Like Goldilocks, some women think their breasts are too big. Others think they’re too small. And amazingly, a small minority of women think their breasts are just right. For women who want larger, fuller breasts, breast implants are a safe, highly successful way to get the breast size they’ve always wanted.
Breast augmentation is typically performed to enlarge small breasts, underdeveloped breasts or breasts that have decreased in size after a woman has had children. It can also make your breasts more symmetrical if one breast is significantly larger than the other.
Breast Lifts can restore the shape and contour of your breasts, helping you to look better in clothing, and feel more confident about your appearance. As a woman ages, she may become unhappy with the appearance of her breasts if they have sagged as a result of pregnancy, weight loss, or other factors.
Breast Revision is performed when patients have their breast surgery corrected or redone. Patients might want to perform this procedure if they decide to change the size of the implant, if there is implant leakage, if there is an implant shifting, or if the skin elasticity has changed.
How do you choose the right breast implant for your body? Well, the answer really depends upon your goals and the tradeoffs you wish to make. Dr. Beran will sit with you during your consultation and help you make the choice that is best for you. There is not one right choice for every woman.
Silicone implants generally feel more “natural” than silicone implants and have less chance of “rippling”. Saline implants are much less expensive. There are some other differences between the two types of implants and we have included a quick overview to aid in your decision:
Silicone Breast Implants:
• All the silicone implants Dr. Beran uses are made in America and are FDA approved
• The implant is filled with a cohesive gel, not a liquid.
• The gel has a consistency that resembles the natural feel and resistance to pressure of breast tissue
• The implants are filled at the factory. The implants are available in a huge selection of shapes and sizes.
• The implants are available in four projections: Moderate, Moderate Plus, High Profile and Ultra High Profile to allow the doctor to give you just the look you want.
• Our MemoryGel® Breast Implants are covered by the Mentor Premier Advantage Warranty.
Saline Filled Breast Implants:
• All the saline implants Dr. Beran uses are made in America and are FDA approved.
• These implants are filled with a saltwater solution directly from an IV bag. The solution is identical to that used in your IV during your surgery.
• Saline implants have a slightly firmer feel than gel-filled implants and don’t mimic breast tissue as well.
• Saline implants are more likely to show ripples.
• The ultimate volume of the implant can be adjusted by Dr. Beran during the procedure.
• You can choose from three projection options: Moderate, Moderate Plus and High Profile.
• Our saline implants are covered by the Mentor Standard or Enhanced Limited Warranty and Lifetime Replacement Policy.
Preoperative: You will see Dr. Beran the morning of your Breast Augmentation surgery. He will sit with you and review your choice of implant size, incision location, and type of implant one last time. Photos will be taken at that time. In addition, you will meet our anesthesiologist who will answer your concerns and questions about anesthesia. After you are certain of your decision, you will sign a surgical consent and be brought into the operating room. Your companion(s) will be escorted to the waiting room or directed to the cafeteria in our building. You do not need to have someone waiting with you.
Surgery: One of our nurses will drape a warm blanket over your shoulders (operating rooms are always cold) and escort you into the operating room. Our anesthesiologist will check your IV and you will go to sleep. The surgery itself will take between 30 and 45 minutes. You will be given a long-acting local anesthetic while you are asleep (like Novacaine) that will last about 12 hours. When the surgery is done, you will awaken with a bra, a strap, or just a simple dressing.
Recovery room: You will spend some time in the recovery room. Usually an hour or so. Your companion will be able to sit with you at this time. When you have recovered, we will review your discharge instructions and bring you to your car.
The first night: You should rest at home. You may be a little sore and will certainly feel a little “out of it” for the first night. Most patients tell us that the discomfort feels like a work-out soreness. Dr. Beran will call to check on you. Our surgery center will call you the day after surgery to check on you as well. You may remove the gauze over your incision and shower 48 hours after surgery.
First postoperative visit: Your first visit after surgery will be about 5-6 days after surgery. Dr. Beran will check your incisions and review your care. All sutures are dissolvable and no stitches need to be removed. You may be instructed to wear a bra, a superior compression strap, or both.
Second visit You will return to the office about 2-3 weeks after surgery and Dr. Beran will instruct you on massage to keep your breasts moving within the pockets. This will help keep the implants soft. You may resume most normal activities. You are not allowed to do push-ups or other pectoral work for at least six months. Dr. Beran will examine the feeling and location of your implants.
Breast augmentation surgery is designed to improve shape, size, and cleavage of the breast. In almost all cases, the implants (saline or silicone) are placed under the pectoralis muscle. This helps to improve both the feel and appearance of the implants as well as decrease the chances of capsular contracture (a firmness that can occur around the implant). You should continue to obtain your normal mammograms after implant surgery.
The incision is a little more than an inch long. It can be a bit smaller for saline implants because they enter the pocket of the breast empty and get filled once they are inside.
Location of incisions:
Inframammary – under the breast. This is the most common incision. The scar lies within the fold of the breast. This incision is the most direct to the implant pocket. The scar is almost always covered by the overlap of the enhanced breast.
Periareolar – around the bottom of the areola (the pigmented skin around the nipple).
This is the second most common incision. The scar is more visible at the beginning, but after it fades can be almost impossible to see. Although the scar is nearer the nipple, the actual surgery does not go through the breast tissue at that point. This helps preserve the ability to breast feed and minimizes the risk to nipple sensation.
Transaxillary – through the armpit.
This is the least common location. The scars can be very visible if they don’t heal perfectly and they can be seen when you are wearing a bathing suit or some workout clothes.
The long distance between the incision and the lower edge of the muscle makes it more difficult to place the implant precisely.
Breast feeding – Generally speaking, breast augmentation surgery will not interfere with breast feeding.
The Connecticut Department of Public Health (DPH) has been working with other states and the Centers for Disease Control and Prevention (CDC) on an investigation of a cluster of nontuberculous mycobacterium (NTM) cutaneous infections among East Coast residents following cosmetic surgery procedures performed in the Dominican Republic. Two cases have been identified in Connecticut residents. This communication is meant to alert healthcare providers to this ongoing investigation and ask that additional cases be reported to DPH. Please share this communication with other providers in your facility.
All reported patients are women (age range 28–50 years) and all report having undergone elective cosmetic surgery procedures (including liposuction, abdominoplasty and breast lifts or reduction) in the Dominican Republic in July or August 2013. Symptoms have included abdominal abscesses, pain, wound discharge, and fever. No deaths have occurred. Five wound cultures have been positive for Mycobacterium abscessus or chelonae. Treatment has included hospitalization, surgical debridement, and intravenous antibiotics. Available isolates are being sent to the CDC for molecular typing. Outbreaks of NTM infections associated with medical tourism to the Dominican Republic have occurred in the past.
A proven link to a single clinic facility in the Dominican Republic has not been confirmed but there is a concern for other U.S. residents who may have undergone cosmetic procedures in the Dominican
Republic and may be at risk for similar infections. Healthcare providers should be aware of these cases and obtain specimens for mycobacterial culture from patients with cellulitis, soft tissue infection or cutaneous abscess after travel to the Dominican Republic for cosmetic or plastic surgery. Providers are asked to report cases of cellulitis, soft tissue infection or cutaneous abscess in which NTM has been identified in patients with a history of cosmetic or plastic surgery in the Dominican Republic since July 1, 2013 to the DPH Epidemiology and Emerging Infections Program at 860-509-7994.
(Above adapted from 2013 Alert #38, released by the New York City Department of Health and Mental Hygiene December 5, 2013)
Although there is no expiration date on breast implants, they are not lifetime devices. However, there is a common misconception that implants, whether saline or silicone, only need to be replaced if there is a problem with them. Even though a problematic issue with any implant should be addressed immediately, it is just as crucial for women with breast implants to have regular check-ups to monitor their breast health.
As part of a routine physical check-up, it is important for a health professional to do breast exams regularly. Breast exams should be scheduled every three years for women over the age of 20 and yearly for women over the age of 40. The examination will focus on any changes in shape, size, or symmetry of the breasts, along with any skin changes such as rashes, redness, or dimpling. With or without implants, regular check-ups are crucial for early detection of breast cancer and other abnormalities.
Unfortunately, there are a number of complications that can arise with having breast implants, requiring the patient to undergo a second breast augmentation. Among these complications are implant rupture and capsular contracture.
A rupture is a tear or a hole in the outer shell of the breast implant that causes it to leak. As time goes on, the risk of implant rupture increases. With saline implants, the body typically absorbs the saltwater solution, which leaves the saline implant deflated and causes an obvious change in size and firmness of the breast. Silicone ruptures vary in that the gel is thicker and may remain in the shell or the scar tissue that forms around the implant. Silicone implant ruptures may be undetectable to the human eye, which is why periodic MRIs (magnetic resonance imaging) are important. In both cases, the ruptured implant should be replaced.
Capsular contracture is another complication that will lead to implant replacement. This occurs when there is a hardening in the tissue surrounding the implant in one or both of the breasts. Sometimes, this hardening can be painful. Although the cause of capsular contracture is unknown, it may happen at any time after the primary procedure.
Therefore, given there are no complications, breast implants typically last between 10-15 years and replacement should be considered. Aside from the natural gravitational pull that will cause breast implants to sag, other operations may also be considered as time lapses. This may include changing the size of implant or a lift in the breasts. Considering the individual needs of each patient, a consultation with a board certified plastic surgeon will determine when replacement is best.
If your desire is to achieve beautiful breasts through augmentation or if you are considering breast implant replacement, Dr. Samuel J. Beran offers many different types of cosmetic surgery procedures to provide you with healthy, natural looking results. To schedule your consultation with Dr. Beran, please call us at (212) 792-7938 or fill out our contact form.
Childbirth often comes with a great feeling of empowerment and satisfaction for new mothers. Their body has nurtured a child for nine months and has triumphantly overcome the painful process of giving birth. It is quite an accomplishment. However, most women would agree that the positive feelings that come with giving birth are also met with negative feelings about their new post-pregnancy body. Although the baby is now the primary focus, many wonder if something can quickly be done to remove the excess skin and stretch marks that result from pregnancy.
The answer to that question is yes, a tummy tuck (“abdominoplasty”) MAY be undergone immediately following childbirth, but this is not advised. A tummy tuck can remove the excess skin that was stretched, along with some of the fat that accumulated in the midsection. Stretch marks can sometimes be removed in the process, and separated abdominal muscles may be brought back together. However, more satisfying tummy tuck results can be achieved if the mother waits at least six months to go through with the procedure. After childbirth, the uterus is still enlarged, and most women carry some extra weight from the pregnancy. These two factors can inhibit the best possible results from tummy tuck surgery.
If a woman went ahead with the tummy tuck procedure immediately after childbirth, she would almost certainly have some recurrence of loose tissues (skin and abdominal muscles) due to any weight loss and shrinking of the uterus. If this does occur, a revision tummy tuck performed later on may not provide the best results when compared to an abdominoplasty performed after the patient’s body has returned to a more stable state after pregnancy. Most surgeons advise waiting at least six months to a year after childbirth to get the best results with a tummy tuck. It is also best to be finished having children before considering the procedure, as a subsequent pregnancy will negatively affect the abdominoplasty results.
If you are interested in the tummy tuck procedure in New York City, please contact Dr. Beran by calling (212) 792-7938 or filling out our contact form today.