Archive for December, 2011

Choosing the proper size breast implants for athletic women

December 12th, 2011 by rgarramone

I am frequently asked: what size implants are right for me? or patients already “know” they want to be a certain cup size after surgery.

How does the athletic patient and the plastic surgeon together decide what size is best?

  • Athletes for fitness or sport typically have relatively low body fat percentages and little breast tissue so coverage of the breast implant is limited.  With this situation there is the possibility of visibility of the implant, specifically rippling.  This can occur with silicone gel implants although it happens less than with saline.
  • Placing the breast implant partially under the muscle, which is how the procedure is performed most often allows an extra layer of coverage over the implant. This should help to limit breast implant visibility.  The trade off is the possibility of implant movement with contraction of the pectoralis muscle, but I have found this to hardly ever be a concern after a breast augmentation even in patients who compete in bodybuilding or fitness competitions.
  • The submuscular position also “hides” the breast implant more effectively so the transition from implant to no implant such as in the upper chest area is not as distinct as in the over the muscle position.
  • As for size of the breast implant, I find most athletically fit women tend to choose a breast implant volume, which is conservative to maintain proportion.  An implant that is too large will overstretch the skin and may lead again to more implant visibility.  I help patients select implant size by taking measurements, which is discussed elsewhere on this site, but also by having women place breast implant sizers in a bra and seeing how this looks in a mirror.  I have found this to be a very effective way to give patients a good idea of how they will look after the procedure.  There is no perfect way to do this but I rarely have my patients return for size changes.  Do not ask a friend or friends what size breast implants they have and expect to look the same.  Make sure your plastic surgeon is certified by the American Board of Plastic Surgery.
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Breast Augmentation Myths

December 6th, 2011 by rgarramone

Many patients are under the impression that breast implants need to be replaced every ten years. As an experienced cosmetic surgeon, I believe this is misunderstood information based on the fact that the potential for saline breast implants to leak is relatively low for the first ten years after the breast augmentation surgery, then it slowly increases after that and increases with implant age. No matter how old the breast implants are if they look good and feel good you do not have to have them replaced. Many women have a secondary breast augmentation procedure for a number of reasons, however. Some have larger implants or in some cases smaller implants placed. After pregnancies and breast-feeding some women no longer like the way their breasts look and they may have their implants changed, usually to larger implants. Women also may have a breast lift, which is used to correct droopy breasts. In some cases, the body forms too much scar tissue around the implants and the implant feels firm or hard. This condition is called capsular contracture. This breast augmentation problem usually leads to more surgery to remove the scar and ideally change the implant. Generally, silicone gel implants, which are the type of implants most women in my cosmetic surgery practice are choosing, will tend to last longer than saline implants because they do not leak. In fact, a silicone gel breast implant can be cut in half completely and the silicone gel will not come out of the implant. Because of this a rupture of the silicone breast implant that is a hole in the outer shell of the implant can be difficult to detect because there is nothing to feel on exam and there may not be anything to see on an MRI, still the best test we have today to screen for rupture of silicone breast implants. Saline implants, on the other hand, will leak out completely if they develop a hole in the shell. This generally takes hours to days to happen and is usually painless. Each breast implant, whether saline or silicone gel, is warrantied by the manufacturer for life.

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