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          Breast Augmentation: Frequently Asked Questions

          Considering breast augmentation surgery? If so, you probably have lots of questions, and you may have some concerns. Following are some of the more common questions along with their answers.

          What are the risks of breast augmentation?

          All surgeries have risks, including breast augmentation. Risks include infection, bleeding, loss of sensation, hematoma (a break in a blood vessel), seroma (collection of fluid under the skin), asymmetry, problems with anesthesia, and/or poor cosmetic results. Breast implants may also wrinkle, rupture, shift or deflate. Capsular contracture, another risk, occurs when scarring forms around the implant, resulting in breast stiffness.

          Breast implants can also interfere with early detection of breast cancer. It is essential that you still get regular mammograms or breast X-rays. Make sure you choose a clinic whose doctors have experience reading mammograms of women with breast implants, and make sure to let the doctor know that you have breast implants.

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          Does breast augmentation hurt?

          Breast augmentation can be painful. Certain surgical techniques may increase pain. For example, placing the implant under the chest muscle may be more painful and involve a longer recovery time than placing it over the chest muscle. Make sure you follow all of your post-op instructions, and take your pain medication as prescribed to minimize any pain.

          If your pain becomes excruciating, contact your surgeon immediately.

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          Can a woman breast-feed after breast augmentation?

          Yes. Breast augmentation with implants rarely affects a woman's ability to breast-feed. That said, breast-feeding can be difficult for some women regardless of whether they have had breast augmentation surgery. If you plan to have children after your surgery, discuss your plans with your surgeon.

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          Can breast implants lift sagging breasts?

          Yes. In some cases of mild sagging, breast implants may provide a much needed boost. Implants may increase the volume of the breast, which helps to lift loose skin.

          They may also rotate the lower part of the breast upward, making the breasts look firmer. Still, the most effective way to lift and firm breasts is with a breast lift (mastopexy). This surgery can be done with or without breast augmentation.

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          Are breasts with implants more likely to sag?

          Not necessarily. Implants may even help stave off breast sagging. As you grow older, your skin begins to lose its elasticity, you may gain weight, and the amount of your natural breast tissue shrinks. Breast implants can add some weight to the breast, and this may increase the amount of sagging. That said, breast implants and the surrounding scar tissue can also provide some internal support for your breasts, which actually controls sagging. Avoid sagging by wearing a properly fitting bra.

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          Will my breast implants feel natural?

          Silicone-gel-filled breast implants may feel more natural than their saline-filled counterparts. Newer surgical techniques — namely those that place the saline implant behind the chest muscle and slightly overfill it — may allow saline implants to feel more natural. Your breast implants will also feel more natural if you have a generous amount of breast tissue before your surgery.

          If you are concerned about how your new breasts will feel, bring it up with your breast surgeon during your initial consultation.

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          Should I wait to get my breast implants until after I have children?

          You can get breast implants at any time, but if you are planning on having children within the next year or two, you may want to wait. Pregnancy-related weight gain and breast changes will likely affect the appearance of your breasts. On another note, if you are planning to lose a significant amount of weight, it is a good idea to postpone your breast augmentation surgery until you have met your goal. Dramatic weight loss can affect the appearance of your new breasts.

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          How big should I go?

          This is totally up to you. The average size for breast implants is a C or D, but some women go much bigger — reality TV star Heidi Montag recently opted for a DDD. The best way to determine what size is right for you is by experimenting. Try the rice test: Take a knee-high stocking and fill it with rice. Begin with about 300 cc's or 350 cc's. (There are 30 cc's to an ounce, which means that 10 oz is 300 cc's.) Flatten the rice in the hose and place it inside your non-padded bra. Add or subtract rice based on how it looks. Your surgeon will also be able to give you some advice about what would look best, but in the end it is your call. Remember that the No. 1 reason women opt for revision breast augmentation is because they wish they went bigger.

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          Am I too young for breast augmentation?

          The Food and Drug Administration (FDA) recommends that no one under age 18 receive saline breast implants and no one under age 22 receive silicone-filled breast implants. The reason for this is that your breasts may still be developing until your early 20s. In addition, younger women may not be able to make a completely informed decision. The reason women must be older to undergo breast augmentation with silicone implants is because they have a different risk profile than their saline counterparts. Advancing age, however, is not a deterrent from undergoing breast augmentation with implants, as long as your general health is good.

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          How should I tell my family about my breast augmentation?

          All families react differently, so there is no one-size-fits-all way to tell them. Begin by explaining how you feel about your appearance. Make a list of the reasons you want breast augmentation surgery and discuss these reasons with your family. Be open, honest and unwavering about your decision. Family members may not be supportive at first, but if they see how important it is to you and how determined you are to go through with the surgery, they will likely come around.

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          Will my areolae stretch after breast augmentation?

          Stretching of the areolae (the discs of darker skin surrounding the nipple) may occur after breast augmentation. Discuss your concerns with your breast surgeon in advance.

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          Why can't they perform breast augmentation surgery using my own fat?

          Fat grafting to the breast, which involves taking fat from places in the body where it is plentiful (your buttocks and thighs, for example) and implanting it in areas where it is not (like your breasts), was once considered controversial, but times are changing. The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery now state that fat injections to the breast can be used to enhance breast appearance after reconstruction, or to soften the appearance of implants. While these two organizations have not yet endorsed the idea of performing purely cosmetic breast augmentation with fat grafting, a growing body of research is showing that fat injections to the breast may prove to be effective.

          Initially there were concerns that the fat might calcify and obscure readings on mammograms, or possibly be mistaken for early breast cancer, but those fears have since been allayed by research. Other technical concerns remain, including exactly how much fat is needed to adequately enlarge a breast, because not all fat survives the transfer. What's more, the success of the surgery is largely dependent on the surgeon's skill and technique. This procedure takes longer and costs much more than breast augmentation with implants. Another issue is that if the injected fat comes from your abdomen, and you have tendency to gain tummy fat, your breasts may grow.

          There are some pluses, namely that fat injections eliminate some of the problems of an implant, like wrinkling and dimpling. The bottom line is that fat injections to the breast may one day be an option for some women seeking breast augmentation. Stay tuned.

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          Can breast implants improve Poland's Syndrome?

          Poland's Syndrome is a congenital disorder characterized by the lack of a chest muscle on one side of the body. It is also called pectus excavatum and carinatum, and is more common in men than in women. Breast implants may be able to help improve this condition. For more information consult a board-certified plastic surgeon who has extensive experience treating this condition.

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          How much does breast augmentation cost?

          The cost of any cosmetic plastic surgery procedure includes the surgeon fee, anesthesia fee, operating room fee and implant fee (if applicable). According to the most recent statistics compiled by the American Society for Aesthetic Plastic Surgery, the average surgeon's fee for breast augmentation is $5,429. Revision breast augmentation may cost more than primary breast surgery, as it often takes longer and can be more complex. That said, surgical error should be covered at the surgeon's expense, so be sure to review your surgeon's revision protocol before booking your surgery. Silicone-filled breast implants cost more than saline-filled implants. In general, costs tend to be higher in urban areas such as New York City, Boston and Los Angeles because overhead is higher and surgeons are in greater demand in these more densely populated locations.

          The cost of breast augmentation surgery also can be financed.

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          Do I need to take antibiotics before having any dental work after I have had a breast augmentation?

          When you have dental work, plaque and bacteria that are normally found in your gums may be released into your blood stream where they can cause infection. This is not an issue for most healthy people, but individuals with heart conditions or poor immune systems must follow a pre-determined antibiotic regimen before they visit the dentist.

          Any foreign body, including a breast implant, can be a target for infection. Discuss the risks and how to guard against them with your breast surgeon and your dentist.

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          Will I develop stretch marks after my breast augmentation?

          It is possible to develop stretch marks after breast augmentation surgery. Stretch marks are caused by any abrupt expansion of the skin. While there is no surefire way to prevent stretch marks, try massaging shea butter, olive oil or vitamin E lotion on your breasts before and after your surgery. Ask your surgeon what type of stretch mark prevention or treatment he or she recommends.

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