Below are the answers to some questions Dr. Zuckerman most frequently receives from prospective patients. If you don’t see your question below, feel free to contact Dr. Zuckerman’s office, and a member of his staff will be glad to reach out to you.
• What size breast implant will get me a C cup? A D cup?
Unfortunately, bra sizes are not standardized, so it is not possible to say what size implant may achieve a certain bra cup size. However, at your consultation, Dr. Zuckerman can give you an estimate based on existing breast tissue. He can also lead you through a virtual reality simulation, so you can “see” what your breasts might actually look like after surgery! The most common implant size Dr. Zuckerman uses is around 350cc. Most patients desire a “full C cup or small D cup”.
• Do I need a breast lift as well as a breast augmentation?
If you wish to raise the level of the breast mound on the chest wall, a mastopexy (breast lift) is the appropriate option, with or without the addition of an implant. A well-done mastopexy results in a high, round, but natural-looking breast. Breast lift surgery will reduce the size of the areola as well. Placement of a breast implant is appropriate for you if you desire additional volume, and an implant can to some extent disguise mild ptosis or sag. However, a breast lift is required if you desire a substantially higher breast mound and smaller areola. Breast augmentation and mastopexy can be combined into a single operation called an augmentation mastopexy.
• Can I combine a breast augmentation with a tummy tuck or liposuction?
Yes, combining a breast augmentation with a tummy tuck or liposuction is very common and is known informally as a mommy makeover, because many women suffer from deflated or sagging breasts and excess abdominal skin or muscle separation after pregnancy and breastfeeding.
• What is the youngest age I can undergo breast augmentation?
Saline implants are FDA-approved for use in those 18 years and older. Silicone implants are approved for those 22 years and older. I generally recommend that a prospective patient wait until their breasts have finished growing before undergoing breast augmentation. This depends from patient to patient, but the breasts may continue to grow into a woman’s early twenties.
• Subglandular versus submuscular breast implant placement?
I may recommend the subglandular placement if the patient is very fit and has a very active pectoralis muscle. Otherwise, while subglandular was the original breast implant placement in the 1980’s, it has somewhat fallen out of favor today. I place the most breast implants submuscular today among breast augmentations I perform.
• How common is breast asymmetry and can it be addressed with breast augmentation surgery?
Most women actually have some degree of breast asymmetry. If your breast asymmetry bothers you, you might be well served by a breast augmentation. For augmentation, I would not want to place a single implant on one side, but it is common to place breast implants of different sizes in the left versus right breast.
• Risks of breast augmentation for people prone to keloids?
As a patient prone to forming keloids, you are not necessarily at any higher risk than anyone else for capsular contracture. You are, however, at significant risk for developing keloids at your incision sites. It is imperative that your surgeon be aware of this risk, and take proper precautions – meticulous incision closure, proper scar care, and likely the use of steroid injection at the incision site during the healing process.
• Breast augmentation before pregnancy and breastfeeding?
Breast augmentation does not impair your ability to breastfeed a child or to become pregnant.
• Breast augmentation after breastfeeding?
Pregnancy and breastfeeding can have some unpredictable effects upon breast size and shape. Often, breast volume increases significantly during pregnancy and lactation, then subsequent “deflation” occurs afterward. In order to restore breast fullness with an attractive shape, a woman would likely benefit from breast augmentation, with or without a breast lift (mastopexy), depending upon the degree of the problem.
• Will weight loss after breast augmentation affect my result?
As the breast is one of the more weight-sensitive areas of the body, you can expect some degree of change in their appearance with significant weight loss. The degree of this change will depend on the amount of your own breast tissue that was present before your augmentation: a greater change with more pre-op breast, lesser change with a smaller breast before surgery.
• Can breast augmentation improve the appearance of stretch marks?
Stretch marks are, in reality, scars of the dermal (thick underside) layer of the skin. As such, there is no treatment (other than removing the involved skin) that will make them completely vanish. Breast augmentation will likely stretch and spread the stretch-marked skin to some degree. This can often lessen and improve their overall appearance.
• I have tuberous breasts. Can I undergo breast augmentation?
To improve the aesthetic appearance of tuberous breasts, you would need to undergo a modified breast augmentation, where the surgeon would perform radial scoring of the breast glandular tissue and would lower the inframammary fold in addition to placing the implants. You may also need a tissue expander before implants would be able to be placed.
• Is there an alternative to general anesthesia for breast augmentation?
General anesthesia is the anesthetic method of choice for most breast augmentation. In a healthy patient who has undergone proper pre-op medical evaluation, and performed by a board-certified anesthesiologist in a properly accredited facility, it is extremely safe and comfortable. That said, breast augmentation can be successfully performed without true general anesthesia – by employing deep sedation with liberal use of local and regional anesthetic nerve blockade. But again, this should be performed by an anesthesiologist and surgeon who are well experienced in these methods.
• Is it dangerous if a silicone breast implant leaks while inside the body?
This is the most common question Dr. Zuckerman receives from prospective breast augmentation patients with regard to silicone breast implants. Today’s breast implants are extremely safe, and leak or rupture is a very low probability event that requires an intense amount of force directly to the chest. When a breast implant of either silicone or saline is placed into the body, fibrous tissue known as a capsule forms around the implant. For a saline implant, leaks are easily reabsorbed by the body. For silicone, most often, leaks or ruptures are contained within the capsule, which is called a “silent failure” or “silent rupture”. It is possible, however, for this capsule to then become inflamed causing the patient pain, swelling, soreness, or changes in breast firmness. If this case, a patient would possibly need to have the implant replaced. Leaks or rupture can be detected via an MRI scan. (Breast implants of either type are not intended to be lifetime devices and may need replacement later in life.) In the very rare case that the silicone gel from an implant escapes the fibrous capsule, the silicone gel has been shown to be biologically inert. It has been shown not to increase the risk of breast cancer and not to increase the risk of autoimmune disease. And, it doesn’t leach out into breast milk while breastfeeding.
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