Can a woman breastfeed after breast augmentation?
For most women, yes. For the vast majority of women who have breast implantation, breastfeeding is no more difficult with implants than without. Breast milk is produced within the glandular tissue of the breasts and is conducted to the nipple through channels called milk ducts. Anything that disrupts or blocks the milk ducts can reduce the amount of milk produced or prevent it completely. Most implants are placed either completely under the glandular tissue or beneath the muscles under the breast, so disruption of milk ducts is minimized. However, if other procedures are done on the breast during implant surgery, such as reducing the size of nipples or removing or adjusting breast tissue, breastfeeding can be impaired.

Breastfeeding is a growing concern for patients considering breast implantation surgery. In previous years, women who had implants had already finished with childbearing. Now, more and more single women, and women who have not begun to have children, are having the surgery.

There has been fear that breastfeeding after having silicone implants would endanger the child. But studies show that this is not the case because the silicone module is too large to pass through the duct.

Particularly with the transumbilical and transaxillary approach, the breast tissue and ducts are not disturbed, cut or affected. The procedure takes place under all of the breast tissue, not through it. However, with other incision locations, especially incisions around the nipple, it is possible to disrupt the milk ducts and impair successful breastfeeding.

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Can breast implants lift sagging breasts?
Although breast implants cannot lift a sagging breast, they can help improve the appearance of mildly sagging breasts. Implants take up some of the slack in loosened skin, thereby increasing the volume and decreasing the saggy breast look.

For moderate or severe sag, a breast lifting procedure called mastopexy can be done during breast augmentation.

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Do breasts with implants sag over time?
Everything sags 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 you get older. Your breasts can be expected to relax and sag whether or not you have implants present. Implants add weight to the breast, which may increase the rate of relaxation, but implants and surrounding scar tissue can provide some internal support for the breasts. The overall result is that usually the breasts sag less. Sagging can be minimized by wearing a properly fitted bra. You cannot expect to go without a bra for the rest of your life after you get implants. If you don’t wear a good bra, especially with larger cup sizes, you will end up returning to your plastic surgeon's office to consult for a breast "lift" (mastopexy).

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Will my breast implants feel like natural breasts?
That depends on a few factors including:

• Pre-existing tissue: The more natural tissue you have pre-operatively, the more of a chance you have of feeling "natural" post-operatively.
  
  
• The amount of filler in the breast implant: Too little volume will give you ripples, too much volume will cause firmness and rippling.
  
  
• Implant filler: Most people say saline feels less natural than silicone gel implants.
  
  
• Implant surface: Smooth-surfaced breast implants are thinner than textured-surfaced implants. Although it is very slight, patients having had both often say that they can feel a difference.
  
  
• Breast implant placement: You may hear that implants placed under the muscles look more natural than those placed over the muscles, but all cases are different. "Overs" actually move more naturally than "unders." Unders tend to jump and twitch when you use you pectoral muscles during everyday movements and working out. Whether this feels more natural or not may be a matter of opinion and preference.
  
  
• Thickness/thinness of skin: The thicker and springier your skin, the less you can feel the edges of the implants. Thinner skin allows for a more palpable result. If you have thinner skin, your surgeon may advise that implants be placed under the muscles.
  

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Will I have stretch marks after my breast augmentation? How can I keep this from happening?
Development of stretch marks after breast augmentation varies from person to person. Some people are more prone to them. There is still no successful treatment for stretch marks once they appear. Some people swear by shea nut butter; others, olive oil. Vitamin E oil squeezed out of vitamin E capsules used to be recommended, however, some studies have shown that this can cause contact dermatitis and exacerbate scar appearance in some patients.

Stretch marks are caused by an abrupt expansion of the skin. Women can get them during pregnancy and men who are bodybuilders can get them over their biceps and other muscles. When the expansion is very gradual, stretch marks are practically non-existent. Ask your plastic surgeon before doing anything other than what he or she instructs before you start massaging creams or oils into your breasts. There is no guarantee that stretch marks will not develop.

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Is there much pain associated with breast augmentation?
Pain thresholds vary. No two people report the same amount of pain from the same procedure, but usually pain is dependent upon the implant placement and incision placement. You can also cause yourself more pain by not abiding by your surgeon's instructions and over-exerting yourself.

If you should experience any discomfort or pain that seems out of the ordinary, contact your surgeon.

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Should I wait to get my breast implants until after significant weight loss?
Although you can have implants at any time, if you are considering losing a significant amount of weight (15 lbs. and up), it might be best to put off having breast implants until you lose the weight. If you lose weight after implants, be prepared to notice some sag if you lose breast tissue. If you have very small breasts and get implants before you lose weight, there shouldn't be a significant problem with sag, since your breast envelopes were not large to begin with. You could safely lose the weight and suffer no ill effects to your breasts if this is the case.

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Should I wait to get my breast implants until after having children?
Although you can get implants at any time, if you are considering having children within the next year or two, it may be advisable to wait. The effects of weight and breast tissue gain and loss will affect the appearance of your breasts.

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How old do I have to be to have Breast Augmentation? Am I too old/too young?
Although there is no set age, it is best to wait until your breasts have completely developed. You can consult with your obstetrician/gynecologist about this. The age at which breasts finish developing can vary, and although you may think you have finished maturing by 18 or 19, your breasts continue to go through changes well into your early twenties. In any event, the minimum age, except in rare instances of pronounced asymmetry or reconstruction, for saline implants is 18 and that for silicone implants is 22.

On the other side of the spectrum, women in their late sixties have gotten breast implants. For an older individual, the only thing to prevent having breast augmentation surgery is any overall health problems.

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What type of anesthesia should I choose for breast augmentation surgery? Which is safest?
The type of anesthesia may not be your choice, since it is often the surgeon's preference. The choice of anesthesia may also be dictated by your health and whether you are having other procedures done simultaneously with breast augmentation.

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Will my areolae stretch after augmentation?
Stretching of the areolae (plural of areola, the darker skin around the nipple in the center of the breasts) is very common and sometimes unavoidable.

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I have gone on several consultations with different cosmetic surgeons, and every doctor had a different opinion of what would be best for me. Now I am confused! What should I do?
All plastic surgeons are different and they can have different opinions. This is where your own research, comparison and word of mouth come in handy. Don't expect every cosmetic surgeon to agree, but make sure you do your own research to better understand what techniques and options can get you what you want. Just remember that you are not the doctor and to listen to what they say. Take notes at your consultations and reflect upon what each surgeon tells you if you see more than one.

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What about augmenting my breasts with my own fat? Isn't this a better idea?
Although this seems ideal, it has a risk of complications. Fat grafting, especially in the amount needed for a breast, requires the transfer of blood vessels along with the fatty tissue to keep it alive. It is not as simple as suctioning out fat in one part of the body and injecting it to your chest.

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I have Poland Syndrome (or pectus excavatum, pectus carinatum, etc.) and have been told breast implants will help me look "normal" — is this true?
These conditions are deformities of the ribcage or muscles of the chest. Many patients with pectus excavatum (sunken ribcage) and carinatum (protruding ribcage) have gotten breast implants to give the illusion of a normal chest conformation. Patients with Poland's syndrome, which involves missing muscle on one side of the chest, have also gotten one implant or two in different sizes to deal with the asymmetry involved with their disorder. Your surgeon will be able to help you decide which option is best.

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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, called capsular contraction (CC). If this occurs, another operation may be required to remove the scar tissue.

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What are the differences between smooth and textured breast implants?
Textured implants were designed to help prevent capsular contraction, or excessive scar tissue formation around the implant, but it has not been determined if this is the case. Textured implants have a thicker wall than smooth implants and are generally firmer. Smooth implants are manufactured with the goal of a flawless surface. There is less rippling reported with smooth implants. You should discuss the choice of smooth versus textured breast implants with your plastic surgeon. He or she may prefer one over the other.

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What are the differences between round and shaped (anatomical) breast implants?
Shaped (or contoured or anatomical) breast implants are said to be more natural looking, but in reality, in most patients the results are about the same. This is especially true when shaped implants are placed behind the muscle as the muscle and chest wall exert force on the implant on all sides, rather equally, resulting in a more rounded appearance. An implant can flip or rotate in the pocket where it has been placed. This does not matter with a round implant, which is the same size in every direction, but it does with a shaped implant and it may require more surgery to correct the problem. However, contoured breast implants were designed for reconstruction procedures. Many women seeking breast reconstruction opt for a shaped breast implant.

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What is the expected product life of the implant? How long do breast implants last?
No breast implant lasts forever.  The FDA and implant makers recommend that implants be removed and replaced after a certain time. The average life expectancy for a breast implant is about 16 years, according to the Institute of Medicine. However, there have been women who have had breast implants in place for more than 20 years with no problems. Still, you should expect to replace your implants at least once in your life.

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Will the breast implant burst when I get my next mammogram?
It is possible, but it is extremely rare. There are special techniques that your mammography technician should use when taking mammograms of your breasts. You must inform your mammography technician of your implants so that special care can be taken.

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Should I go over or under the muscle?
You will have to make this choice with input from your surgeon. Where the implants are placed depends on your needs and your desires. There are pros and cons to both implant placements. Some plastic surgeons prefer one type of placement more than another. See the discussion on placement here.

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I am a very active person.  How long should I wait after breast augmentation surgery until I resume exercising?
It is usually advised to wait at least 2 weeks for exercising, but 3 weeks may be better. Although you may feel good, you are not healed completely and will not be fully healed for some time. Abide by your doctor's instructions. If you have spent all this time and money on breast augmentation, why risk putting the results in jeopardy?

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How soon can I go back to work after breast augmentation procedure?
This depends upon your type of employment and on your incision type and breast implant placement. If you have a sedentary job, you can generally go back sooner than if you have a job that involves physical activity. If you have a job requiring lifting, long walking or other activity, you must wait 3 weeks at least. As a rule of thumb, 5 days is a good amount to take off work but 2 to 4 days is possible. A full week off from work plus the weekends should give you enough time to heal enough to go back to work. But don't overdo it. Even jobs that are sedentary can injure you. 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. It happens often. Your nipples may be very sensitive to the point where the rubbing of your clothes is irritating. You can try using round adhesive bandages, large corn pads or nursing pads to cover your nipples. These pads will not only protect your nipples from irritation, they will also shield them from poking through your clothes.

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