Archive for the ‘Breast Augmentation’ Category

Cosmetic Surgery Basics – Post #9 – How do I pick a breast implant size?

Tuesday, January 10th, 2012 at 10:00 am | Posted in Breast Augmentation, Breast Surgery

Picking a breast implant size is a difficult decision. First of all, many ladies come in to see me stating they want to be a “B” cup. What does that mean? What store does she shop at? A bra specialty store, a department store? Is the bandwidth being measured properly?

Maybe she wants to be a “C.” A small C? A large C? Such a difficult decision….

Many surgeons recommend different ways of deciding what implant to be used. First of all, the most important thing is that the prospective breast implant patient knows what she wants herself. My best recommendation is to look at many sets of breast implant photos. Go online and look at various plastic surgeon websites. Go look at Playboy(C) or a similar magazine. If she doesn’t know what she wants, there is no way the surgeon can deliver a result.

The next important issue is communicating her desires to her surgeon. She needs to not be shy. She needs to tell him or him exactly what she wants. I tell patients in my New Jersey plastic surgery practice to find pictures of breasts that they like. A picture is worth a thousand words and when she shows me what she wants, I have a much better understanding.

The next possibility is things like sizers. Some surgeons’ offices have sets of sizers ladies can put in bras. Some ladies place rice in ziplock bags and place in their bra to determine how much volume they are comfortable with. Weighing the rice can be converted to cc of volume. Some surgeons use computer imaging. I have used computer imaging in my office and found it to be a very artificial, unrealistic portrayal of different sized implants and while it sounds good it didn’t work well for me in my NJ practice. I hated putting the expensive imager in storage but found it misleading. Thus, I have gone back to using sizers in bras as it is a reliable method for me.

The final issue is understanding that different implants look different on different body type frames. A 400cc implant will look very different on a lady that is 5 feet 1 inch tall and 95lbs compared to 5 foot 7 and 150lbs. Thus, when a lady comes in and tells me I put 350cc implants in her friend “Amy” and she wants that size I need to explain to her that the size of the implant is based on her individual chest width, height, weight, and tissue characteristics.

Communication of her desired result is the most important thing I can stress. The potential breast augmentation patient needs to have a good insight into her desired result and to communicate this to her surgeon for a successful outcome.

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Cosmetic Surgery Basics – Post # 8 – Above or below the muscle?

Monday, January 9th, 2012 at 9:09 am | Posted in Breast Augmentation

Will you be putting my implants above or below the muscle? I get asked this question all of the time in my NJ breast implant practice.

This is an easy answer for me. Implants belong below the muscle. Occasionally they belong in a dual plane partially under the muscle but it is rare where I would put them above the muscle.

What are the differenceS?

Above the muscle looks more round and fake. Under looks more natural.

Above the muscle feels less natural. Under feels more natural.

Above the muscle does not move with muscle activity while under the muscle they can move. This can look a little weird and weaken strength for a professional athlete. I don’t think this is a huge issue for most people but a consideration for some.

Above the muscle interfere more with mammograms. Under the muscle interfere less.

Above the muscle get more capsular contracture or hardening over time.

Above the muscle ripple more.

Above the muscle might have a slightly easier surgical recovery (by a day or two….)

While this is not an all inclusive list, the majority of these differences point in favor of putting the implant below the muscle. Since breast cancer can impact 1 out of 8 American ladies, the mammography difference is very significant to me.

I place most implants totally submuscular. Occasionally I use a dual plane technique in someone who could benefit from a little bit more “lift” due to the shape of her breasts to start with. If an implant was placed previously above the muscle and I am doing a revision sometimes I will stay in this pocket.

So, it is a confusing issue to some, but easy for me to choose. Most breast implants belong below the muscle in my opinion. If you are considering breast enhancement I would highly suggest meeting with a board certified plastic surgeon to discuss all of your options and get educated in detail.

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