Breast Surgery Mega-Site by Rebecca
The Original Breast Surgery Mega Site, with the Top Breast Surgeons,
before and after photos, breast implant info, breast lift surgery,
breast reconstruction and more since 1997!
Breast Surgery FAQ & Glossary
Some of the following explanations may be a matter of opinion. In those cases, we used the majority opinion based on feedback from our top breast surgeons and breast surgery patients.
Acellular dermal Grafts - (Flex HD, Alloderm, Neoform & Strattice) add structural support to internal repairs, strengthening the permanent suture placement, and adding soft tissue thickness, as well as potentially reducing recurrence of Capsular Contracture. More on Acellular dermal grafts by Dr. DeWire.
Additional Surgery - May be required if you incur complications, which will cost more in most cases. Ask your PS what his/her policy is. Some complications may be covered by your health insurance.
Age - Should not be a concern, we have seen many women in their 40s experience augmentations successfully.
Adjustable Implants - See Spectrum implants.
American Women - See before & after photos and Scars.
Anatomical Implants - Teardrop shaped breast implants for a more natural appearing breast. Some breast surgeons contend these anatomical implants are harder to place as the surgeon must be much more precise and the implant can turn upside-down. Read more about Anatomical Breast Implants here. If you want anatomical breast implants, find a breast surgeon willing & experienced with the anatomical breast implants.
Antibiotics - May be used to deter infection after surgery and in treating Capsular Contracture.
Anti-Nausea Medicine - Is available, including Zofran and Scopolamine, a patch you wear the night before. Ask your doctor. Here is a tip on the meds if you are getting sick: take the pain pill and cut it in half so if you are taking one pill every 4 to 6 hours take 1/2 pill every 2 to 3 hours.
Armpit Incision - See TransAx Incision
Asian Women - See before & after photos.
Aspirin - Do not take two weeks before or two weeks after as it can cause bleeding. See Pills & Rx page here.
Back Pain - Probably will not be a problem with implants as they do not weigh as much as real boobs, unless you get really large breast implants. Some experience some back pain during recovery.
Bacteria - The only way for bacteria to get inside the breast implant would be during surgery. Which means the OR was not sterile during surgery. If you find a good, ABPS certified surgeon this should not be a problem.
Band - Some breast surgeons will have you wear a band above the breast implants to help push the implants down. You can also roll-up a sports bra to act as a band.
Blood Clot - See Hematoma
Bras - Most breast surgeons suggest wearing only a sports bra after surgery. Some surgeons suggest not wearing an underwire for 6 weeks after surgery, some suggest wearing an underwire bra 24/7; follow your plastic surgeon's advice. You may find certain bras uncomfortable for a long time, T-shirt bras and other "plain" type bras tend to be the most comfortable as less and other fancy materials tend to itch newly augmented breasts. I always advise to do what your plastic surgeon says (provided you researched your PS well). I do not recommend wearing a bra all the time (after the initial period if the PS suggested it) because it sits tight on your lymph nodes which may not allow the lymph system to be properly cleansed. Underwires: make sure the wire goes around the outside of the implant to fit properly otherwise Underwires can leave an indent in your breast implant. Shop for bras here.
Enhancing Pills - Save your money, I even found 1 company that
was selling them using before and after photos from this site! Plus,
they are not approved by the FDA and can be dangerous. More on Breast
Enhancement Pills here.
Breast Feeding - According to La Leche League one can breast feed after with silicone or saline breast implants.
Breathing Tube - Used with general anesthesia. May make your throat sore for a few days.
- Can be expected, especially with larger breast implants and/or the armpit
incision. As with any bruise, it will heal. Do not massage bruises!
Ask your doctor about Arnica Montana (available at Health Food &
Vitamin Stores) to help alleviate bruising.
Cancer Detection - Will be much easier if you have your breast implants under the muscle. There have been several studies regarding breast implants and cancer. One study in Canada examined 11,000 women with implants and 11,000 without implants. The study concluded that there was no increased incidence of breast cancer among implant patients. In other words, implants do NOT cause cancer. Another study performed at the Mayo Clinic examined roughly 6,000 women with implants and 6,000 without implants to try and determine if implants impeded the ability to see cancers on mammograms. In other words, were cancers more developed before they were spotted in breast implant patients. The conclusion of this study was that they were not. In fact, there have been a couple of studies that have suggested that implants might actually have a protective effect against cancer. The idea here was that implants are foreign to your body and your body is always trying to reject the implants by sending immune cells to fight the implants. If those immune cells happen to come across a cancer cell, they will destroy the cancer cell. It is an interesting proposition but still needs more work. My father came into practice in 1961 and implants came on the market in 1962. I have seen patients from the beginning of implants to the present and we have not had anyone have a problem related to cancer, cancer screening, or implants. In fact, early on in my practice, I had one of my breast implant patients call me and thank me for doing her implants. Because she had implants, she was doing more self exams and had actually found a small mass that turned out to be an early stage cancer. She said that if she hadn't had the implants, she would not have been doing such self-screening and would probably have missed the mass until it was much larger and further developed.
Capsular Contracture (cc) - Scar tissue that forms around the breast implant which causes the breasts to harden (similar to what a contracted muscle feels like). This is the most common complication of breast augmentation. Textured breast implants help deter contracture because of its rough surface. It also helps to place the breast implants under the muscle. Massage and or compression of the breasts may also help deter cc. See more about Capsular Contracture Prevention & Treatment.
Cleavage - Can be improved with a larger and or wider breast implant. See Breast Implant Cleavage Revision photos below.
|Cleavage Breast Revision
Patient desired improved symmetry and shape of breast. She underwent pocket revision and exchange of her breast implants from saline to cohesive "gummy bear" silicone. See improved shape and contour of breasts, improved symmetry especially of the cleavage. Surgery by Dr. Repta.
Complete Submuscular, or Complete Unders: See Total Submuscular
Compression - Used to prevent Capsular Contracture. It is compression of the implant such that it takes up more space than it would in a more spherical shape. Mathematically they have shown that a compressed implant takes up more space than a non compressed one. What that means is that while it is being compressed the tissues around it are healing such that they are allowing the pocket to be large enough for the implant. It is a newer phenomena and there seems to be several docs using it. It can be achieved by wearing a compression bra continually, lying on your stomach or by the exercise (ask your breast surgeon). I have seen it suggested with both smooth and textured breast implants.
Corrective Taping - Using a tape technique to adjust placement of uneven breast implants.
Dentist - I've heard some breast surgeons prescribe antibiotics when you see the dentist, but usually it is not necessary.
Dog Walking - Please consult your doctor as to when it is safe to walk your dog after surgery.
Doctors - Finding the right plastic surgeon is the key to a good breast surgery result. Make sure your surgeon is Board Certified by the American Board of Plastic Surgery. Choose a surgeon you feel comfortable with. Check Our Surgeon Directory and read How to Check up on Your Surgeon.
Breast Augmentation - A small incision is made in the hollow of
the underarm and much of the surgery is performed under direct vision
using an endoscope. The procedure is visualized on a television monitor
allowing up-close and precise control of your breast augmentation surgery.
Endoscopic technique is optimal for achieving reliable, beautiful results,
when the underarm incision is used. The underarm scar fades over time
and blends into the skin creases well. The scar is usually not apparent,
even in a sleeveless dress or swimsuit.
Fibrous Cysts - Are very common.
of Implants - Implants feel a bit firmer than natural breast tissue.
Depending on how much tissue you have naturally will also make a difference.
Most men do NOT care, most probably wouldn't notice the difference anyway.
See How Men Rate Implants. NOTE: Contracture can cause the breasts to feel hard.
Gap - Implants create a gap between the breasts. This gap does not occur in natural breasts, as they slope down from the center.
Garlic Pills - Do not take two weeks before or two weeks after as it may cause bleeding.
General Anesthesia - Puts you completely out. Some docs prefer this so you won't move during surgery. However, make sure your surgery is in a hospital or accredited surgery facility. The JCAH usually accredits hospital facilities and hospital-based outpatient surgery facilities. The AAAASF specializes in accrediting outpatient or ambulatory surgery facilities. Ask to see the accreditation certificate.
Grafts - Acellular dermal grafts (Flex HD, Alloderm, Neoform & Strattice) add structural support to internal repairs, strengthening the permanent suture placement, and adding soft tissue thickness, as well as potentially reducing recurrence of capsule contracture. I personally have not seen studies on acellular dermal grafts but do have one friend who has used it to deter capsular
contracture (after two previous capsular contractures). According to the makers of Strattice it can increase implant coverage and reduce the incidence of breast implant visibility or ripples. I read, "Strattice has been shown to decrease the recurrence of capsular contracture." But again, no case or study was cited so where was it shown to actually treat capsular contracture. Strattice is an acellular dermis made from bovine tissue and has been used extensively for other problems involcing breast implants and breast reconstruction. The extra tissue provides more implant coverage and support. This may suggest it could reduce the recurrence of capsular contraction. More on Acellular dermal grafts by Dr. DeWire.
Hematoma - Is a blood clot that must be addressed by your doctor. To avoid, don't push yourself into doing things you shouldn't be. That's why you are not supposed to play tennis, golf, lift, etc. for 3-6 weeks after. Using common sense, you will be able to determine what you can and can't do. Also avoid certain drugs 2-4 weeks before and after surgery. The risk is about 2%, this risk is reduced if your surgeon dissects the muscle rather than cutting it as the cause is from uncontrolled bleeding during the surgery.
Although not a surgical emergency, it should be taken care of within a day or two of when it is noticed. The blood collection, as long as it is not enlarging, can be managed with ice, support, reassurance of the patient and waiting. It will usually liquefy in 2-3 weeks and can be easily withdrawn with a needle and syringe. This requires only local anesthesia and carries minimal risk to the health of the patient. If the surgeon does the procedure, he should be able to remove the blood without injuring the patient or the implant.
Ibuprofen - Not recommended two weeks before or two weeks after as it can cause bleeding, however, some doctors says it's ok.
Implant Life - The only research I found says 50% last 10 years. This is based on the older type implants. See Risks. Mentor & Inamed (formerly McGhan) now have a lifetime warranty with $1200 toward replacement surgery for the first 5 (Mentor) & 10 years (Inamed (formerly McGhan) ). Thus, I believe our current generation of implants will last much longer.
Incision - There are four possible incision locations. The areola (nipple) incision is probably the most common, followed by under the crease of the breast, the armpit, and the belly button. Whichever you choose, make sure your surgeon is experienced with surgery using the location you have chosen. Personally, I do not recommend the areola, as it can leave an obvious scar, as it did on me.
Local Anesthesia - I have to agree with LaurienRN when she says "Local with IV sedation (aka Twilight) is the way to go if your PS agrees. No tube in the throat and rarely if ever, any nausea post op. Generally used for short procedures and is very safe. You are in a twilight sleep, but you feel no pain and will not remember any of the procedure. Also, you come out of it very quickly. Less "looped" afterward. Also limits hospital stay if necessary, less bowel problems afterward. You need an IV in your arm to administer to drug, and you our sleeping within seconds of administration."
of Implants - After surgery, implants will ride high on the chest.
It will normally take 4-12 weeks for them to "drop" into place. The
more natural breast tissue you have and the smaller the implant, the
more natural the look. Keep in mind, most women wish they had gone larger!
Placing them under the muscle also allows for a more natural appearance.
As you age, your natural breast tissue will sag, the implant will not.
- Will be much easier to read if you go under the muscle. Mammograms
are sometimes suggested before BA for patients with a history of breast
cancer or to use as a base.
Massage - May be suggested to help reduce contracture. This is usually only done with smooth implants and may be suggested for a period between a few weeks to as long as you have your implants. Do not massage bruises! More can be found on Dr. DeWire's massage page.
Men - See What Men Think of Breast Implants here.
Disease or Cord - (pictured) Hardening or blood clot in a vein
leading away from the surface of the breast. This is a blocked vein
that it will go away in a month or two. If it is large or painful, you
can put a warm washcloth on the cord or to break up the matter that
is blocking the vein, massage the cord. Push on it and rub it and the
blockage will dissipate faster.
Navel Incision - Also known as the TUBA method. See the TUBA page.
Nausea - Is a common side effect of pain killers and anesthesia. Try taking pain meds on a full stomach. See "Anti-Nausea Medicine" above.
Nipple Sensation - Usually changes of being more or less sensitive after surgery and may take up to a year to return to normal. There is a small chance the change may be permanent. You may also experience a temporary burning sensation, but lessens with time.
Other Surgeries - May be planned for the same day. Recovery may be longer, but you will only have to go under anesthesia once.
Overfill - By overfilling implants, but not beyond the manufacturer's guidelines,
the implants will be less likely to ripple. However, with the more fill,
they become more firm. Mentor
& Inamed (formerly McGhan) Size Charts. Studies show overfilled
implants are also less likely to rupture.
Pain - You should not feel any pain during surgery. It is the first 24-72 hours that will get you.
Pain Meds - Coming Soon.
Physical Activity - You should be able to return to sports such as tennis and golf in 4 to 6 weeks. More details on the Tips page.
Pimples - Between the breasts may pop-up from your new cleavage. Can be alleviated with powder and/or a cotton ball.
PIP Implants - Have not been FDA approved. Pre-filled, made in France 888-700-9831.
Pregnancy - Most docs recommend you have children before a BA. See Breast feeding.
Recovery Time - Most women say BA really does you in for the first 24-48 hours. You must have someone with you for the first 24 hours, if not longer. If possible, allow yourself a week or two off from work, more if your work requires physical activity. If you have young children, have someone help you for a week or more. Please consult your physician as to when you may resume lifting your children! Please see the tips page.
Ridges - Depending on the implant size and the amount of natural tissue, you may notice the top ridge of the implant.
Ripples - Rippling comes from not having enough natural tissue to cover the implant or having a large implant. Having the implant filled all the way (overfill) may help deter the problem. Ripples are usually only seen when the body is in a certain position, which varies in each person.
Risks - Read Risks.
Rupture - See Deflation
Sag - BA automatically gives you a lift. If your nipple is below the crease of your breast, a "breast lift" may be necessary. Check with your surgeon and get several opinions.
Saline - Is salt water that is safely absorbed by the body. The shell of the implant is still silicone. These type of implants by Mentor & Inamed (formerly McGhan) have been FDA approved.
Scars - Your incision scar will be permanent, but most are light to nearly invisible. At first it may be thick & red, but should become thin and light. Vitamin A & E cream or vitamin E oil capsules, splitting them open, and applying the oil directly as often as possible. Neosporin may help (do not apply to fresh incision). I've also heard of using Rosa Mosqueta (which is essentially Rose Hip oil). Previous scar history does not indicate how your breast scars will heal. One breast surgeon states most heavy scars (aka: hypertrophic scars) occur in about 10% of crease incisions, about 5% of areola and less than 1% of axillary (armpit) incisions.
Sex - A friend of mine had sex two days after surgery. However, if you get your blood pressure up then swelling can occur, causing bleeding which can cause more scarring.
Shooting Pains - You may feel short, shooting pains in your chest after surgery. This is ok, but can continue up until about a year after. This is the nerves in your breasts regenerating.
Silicone - See our Silicone Page for silicone studies & research.
Sleeping - Will be a major problem the first few nights after surgery. If
you sleep on your stomach it will continue to be a problem, especially
with larger breast implants especially if they are saline implants. Help alleviate by
lifting yourself higher onto two pillows. I found that two feather pillows
inside of a sham works well. How to sleep with breast implants.
Smooth Breast Implants - Usually have less rippling and seem to be more appealing cosmetically. They tend to move more like natural breasts and not get "stuck in place" like textured breast implants can do sometimes. However, they are thought to be more prone to contracture and therefore, breast massage is recommended.
Smoking - Smoking causes blood vessels to constrict, decreasing the flow of blood and oxygen your body needs to heal properly causing recovery to take longer. Nicotine and carbon monoxide is known to inhibit recover time, increases the risk of pulmonary complications and can impede wound healing, which may decrease the quality of surgical results. Most plastic surgeons urge patients not to smoke for at least 2 weeks before and after surgery. Some plastic surgeons offer smoking cessation aids, such as oral medication or nicotine patches. Consult your plastic surgeon. If you cannot quit, please at least switch to an Electronic Cigarette. I researched them and found V2 Cigs to be recommended the most. Get $15 off a starter kit (use code 353355).
Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.
Stairs - Are not a problem, but, due to fatigue after surgery, don't go up and down too much.
Strap - Used by some plastic surgeons to help the breast implants migrate down into the breast pocket.
Steroids - A few doctors are using this in hopes to deter capsular contracture. It's safe to use when prescribed by an MD and only taken for a short period.
Stretch Marks - Are not common because breast implants do not increase the the projection of the breast as much as the base diameter where there is more skin. Stretch marks are common with pregnancy because this causes the breast tissue to enlarge. Stretch marks may be more likely with larger breast implants as there will be more stretching of the skin.
Strattice Grafts - Acellular dermal grafts (other brands: Flex HD, Alloder & Neoform) add structural support to internal repairs, strengthening the permanent suture placement, and adding soft tissue thickness, as well as potentially reducing recurrence of capsule contracture. According to the makers of Strattice it can increase implant coverage and reduce the incidence of breast implant visibility or ripples. Strattice is an acellular dermis made from bovine tissue and has been used extensively for other problems involcing breast implants and breast reconstruction. The extra tissue provides more implant coverage and support. This may suggest it could reduce the recurrence of capsular contraction. More on Acellular dermal grafts by Dr. DeWire.
Surgery Time - Takes about 2 hours, but you'll need at least 24 hrs if not a few days to recovery from surgery.
Sweat - Between the breasts may form from your new cleavage. May want to leave powder and/or a cotton ball between the breasts.
Swelling - Most women will experience swelling after surgery, especially with larger breast implants. Ask your breast surgeon about taking Bromelain (available at Health Food & Vitamin Stores) to reduce swelling after surgery. Approximately 500 mg is taken daily for seven days prior to surgery and for 7-10 days following surgery. One breast sugeon recommends taking the 500 mg in divided doses following each meal as in some people it may cause minimal gastric symptoms when taken on an empty stomach.
Symmastia - (aka "bread-loafing " or "uniboob") This is when the breasts implants
become like one breast. This is extremely rare. As long as you have
a good breast surgeon, this should not be problem. Correction surgery may be covered by your
Tanning - Is OK if you cover your nipples and/or the stitches although some surgeons suggest no tanning for up to a year.
Telling Others - Don't bother, unless you want to. People won't know unless you went extremely large or walk around in a bikini.
Textured Breast Implants - Textured breast implants help deter contracture because of their rough surface but tend to cause more ripples than the smooth breast implants, especially in thin women. Because the texture adheres to the body, they usually do not move around like a natural breast would either. Because of the thicker shell, they may feel firmer as well. However, if they need to be removed, small chips of the textured silicone shell may come off and be left behind. They do not need to be massaged.
Total Submusculofascial or Total Submuscular: According to a board certified plastic surgeon, the total "submusculofascial" approach has several advantages, including reducing the risk of Capsule Contracture. The implant is placed behind the pectoralis major and minor muscles, the serratus anterior muscle, the rectus abdominus and the external oblique muscles. There are several benefits to covering the breast implant with these 5 muscles. The external oblique and rectus abdominus muscles act as support for the breast implant so it helps reduce the risk of long-term 'drooping of the implant, (a.k.a., 'bottoming out'). Also, there is less problem with wrinkling/ripples of the breast because more muscles are covering the breast implant and mammograms should theoretically be more accurate. Note, although the procedure is called "Total or Complete Submuscular" the implants are not 100% covered by muscle.
Trans Axillary (TransAx) Incision - Armpit incision which leaves no scar on the breast and virtually no scar on the site 99% of the time. This approach remains the most difficult to learn and master consistently. Thus, be sure your breast surgeon is experienced with this incision. One plastic surgeon said waxing would be better than shaving because you only have to wax every few weeks, reducing the risk of ingrown hairs.
Under vs. Over the Muscle - Under the breast muscle is more painful however, over is directly underneath the skin and therefore, shows the outline of the breast implant more. Mammograms are easier to read with implants that are placed under. There are partial and complete unders.
Underwire Bras - If your surgeon recommends not wearing them, you can make a small snip in the bra and pull the underwire out. If your plastic surgeon recommends an underwire, make sure you get one that fit around your breast implants. It should go all the way around the implant and not indent into the implant or you could end up with an indent on your breast, especially with the silicone gel implants.
Viagra - Do not take 24 hrs before surgery!
Vitamin E - Is rumored to help in healing scars. However, it may cause bleeding after surgery so don't take 2 weeks before & after.
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