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Breast Augmentations

*Q: Why would a PS recommend wearing a bra after surgery for 3 – 4 weeks?

*A: Bra after surgery*

Thank you for the question. I would highly recommend that you heed your
plastic surgeon’s advice. In the early part of healing, the pocket created
for the implants has not healed sufficiently to resist the force of gravity
or the contraction of muscle which may cause your implants to shift in
position. I will typically ask my patients to wear the bra for 6 weeks 24/7
during their initial recovery. I hope this helps. Best wishes


*Q: BA: indentation 2 months post op? Had hematoma in this exact same

*A: Indentation after breast lift with implants*

Thank you for the question and the photographs. You appear to be healing
well. Asymmetry during the healing process is not at all unusual as the
breasts may not settle and heal at the same rate, especially after a
hematoma. At this point I would recommend to remain patient. If after 3
months have passed you continue to see the indentation, discuss it with
your plastic surgeon to determine the best course of action. I hope this
helps. Best wishes.


*Q: Right breast has more fullness to the side and appears wider than the
Left. Will this balance out?

*A: Post operative asymmetries*

4 days post-op is very early in healing. Swelling and apparent asymmetries
are normal at this point. Remain patient and if after your 3 month mark you
are still not sure about your results, discuss this with your plastic
surgeon to determine the best course of action. Best of luck.


*Q: What are the differences between the different incisions (besides
location) for a breast augmentation?

*A: Incisions for breast augmentation*

Thank you for your question. There are 4 incisions used for breast
augmentation. Which one is chosen is based on surgeon’s personal experience
and preference. They are:

1. AXILLARY

Advantages:

-No scar on the breast and it tends to blend into skin crease well and is
therefore difficult to detect

-Usually least visible of the different augmentation incisions

-This technique, with the use of the endoscope, provides full visibility
and precise surgical control of pocket creation, bleeding and implant
placement

Disadvantages:

– A poor or longer incision, such as the incision need for placement of a
silicone implant, may be visible in sleeveless tops

– Not indicated in treatment of some cases of mildly sagging or tuberous
breasts.

– Removal of scar tissue from around the implant (capsulectomy), may be
difficult with this approach.

– Risk of numbness of the skin around the underarm and upper arm.

– Risk of scar tissue band formation under the axillary scar, which
typically resolves spontaneously over time.

– Increased risk of capsular contracture due to increased contamination.

2. INFRAMMARY

Advantages:

– Precise control of the surgical pocket and implant positioning.

– Incision scar is usually hidden by the breast.

– Good access for any additional breast surgery such as in treatment of
cases of ptotic (sagging) or tuberous breasts.

– Ease of access for placement of silicone gel implants.

– Lowest rate of capsular contracture.

– Only approach for placement of memoryshape silicone gel implants.

Disadvantages:

– Scar on the breast.

– Scar may be visible when you are lying flat.

3. PERIAREOLAR

Advantages:

– Good control of pocket creation and implant positioning, due to direct
visibility.

– Incision typically well hidden by areolar tissue.

– Good access for additional breast surgery, including the treatment of
cases of ptotic or tuberous breast .

Disadvantages:

– Sensitive area.

– Incision is often visible and at breast focal point.

– Exposes the implant to breast tissue and bacteria within the breast
tissue.

– Increased risk of capsular contracture due to increased contamination.

– Some sensory nerves around the areola are cut. (However, increased risk
of loss of nipple sensation with this approach has not been proven).

– Greatest risk of problems with breast feeding.

4. TRANSUMBILICAL

*Not performed by Dr. Soler.

Advantages:

– No scar on the breast.

Disadvantages:

– Not approved by implant manufacturers.

– Blind, blunt pocket creation.

– Cannot place silicone gel implants though this approach.

– Precise creation of a pocket and implant positioning is very difficult.

– Cannot adequately control bleeding.

I would suggest that when you feel the time is right to consult with
several (3 or so) Board Certified Plastic Surgeons for an in-person
evaluation and a discussion of your goals. I hope this helps. Best wishes.


*Q: Recreational drug use and breast augmentation?

*A: Cocaine use prior to breast augmentation*

Thank you for your question. Cocaine, especially in combination with
general anesthesia, can cause drastic changes in your blood pressure and
irritability of your heart. I would suggest you discuss this with your
chosen plastic surgeon. I hope this helps.


*Q: I want to increase my breast size at least 1 cup. Is it possible
without an implant? Is breast fat transfer an option?

*A: Breast Fat Transfer*

Thank you for the question and the photographs. While fat can be used for
breast enlargement, it would appear from your pictures that you do not have
sufficient fat to harvest for such procedure. I hope this helps.


*Q: Do I have tuberous breasts!?

*A: Do I have tuberous breasts!?*

Thank you for the question and the photograph.

A typical tuberous breast deformity will have:

* A constricting ring of tissue at the base of the involved breast(s)

* A decreased distance from the bottom of the areola to the infra-mammary
fold (fold under the breast)

* A narrowed breast base

* Herniation of breast tissue into the areola causing a stretching of the
areola

The deformity is a spectrum, so women may have some or all of these
findings in varying degrees of severity. Unfortunately, the picture you
have provided does not show enough detail to make any kind of
determination. I would suggest to post other photographs that better show
the anatomy of your breast(s).


*Q: What is my left breast bigger then my right when I first did my surgery
they were both the same size? (photos)

*A: Asymmetry after Breast Augmentation*

At 18 days post-op you are still in the early period of healing. Swelling
and apparent asymmetries are normal at this point. Remain patient and if
after your 3 month mark you are still not sure about your results, discuss
this with your plastic surgeon to determine the best course of action.
Best of luck.


*Q: 18 days post op, are they suppose to look like this? (photos)

*A: 18 Post Op Mastopexy with Augmentation*

Thank you for the question and the photographs. At 18 days post-op you are
still in the early stages of healing. Asymmetry during the healing process
is not at all unusual as the breasts may not settle and heal at the same
rate. At this point your photographs do not show anything out of the
ordinary. If after 3 months have passed you remain unhappy with your
outcome, discuss it with your plastic surgeon to determine the best course
of action. I hope this helps. Best wishes.


*Q: Is a small bruise normal to appear 5 to 6 days after surgery? (photo)

*A: Post op bruising*
From the picture provided, the bruise does not appear to be significant. A
small amount of bruising is not at all unusual after a procedure and can
often times take days to appear. This should resolve on its own, but if it
begins to enlarge and/or your breast becomes painful, you would need to
contact your surgeon. Best wishes.


*Q: Do I have tuberous breasts ?

*A: Do I have tuberous breasts ?*
Thank you for the question and the photographs. While pictures cannot take
the place of an in-person evaluation, it would appear as though you have
significant ptosis (drooping) and asymmetry of the breasts and perhaps a
mild form of tuberous breast deformity.

A typical tuberous breast deformity will have:

* A constricting ring of tissue at the base of the involved breast(s)

* A decreased distance from the bottom of the areola to the infra-mammary
fold (fold under the breast)

* A narrowed breast base

* Herniation of breast tissue into the areola causing a stretching of the
areola

The deformity is a spectrum, so women may have some or all of these
findings in varying degrees of severity.

From the severity of the ptosis an augmentation without mastopexy (breast
lift) will most likely result in a “snoopy” breast deformity. This is where
the breast tissue “hangs off” the inferior aspect of the breast implant. A
mastopexy (breast lift) alone will elevate your nipple areolar complex and
leave a better shaped breast, but the superior pole of your breasts will
remain “hollow”. Therefore I would recommend a lift with implants to give
you the optimal result.

I hope this helps. Best wishes.


*Q: Cellulitis in right breast

*A: Breast cellulitis*
Thank you for the question. From the details provided it sounds as though
you are being appropriately treated. There is not much else that can be
done, other than to monitor your improvement. Should the redness return
after/during the antibiotic regimen, this may be an indication that the
infection has reached the implant. Continue in close follow up with your
surgeon as he is in the best position to evaluate and treat you during this
time.


*Q: How long do I need to wait to sleep on my side?
<https://www.realself.com/question/grand-junction-long-wait-sleep-side>*

*A: Sleeping after breast augmentation*
Thank you for the question. I will typically ask my patients to sleep on
their backs for 2 weeks or so. It is also not uncommon to require pain
medication at 9 days post op. Having said that, each surgeon has their own
style in the post operative management of the patient. I would therefore
recommend you discuss this with your chosen plastic surgeon. I hope this
helps.


*Q: Is redness spreading?

*A: Redness after breast augmentation*
Thank you for the question and the photographs. This is a matter in which
an accurate opinion cannot be given without the aid of an in-person
evaluation. I would therefore suggest you follow up with your plastic
surgeon to deliniate your best course of action. I hope this helps. Best
wishes.


*Q: Can I sleep I my side after a breast augmentation?

*A: Sleeping after breast augmentation*
Thank you for the question. I will typically ask my patients to sleep on
their backs for 2 weeks or so.Having said that, each surgeon has their own
style in the post operative management of the patient. I would therefore
recommend you discuss this with your chosen plastic surgeon. Best wishes.


*Q: How soon can I lift weights after BA?

*A: Weight lifting after breast augmentation.*
Thank you for the question. You should be fine in carrying through with
your planned events. As for the lifting, I will ask my patients not to lift
for approximately 6 weeks after their breast augmentation. Having said
that, each surgeon has their own style in the post operative management of
the patient. I would therefore recommend you discuss this with your chosen
plastic surgeon. I hope this helps. Best of luck.


*Q: Breast augmentation: Just a lift, or lift and implants?

*A: Breast augmentation*
Thank you for the question and the photographs. While a picture cannot take
the place of an in-person examination, it would appear as though you would
benefit from a lift and augmentation. If you only have the lift, your
breasts will be smaller with a flat upper pole. The implant will provide
the volume needed to maintain your size while also providing upper pole
fullness. I would suggest that when you feel the time is right to consult
with a Board Certified Plastic Surgeon for an in-person evaluation and a
discussion of your goals. This should help to determine your best course of
action. I hope this helps.


*Q: Where to get a breast augmentation?

*A: Where to get a breast augmentation?*
Thank you for the question. I would direct you to the American Society of
Plastic Surgery website to begin your search for Board Certified Plastic
Surgeons in your immediate and surrounding areas. Once you have found
several physicians that appeal to you follow up with a consultation(s).
Once you have had several consultations I would suggest to chose the
surgeon you feel most comfortable with. I hope this helps.


*Q: I’m 6 wks post op & more uneven than pre-op. I got under muscle,
saline, 375 on left, 390 on right. Is it normal?

*A: I’m 6 weeks post-op & more uneven than pre-op.*
Thank you for the question and the photograph. At 6 weeks post-op you are
still in the early stages of healing. Asymmetry during the healing process
is not at all unusual as the breasts may not settle and heal at the same
rate. At this point it is best to wait till you are approximately 6 months
post-op to evaluate your final results. If at that time you remain unhappy
with your outcome, discuss it with your plastic surgeon to determine the
best course of action. I hope this helps. Best wishes.


*Q: Implant rotation or something else? (photos)

*A: Implant rotation?*
Thank you for the question and the photographs. At 3 weeks post op you are
still in the early phase of healing.This period will typically last
approximately 3 months. After this initial time period the swelling will
continue to improve and the soft tissues will accommodate allowing your
final results to appear. Be patient, this process can occur at differing
rates in each of the breasts. I tell my patients that they will not see
their final results for up to 6 months. I would recommend to continue in
close follow up with your plastic surgeon as they are in the best position
to make recommendations in the post operative period. Best wishes.


 

*Q: Normal to have scab at corner of scar 14 weeks after breast aug?

*A: Scab 14 weeks post op*
Thank you for the question. This does not sound normal at 14 weeks post op.
You may want to post pictures to aid in the formulation of an opinion. I
also recommend to call around and find a plastic surgeon in your area that
would be willing to evaluate and treat you if necessary. Best wishes.


*Q: Breast implants- 6 weeks post op scars?

*A: Post op scar*
Thank you for the question and the photograph. Your incision is healing
very nicely. The firmness is normal at this stage of healing. Over a period
of 12 months the scar tissue you feel will soften and improve in texture
but not go away. Scar is permanent, this is how your body heals after
surgery or any other type of trauma that causes tissue injury. Best wishes.


*Q: Any suggestions for breast implants and rash?

*A: Breast implants and rash*
Thank you for the question. Unfortunately it is not possible to give a
recommendation on this matter without the aid of an in-person evaluation. I
would suggest to call your plastic surgeons office and relay what is
occurring. If this does not motivate the staff to bring you in the office
sooner, then ask to speak with the surgeon directly, it is almost certain
that they will want to see you right away. Best wishes.


*Q: Had breast implants 2 months ago. Is it OK for my honey to lay on top
of me while making love?

*A: Making love after breast augmentation*
Thank you for the question. At 2 months post op there should be enough
healing that it should not be a problem. However, should it become
uncomfortable you may have to find a different position. Best of luck.


*Q: My boob job does not look right. They’re flat and don’t sit up at all.
They were not like this last summer please help (Photo)

*A: They’re flat and don’t sit up at all*
Thank you for the question and the photographs. It would appear from the
pictures provided that your breasts are ptotic (drooping). Therefore you
would benefit from a mastopexy or a breast lifting procedure. Best wishes.


*Q: Asymmetry, bottoming out or something else?

*A: Asymmetry, bottoming out or something else?*
Thank you for the question and the photographs. The asymmetry you speak of
can certainly be appreciated in your preoperative photograph. You do not
appear to have bottomed out, but rather as you had stated it is a
magnification of your existing asymmetry. Best wishes.


*Q: What is Singulair’s role in breast issues/recovery?

*A: What is Singulair’s role in breast issues/recovery?*
Thank you for the question. Singulair is used, off label, to prevent the
formation of capsular contractures. It supposedly works because of
its leukotriene receptor antagonism. The evidence that exists is at best
anecdotal as there are no large randomized studies confirming its’ effects.
I hope this helps. Best wishes.


*Q: Why does my breast feel like it moved up and is swollen/tender?

*A: Why does my breast feel like it moved up and is swollen/tender?*
Thank you for the question. While it is difficult to render an accurate
opinion without the aid of an in-person exam, it would sound from your
narrative that this may be a capsular contracture. I would recommend to
follow up with your plastic surgeon for an in-person examination and a
discussion of your concerns. Best of luck.


*Q: Will my implants still drop and fluff? I’m 2 months. Am I on the right
track?

*A: Am I on the right track?*
Thank you for the question and the photographs. At 2 months post op you are
still within the early phase of healing. This will typically last
approximately 3 months. After which the period known as remodeling begins.
During this time the swelling greatly improves, the soft tissues stretch
and accommodate as the implants drop into their desired position. This can
occur at differing rates in each of the breasts. I tell my patients that
they will not see their final results for up to 6 months. I would recommend
to continue in close follow up with your plastic surgeon as they are in the
best position to make recommendations in the post operative period. Best
wishes.