Posts Tagged ‘breast implants’
Tuesday, July 6th, 2010
Q: I was looking at having breast augmentation done. One of my breasts is larger than the other. But I was woundering if you could use instead of saline implants fat from somewhere else on my body, like my stomach area?? That would solve two problems at once!
A: The appeal of using fat instead of a synthetic material certainly is of interest to some patients. If fat worked just as well as implants, and was no more costly to perform, then it truly would be a better option. However, as of today, fat remains a breast technique in evolution and development. The harvesting and injection of the fat are standard plastic surgery methods. However, fat after injection is not yet completely predictable and is prone to resorption, uneveness and lumps. It is also highly likely that multiple sessions of fat injections would be needed to get close to what most women would want. With multiple treatments, the cost would exceed what breast implant surgery would cost.
Scarring and lumps in the breast are also a concern for long-term breast cancer surveillance. It is not yet known if fat grafts into a non-reconstructed breast who has not had a mastectomy interferes with the detection of breast cancer.
Until the science of fat transplantation is better understood, fat injections into the breast should only be considered for those patients who are willing to accept the risks that come with being an early adopter of a surgical technique. For now, the use of a breast implant is more predictable and economical.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast enhancement with fat injections, breast implants, dr barry eppley, indianapolis, plastic surgery
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Tuesday, July 6th, 2010
Q: I am very interested in breast augmentation. I have been pregnant four times and between weight gain and loss my breasts are in need of some repair. Do you think I will need a breast lift also?
A: The anatomic determination of whether any breast needs lifting is based on where the nipple is sitting relative to where the lower breast crease or fold is. If the nipple is at or above the lower fold, one will not need a lift in combination with breast implants. If the nipple sits below the fold, whether it be a little or down so far the nipple points to the floor, then a combination implant and lift will be needed to get a well shaped breast that has the nipple centrally positioned on the mound and pointing forward.
When a women has had more than two pregnancies, it is almost a certainty that a breast lift will be needed. I do not recall ever seeing in my Indianapolis plastic surgery practice a patient with three or four pregnancies who has not needed one. When you combine the number of pregnancies with up and down body weight, there has undoubtably been a lot of stress and strain on the breast skin. This translates into breast skin that is loose, deflated and has a low nipple position. This will happen to most breasts whether one has breastfed or not.
A breast implant will add volume to the mound but will not significantly lift a downturned or low nipple position. That is exactly what a breast lift does…get the nipple back up to where it once was or close to it.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implants, breast lift, breast surgery after pregnancy, dr barry eppley, indianapolis, plastic surgery
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Thursday, June 24th, 2010
Q: My breasts are in terrible shape after having had 4 children and nursing them all. They are saggy and disgusting. I think they need a total breast overall. They look so bad I don’t even know if they can be helped. I have read about breast implants, breast lifts, and breast reductions and I think I need all three. Is it possible to have all three of the procedures I am asking for done at the same time?
A: The combination of a breast lift (skin reduction and tightening) with an implant is a very common procedure for the breast that is small in volume but has an excess amount of skin that sags over the lower breast crease. With the breast in this kind of shape, all three procedures are needed simultaneously to give a more pleasing and uplifted breast shape. This is the most difficult of all cosmetic breast procedures and is best thought of a breast reconstruction rather than a simple breast reshaping.
Unlike breast implants alone, this more extensive form of breast reshaping will result in scars on the breast. The scars will be similar to that of a breast reduction. Because of the difficulty of the procedure, secondary revisional surgery is not rare to get the best shape and symmetry between breasts that often start off not only badly shaped but different.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implants, breast lift, breast reduction, dr barry eppley, indianapolis
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Saturday, June 5th, 2010
Q: I have a strange question for you Dr. Eppley but I am very curious. I am going to get breast augmentation in the near future and am an avid swimmer. My friend told me that it might interfere with me swimming. She said she heard that breast implants will act like floats and slow me down or could weigh me down and make it harder to stay afloat. Is what she is saying true?
A: Your question/concern about the impact of breast implants in the water is neither strange nor new. Women have asked me about that numerous times in my Indianapolis plastic surgery practice. One the one hand, millions of women over the past thirty years have had breast implants and such potential problems have never surfaced or been reported. This would strongly suggest that what your friend is telling you is nothing more than an urban myth.
From a scientific standpoint, the question is one of the buoyancy of breast implants. Depending upon the type of breast implant, the answer differs slightly. Saline implants are neutrally buoyant, meaning that they will neither float nor sink. This makes perfect sense since they are essentially the same density as the water in which they are immersed. The two fluids are only separated by the thin containment shell of the implant. Silicone implants, however, are a little more dense than water and will have a slight sinking effect.But they will not completely sink and essentially float as well. This can be easily demonstrated by placing both type of implants in a sink filled with water.
When placed in the body, however, the buoyancy of breast implants demonstrated by benchtop testing becomes irrelevant. Their impact will be the same as any other enclosed body part. Their only potential impact on swimming is on the aerodynamics of the body shape, which is only relevant if one is an Olympic or competitive swimmer.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implants, dr barry eppley, indianapolis, plastic surgery, saline breast implants, silicone breast implants
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Wednesday, June 2nd, 2010
Q: I am a 31yr old mother of two kids. I got out of a five year relationship where I got too comfortable and gained a lot of weight. About six months ago I started working out and lost over 30lbs along with a strict diet. I still have about 25lbs to go to reach my goal weight but I know that dieting alone will not give me the final results I want. I am interested in a tummy tuck, a monsplasty, and breast augmentation. I was born with one breast about 1 cup size bigger. I would like them to be equal in size along with a lift. Can all of these procedures be done in a single operation?
A: Congratulations on the results you have obtained so far. It is always surprising what effort and discipline can do for one’s weight. You should be proud that you have gotten this far. In pursuit of your goal weight, think of the plastic surgery as an incentive to get there.
The first step in body contouring is weight loss but this alone is often not enough to get the shape that one wants. There is no better combination than a combined breast and abdominal procedure to change a woman’s appearance between the shoulders and the waistline. In a few hours of surgery, some dramatic changes can be obtained. Putting these two operations together is very common and I have done it many times in my Indianapolis plastic surgery practice. Breast enhancement and tummy tucks together can still be done as an outpatient procedure.
Many larger tummy tucks require reduction of a large mons at the same time. It is done as part of the tummy tuck by modifying the location and orientation of the lower incision. Complete mons reduction may still require a secondary liposuction procedure for optimal flattening. Breast enhancement in most significant weight loss patients requires a combined lift with an implant, known as an augmentation mastopexy.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implants, breast lift, dr barry eppley, indianapolis, plastic surgery, tummy tuck, weight loss
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Monday, May 24th, 2010
Q: I have breast implants originally placed in 2002. I got pregnant shortly afterwards and once I delivered my breasts changed afterwards and I developed some drooping. So I went back and had new implants placed in 2007 that were bigger and helped to fill out some loose and droopy skin. After having these implants for a while, I have decided that I want to go back to my original augmentation size. But I fear in doing so that I will get saggy breasts again. What do you recommend?
A: Going up in breast implant size is always easy because loose skin is expanded and filled out. While breast implants alone are often not the sole solution to a really saggy breast, they do help tremendously and are very forgiving of less than ideal breast skin.
Going down in breast implant size, however, is not so forgiving. Even the smallest amount of loose or droopy breast skin will get much worse as the ‘balloon deflates’ so to speak. As a result, some form of breast lift is often needed in many breast implant downsizings. What makes this aesthetically difficult is that this will involve creating breast scars which is another form of a cosmetic breast deformity.
If the nipple is fairly centered on the breast mound, a smaller implant replacement may not involve any type of lift or only a very small one such as a nipple or circumareolar type lift. If the nipple is off-center or points any amount downward, then a more significant lift with breast skin scars may be necessary when the breast implants are down-sized.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast augmentation, breast implants, breast lift, dr barry eppley, indianapolis, plastic surgery
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Wednesday, May 12th, 2010
Q : I had saline implants done three years ago in 2007. I had some left breast pain last night and woke up this morning with my left breast almost completely flat. I was mortified. How did this happen? I need to get my implant replaced as soon as possible. How quickly can we get this done?
A: Failure of a breast implant is a lifetime risk for anyone that undergoes breast augmentation. While everyone thinks it just happens to someone else, the statistics say that the risk is 1% per year of implantation. Failure of most breast implants occur spontaneously, meaning that there is no specific reason why or there is nothing that the patient has specifically done to cause it. It just happens from the fatigue of the implant folding back and forth.
Saline breast implants fail in a particularly dramatic fashion, known as deflation. Once the implant shell develops a hole or tear, the saline fluid comes rushing out and the breast goes partially or completely flat. This is one of the few cosmetic ‘emergencies’ that exist from a patient’s perspective.
If this should happen, contact your plastic surgeon immediately. Arrangements should be made to have replacement surgery within a few days. In my Indianapolis plastic surgery practice, we make every effort to get a patient’s deflated implant replaced no later than the next day if possible. If you have a copy of your implant size and serial numbers that is very helpful to get an exact size replacement. In the past ten years, most plastic surgeons provide a plastic card to the patient after surgery that has the lot and serial numbers from the manufacturer. This information is also very useful to find out what your warranty replacement is from the manufacturer, if the implants are not too old. (greater than 10 years)
The good news is that the breast implant replacement surgery is nothing like the original surgery. The pocket has already been made so the surgery is simpler and is comparatively painless from the initial breast augmentation surgery.
Dr. Barry Eppley
Tags: breast augmentation, breast implant deflation, breast implants
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Tuesday, May 11th, 2010
Q: I had breast implants done about 8 to 9 years ago and am looking to have them redone. Thr original size was 600cc implants. I am between D and DD cup size I think…but it depends on the bra. I want them increased but not sure if that is something you do? I know I would like to be DDD cup. I am a body builder as a hobby. I think it would balance my shape better.
A: Breast implant size is a personal choice and no one can really say what size someone should or should not be. Breast implants of 600cc size can be big or not so big depending upon whose chest they are on. For a small person this could be fairly large, for a bigger and broader-chested woman this may only be average looking in size. Most women are interested in having breasts that are in proportion to the size of their body but a few women want more than that.
Within reason, just about any breast implant size can be put in any patient. Whether that final size is in or out of proportion, or what someone really desires, is up to the patient to judge. In my Indianapolis plastic surgery practice, I try and accomodate a woman’s breast implant size desires. That being said, women should know that there are potential long-term consequences for having large breast implants. (i.e., extreme breast augmentation) Over time, the weight and size of the implant may cause tissues to stretch out and a ‘bottoming out’ of the implant may occur as the implant falls on the chest wall. This is known as loss of tissue support. This is why as a general rule it is wise to keep the base width size of the implant within the natural breast base width. Also remember, it is easy to go up in size without significant scar consequences. Should one day the desire arises to go smaller, there will be significant breast scars to remove and tighten the loose skin that the implant has created.
Dr. Barry Eppley
Tags: breast augmentation, breast implants, dr barry eppley, extreme breast augmentation, indianapolis, plastic surgery
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Sunday, May 9th, 2010
Q : I would like perky and fuller breasts. I have had three children and my breasts have just lost everything. They are so saggy and droopy they are disgusting. I am so embarrassed about them I won’t even let my husband see them. My right breast is also different than the left. It is bigger and more saggy and the nipple is much bigger. I know I want implants but I think I may some sort of lift too. Can you tell me how bad the scars will be?
A: The need for a lift with the use of breast implants can be determined by one simple anatomic measurement…where does the nipple sit relative to the lower breast fold. (inframammary crease) If the nipple is above this level, an implant alone will give the breast a good shape with the nipple reasonably centered on the new larger mound. If the nipple sits at or below the fold, then an implant will make the breast bigger but the nipple will be on the ‘southside’ of the mound. (i.e., pointing downward)
There are essentially four types of breast lifts based on how much the nipple needs to move upward. They are with their resultant scars; type 1 superior nipple lift (scar on top part of nipple), type 2 circumareolar lift (scar 360 degrees around the nipple), type 3 vertical breast lift (scar around the nipple and vertically down to the fold) and type 4 full breast lift. (around the nipple and vertically down into the fold and then horizontally along the fold, an anchor scar pattern)
In general, breast lift scars usually turn out pretty well. The scars around the nipple and along the inframammary fold do the best. If a vertical breast scar is needed between the nipple and the fold, this is the one that has the most potential to widen due to the constant pulling by the weight of the breast against the scar. Most breast lift scars revisions involve that scar if needed.
Dr. Barry Eppley
Tags: breast implants, breast lift, breast lift scars, dr barry eppley, indianapolis, plastic surgery
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Sunday, May 2nd, 2010
Q : Dr. Eppley, I have had silicone gel implants for 31 years and am still very pleased with them. I am presently 65 years old and in good health. I regularly had mammograms every two years until five years ago. At that time, the place where got my mammograms asked me to sign a disclosure form stating that I would not hold the clinic or technicians responsible if one or both of my implants as a result of the test. This was alarming to me and I walked away without the mammogram and have not had one since!
I realize that foregoing mammograms is foolish. My doctor encourages me to have it done even though I have shared my fear. Is there a better way to examine the breast with silicone implants other than a mammogram? My breasts are small and when the paddle compresses them, it does feel like the implants could burst especially since they are such old implants. How do we know that the bag that encloses the silicone will not leak or burst? I’ve also had an ultrasound but they said that is not a good substitute and will not detect cancer cells.
Dr. Eppley, if you have any suggestions or answers to these concerns, I would certainly appreciate hearing from you.
A: Your fears about rupture of breast implants with mammograms is understandable, particularly in light of their age. While today’s breast implants have improved shells (the bag containing the implant filler) that are known to be resistant to the compressive forces of mammograms, the physical characteristics of implants thirty years ago are undoubtably less so.
I have seen breast implants of this age before on removal and most of them are either ruptured or no longer have any identifiable shell remaining. (meaning it has completely disintegrated)At thirty-one years of age, it is very likely that your breast implants are already ruptured or the shell is no longer intact. Even in asymptomatic, capsular contracture-free breasts, old breast implants will often, if not usually, not be intact.
That being said, I think your concern about breast implant rupture should not outweigh the potential benefits of mammography. Mammograms are still the simplest and most cost-effective screening tool that exists for breast cancer detection. An MRI of the breast can be done but it is more sensitive to look at whether breast implant rupture exists than to detect breast cancer.
Dr. Barry Eppley
Tags: breast implant rupture, breast implants, breast implants and mammograms, dr barry eppley, indianapolis, plastic surgery
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