Q: Dr. Eppley, I am wanting to get saline breast implants. I am probably considered and A cup and would like to be around a full C cup. One of my biggest concerns is cost. How much would it cost from start to finish to have breast implants done by you? (Including any pre and post-op appointments). I am hoping I can find a good surgeon that is able to do the procedure in my price range because my husband would be the one paying for it and he takes a lot of convincing 🙂 Thank you!
A: As a good working number for saline breast implants, the cost of $4700 can be used. This includes the before surgery consultation, all surgery costs (implants, anesthesia, operating rom fees, surgeon’s fee) and any after surgery visit up to six months after the procedure. You may use this number in your ‘negotiations’ with your husband. May it work favorably for you in these discussions.
The advantages of saline breast implants are their lower cost, the ability to place them through hidden armpits incisions and the capability to adjust the volume of the implant during surgery for any differences seen in the two breasts as they are enlarged.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in having breast augmentation. I have had several plastic surgery consults and they have left me confused. One doctor told me that silicone implants do in fact appear more natural (less rippling on the breast) than saline after surgery. Another doctor told me that it doesn’t matter and I should get saline implants because they are cheaper and he could do it through a periareolar incison. Is the appearance difference between silicone and saline implants real or is this a myth?
A: What constitutes a natural appearance after breast augmentation is largely a matter of one’s viewpoint. Beauty truly is in the eye of the beholder. But the definition of what a naturally-appearing breast augmentation result is aside, the more natural appearance of a silicone implant compared to a saline implant is largely a myth. But as in all myths there is usually a kernel of fact hidden in them and this is equally true of this breast implant issue. With good breast tissue and a submuscular position, both types of breast implants will have a similar appearance and one could not tell the difference. However, differences in their appearance may be seen in very thin patients with little breast tissue particularly if they are placed above the muscle. The real differences in these implants is how they may feel, with saline implants having a higher risk of rippling which can be felt in the bottom and sides of the breasts where there is no muscular cover. I always tell my patients that choose saline implants that they can expect to feel riplping in their implants which affects show they may feel but not how they look.
Dr. Barry Eppley
Q: I had saline breast implants placed two months ago. Today I felt the implant at the bottom of my breasts. When i touch the bottom of my breast I feel the implant itself. I don’t know if this is normal or not?? Please advice.
A: The feeling of saline implants at the bottom of your breasts could be one of two phenomenon. First, it is likely it is completely normal if it is present on both sides. Initially breast implants can be initially high and then they eventually settle lower. Because the implant is only partially covered by the pectoralis muscle (the upper half), the bottom pole of the breast has the implant covered by just skin and whatever breast tissue you had to start with. Since saline implants will usually develop a little rippling in the implant shell, this is most palpable at the bottom and the sides of the breast. This is initially not able to be felt because of the tissue swelling and skin stretching which takes several months to go away. Since you are two months out from surgery, you are exactly in the time frame when this will occur. The other possibility, particularly if it has happened on just one side, is that one of the implants has bottomed out. (dropped too low) You would know this because the breasts would be asymmetric. (unless it has occurred on both sides) But either way, it would be apparent because the implants look too low. That is a surgical (revisional surgery) problem.
Dr. Barry Eppley
Q: I am looking to have what I think is called a Mommy Makeover. I have it on TV shows and read about it on the internet. For the breast implants, I am looking to have saline implants done. I would like them placed behind the muscle if possible. I am not sure what my ‘true’ cup size is. I know it is between an A and B. I would like to be a full C to a small D. I do need a slight lift but I am concerned about scarring. I would like the incisions to be as discreet as possible. As for the tummy tuck, I think I only need a mini-tuck. I have a little bit of fat in my lower stomach that stays and I cannot get rid of it. I also have a little bit of stretched skin that needs to be removed. I am looking to have the problem fat suctioned out and the muscles to be sutured back together and the little bit of stretched out belly skin removed. After looking at pictures and watching animated videos on tummy tuck; I realize that my tummy problem is quite small compared to majority of the pictures I have viewed. I am a small frame as it is. I am about 5’2” and weight about 115 pounds.
The issues I have may not seem like anything to someone else; but they are BIG to me. I look at myself each day and do not see a young beautiful woman. I wonder each day how in the world is my husband still attracted to me. I am wanting to do this for my self. I would love to love myself again! Does this sound like it can be all done in a single operation?
A: Mommy makeovers are typically a combination of breast and abdominal reshaping. Improving the very problems that being a mommy has created. Saline breast implants can be placed from a remote incision high up in the armpit that will never be seen. The most limited incision breast lift is that of the superior crescent mastopexy, also known as a nipple lift. It puts a fine line scar at the top of the nipple only right at the junction of the areola and skin. Given your body frame size, you are describing perfectly what a limited or mini-tummy tuck accomplishes.
Dr. Barry Eppley
Q: I am getting saline breast implants in the next several months. I am getting them because they are less expensive and the size of the cut to put them in is much smaller. What I want to know is where is the best place to put them through…my armpit, nipple, or under my breast in the crease?
A: One of the two advantages to saline breast augmentation, besides a lower cost, is that they can be inserted through very small incisions. Because they are put in deflated, they are rolled up to about the size of a small burrito. This enables them to pass through incisions as small as one inch or 2.5 cms. Once in place, they are the inflated to their desired size.
While all three incision locations will work (armpit, nipple, lower crease), choosing one of them is based on the patient’s preference for scar location and how soon they must return to work and what type of work they do. If one has darker skin color (e.g., Asian or Hispanic), they I would definite choose the armpit or axillary approach. This is because this puts the scar away from the breast and women of these ethnic backgrounds are very sensitive about any visible scarring. Conversely, if one needed to return to work quickly and their job involved lifting, then I would choose the lower breast crease. Becasue the entire pectoralis muscle does not need to be elevated (only the lower half is), one will have less pain and a quicker recovery due to the more limited muscle trauma.
Dr. Barry Eppley