breasts. Underfilled saline implants will result in ripples, and overfilled implants will cause unnatural firmness. Discuss with your surgeon before surgery how he or she plans to fill your saline implants for the most natural look. Additionally, many women feel that saline implants feel less natural than silicone gel or hydrogel-filled implants. Smooth-surfaced implants are thinner than textured-surfaced implants. Although the difference is slight, patients who have had both often report that they can feel a difference. You may hear that "unders" (implants placed under the chest muscles) look more natural than "overs" (implants placed over the muscles). This can vary from woman to woman. Overs actually move more naturally than unders, but they may have a pronounced upper pole fullness, especially in overfilled implants. Unders tend to "jump" and twitch when you flex the pectorals during everyday movements and while working out. Lastly, the thicker and springier your skin, the less likely the implant edges will be felt. Thinner skin allows a more palpable result, so thin-skinned women often opt for placement under the muscle.

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Will I have stretch marks after my breast augmentation? How can I keep this from happening?
Stretch marks are caused by an abrupt expansion of the tissues and are highly dependent on a person's skin elasticity. Some women develop stretch marks from the hormones and growth spurts associated with puberty, muscle tissue gain from weightlifting, and pregnancy. When the expansion is very gradual, stretch marks are practically nonexistent. Some individuals never develop stretch marks while others are very prone to them. Mature stretch marks are very difficult to remove. You can tell a stretch mark is mature by its age and color, which is usually white. Deep fissures that are purple in color can not be removed with treatments short of excision. The white marks can be darkened using a flesh-colored pigment implanted using micropigmentation. If you had stretch marks on your breasts before augmentation, they will still be there afterwards.

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Is there much pain associated with breast augmentation?
Pain thresholds vary from person to person. Breast augmentation pain is dependent upon implant placement, incision placement, and if you choose to take your medications on time. You can cause yourself more pain by not following your surgeon's instructions and overexerting yourself during recovery. Many patients liken their discomfort to pressure or muscle soreness. If you should experience any discomfort that seems out of the ordinary, contact your surgeon.

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Should I wait to get my implants until after I've lost weight?
Although you can get your implants at any time, if you are considering losing any significant amount of weight (15 pounds of more), lost breast tissue can result in breast sag, or ptosis. If you have very small breasts and get implants and then lose weight, there shouldn't be a significant problem with sag since your breast envelopes were not large to begin with.

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Should I wait to get my implants until after having children?
If you are considering having children within the next year or two, it is advisable to wait since the effects of weight and breast tissue gain and loss will affect the appearance of your breasts. Additionally, if you are planning on breastfeeding future children, you should be aware that implants may impede your ability to do so.

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How old do I have to be to have breast augmentation?
The U.S. Food and Drug Administration limits the use of saline breast implants to women aged 18 and above; silicone-filled implants are limited to women aged 22 and above, unless they are being used to reconstruct the breasts. Although you may think you have reached physical maturity by 18 or 19, your breasts will continue to go through changes well into your early twenties. On the other side of the spectrum, women in their late 60's have gotten breast implants. As women age, the only thing that may stop them from having breast augmentation surgery is their general health, so be sure to have a physical to see if you are in good health first.

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What type of anesthesia should I choose? Which is safest?
Unfortunately, the type of anesthesia is not usually your choice. The surgeon and/or anesthesiologist uses what he or she prefers. Discuss your anesthesia options with your surgeon.

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Will my areolae stretch after augmentation?
Stretching of the areolae (plural of areola, the disc of darkened skin around the nipple in the center of the breasts) is very common and sometimes unavoidable. This can create more sag in breasts that are already saggy, although usually the stretching comes from the pressure of a tight breast envelope. If you have less tightness, you will usually experience less stretching. It may not happen overnight, but it will happen over time. In women with periareolar lifts and areolar reductions, some surgeons use permanent stitches around the areolae to keep them from stretching.

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I went on several consultations and every doctor had a different opinion of what would be best for me. Now I am confused! What should I do?
All surgeons are different; hence they may have differing opinions. That is where your own research, comparison, word-of-mouth recommendations, and several consultations come in handy. Don't expect every surgeon to agree, but make sure you do your homework to better understand what techniques and options can get you the results that you want. It pays to listen, take notes at your consultations, and reflect upon each surgeon's recommendations. 

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What about augmentation with my own fat? Isn't this a better idea?
On the surface, fat grafting would seem to be the idea solution, but until better results without complications are possible, it is actually risky. Fat grafting, especially in the amounts needed for a standard augmentation, may not last over time. In order for fat to survive, it must be transferred successfully and become revascularized once it is grafted. If not, the fat cells will die. It isn't as simple as liposuctioning fat out and then injecting it into the breasts. Not all fat that is grafted survives the procedure, which may result in asymmetry, lumpiness, fat and tissue necrosis, and irregular mammograms for years to come. Fat grafting into the breasts can develop into calcifications and scar tissue masses, which show up on mammograms as irregularities. When these are found they must be biopsied to be sure they are not malignant masses. However, fat can be transplanted to the cleavage areas to help with overly-bony sternums and to soften the transition from implant/breast mound to breastbone.

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I have Poland's Syndrome (or pectus excavatum, pectus carinatum, etc.) and have been told breast implants will help me look "normal".  Is this true?
Many patients with breast abnormalities have gotten breast implants to give the illusion of a normal chest. Implants in two different sizes can also be used to give a look of symmetry to the breasts. Your surgeon will be able to help you decide which option is best for you.

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What are the risks of breast augmentation?
A bad reaction to anesthesia is always a possibility. Although extremely rare, it is possible to bleed postoperatively, resulting in another surgery to control and drain the collected blood. You could develop a postoperative infection and need to have the implant removed, treat the infection, and then wait several months before an additional surgery can be performed to reimplant. Loss of sensitivity is common, although temporary. Permanent sensation loss in the areolae or breasts can occur. There is also the possibility of developing a seroma, which is a mass caused by the accumulation of serum fluid within a tissue or organ, or a hematoma, which is a localized mass of blood.

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Can saline-filled implants harden?
The hardening that can occur is due to excess scar tissue formation and contraction of that tissue around the implant. This is called capsular contracture (CC). If this occurs, another operation may be required to remove the scar tissue. CC may also be remedied in some cases with a prescription of prednisone and repeated manual compression by the patient. Some surgeons recommend daily manual massage to prevent the condition from developing.

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What are the differences between smooth and textured breast implants?
Smooth implants are manufactured with the goal of a flawless surface. There is less rippling reported with smooth implants. The textured implant reportedly takes longer to drop, resulting in implants that appear higher on the chest. Also, the deflation rate for textured breast implants is reportedly slightly higher due to the slight imperfections purposefully made on the implant surface during manufacture. It has also been reported that the body's naturally-occurring scar capsule grows into the implant surface, which could make it more difficult to remove the implants should that become necessary. Although the safety reports are basically the same for both surface types, smooth implants are more commonly used.

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What are the differences between round and contoured breast implants?
The belief that contoured (anatomical or teardrop) implants are more natural looking is good in theory, but in actuality the results are about the same as with round implants. This is particularly the case when contoured implants are placed behind the muscle because the muscle and chest wall exert force equally on the implant from all sides, creating a more rounded appearance. Also, contoured implants have been known to invert themselves, or turn themselves upside down, if placed improperly. If this happens a second surgery is usually necessary to correct the situation.

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How long can I expect my implants to last?
A 'guesstimate' for the product life is 15-20 years, according to the Institute of Medicine. Implants do not need to be changed unless they deflate or rupture. One may consider changing a silicone-filled implant out after this time has passed to decrease the chances of a rupture, which would necessitate a silicone gel removal procedure. There is a 2% rate of deflation in the first 10 years, although wear and tear will be different in each individual depending upon implant surface type. However there are women who have had implants for over 25 years with no problems. That said, expect to replace implants at least once in your lifetime.

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How many cc's make a cup size?
The results of a study by the American Society of Plastic Surgeons showed that an average of 189cc of saline was needed to change one bra cup size. Increasing an A cup to a C cup required a total of 391cc, or 196cc per cup. Moving from a B cup to a D cup required a total of 448cc, or 224cc per cup. While these amounts help achieve the desired size, they are not exact and that differences may occur because of other variables, such as chest wall size, breast tissue and the tissue envelope size.

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Will the implant burst when I get my next mammogram?
It's possible, but extremely unlikely. Tell your mammography center that you have implants when you make the appointment, and be sure to inform your mammogram technician so that he or she can take the implants into account while performing the test. You will also have to have additional films of your breasts taken, which means that you will need a longer appointment time.

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Should I go over or under the muscle?
This is a decision you will have to make in consultation with your surgeon. There are pros and cons to both and choosing your placement should be a decision based upon several consultations and medical opinions and your own needs. Although some surgeons may prefer one placement over another, if you have adequate tissue and average skin thickness, overs should not be a problem. Not every woman needs to have subpectoral coverage to help hide the implants.

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How long should I wait after surgery until I resume exercising?
Surgeons usually advise a waiting period of at least 2 weeks before exercising; longer may be better. Although you may feel good, you will not be completely healed for some time. Take care with lifting heavy objects, bending over, or participating in vigorous activities once given the go ahead by your surgeon. Always abide by your surgeon's instructions.

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How long before my implants drop and fluff?
This depends upon several factors: implant size, what size you were preoperatively, implant surface type, implant placement, use of massage, muscle tone, etc. Every woman drops at a different rate. For instance, smooth implants drop faster than textured. If you go under the muscle you will drop slower than overs. If you go from a saggy C to a D/DD with a smooth implant in the subglandular position, you will probably drop faster than a woman going from an A to a C/D who has textured unders. If you had very small breasts before, and get moderate to large implants for your frame, they will take longer to drop because of the tightness of the skin.

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How long before they soften up?
Again, this depends upon your implant surface type, implant filler, overfill, muscle tone, and implant placement. You will be firm for a while due to postsurgical swelling. There are many factors that will affect the firmness of the implant. Ask your surgeon for guidance.

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How soon can I go back to work?
This depends upon your type of employment and incision type/implant placement. If you have a sedentary job you can generally go back sooner than someone with a more physically active job. If you have a labor-intensive job, you must wait 3 weeks at least. Generally, 5 days is a good amount to take off from work, but 2 to 4 days is very possible. Just remember, don't overdo it. Even jobs that are sedentary can stress your body. Ask your surgeon, as he or she is the one who will release you for activity.

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My nipples are too sensitive and are constantly erect. What can I do to ease this?
Many women complain of very erect and sensitive nipples after breast augmentation You may try using round bandages, large corn pads, or nursing pads to cover your nipples. These pads will protect your overly-sensitive nipples from the abrasiveness of your clothing as well as shield your erect nipples from the wandering eyes of the public.

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