Breast Surgery Concepts

Asymmetry and Appearance: “Sisters, not Twins”

1. The body is not symmetrical in any of its parts including breasts. Do not expect your breasts to be mirror images of each other. Also, the breast tissue you have prior to surgery and the shape of your torso determines the placement and appearance of your breasts after surgery. The surgeon cannot change that nor can he change how they heal over time.

2. The larger the implants, the more noticeable asymmetries will be. Also, implants may make the areolas bigger and stretch marks (striae) more pronounced (or make new ones).

3. Everyone who has saline breast implants will be able to feel the implants and will have visible and palpable rippling. The same is true for silicone gel implants, however for most people it will be less. The degree this may happen is determined by your preexisting tissue and the size of the implants.

4. How your breasts look immediately after surgery and in the early healing stages is not how they will look in 3 months, 6 months, or even a year. They will continue to change as your tissue relaxes and accommodates the implants. Supporting your breasts with a good bra will help preserve your new look.

5. Where the implant is placed, under the pectoralis muscle, under the fascia of the pectoralis muscle, or above the pectoralis muscle, affects how the implant looks and moves on the chest wall.

6. Every effort is made at your preoperative visit(s) to help you choose the size of implant for the result you desire. However, the final decision is yours and this office makes no guarantee that you will be happy with the size or the appearance. The number one complaint nation wide by women after breast augmentation is that they are “not big enough.”

Ptosis – “Droopiness”

1. Patients who have droopy breasts before surgery will have a more relaxed look to their breasts after surgery and will tend to droop more over time especially if they are not well supported in a good bra.The larger the implant, the more weight is pulling on the tissue and the more likely ptosis will occur or worsen.

2. Pregnancy and/or nursing can cause stretch marks, droopy breasts, and larger nipples and areolas with or without breast implants. However, implants may make it worse in some patients.

3. Sunbathing or tanning in a tanning bed may cause permanent discoloration of the overlying skin of the breasts particularly in the first 6 – 12 months.

Capsular Contracture

1. The body sees a breast implant as a foreign body and as a result, walls it off from the rest of the body by a thick, fibrous scar or “capsule.” This is a normal part of healing and can be desirable. However, a potential complication of breast implants is for the capsule to shrink or tighten too much. This can happen at any time the implant is inside you. Infection may play a role, but more likely, it is determined by genetics and other factors.

In the event of capsular contracture, the breast may become hard, misshapen, and/or painful.

2. Capsular contracture may require surgical correction at an additional cost to you. Doing the postoperative displacement exercises daily with smooth implants may help to prevent this problem.