Breast Surgeries Tips

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Should I have surgery again to re-enlarge my breasts?

Breast Revision: One More Time

Another breast surgery? You're the type who risks going over 21 in Vegas. Now you want breast augmentation revision. It's not because your breast surgeon made a mistake. You just want bigger breasts. Some reasons for wanting breast revision surgery:

  • You've gained needed weight so that you're not as top-heavy, or your proportions are right for bigger breasts
  • You've had your last pregnancy and your breasts need a boost again
  • Breast implants haven't filled out your breasts correctly or the way you desire
  • Your height has changed (some women grow shorter as they age)
  • You just want more breast enlargement!

You've decided on the procedure. The $5,000-$7,000 question (that's the approximate fee for breast enhancement revision surgery): Should you go back to the breast surgeon who did your initial breast augmentation surgery? If you can go back to your breast surgeon, then do. She'll be aware of your needs, your body type, and your history.

If you've moved or it would be impractical to consult your original breast surgeon, make sure you keep records of your procedure to share with another breast surgeon. This is good advice no matter what doctor you choose. After all, your doctor was extremely competent, but you know what you want, and updating your look is important. However, as with gambling, you should know the risks of breast augmentation, and know when to hold 'em.

How does my breast surgeon decide how to augment my breasts?

Your Basic Anatomy

You aced basic anatomy in college and med school. You're giving yourself a gift for being a dedicated resident. While you didn't study plastic surgery, you know quite a bit about breast surgery. So you'll be able to tell your breast surgeon what she already knows about your breast implants and breast augmentation. Basic anatomical considerations include:

  • Your build--medium, slight, heavy
  • Your shoulder width (have you been hitting the gym in-between rounds)?
  • Laxity or tautness of your chest wall
  • Whether you have scoliosis
  • Any pectal muscle deformities)
  • Body asymmetries

You delved into specific body systems and organs, so while you're telling the breast surgeon she should make incisions beneath the breast (inconspicuous incisions with less risk of bleeding) rather than through the underarm, you rattle off everythign she should know about your breasts:
  • Your skin and tissue--lax or taut?
  • Spacing--how far apart are your breasts? Are they widely or closely spaced?
  • Cleavage--how wide or deep is it?
  • Asymmetries--are your breasts even? (Usually one breast will be bigger than the other.)
  • Size--small, medium, large?
  • Breast placement--high or low?
  • Nipple placement--dead center? Up and "perky"? Above the intramammary fold is best.
  • Shape--round or teardrop? Pyramid is usually best.
  • Narrow base (tubular) with abnormally narrow tissue? Wider tisse and a wider base are ideal.

Avoid sounding like an arrogant know-it-all (something people hate in doctors). Think like the patient you are. Try not to yawn during your consult (lack of sleep), and make sure that you can take it easy after your breast augmentation surgery. Maybe you should wait until your sabbatical. After all, you'd tell your patients not to overdo. Doctors do make the worst patients, so follow the recommendations and advice of your breast surgeon. Learn from your breast augmentation and breast enhancement surgeon. Let your experience be a boost to your bedside manner and your professionalism as well as your bust.

What is capsular contracture and how do I prevent it?

Breast Implants and Capsular Contracture

It hurts to wear a bra and despite the admiring looks you're getting, you just want to hide in a closet. Aren't breast enhancement and breast enlargement supposed to make you more confident? Your breasts may have become hard because of capsular contraction around breast implants after breast surgery. Scar tissue tightens around your new breast implants. How can your breast surgeon prevent capsular contraction?

  • Some Breast augmentation experts think that placing breast implants closer to the breast wall will eliminate capsular contraction.
  • Rounded breast implants under the tissue, sub-mammary, reduces the risk of capsular contracture by over half.
  • Massage after breast surgery can help if you have soft silicone or saline implants.
  • If you take Vitamin E, except two weeks before surgery, you may avoid capsular contracture.
  • Textured implants over the muscle resist capsule contracture after breast augmentation.

Surgeons can treat the problem, should it occur, with antibiotics and/or a capsulectomy to remove the scar tissue. Your breast surgeon may not charge you for this corrective surgery. You don't want to hide away--you want to show off your new look. Some pre-planning can help you face the world happily.

What is capsular contracture and how do I prevent it?

Teardrop or Round Shaped?

Teardrop or round-shaped? This is a matter of personal preference when you're choosing earrings. You assume that the decision is that simple when you're choosing round or teardrop breast implants. Teardrop breast implants, you've heard, are better for breast augmentation because they more closely mimic the natural shape of the breast--and you do want your breasts to look natural, just bigger. Round breast implants are traditional, but sometimes result in that "balloon" effect we've all seen. You think that teardrop breast implants will make your breast augmentation surgery or breast lift a greater success. Not necessarily.

Some surgeons believe that teardrop breast implants work best when you have enough breast tissue to place the implant over the muscle or when you are small-breasted with tight skin. In general, the looser your skin, the rounder or more "balloony" your breast will look no matter what the implant resembles when you see it in the breast surgery clinic. If your tissue is lax, you won't get that teardrop shape. You might consider getting a breast lift or mastopexy to tighten your skin and tissue. Your surgeon may or may not insert an implant as well. If you have implants after a breast lift and you can't "pinch an inch," you can consider getting teardrop breast implants.

Whatever implants you get, textured breast implants will help them fill out your breast, since they're said to grab the breast wall like Velcro. If you're thinner with smaller breasts, textured breast implants may cause a rippling (like water, not teardrops) effect if they're placed above the breast muscles--so if you're supermodel thin, textured breast implants under the breast muscles will work best for you. After all, you may or may not wear those earrings, but your breasts will be with you for the rest of your life.

Can my breasts be too large?

Breast Reduction or Breast Implants?

Jay Leno once quipped, "In the last couple of weeks I have seen the ads for the Wonder Bra. Is that really a problem in this country? Men not paying enough attention to women's breasts?" Believe it or not, guys can pay attention to women's breasts for medical reasons. Yes, it's true. If after having a baby or after menopause, your breasts sag, your husband may hesitate to tell you they're too large even though you think you need breast implants. Your husband should listen to his instincts--or drive you to the breast surgeon, who will tell you your breasts may be too low or large for implants.

If they cause back pain, you can get breast reduction or a breast lift. If you have a healthy attitude and your hubby doesn't mind less-than-perfect breasts (he loves you anyway, right?), you're a good candidate for a breast lift surgery. You can even have breast implants for breast augmentation afterwards.

If your breasts aren't overly large after all (see, your hubby was wrong) but droop and sag, mastopexy or breast lift surgery usually removes excess skin around the nipple. Your breast surgeon will reposition the nipple so it lines up with the crease. Often, your surgeon combines the lift with breast implants. Breast implants may be an option to fill out your breasts post-breast lift. Just make sure you don't have excess or sagging skin, or a narrow tubular base--a breast lift will typically take care of tubular adbormalities.

In either case, breast lift or breast reduction, you'll wear a special bra. Breast reduction and breast lift surgery carry several permanent scars that will fade over time, especially with use of scar reduction creams. On the plus side, you'll feel better, your clothes will fit you better, and your hubby will pay as much attention to you as before--without the added worry of having to tell you that your breast sag and are too big. Men don't have trouble paying attention to women's breasts, or anticipating when breasts might get them in big trouble.

Are silicone breast implants dangerous?

New Silicone Developments

Lawsuits over silicone and saline breast implants leaking. Do you choose something that your body might reject? There are natural breast implant solutions such as breast implants made of potato--"Wait until President Clinton finds out there's French fries in there," Jay Leno once joked. But are silicone-based breast implants dangerous to your breast enhancement dreams?

Advances in breast augmentation and breast surgery have made breast implants safer. Several surgeons such as Dr. David Broadway of Denver-Boulder, Colorado, have participated in breast enhancement implant trials such as the ones offered by Silimed. Silicone gel implants by Silimed don't have as many wrinkles and are lightweight. They may not be textured, which means you have a risk of capsular contraction if they're placed above the breast muscle. If they're placed below the breast muscle, you're safer. Silicone breast implants can leak and break several years after surgery. You may have to have a replacement implant, and it's difficult to remove all the silicone from breast tissues.

Try to cleanse your body of toxins with various natural cleansing methods--wheatgrass can flush out your system. Make sure your implants are manufactured well so you can avoid leaks. You've decided to go with silicone breast implants, so talk to your breast surgeon about which ones are best for you. While the FDA may be cautious about silicone breast implants, your breast surgeon can steer you to the safe ones. But if Bill Clinton offers to give you advice, don't take it.

Can I have the fat taken out of my stomach area and put into my breast?

Breast Reconstruction: Using Stomach Tissue

For some women, flattening their tummies while they are augmenting their breasts would be the ideal scenario. And, indeed, stomach tissue is often used in cosmetic surgery of the breast, although most often in reconstructive surgery following a mastectomy. A TRAM (Transverse Rectus Abdominis Muscle) -- a flap of skin, fat and muscle from the lower abdomen -- is transplanted into the breast region. The recipient receives a new breast and a tummy tuck at the same time. The advantage of a TRAM procedure is that it creates a natural breast ‘mound' that will change in size according to any future weight gain or weight loss. Having both procedures at the same time may increase the patient's time in the hospital and recovery time.

Am I caving to male expectations if I get larger breasts?

Why Larger Breasts?

Do you want to give in to society's over-emphasis on looks and sexist attitudes towards women? These days, women choose to have breast enlargement surgery for themselves, to look more feminine and full. Most women are born with one breast larger than the other. You might feel lopsided, so you might choose to have one breast enlarged. Breast implants and contouring can enhance your shape and give you a feminine, fuller figure. Often you'll lose definition in your breast because of age, or you may not have had it to begin with.

While the image is of young, nubile women getting implants, older women choose breast augmentation as well. It's important to note that while fuller, shapelier breasts can increase your confidence, don't expect a complete life transformation. You might attract attention because of larger, firmer breasts, but if you aren't outgoing, your life won't have the miraculous turn you believe. Then, you'll really be trapped in superficial ideals, beauty myths, and so on. Be confident. Be outgoing. Wear your clothes well and get a makeup upgrade. That way, breast surgery will work well for you, a woman in control.

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Mary White