Cosmetic Surgery Blog

Q: Breasts Don't Look Right After Augmentation

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:22

I had PS breast augumentation and lift in July 2010 with basically same results as pictured. Flew to PS in January 2011 b/c he said implants needed to be "dropped" in place. He opened me up, found tissues around nerves- oh! so, the intense pain I'd had WAS real, and also ended up re-doing the lift.

Now,PS sees results of recent (March 2011) photographs, and says I just need to come in and have the implants dropped! I think it's more complicated. SOMETHING IS NOT RIGHT!

A: Your subpectoral placement of implants has made the condition worse

A revision of the mastopexy alone will not be sufficient. At best it will temporarily help until this soon returns. More predictable in outcome wound be to exchange the implant into a submammary plane along with a redo of the mastopexy. This would be best managed with a silicone cohesive implant.

Q: Do Fibroadenomas Have to Be Removed Before Breast Augmentation?

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:10

i had a ultrasound one year ago showing a possible fibroadenoma and recently had a new ultrasound showing no changes at all in size or shape of it. i thought it would have to be removed but after having two consultations with board certified plastic surgeons who reviewed my reports they both told me that my fibroadenoma would not need to be removed.

i am 23 and have no history of breast cancer in my family. is it safe to continue with breast augmentation or should i insist on having it removed.

A: It would be worthwhile having the opinion of an oncologic breast surgeon

You are asking the right questions. Certainly your youth, family history and stable breast mass favors a benign lesion. Depending on the location of the lesion within the breast, a breast augmentation may alter you ability to follow it over time. Before proceeding further, it would be wise to see an experienced oncologic breast surgeon to have his expert opinion from an oncologic surveillance viewpoint before proceeding with breast augmentation.

Q: Athlete with Large Pec Muscles Looking for Natural Breast Augmentation.

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:02

I am very athletic, I work out 6-7 days of the week (muscle training on at least 5 days weights & TRX) I would like breast augmentation, my breasts are truly just loose skin from being larger & then weight loss, there's no fat-this is the only place on my body with this issue (I wear a 36 B,a smaller size skin would push out sides/top of bra). I don't want to lose any of my abilities in athletic side & just want to fill the skin not oversize. I am good with silicone, not sure on the placement.

A: Muscled thin body types pose special problems in breast augmentation

If you proceed with breast augmentation you will be having to choose from the submusclular placement of implant where the muscle twitch will likely indent the implant and cause movement vs submammary where movement is not a factor but the thin subcutaneous skin may permit visible seams and ripples of the implant show through. This is especially a problem with saline problems.

If you do proceed with submammary do it with the silicone cohesive gel implants as the ripples and seems will be less.

Q: Breast Augmentation and Horseback Riding Limitations?

Submitted by Q-A from clee on Fri, 05/13/2011 - 09:53

I regularly ride and want to know my limits and time off after surgery (a cup to c cup). I can have someone saddle my horse and I use a stool to get on so am not reaching much. In saddle, my elbows generally stay at my side. Knowing this, what can I expect for time off and limitations?

A: Avoid anything strenuous for 6wks

Six weeks of healing is a safe recommendation as it usually takes this time for durable healing of the skin. If the implant is submammary you might consider gentle riding earlier. However if the implant is submuscular you should avoid riding for up to 8 weeks as the pectoralis muscle might be too painful to allow you to safely hold the reins.

Q: Age 27, 5'6", 143lb, 34B. Best Size for my Body?

Submitted by Q-A from clee on Fri, 05/13/2011 - 09:49

I am interested in breast augmentation. I currently have a small 34B no children, firm. I am 27 5'6" 143lbs. BWD 14. ribcage 31. I would like to achieve the look of a small-full D while looking natural. I currently have gone for one consult in which the PS recommended 450 saline unders crease incision moderate+ to achieve this look. I am looking for feedback to see if this will be too small or large for my frame. Thanks!

A: An examination with breast base measurements is necessary

To truly have your expected outcome, surgical planning with a detailed examination is necessary to determine your breast footprint, chest shape, and the elasticity of your breast envelope. With your next consultation ask your surgeon what are the specific details about your body does he take into consideration in making implant size recommendations.

Q: No Bra post-Breast Augmentation??

Submitted by Q-A from clee on Fri, 05/13/2011 - 09:37

I just had my breast done 4days ago.I was a 32b and i wanted a full C so he put 350cc of saline in me. Now the next day after my surgery he told me no bra for 3weeks so they can drop.I been in soo much pain so i went back in to see him. now he put a sports looking bra on me!? one looks bigger than the other. i just dont know what to make of this. im alil confused. can someone help me understand why he would say no bra and then tell me wear a bra. he says the implants are ok but one looks bigger?

A: Bra and garments are used to control position

Bras and external garments are used adjunctively to control position of the implant so that they will heal in a desirable position. If the pocket is well dissected and the implant is stable in the pocket then no garment may be necessary at all. However most patients have tight lower breast envelopes that push the implant superiorly. In these instances in might be warrented to use a specialized bra strap to resist superior migration. In contrast an iplant placed for revisional breast surgery for a bottomed out breast miight require a support bra to lessen the forces acting on the breast to bottom out again. Usually the pocket stabilizes by one month to remove all external supports. I hope this information helps you interpret your doctors recommendation but without knowing further details of your situation it is difficult to comment more.

Q: Full Tummy Tuck w/ Lipo and Breast Augmentation - Is This Safe?

Submitted by Q-A from clee on Fri, 05/13/2011 - 09:28

I'm 30 yrs old, 5'3" 130 lbs, athletic, and good health. I'm scheduled for May 11, 2011. My surgery consists of a full tummy tuck, liposuction of back, flanks, inner knees, and slightly around the inner thighs. Also I'm getting a breast augmentation under the muscle. Is that too much??? My PS seems very optimistic about it and has been practicing for over 30 yrs. He's also one of the top plastic surgeons in Houston, Tx but I'm still a little nervous about it. Is this common?

A: If no signifcant medical history - safe

If you are healthy with no significant medical history (ie no DVT, coagulation problems) then it can be safely performed in one surgical setting. The two most significant concerns are vein thrombosis in your legs and bleeding at surgery. With early ambulation and no other history of medical problems the procedure can be safely performed.

Q: Pain when Wearing a Bra Post-op

Submitted by Q-A from clee on Fri, 05/13/2011 - 09:23

20 days post-BA (250cc silicone moderate profile unders inframammary). At 14 days with surgical strap I felt the implant edge on the left breast. My PS said to stop wearing the strap and try a supportive sport bra. The sport bra hurts: muscle spasms, tightens up, feels like 'let down' when breast feeding. Some numbness and tingles. Have tried different bras. Am massaging. The muscle is tight and ROM is limited on left side. Sensitive to touch. Can feel the implant over most of the left breast.

A: Common with subpectoral implant

What you are experiencing is very common after subpectoral implantation. I am not fond of massages with textured implants under under the muscle as it may increase your symptoms and does not decrease capusules from forming. Your implants appear to be well positioned so the need for any type of external bra or straps is unnecessary. Just use what makes you comfortable and time will take care of the rest.

Q: Are Gurgling and Swishing Common in Silicone Implants at High Altitudes?

Submitted by Q-A from clee on Fri, 05/13/2011 - 08:50

10 months ago, I had breast augmentation (silicone). Now, each time I travel to Lake Tahoe, the high altitude seems to have an effect on them. I hear a gurgle and swishing sound. I have found that if I massage them, this usually goes away.

Nevertheless, I am concerned. Doing a google search, I came across a woman on this site with a similar experience, but the doctors seemed to be unaware of these effects. Are there any doctors who have heard of this and should I see my doctor about it?

A: Not common to have this with silicone

Regardless of altitude it is not common to find gurgling and swishing feeling with silicone implants as the viscosity of these are similar to tissue.  Perhaps you should see your surgeon for reassurance.

Q: What are the Risks of Capsular Contracture with Vitiligo?

Submitted by Q-A from clee on Fri, 05/13/2011 - 08:17

I am 22 days post BA (250cc silicone unders). I have vitilago (which some doctors consider an auto-immune disease and some would not) for 38 years that has periods of remission and advancement.

I take no medications nor treatment. My PS assured me that my risk of developing capsular contracture was the same as any other patient. What are the risks? I am massaging often during the day but worry about any tightness that I experience. My next check up with PS is in three weeks. Thank you.

A: Vitiliigo does not affect capsular contracture

Vitiligo does not affect capsular contracture.  Massage is unproven but very popular recommendation.  I do not recommend massage for textured implants early after surgery as it may affect its ability to adhere to the pocket.