Breast Augmentation: Frequently Asked Questions

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Breast Augmentation: Everything you’ve wanted to know and more.

Year after year, breast augmentation is always ranked the #1 cosmetic procedure in New Jersey, and really in the country.  The recovery is quick, the surgery is short, and patient instantly love their results.  While breast augmentation may seem straightforward, there are nuances that only a Board-Certified Plastic Surgeon like Dr. Smita Ramanadham, would understand and be able to safely treat.  This blog is aimed at providing some of the basic information to consider when thinking of a breast augmentation. 

What is a breast augmentation? This is a procedure that aims to enlarge the size of the breasts through the use of implants or fat from your own body.  

Who is a good candidate?  If you are in good health and your breasts do not sag (have extra skin) and the nipple is already in a good position, meaning it’s in the center of the breast, you may be a good candidate for a breast augmentation. If they do sag or the nipple is lower on the breast, you may need a mastopexy or breast lift

What types of implants are there? There are two main types of implants that we commonly use, saline and silicone. This describes what the implant is filled with, either saline or salt water or a silicone gel.  Both are safe, the decision is yours to make as to what you prefer. 

Is saline or silicone safer?  Both are completely safe implants.   The main difference is that the silicone implants feel more natural while the saline implants may feel a little bit heavier.  If a rupture occurs which can happen with either implant, the saline implants will deflate and the silicone implants will maintain their shape.

What will my incisions look like?  The most common incisions are through the inframammary crease, the areola, or the armpit.  The incisions regardless of where they are placed are 5cm or less. 

Is above or below the muscle better? The muscle we are talking about here is the pectoralis major muscle. This is a muscle that fans across our breast.  We can detach the inferior attachments of this muscle and place the implant underneath. The benefits of this is the muscle provides a natural slope to the upper portion of the breast, it adds an additional layer of protection between the implant and the outside world, and it can decrease the risks of capsular contracture. Placement above the muscle provides a more “augmented” appearance and may be a good option if you are a body builder or work out aggressively and do not want to risk weakening this muscle. 

How do I choose the size of the implant?  The implant chosen will be based on several things. First, is tissue-based planning. This means that we measure and examine your breasts so ensure that you have enough breast thickness that will prevent long term complications of the implant applying too much pressure on the breast internally and thin out the breast tissue.  The measurements also ensure that the implant will fit within the borders of your breast.  All implants have varying dimensions.  They differ in diameter, projection, and volume. If we put an implant in that is too wide for your breasts, you will look very top heavy, the implant may cause a “uniboob” look or you may feel it when you have your arms down to the side.  If it’s too narrow, it will look unnatural and conical. Second, we have a good discussion with you about your goals and what size you would like to be.  While we can never guarantee a bra/cup size, we can estimate that for every cup size increase you will need to go up on your implant size by 100-150cc.  Many surgeons, including myself, will have you use sizers in the office and feel the various implants. You’ll be able to choose the size you’d like and I will get as close to that in the OR as I can safely and that your chest and breast will allow. Other surgeons might also have 3-D imaging so you can see what your chest will look like through photos of varying implant sizes. 

Are implants associated with breast cancer?  Textured implants have been associated with a rare type of lymphoma called Anaplastic Large Cell Lymphoma or ALCL. There is no data suggesting that this has been found in patients that have smooth implants placed. Of note, textured implants describe the shell of the implant.  Textured implants have a rough surface while smooth do not. 

Are implants safe if I become pregnant? Yes, implants are safe and you may still be able to breast feed. Most often, however, you might need to supplement with formula.  They are safe for your baby, however. 

Should I have implants before or after I have my babies?  This is completely your choice.  One is not better or worse than the idea, it’s really just a matter of timing and preference.

Will my breasts look the same years after my augmentation? While an augmentation will increase the size of the breasts, our breasts will continue to change as we go through life. They may get bigger or smaller with weight changes, they may sag or deflate with pregnancies or aging.  Additionally, after surgery, the implants will be rather high on your chest and the breasts will feel tight. As the swelling goes down and the skin adapts and stretches to its new shape, the implants will also drop to a more natural position.

Is fat a good option instead of implants?  Fat transfer or fat grafting is a good option for a breast boost.  It may increase your breast size by 1 cup or 2 but typically will fill out the cup size you already are.  Remember 40-50% of the fat we transfer will dissolve in 6 months to 1 year so you may need a second session depending on your goals. 

Alright folks, hopes this helps streamline some of the questions you might have about breast augmentations.  Always go over these questions with your board-certified plastic surgeon.  They should easily be able to discuss all of this with you and counsel you about the appropriate procedure and implant that will be best for you

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.