Frequently Asked Questions

Q1- What is an implant made of and are there different types?

A- Implants most commonly comprised of a silicone shell and are then usually filled with a saline solution or are silicone gel-filled. There are different types of implants, including differences in size, shape and texture. The shape of the implant can be either contoured (a tear-drop shape) or round, while the texture can be either smooth or textured. The implant type that is best for you will depend upon your individual circumstances and is best determined with the help of your doctor.

Q2- What is symmastia?

A- Symmastia, also referred to as ‘breadloaf’is, it occurs when the implants slide together to the center of the chest, giving the appearance of a bread loaf or one single breast. Treatment typically requires correction through additional surgery.

Q3- Do the breasts really make noises after breast augmentation?

A- Some women have described noises coming from their breasts after breast augmentation surgery. These noises have been described as anything from a buzzing, squeaking or cracking, to a sloshing or gurgling. Implant noise may be the result of the implants not yet being settled, air bubbles in the implant pocket, or fluid build-up and tends to fade within a few weeks.

Q4- How long does the surgery for breast augmentation last?

A- Breast augmentation typically takes between one and three hours to complete, but the exact time will vary according to the particular patient, the technique used, the implant placement, and the type of anesthesia used.

Q5- Is breast augmentation a painful procedure?

A- The procedure itself will not be painful as some form of anesthesia will be used. After surgery, you may feel some degree of pain, though this will vary from patient to patient. Further, there is typically more pain associated with the sub-muscular placement of the implant. Though any pain experienced usually clears up within two days or so, pain medication can be prescribed by your doctor.

Q6- Does breast augmentation cause changes in sensitivity to the breasts?

A- Changes in sensitivity to the breast or nipple can occur after breast augmentation, though these changes are most often temporary. Some patients experience an increase in sensitivity, others a decrease, and a small percentage of women even experience a complete loss of feeling in the breast or nipple. Also, in some rare cases, these changes can be permanent and can affect a woman’s ability to nurse as well as her sexual response.

Q7- Will breast implants affect future pregnancy in any way?

A- It is possible for breast implants to adversely affect the ability to breast feed in the future. Further, pregnancy can alter the appearance of augmented breasts just as it can with natural breasts, and a postpartum lift may be required.

Q8- Are there concerns about mammograms with breast augmentation?

A- Breasts implants, particularly those in the sub-glandular placement, can interfere with mammogram readings. Women with implants should be sure to tell the mammogram technician that they have implants. Calcium deposits can form around the implant and be misdiagnosed as cancer, in which case the implant may need to be removed in order to determine the presence of cancer.

Q9- What are the possible locations for the incision and is one better than the others?

A- Breast augmentation can involve incisions placed in one of three locations: periareolar, or around the nipple; inframammary, or within the crease beneath the breast; or axillary, which is below the armpit. The best incision placement for you will depend upon several factors and should be determined with the help of your doctor. In general, however, the axillary and inframammary placements are typically associated with fewer complications with future breast feeding, though both of these placements do produce a visible, though small, scar. The periareolar placement, on the other hand, involves a less visible scar, but it is associated with an increase in breast feeding complications.

Q10- How do breasts with implants feel after surgery?

A- Generally speaking, breast with implants tend to feel more firm than natural breasts. Most patients, however, find this to be a good thing. Many factors can impact just how natural your breasts will look and feel after breast augmentation, including the implant placement, the implant surface and filler, the texture of your skin and the amount of existing tissue that you have.

Q11- What is the anesthetic used with breast augmentation?

A- Either general anesthesia or a combination of local anesthesia and sedation is commonly used.

Q12- How much recovery time is needed after surgery?

A- Individual patients will recover in different ways and in different amounts of time after breast augmentation. On the whole, however, patients can usually return to work within several days after their procedure, though strenuous activity will need to be avoided for 3 weeks or longer.

Q13- How long does it take for the scars to heal and fade?

A- Full fading of the scars after breast augmentation can take anywhere from several months to a whole year.

Q14- Are there risks associated with the procedure?

A- As with any type of surgery, there are risks associated with breast augmentation. These may include the following: bleeding, infection, capsular contracture, mammography interference, changes in breast or nipple sensation, deflation, and removal and/or replacement of the implant.

Q15- What are gummy bear implants?

A- Gummy bear implants, technically known as cohesive gel implants, are a fairly new type of implant with an inner substance similar in quality to a gummy bear. They were designed like this to decrease wrinkling. Further, they are said to maintain their shape and integrity if leakage or rupture occurs.

Q16- Can breast augmentation be done with fat injections?

A- Fat injections can be a wonderful tool for some procedures, particularly when used as a soft tissue filler for the face to increase the size of the lips or reduce some facial lines and wrinkles. For breast augmentation, however, fat injections are not a good option as the results are only temporary and they can lead to problems with mammography readings.

Q17- What are contoured implants vs. round implants which one is one best?

A- Contoured implants, also known as anatomical implants, are in the shape of a tear drop while round implants are simply round. The one that is right for you will depend on several factors and is best determined with the help of your doctor. Some people prefer the contoured implants, saying that they have a more natural shape since there is less fullness toward the top. However, other people believe that the most natural appearance is achieved by using round implants in the submuscular placement.
Because contoured implants have a specific shape to them, problems can result if they shift or turn, which can require further surgery. To help reduce the risk of shifting, most contoured implants are textured.

Q18- What is the difference between textured implants and smooth implants and is one best?

A- Smooth implants are smooth on the surface, or without texture, while textured implants have a textured surface. Textured implants were originally devised to reduce the risk of capsular contracture, though it’s not fully certain if they do. In addition, most contoured implants are textured to help reduce implant shifting or turning. There are several factors that will help determine which implant is best for you and the choice is one which should be made with your doctor.

Q19- Are there any risks of getting very large implants?

A- When determining the size of the implant, it’s important that your individual body and what it can best accommodate be taken into consideration. Women without sufficient existing tissue opting for a very large implant can end up with implants that are more easily seen and felt through the skin after surgery. Further, naturally large breasts have a tendency to prematurely sag or droop, and large implanted breasts may do the same.

Q20- How do you determine what size the implants should be?

A- There are many factors that help to determine the size of implant that is best for you, and your doctor can help you to make this decision. Nevertheless, many women undergoing breast augmentation find the choice of size to be one of the most difficult decisions to make. There are some things that you can on your own to help you get a feel for the size that you might like. First, start by looking at pictures in magazines. This will help you to better understand the sizes and shapes of breasts that you find attractive. Another very helpful thing that you can do is to buy several different bras in several sizes and try each one out, filled with padding of course.

Q21- What are the different options for implant placement and which one is best?

A- There are two options for implant placement, including the sub-glandular placement (above the chest muscle) and the sub-muscular placement (below the chest muscle). There are advantages and disadvantages to each, and choosing which is right for you are best done with the help of your doctor. In general, the sub-muscular placement is associated with a decreased risk of implant palpability, capsular contracture and mammography interference, but this placement also involves longer surgery and recovery times, less accessibility in case of re-operation and more pain. The sub-glandular placement, on the other hand, is associated with shorter surgery and recovery times, easier accessibility in case of re-operation and less pain, but this placement also involves an increased risk of implant palpability, capsular contracture and mammography interference.

Q22- How does rippling occur?

A- Rippling, one of the leading causes of breast augmentation dissatisfaction is when waves or indents appearing on the surface of the implant may be felt or even seen through the skin. Surgery is usually needed to remove and replace the implant, though in some cases the rippling may only be temporary.
Rippling may occur for a number of reasons. The sub-glandular placement of the implant (especially in women with little or no tissue coverage and thin skin), textured implants, and under filling of the implant may involve an increased risk of rippling.

Q23- Do implants last forever?

A- Implants are not intended to last a lifetime and women undergoing breast augmentation should know that they may very well require surgery at some point in their life to remove and/or replace the implant. Implants may fail at any time, though some believe they have an average lifetime of around ten years. Some manufacturers of implants include some type of guarantee that may include replacement of the implant when necessary.

Q24- What does bottoming out mean?

A- Bottoming out occurs when the implant, after surgery, drops too low on the chest. Additional surgery is usually needed. There are many different possible causes and bottoming out can occur immediately after surgery or over time. The inframammary and periareolar placements of the incision and the sub-glandular placement of the implant are typically associated with an increased risk of bottoming out.