Breast Augmentation

Breast Augmentation and Breast Implants

Breast augmentation surgery has a 97% “Worth It” rating on RealSelf.com (http://www.realself.com/Breast-implants/reviews) – and for good reason. When done properly, breast enlargement is a truly positive and transformative experience. Recent breakthroughs in product choice and surgical technique allow more natural results that inspire confidence and a healthy self-image.

Manhattan plastic surgeon Dr. Thomas W. Loeb is among the city’s most respected plastic surgeons.  In addition to his long surgical career, he is also a clinical instructor of plastic surgery at Cornell University whose work has been published university text books. He has received the American Medical Association’s “Physician Recognition Award” on numerous occasions and picked up nationwide notoriety for his work in breast augmentation among other procedures.

Breast Augmentation - Thomas Loeb, MD Dr. Thomas Loeb shares breast augmentation before and after photos from 4 patients and discusses how you can get the the best results from your breast enhancement procedure.

Those searching for the “best” breast augmentation surgeon in NYC will be well-served by working with a surgeon as reputable as Dr. Loeb.  However before you take the next step, it is important to first become educated about the procedure, the types of implants available to you, preparation, recovery, and other important considerations that will lead you to your desired result.

Breast implants: Saline vs. Silicone

There are two general options for breast implants that both contain an outer silicone shell, but differ in terms of filler material and overall consistency. The choice of implant ultimately boils down to patient anatomy, body type, desired results and, ultimately, patient preference.

types of breast implants

  • Silicone Breast Implants: In 2014, 77 percent of augmentations done by board-certified surgeons were silicone breast implants. The Mayo Clinic explains, “Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Most women feel that silicone breast implants look and feel more like natural breast tissue.” Women with very little breast tissue and those who have had a mastectomy done are particularly good candidates for this type of implant, as alternatives could cause cosmetic problems like rippling, wrinkling, lower breast pole stretch and less natural-looking results in these cohorts.
  • Saline Breast Implants: The remaining 23 percent of 2014 augmentations were saline breast implants. The Mayo Clinic explains, “Saline implants are filled with sterile salt water. They’re inserted empty, and then filled once they’re in place.” Women with much breast tissue or those going for sub-muscular placement, saline implants can provide an equally desirable aesthetic appearance of larger breast size, smooth contour and realistic texture.

Read more about these popular breast implants at http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-implants/art-20045957 .

Though surgeons prefer silicone for most patients based on look and feel, this type of implant is not without controversy. “They pose more of a risk if they leak,” reports WebMD  at http://www.webmd.com/beauty/breast-implants/cosmetic-procedures-breast-augmentation.

“In 1992, the FDA halted the sale of silicone implants because of safety concerns. In 2006, after reviewing more research, the FDA started allowing certain silicone breast implants back on the market.” That said, both implants are considered safe, as demonstrated by ongoing studies.

Gummy bear implants

“Gummy bear implants” are another term you’ll hear used in many circles. ABC News referred to this particular type of silicone implant as “the future of breast augmentation surgery” due to the natural-looking results and lower rupture rates compared to other kinds of silicone implants.

gummy bears

They received their nickname from California Plastic Surgeon Dr. Grant Stevens who said the term refers to the gel’s ability to maintain its shape, as a gummy bear cut in half might. However, as Tennessee Plastic Surgeon Dr. David B. Reath points out, the fifth generation “highly cohesive” gel implants are “not as solid as the moniker ‘gummy bear’ might imply” – but, rather, are just slightly thicker than fourth generation “cohesive” implants.  For more information, see http://www.dbreath.com/blog/the-truth-about-gummy-bear-breast-implants/.

Dr. Loeb explains: “I like using so-called ‘gummy bear’ implants in many of my patients because they are less likely to ripple, rotate, cause contracture or change shape over time. Not only are they durable, but they provide a very natural looking breast profile and are easy to implant without noticeable scarring compared to other types of silicone implants.”

However, he adds, form stable implants are not necessarily for everyone. “They do require a bigger incision than I would use for a saline implant,” Dr. Loeb clarifies, “so the risk of a more noticeable scar is greater. Also, I recommend that patients who need extra fullness in the upper pole of the breast go with saline for a more natural contour as well.”

Round & Teardrop Breast Implants

Shape is an important consideration, whether you choose silicone or saline breast implants. “The shape that is selected will make a difference in the fullness and positioning of the augmented breasts,” explains Dr. Jennifer B. Walden of Austin, Texas. “The goals of the patient need to be assessed along with the amount of natural breast tissue, where the implant will be placed and the incision technique to be used to establish the best shape option.”

Round Breast Implants: Round breast implants are the most common choice among women because they’re the look featured in “fashion magazines and Victoria’s Secret catalogs,” says Dr. Timothy Connall, a plastic surgeon in Portland, Oregon at http://www.drconnall.com/Breast/Implants/Round-Teardrop-Implants.aspx. The soft, smooth shell of round implants are less likely to be felt compared to more textured shells. When a patient stands, the implant takes on a teardrop shape, but when a patient lies flat, these implants are more likely to take on a natural, flat shape, rather than sticking straight out. They’re also less likely to rotate or ripple.

  • Teardrop Breast Implants: Teardrop shape implants (a.k.a. “form stable” or “gummy bear” implants) are newer and more ideal for certain types of patients. “A greater degree of control can be added in fitting the implant shape and dimensions to a woman’s anatomy and desired breast shape,” says Dr. Connall. “This control is especially useful in patients that wish to emphasize filling a certain area of the breast, such as the upper pole.” In other words, textured teardrop implants can provide shape where there is none and offer greater projection in the bottom of the breast when it is warranted by a patient’s unique anatomy.

Breast augmentation sizes

tape measure

Breast augmentation size is measured by cubic centimeters of volume within the implant. Aesthetics are one factor in determining size, but it’s also important to consider your body type – how the implants will sit and what your body can physically withstand. You’ll need to consider your lifestyle. Furthermore, you’ll want to be sure your news breast size won’t cause wardrobe issues or cause sagging and back pain later on.

According to New Beauty Magazine, other long-term risks of oversized implants include:

  • Tissue, fat and muscle thinning
  • Reoperation
  • Pressure atrophy
  • Bottoming out
  • Rippling, wrinkling and ridges
  • Stretchmarks

Surgeons often talk about “profile” in discussing breast implant size:

  • Moderate Profile Breast Size: Breasts protrude a minimal amount; ideal for wide chests.
  • Moderate Profile Plus Breast Size: Breasts protrude a little more and are slightly tapered; ideal for small, wide chests, as they don’t create an overabundance of width on the sides.
  • High Profile Breast Size: Breasts appear ample and full, projecting a lot to provide maximum cleavage; the downside is that they can appear “fake” on certain body types.

Often, women come to a plastic surgery office asking to be a certain “cup size.” This can be a deceiving measurement, though. Bra sizes vary from manufacturer to manufacturer – and, on top of that, a study conducted by Wacoal Lingerie found that 8 in 10 women were wearing the wrong sized bra anyway, so what women think they want may not be what they actually want. By rough estimates, each 150-200 ccs takes you up one-and-a-half cup sizes.

Breast augmentation before and after pictures

breast implant before and after photoThe American Society of Plastic Surgery website has an extensive collection of breast augmentation before and after photos that can help women considering breast augmentation visualize their potential results.  Dr. Loeb’s own gallery of before and after images serves as a great testament to the quality of his work as well as gives patients an idea of the thought process behind the procedure and how he achieved the result desired.

It is important to review such images with Dr. Loeb as guidelines for what you hope to achieve. While it may not be possible to exactly replicate the looks you choose, breast implant before and after photos serve as important communication tools between doctors and their patients.

Fat transfer with breast augmentation

One of the newest advances in breast augmentation surgery is the use of a patient’s own fat to build new breast tissue.

Breast augmentation with fat transfer is particularly ideal for:

  • Patients who would otherwise never get a traditional implant due to personal beliefs on “foreign substances.”
  • Patients with asymmetry, constricted breasts, poor cleavage lines or sagging breasts

According to Dr. David Halpern of Tampa, Florida, there are many benefits of using fat transfer in breast augmentation procedures. “When compared to traditional breast augmentation, the scars are smaller,” he explains. “Fat grafting is especially useful in correcting deformities or abnormal breast shapes. For mastectomy patients, fat grafting is the only way to truly restore the quality of scarred, damaged and irradiated tissue.”

On the other hand, you may not want a fat transfer breast augmentation if you’re going for very large breasts. Some of the transferred fat will inevitably be reabsorbed by the body. Even if a surgeon adds a little extra fat, the end results are more difficult to precisely predict. For mastectomy patients, fat transfer could require multiple procedures, which not everyone wants to do. Also, extremely thin women who don’t have 10 pounds of extra fat to spare may not have enough tissue to harvest.

Breast augmentation cost

“How much are breast implants?” seems to be the million-dollar question everyone is afraid to answer. The cost of breast implants depend upon several factors. Keep in mind that breast augmentation prices also typcially include the cost of surgery, anesthesia, the implants themselves, and all required follow up visits with the surgeon.

Breast implants cost does not vary wildly whether a patient chooses saline or silicone. Silicone implants are usually slightly more expensive, but the difference is usually not enough to dictate the patient’s choice. It’s more important that a patient choose the look, feel and end result that will yield long-term satisfaction so money is saved on the need for future procedures to replace the implants later on.

Dr. Loeb’s office works with individuals on financing breast implants prices into affordable payments. For those seeking breast reconstruction after mastectomy, insurance companies will often cover the cost of your breast implants. Patients are encouraged to speak with their insurance providers about such options.

Breast augmentation recovery

For many patients, one of biggest concern is the recovery phase. Pain consideration and management, time off from work, swelling, and follow-up visits are all part of the process.

Most patients manage post-operative pain by taking prescribed pain pills on a set schedule to head off any discomfort, and most patients are back to work within about one week of surgery. Patients are advised to avoid heavy lifting and particularly strenuous activities for 2-4 weeks. It takes about three months for the swelling resolve and to see your final results. Your surgeon will follow-up with you several times during throughout the recovery period to ensure proper healing.

Breast augmentation scars

breast implant scarsWith any incision, there is going to be a scar. How visible that scar is depends on individual healing abilities and surgeon skill. Breast augmentation scars can be minimized through several surgical approaches including the trans-axillary technique, where incisions are hidden within the armpits, and the peri-areolar technique, where incisions are made around the border of the areola. See: http://torontosurgery.com/guide/breast-augmentation-scars/.

Infra-mammary breast augmentation is among the most common of procedures. In this type of situation, the surgeon makes the incision inside a well-defined breast fold thereby concealing the scar.  Silicon gels, Vitamin E supplements and pressure bandages are also often recommended to aid healing. For more information on reducing breast implants scars, see http://www.livestrong.com/article/79505-reduce-scar-tissue-after-breast/.

Breast implants and breastfeeding

woman breast feeding with implants

Breast implants and pregnancy do not need to be mutually exclusive. Women with implants are almost always able to nurse their babies without incident.

However Baby Center warns that there could be some unwanted side effects such as:

  • Increased nipple sensitivity
  • Exaggerated breast engorgement when the milk first comes in
  • More intense Mastitis with symptoms of pain, fever and chills
  • Diminished milk supply if glands or nerves have been clipped or injured during surgery

If you plan to breastfeed a baby in the future, be sure to discuss this with Dr. Loeb, as it may affect the exact surgical technique he chooses. For instance, he may choose an incision under the breast or in the armpit, rather than around the areola to avoid any possibility of nerve or gland interference. He may also choose to position the implant under the chest muscle, where it will put no pressure on the mammary gland.

Breast implant removal

Sometimes breast implant results don’t always meet a patient’s expectations. “You don’t have to live with unwanted breast implants because you fear how your natural breasts will look after the implants are removed,” says Lisa B. Cassileth, a board certified plastic surgeon from Beverly Hills, California. “Breasts don’t need to be flat or deflated–-they can be put back together from within.”

Aside from complications like capsular contracture or implant rupture, there are a plethora of other reasons to opt for breast implant removal – many of them psychological.

Women on GoodbyeImplants.com discuss feeling:

  • Burdened by “keeping this massive secret from everyone.”
  • Uncomfortable with how “unnatural” or large the end results were.
  • Disturbed at the thought of having “foreign objects” inside the body.
  • Awkward wearing low-cut shirts or bathing suits and starting new relationships.
  • Persistent lack of confidence and esteem, despite receiving new breasts.
  • Worried that they got implants for the wrong reasons – due to public pressure or for someone else.

Women dissatisfied with a prior breast augmentation are encouraged to talk with Dr. Loeb about making a change.

Be sure to check out this Women’s Health Magazine article, which shows what results are possible for women whose breast implants were done incorrectly the first time or experienced complications over time.

Breast augmentation risks and complications

Surgery is a major decision that shouldn’t be downplayed by strong desires to look more attractive. Any good plastic surgeon will make it perfectly clear that breast implants do not necessarily last forever. The FDA says that “up to 20 percent of women” will need to have their implants removed or replaced in 10 years.

CBS news has reported that the “shelf life” of breast implants is said to be about 10 years, although that does not mean you need to worry or have them replaced after that amount of time if they are not causing issue. For more on that report, go to http://www.cbsnews.com/news/breast-implants-safe-but-dont-last-forever-fda-says-what-women-need-to-know/ .

The most commonly experienced breast augmentation risk is rupture. According to the FDA, a breast implant may leak or break open due to capsular contracture, mammogram compression or damage sustained during a biopsy, overfilling or over-handling during the procedure itself, damage from surgical instruments, normal implant aging and physical trauma. Ruptures can be apparent with deflation occurring or they can be silent and only detected through diagnostic imaging.

Other adverse effects reported by the FDA:

  • Capsular contracture
  • Unsatisfactory Results
  • Breast Pain
  • Skin Issues

“Many horror story scenarios you hear about in the media about breast implants gone wrong often stem from patients choosing the wrong surgeon,” explains Dr. Loeb. “Doctors may have misrepresented their experience with breast augmentation specifically or patients may have hastily selected a surgeon who was not board-certified, overseas, or offering rock bottom prices.”

Choosing the right surgeon will ensure that you have someone fully invested in your recovery who is not only capable in performing low-risk breast augmentation procedures, but also in managing any unavoidable complications that may arise from surgery.

Are breast implants worth it?

woman feeling breast implants

According to the American Society of Plastic Surgeons, over 286,000 women had breast augmentation in 2014, holding its spot as the #1 cosmetic surgical procedure in the country since 2006.  Most women who elect to have implants are between 30 and 39 years old, but the surgery is just as common in women in their forties as it is for women in their twenties.

Breast augmentation is most commonly done to repair the toll of pregnancy and breastfeeding once a woman is done having children, to correct natural anomalies or deformities that cause insecurity, or simply to fill out a cup size to gain a better fit for most clothing and a more attractive silhouette.

Before you get the procedure done, Cosmopolitan Magazine recommends asking yourself the following questions:

  • How much does my current situation bother me?
  • Why do I want this procedure?
  • How excited am I to go through with this?
  • Can I handle the time off from work and exercise?
  • How much am I willing to expose myself to certain risks?

Whatever your personal reasons for seeking breast augmentation may be, Dr. Thomas W. Loeb would love to hear your story. He is happy to discuss breast implants pros and cons with you at a consultation done either in-office or virtually via Skype if you do not live in the New York City metro.

Call 212-327-3700 and find out if you are a good fit for breast augmentation and  take the next step toward a happier, sexier, more confident you!

Additional Breast Augmentation Resources:

  1. ABC News – Gummy Bear Breast Implants: The Future of Breast Augmentation Surgery? http://abcnews.go.com/Health/gummy-bear-breast-implants-future-breast-augmentation-surgery/story?id=…
  2. Dr. Jennifer Walden – Textured Shape Implants http://www.drjenniferwalden.com/procedures/breast/breast-augmentation-with-textured-shaped-breast-im…
  3. New Beauty – Choosing Your Size http://www.newbeauty.com/treatments/breast-implants/4-choose-your-size/
  4. United Breast Cancer Foundation – Wacoal Lingerie Study http://ubcf.info/women-wear-wrong-bra-size/
  5. ASPS – Before and After Photo Gallery http://www1.plasticsurgery.org/before_and_after_photo_gallery/?procedure=Breast_Augmentation
  6. FDA – Breast Implant Risks http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants…
  7. ASPS – Plastic Surgery Trends http://www.plasticsurgery.org/news/press-releases/plastic-surgery-statistics-show-new-consumer-trends

Related Breast Implant Articles:

  1. ABC News 7 – Surgery Replaces Breast Implants With Body Fat http://abc7news.com/health/surgery-replaces-breast-implants-with-body-fat-/989733/
  2. Cosmopolitan – Things You Should Know Before Getting A Boob Job http://www.cosmopolitan.com/health-fitness/advice/a38708/things-you-should-know-before-getting-a-boo…
  3. ASPS – Breast Augmentation Prices http://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation.html?sub=Breast+augmentation+cost
  4. Dr. Youn Plastic Surgery – Recovery http://www.dryoun.com/services/breast
  5. UK Daily News – Horror of woman, 25, who discovered her £4,000 breast implant was left hanging OUT of her chest http://www.dailymail.co.uk/health/article-2295139/Boob-job-horror-woman-25-implant-fell-OUT-chest–leaving-lopsided-seven-months.html

 

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