Breast Enlargement (Augmentation Mammoplasty)
Q: Can I use silicone implants for my breast enlargement?
A: Silicone implants are the overwhelming choice today for breast augmentation surgery. In fact, effectively one hundred percent of my patients select them as their implant of choice.
Q: Do silicone breast implants give a better result than saline implants for a breast enlargement?
A: Silicone breast implants are made of a thick, cohesive gel that simulates the feel of a breast. They are the “Gold standard” of breast implants. Saline implants are filled with salt water which lacks the viscosity and other important characteristics of silicone, leading to less natural results in general. On average, silicone implants do last substantially longer than the saline ones. We have using them for well over 30 years with excellent results.
Q: Will I need to have my breast implants replaced sometime in the future?
A: Breast implants will not last forever. They may last 5-30 years, possibly less or more but expect that at some point in time they will need to be replaced or removed. It is usually easy to determine when saline implants deflate as there will be a noticeable and rapid decrease in the size of one breast. Loss of integrity in silicone implants can be more difficult to detect since there is no real change in volume and with today’s implants, little or no change in breast shape (though with earlier generation implants there often were shape changes). An MRI or digital ultrasound may be needed to make the diagnosis.
On average, silicone implants will last significantly longer than saline implants. Read more about breast implant durability.
Q: Where do you place the incisions when inserting breast implants?
A: There are three acceptable incision locations for the insertion of breast implants including:
1. near or at the crease at the lower part of the breast
2. around the lower half of the nipple
3. through the armpit
In some situations, one site may offer an advantage over the others. Virtually all of Dr. Turkeltaub’s patients elect to have their incisions placed near the crease at the bottom of the breast (inframammary).
No matter which approach is used, the incisions usually heal fairly inconspicuously.
Q: Do you usually place the breast implants in front of or behind the muscle (pectoralis major muscle)?
A: With the rare exceptions, Dr. Turkeltaub recommends placing the breast implants behind the muscle for several reasons. They look and feel more natural and there is a lower associated rate of the occurrence of firm scar tissue forming around the breast implants which can result in the breasts feeling hard (known as capsular contracture). Quite importantly, the breasts can be seen much better on mammography in this location.
Q: Will I still have sensation of my nipples?
A: Immediately after surgery, your breasts may “feel” somewhat numb. Most patients quickly regain most if not all of the sensation of their nipples and breasts. It would be very rare to lose total sensation in both nipples.
Q: Will I be able to breast feed?
A: Breast augmentation surgery should have little or no impact on the ability to breast feed.
We can discuss breast implants in greater detail during your consultation at our Scottsdale office.
Breast Lift (Mastopexy)
Q: Where will my scars be located?
A: The location and extent of the breast lift scars depends on several factors including the degree of drooping. For the most minor of drooping and in very rare situations, it can involve just the top half of the nipple (mini-lift). The three major incision options available for a breast lift are the circumareolar (also called periareolar or Benelli) which just goes around the areola, the lollipop which goes around the areola and extends down to the crease, and the anchor (also called the inverted T) that also extends along the crease at the bottom of the breast. A variety of factors will determine which approach would be best for you.
Q: Do the scars heal well?
A: They generally heal in an acceptable way and will fade somewhat over time. The final outcome would depend on multiple factors including genetics, skin color, surgical skill, adherence to recommended postoperative regimen including scar care. The trade-off for these scars are more perky, youthful appearing breasts.
Q: My breasts are saggy but I definitely don’t want breast lift scars on my breast. Will Dr. Turkeltaub do just a breast augmentation without the breast lift?
A: With the rare exception being the mildest of situations, breast implants by themselves will not treat sagging breasts. What you would see is much of your breasts hanging off of the implants creating a bizarre appearance. Dr. Turkeltaub, therefore, will not perform your surgery if you elect not to undergo the necessary breast lift.
Q: Will I lose sensation in my nipple?
A: There can be some loss of sensation in the nipples following a mastopexy though this is usually temporary. A vast majority of women retain most if not all of their sensation. It is extremely rare to have total loss of sensation.
Q: My breasts not only became droopy after pregnancy and breastfeeding, but they are also smaller than they used to be. Can I get them lifted and enlarged at the same time?
A: Yes. Most women undergoing a breast lift also choose to have them enlarged as well.
Q: Is a breast lift permanent?
A: No. Your breasts will continue to droop with time. This is due to the loss of elasticity of the tissues and the effects of gravity. If you maintain a stable weight and wear a supportive bra, the results will last longer.
Q: Can I prevent my breasts from continuing to sag?
A: Unfortunately, you can’t totally prevent your breasts from sagging with time but you can slow down the process. What can you do? Wear a supportive bra on a regular basis, minimize weight fluctuations, stay in a good nutritional state, and avoid tanning your breasts whether by the sun or in a tanning booth. There are other important factors that you have no control over including heredity, age and hormone levels. Large breast implants also will have a much greater impact on sagging compared to smaller ones.
Male Breast Reduction (Treatment of Gynecomastia)
Q: Is it rare for a man to have enlarged breasts?
A: No. In fact, it is a very common occurrence. Most of the time it is a result of persistence of the enlargement that commonly develops during puberty. Some of the other causes include obesity, anabolic steroids, certain medications and marijuana.
Q: I feel very self-conscious about my breasts, which are large and feminine looking. How can they be treated?
A: Depending on the exact nature of your gynecomastia (enlarged male breasts), treatment can usually be accomplished by either direct excision of the abnormal breast tissue or by using liposuction with or without the direct removal of enlarged breast tissue.
Q: Where are the incisions placed for the surgery?
A: The incisions can be placed around the lower part of the areola (colored portion around the nipple), in the armpit, or in the crease at the bottom of the breast. These usually heal well and can be fairly inconspicuous.
Q: What happens to the extra skin?
A: If you have good skin tone (elasticity), it will usually contract and contour to the underlying structures. In situations of massive breast enlargement or considerably droopy skin, excision of the excess skin may be warranted.
Q: How soon after surgery can I return to work?
A: Depending upon your job and the need for pain medication you may be able to return to work within a few days. If your job is physically strenuous then it may take a week or more.
Q: I had a mastectomy 7 years ago but wasn’t ready at the time for reconstruction. Is it too late now?
A: No, it is not. Some women elect to start with the breast reconstruction at the time of their mastectomy which is known as an immediate breast reconstruction. Others wait until they are ready, either mentally or physically, which could be at any time after their mastectomy. This is called delayed reconstruction and there is no time limit.
There have been substantial advances in breast reconstruction, even over that last five to 10 years, that have translated into significantly better results than ever before for women who have had either mastectomies or lumpectomies.
Q: I had reconstruction on my right breast and like the results. Unfortunately, at the time, I didn’t want to do anything with my left breast to have it match the right side better and now I find that it is difficult to wear certain bras and clothes because of the differences. What can I do?
A: To obtain closer symmetry, a procedure can be performed on the other side. Depending on the difference, it could require an enlargement, lift or even a reduction. This compensatory surgery is considered to be reconstructive in nature, not cosmetic, and should be covered by your insurance company.
Q: My general surgeon just diagnosed me with breast cancer and recommended a mastectomy. She told me that I would be a good candidate for immediate reconstruction. Because I have large breasts, she thought that I may be able to have the reconstruction using breast implants but recommended that I see a plastic surgeon. If breast implants are an option, which is better – saline or silicone ones?
A: It is important that you consult with a reputable board certified plastic surgeon who is experienced in breast reconstruction. He/she will review your medical history, examine you and then lay out your options and which one he/she thinks is best for you. If breast implants are recommended, then the pros and cons of saline and silicone particularly as relates to reconstruction can be discussed.
My personal opinion from more than 35 years of experience doing breast reconstruction is that silicone implants provide far superior results in essentially all aspects as compared to saline implants. This includes important issues like appearance, feel, durability, naturalness, shape, flexibility and stability.
If you have additional questions about breast enlargement, breast lift, breast reduction, male breast reduction or breast reconstruction, please contact the Arizona Center for Aesthetic Plastic Surgery today.