Can I Have Liposuction and Breast Augmentation At The Same Time And Soon?

Q: Dr. Eppley, I have thought about liposuction a long time on my abdominal area which has always had a roll, even as a child. I would like to consult on liposuction and perhaps breast augmentation. I am going on vacation by the middle of June and did not know if it is even possible to schedule with you prior to that time.

Breast Augmentation in Hispanic Women Dr Barry Eppley IndianapolisA: It is very common to perform breast augmentation with any number of other body contouring efforts. Coming breast implants with a little bit of liposuction would not extend that recovery to any significant degree. Given that you are going on vacation in the middle of June, I would recommend that you have this surgery at least six weeks in advance of that event so you can be fully recovered, have few if any twinges of discomfort/soreness and be able to be completely in the the benefits phase of the surgery with little body ‘memory’ of the actual surgery. Thus it would be ideal for you to have this surgery no later than the end of the month. We strive to service our patients in an expeditious manner so I can see that happening on our end. I will have my nurse contact you tomorrow to find a convenient consultation time as soon as possible.

Dr. Barry Eppley

Indianapolis, Indiana

 

What Does Gummy Bear Breast Augmentation Cost?

Q: Dr. Eppley, I am interested in gummy bear breast augmentation.  I’m a mother of three and have breastfed each baby for about a year. (currently breastfeeding my six month old). Once I’m done, I’d like to have breast augmentation with gummy bear implants. After breastfeeding, I have been left with very small breasts (embarrassing!). Can you possibly just shoot me a ballpark figure so I know what I’m able/not able to do? I’ll be probably a small B and will want a natural looking D.  Thanks in advance!

A: Pregnancy and breastfeeding always cause some degree of breast involution or loss of one’s breast tissue. The breast skin is stretched out and then there is less volume inside to support the skin. This often, but not always, leads to some degree of breast sagging. How significant that is depends on what size breasts one had before the pregnancies. The bigger breasts one had to start with the greater the sagging will be afterwards.

Gummy Bear Breast Implants Indianapolis Dr EppleyWhen it comes to gummy bear breast augmentation using highly cohesive silicone implants, knowing whether any breast sagging has to be dealt with is critical in determining whether a breast lift is needed with the implants and that impact on cost. But for general numbers expect the total cost for gummy bear breast augmentation to be $5,500 and the addition of a lift can increase the to total costs to around $8,000.

Dr. Barry Eppley

Indianapolis, Indiana

Can You Help Me With Breast Implant Sizing?

Q: Dr. Eppley, I am interested in breast augmentation and need help in breast implant sizing. I am very small in size I am not looking for something huge. I am 4’11 and weigh 100 pounds. I am a 32C Cup. What cup size would you recommend?

Breast Augmentation in Asians Dr Barry Eppley IndianapolisA: When it comes to breast implant sizing there is no question that you are small in frame but what constitutes an adequate size that is not too big depends on numerous factors…not the least of which is your perception of ‘huge’ or what looks right. Obviously you do have some breast volume given that you wear a C cup bra. Having some breast volume also plays a role in how an implant will look in size compared to someone who is flat chested. Given someone with more loose breast skin compared to tighter skin in a woman with little to no breast volume also makes a difference in how the size of the implant affects the overlying look of the breast. I would really need to see some pictures of your breasts currently and some pictures of what you think is a good size or even too big on someone else before I can really offer any meaningful input. The most assured way to choose the right breast implant size is to use volumetric sizers which is done in the office. In my experience, this is the most reliable method to give women the breast size they want with implants.

Dr. Barry Eppley

Indianapolis, Indiana

What Are My Restrictions After Breast Augmentation Surgery?

Q: Dr. Eppley, I am interested in breast augmentation surgery but needs some basic recovery questions answered. What is the average time you recommend returning to work? I already have dates that I’m taking off for this year for vacation and other things, so I don’t want to have to take too much time off work. Also, I have an 18 month old, and she is a big girl for her age right now! She is a momma’s girl and is always wanting me to hold her and carry her, so my other concern was being able to lift her and carry her. What are your lifting requirements after surgery? 

Breast Augmentation in Hispanic Women Dr Barry Eppley IndianapolisA: Returning to work after breast augmentation is highly variable based on what one does, how physical their job is and their own discomfort tolerance. On average, it can be anywhere from 3 to 5 days. I place patients on arm range of motion exercises the night of surgery and the more you move the quicker you will recover. I have no lifting restrictions after surgery and you can lift anything you want without fear of hurting the result. Your body will tell you what you can and cannot do.

Dr. Barry Eppley

Indianapolis, Indiana

How Do I Know What Size Breast Implants To Get?

Q: Dr. Eppley, I am interested in having breast implants. I am currently a 34B and am interested in a full C or a small D cup. Also, I was previously 190 lbs and am now 135 lbs. I have a flabby area above my belly button which I would love to have tightened. I work out regularly, yet it just doesn’t seem to help. This area would be optional though, as my primary interest would be having breast implants. I saw the general fees for each procedure, and was curious if combining procedures offer any cost reduction. 

A: In answering your breast implants and tummy tightening questions:

Volumetric Sizing System for Breast Implants Dr Barry Eppley Indianapois1) When it comes to size of breast implants, I do not use the concept of cup size. While women understandably have that as a breast reference, implants come in volume (ccs) not cup size. And regardless of cups size or ccs, in the end all you really care about it how the breast looks…the number attached to it in that regard is not important as long as it looks the way you want. In choosing breast implant size in volume for any patient, I use a Volumetric Implant Sizing System. You can try on the various volumes and see how they look and then choose. I find this to be incredibly accurate which less to a very rare problem of patient dissatisfaction withe the outcome of their breast augmentation procedure.

2) Having lost 55 lbs, this raises the question of whether you have any loose breast skin or sagging. This is an important preoperative consideration since breast implants do not create a ‘breast lift’ effect and can make make a saggy breast look worse even though it is bigger. Seeing some pictures of your breast would help answer that question.

3) Your weight loss is also the source of the flabby area around your belly button. Since the belly button  is the only fixed point on the stomach, weight loss causes the skin around it to sag resulting in flabbiness and sometimes an actual upper belly button overhang. The only method to truly tighten loose abdominal skin is some form of a tummy tuck.

4) Your assumption is correct in that there is some cost savings when procedures are combined.

Dr. Barry Eppley

Indianapolis, Indiana

Do Silicone Breast Implants Have An Increased Rate of Capsular Contracture?

Q: Dr. Eppley,  I am interested in breast augmentation surgery and am having trouble deciding between saline vs silicone implants. I know there are numerous differences between them but one specific question I have is about capsular contracture. Does silicone implants lead to a higher rate of capsular contracture problems than saline implants?

A: One of the risks of breast augmentation surgery is capsular contracture. Capsular contracture is the result of excessive scar tissue forming around the implant. Then like a shrink wrap, it tightens around the implant causing it to feel more firm and can also distort the shape and position of the implant.

Historically silicone gel implants were associated with a higher rate of capsular contracture problems. This occurred because the implant allowed for some of the gel material to get through and out into the breast tissue (gel bleed) leading to the soft tissue reaction known as capsular contracture. In addition there was a moderately high rate of silicone implant rupture which exposed a lot of the gel material to the breast tissues. By comparison, today’s newer silicone gel implants do not have any significant gel bleed and a much lower rate of implant rupture. (less than 1% in the first five years for one manufacturer)  Thus, silicone gel breast implants of 2014 are much improved designs over those used in 1989 with a much lower rate of capsular contracture.

The other issue that has led to a dramatic drop in capsular contracture problems over the past two decades has been the change in implant position. Today the vast majority of breast implants are placed in a partial submuscular (dual plane) position. Decades ago it was far more common for implants to be placed above the muscle (subglandular) position. Submuscular breast implants have a known lower risk of capsular contracture rate.

While the risk of capsular contracture always exist with any type of breast implant, it is a very low risk today with the use of either silicone gel or saline implants placed in either a total submuscular or dual plane pocket position.

Dr. Barry Eppley

Indianapolis, Indiana

Will Replacing My Breast Implants Create More Cleavage?

Q: Dr. Eppley, I had breast implants done about one year ago.  I had textured silicone gel shaped breast implants placed under the muscle. They were 335cc in size. My breasts were A cup size before surgery. I would like to know if corrective surgery with bigger implants will create more cleavage.  have quite a small frame and chest. I would not mind getting bigger implants but only if they looked natural and the breasts did not move any further out to the sides than they are now.

A: One of the basic principles of breast augmentation surgery is that the breast implants merely take the breast features that one currently has and makes them bigger. Therefore, if one’s breasts are fairly widely spaced, getting implants will not create cleavage. It is clear based on your pictures that your breast mounds, small as they were, were more to the sides of your chest wall. That can clearly be seen by how far your nipples are to the side before and after breast implant surgery. With the placement of implants under the muscle, it is hard to create any semblence of cleavage unless one has breast mounds that are naturally close together. That being said, the question is whether bigger implants will give you cleavage. If you place large enough breast implants, you will likely end  up with more cleavage but they will not likely look very natural and will be oversizes for your frame. You are better off just accepting the good breast augmentation result you now have even if it doesn’t create the cleavage you want. That is where bras can compensate for what implants can’t do.

Dr. Barry Eppley

Indianapolis, Indiana

What Profile Implant Should I Use for My Breast Augmentation?

Q: Dr. Eppley, I’m undergoing a breast augmentation in less than a week and I like the look of your case study, breast augmentation in Asian women.  I am exactly her size except a smaller breast base  diameter (10.5). For reference, what profile is the implant you used?  I would appreciate any info you could give me. Choosing between 260 high profile, 280 high profile, or 320 full profile (leaning toward 280).

Breast Implant Profiles Dr Barry Eppley IndianapolisA: Many patients get hung up when considering their breast augmentation of an implant’s profile which actually has little to no influence on the final breast shape, contrary to popular perception. The only real relevance to an implant’s profile is how it influences the base diameter with the goal of using an implant whose base diameter is no larger than one’s natural breast base width. This is the real role of high projection/profiled implants, keeping the desired volume in a very narrow chest to within the breast dimensions. Almost assuredly with a breast base diameter of only 10.5 cms, any implant volume over 225cc will need a high profile implant to accomplish that important aesthetic goal.

Not to confuse you further, as the implant manufactures do a good job of that in this regard anyway, there is no correlation between any of three manufacturer’s (Allergan, Mentor and Sientra) implants in regards to volume and their profile types.

Dr. Barry Eppley

Indianapolis, Indiana

What Is The Best Way To Choose The Size of My Breast Implants?

Q: Dr. Eppley, I am getting breast implants in the near future. I am currently a 32A and am looking at 400cc silicone breast implants. (high profile) My hope is that they will make a full C or a small D cup. I am 24 years old and am 5’ 3” and 115 lbs. I tried the 400cc sizers in the office and they looked a little big to me. But I was told that they may look a little smaller since they are going under the muscle and that it was always a good idea to go a little bigger than you think anyway. I’m not sure if I should go with 400 cc or go smaller to be safe. On the one hand I don’t want to be too big but I’d hate to wish I would’ve gone bigger afterwards.

A: There is no question that the biggest issue in getting breast implants, for the patient, is what size in volume to get. The reality is that there is no magical and assured method that can guarantee any patient that they will get end up with the exact breast size that they want. No matter how it is done there is some ‘guessing’ involved and there is always the unknown variable of how any patient interprets what a C or D cup looks like in their mind. With that being said, there are certain presurgical measurements that can be done to help hedge the bet so to speak.

The Volume Sizing System is very good at providing a good estimate of the final size and this should be a good guide. If you think it is just a little big then drop down 25cc to 50cc. From this volume, the patient’s breast base width can help guide the projection that the implant should have, keeping it within the dimensions of one’s natural breast base width. High projection silicone implants should only be used if one wants a very round or full look, If not then consider either a lower projection or even a shaped (teardrop) implant.

Dr. Barry Eppley

Indianapolis, Indiana

What Type and Size of Breast Implants Should I Get For My Breast Augmentation?

Q: Dr. Eppley, I am interested in breast augmentation. After having two children I have lost all of my breast tissue, I am completely flat, the proverbial straight as a board chest look. I desperately need breast implants. What size and style of breast implant would you suggest? 

A: Based on a review of your pictures, you are an ideal candidate for breast augmentation. Let me detail what makes one an ‘ideal candidate’ . An ideal candidate for any plastic surgery procedure is the one that is most likely to get the best result based on their natural anatomy and the anticipated changes from the surgery.

The best breast augmentation results come from small breasts that have no sagging and with the nipples centered on the diminuitive breast mound. Thus when the mound gets expanded by an underlying implant the resultant shape assumes completely the shape of the implant with firm skin and a perfectly positioned nipple-areolar complex. Your pictures demonstrate that you have an ideal presurgical breast mound by this description.

When choosing a breast implant, the first thing to decide is between saline or silicone-filled. With your lack of any breast tissue, silicone would be a better choice to avoid the rippling of saline implants which would be revealed without a thick layer of breast tissue to disguise it. Implant size is a matter of personal choice but the volume of the implant should generally not exceeded your natural breast base width. The final implant decision is whether the implant should have a round or teardrop shape. That is a personal choice of whether you want an augmented breast look that is round (full upper pole) or a more natural or sloped breast shape. (lower pole fuller than the upper breast pole)

Dr. Barry Eppley

Indianapolis, Indiana