Q-A from clee's blog

Q: Why Would a PS Choose to Put a 500cc in One Breast but Only a 450cc in Other?

Submitted by Q-A from clee on Thu, 05/12/2011 - 09:53

I just had BA done about 2 weeks ago. I had BA revision done from a BA 10 yrs ago (250cc silicon implants). My right breast was bigger then my left before this recent surgery. I asked for 475cc implants this time. Looking at my breast just after the surgery I could tell the left one was still smaller. My implant cards show 500cc in right and 450cc in left. Why would I get a smaller implant in an already smaller breast to begin with? To me a 50cc difference seems like that would be noticeable.

A: Photos show preexisting asymmetry but volume not easily evaluated

Your photos definitely demonstrate well asymmetry in your breast.before and after surgery. Asymmetry may result from either your breast envelope being "relaxed" ie with ptosis or from your left breast having a smaller volume. In your photos we can conclude you have asymmetry as well as ptosis but cannot comment on volume without a physical exam. Since the asymmetry has mildly improved after implantation with a smaller implant on your left, It is very possible that your left breast may not have been smaller in volume prior to surgery. It might be worthwhile to have an open discussion with your surgeon about your situation. If his/her explanations do not adequately address your concerns consider seeking another opinion from an experienced surgeon. All the best to you.

Q: How many cc's will give me a natural and proportionate look?

Submitted by Q-A from clee on Thu, 05/12/2011 - 09:51

I am 5'7", 200lbs with large body frame, wide shoulders/chest, small 40B-cup; I look manly. I am scheduled for a BA w/silicon in two weeks, but I am still stuck as to which CC size/profile shape will look best on me: 500cc or 550cc, moderate or moderate plus. I want to look natural/proportionate and do not want to regret 'not going bigger' later, but neither do I want to look like an 'overdone' porn star; I told the dr he can choose the final size/profile for me, but I'm still confused. Please help!

A: Use implant dimensions to guide you for the desired look

Thank you for the photos. Your final look will be determined by how the implant projects from your chest base and the tissue envelope that it sits under.  cc volume is not the ideal means by which to judge the fit of an implant.  Most mass manufactures of implants have modeled their styles of implants offered to match the base width of your native breast/chest.  As general rule, the measured base diameter of your chest/breast will yield the size of the implant footprint.  The projection is then adjusted by selecting from the mass production list of all major breast implant companies.  This is the most reliable standard to yield natural looking breast outcomes following breast augmentation. 

Instead of focusing on cc volumes, select the dimensions of the implant to match well with the base of your breast augmentation will have a far greater chance of being a natural look.  Wishing you a safe and satisfying experience.

Q: Can daily life stress be another cause of capsular contracture after breast augmentation?

Submitted by Q-A from clee on Thu, 05/12/2011 - 08:28

It has only been a month since surgery (breast augmentation). And have been concerned of what causes capsular contracture. Can stress cause capsular contracture? And what are many ways to "PREVENT" capsular contracture? I have saline breast implants and smooth textured. And the implants are under the muscle. It will be greatly appreciated for all advise.

A: Life stress does not cause capsular contracture

Known predisposing factors causing capsular contracture include, infection, fluid collection around the implant and contamination (bacterial or particulate) of the implant. Known factors lessening the risk of capsular contracture include placement under muscle, textured implants, saline implants. Probably the greatest predictor that you will develop capsular contracture, is a previous history of having had a capsular contracture in the past. This likely is a major indicator of a hereditary component in the evolution of this condition. Now that you are 1 month after surgery, it is important to know that all that is known has already been done with regard to your capsular contracture risk. Since medicine is not advanced sufficiently to alter our hereditary predispositions, it might be most productive to move forward without too much concern on this risk.

Q: My right breast never dropped and now my PS is telling me that he has to re-operate

Submitted by Q-A from clee on Thu, 05/12/2011 - 08:14

BA performed 1 month ago. The next day my bandages were removed, and my right breast was significantly higher than my left. The doctor assured me that it would drop after the muscle relaxed. I'm 5 weeks PO and it's in same exact place. Stitches were removed 10 days PO and he showed me on how to do my daily massaging, which I did religiously. I also wore the strap 24/7. I had a checkup last Friday & he says that he has to re-operate. I don't think that he made the pocket big enough. Opinions welcomed!

A: It can be a challenge to make a diagnosis by photo

You did a great job posting photos demonstrating the asymmetry following your surgery. Unfortunately, there are many potential causes for this problem. The incomplete list of problems include acute fluid collection (seroma, hematoma), asymmetry before surgery, technical aspects such as inadequate pocket dissection, malrotation of shaped implants, etc... Your definitive diagnosis will necessitate at least one other examination by an experienced plastic surgeon. Within my stated partial list of problems, only the acute collection of fluid necessitates early semi-urgent attention. Otherwise you will have the luxury of time to clarify the cause and decide on the best treatment plan for your situation. So do not rush into a plan of action. Best of luck.

Q: Doctor recommendation for breast augmentation in central Texas

Submitted by Q-A from clee on Thu, 05/12/2011 - 08:07

I've been doing lots of research on BA for quite some time now, and finally decided i want to do it. I'm wondering if there's any surgeon out there that will help me self finance? I can make my monthly payments on time, it's just that I've tried to apply for every cosmetic loan possible and I keep getting denied bc of how long I've had my acct open. Any suggestions?

A: Today there are many financing options available

Today there are many financing options available. Search engines on the internet are fabulous resources to find the most suitable Plastic Surgery financing options for your situation. Most plastic surgeons accept major credit cards. Saving for that planned procedure is the most fiscally responsible approach. If none of these options suit you then discounted breast augmentation services can sometimes be found in plastic surgery residency programs at major teaching institutions where a no frills approach is undertaken with your surgery provided by a trainee. Your follow up at these low cost trainee offerings is at times problematic as these trainees eventually graduate and move on. Wishing you the best.

Q: 600cc silicone implants look small on me

Submitted by Q-A from clee on Thu, 05/12/2011 - 03:13

My first ba I had 340cc overs mod profile and was unhappy as they looked too small. I had my 2nd ba 3 months ago and went for 600cc HP silicone under the muscle. I was really gutted to find I still haven't got the desired projection I was after. My surgeon said it's because I have a high rib cage which is why my implants do not project much. Should I consider a ultra high profile saline implant or just accept the fact boobs don't look big on me??? Please help!!! Thanks

A: Sizing an implant to achieve a desired shape and projection can be a challenge

Sizing an implant to achieve a desired shape and projection can be a challenge. The final projection and shape achieved depends on the following: 1) the underlying chest wall supporting the implant. A flat foundation will allow the implant to fully express its projection whereas a tilt to the chest wall will result in loss of or uneven projection to one side. 2) from the underlying shape of the implant. The actual measured dimensions of your implant to the dimensions of your breast envelope is more important than the brand model marketed. 3) the tissue plane of implantation and its resistance to stretch is another major factor on both projection and the visibility of the implant margins. As surgeons, we can only control the selection of the implant model and the tissue plane of insertion. Perhaps you should have another visit (with your surgeon or another experienced opinion) to review the various suitable dimensions of implants to be tried via sizers in the operating room to better approach your goals. Furthermore, submammary placement is more likely to achieve the full implant projection then submuscular placement, however, the implant (especially saline implants) will show ripples and edges in this submammary plane.

Q: Right breast deformed post op, why did it happen and how can this be corrected?

Submitted by Q-A from clee on Thu, 05/12/2011 - 02:04

I had a breast augmentation one year ago (round silicone mod+ 275 ml placed  partially under the muscle). I had aalso a Benelli breast lift 7 weeks ago. My right will not drop and there is a ridge on lower pole. Is it my muscle creating this deformed line? Its like the implant is hung up on something and my tissues won't cover the bottom half of implant or allow it to relax and drop fully. Basically, my right lower pole is completely deformed. My creases were not lowered and the right is sitting higher than original fold.

A: Benelli mastopexies can cause wrinkles that take time to settle but this looks more than expected

Benelli mastopexies have the advantage of confining the scar to around the areola but problems with early wrinkling of the scar and flattening of the breast from circumferential pressure. In your photos, the deep visible banding exceeds what I would expect from the wrinkling of a Benelli. Instead, it is possible that the increased pressure from the recent mastopexy may have brought out some latent problems with your 1 year old implants. There may have been some underlying degree of capsular contracture that became visible with the breast tightening from your mastopexy. This can be easily confirmed with a physical exam. If a firm underlying band is present, then a capsulotomy with implant exchange may be necessary to correct the underlying problem.

Q: SCUBA diving after breast augmentation

Submitted by Q-A from clee on Thu, 05/12/2011 - 01:23

I had silicone breast implants placed 2.5 weeks ago via infra mammary incisions. When if ever, can I resume SCUBA diving? Any depth limitations?

A: Strenuous activity should be limited for 6-8 weeks then no restrictions

After breast augmentation, 6-8 weeks of avoiding strenuous activity is recommended (especially if placed under the muscle). Thereafter, no restrictions on activities are necessary. SCUBA diving is not a problem with your implants. The increased pressure from the depth of the dive does not cause any problems for the implant as these forces act evenly over the entire surface of the implant. A similar analogy is that your skin is not damaged from the pressure of a dive as these forces are evenly applied. In contrast, uneven forces such as may occur from accidental trauma might cause implant damage just as it would to your own tissues.

In summary, SCUBA is fine 6-8 weeks after surgery. Have fun diving!