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FAQ - Breast Augmentation

Patients must be 18 years of age or older, be in good health, have appropriate expectations for their surgery, and have an adult support person be with them in the first 24 hours after breast augmentation surgery.

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Women within three months of pregnancy or breast feeding, women in poor physical and emotional health, those with unrealistic expectations about what can be achieved with breast augmentation and those without a post-operative support person.

You should be at a stable weight. And, if possible, you should be close to your ideal weight. A significant loss of weight after receiving breast implants could alter the results in a way that is not satisfactory to you. There could be some ptosis (drooping) and a reduction in breast size. A significant gain in weight could cause an increase in breast size.

Not necessarily. A large percentage of women have breast augmentation before having children. However, if one is actively trying to get pregnant or intends to become pregnant in a year or two after surgery, then breast augmentation should be postponed until after pregnancy.

Some sagging and deflation of the breasts often occurs after pregnancy and the added weight and volume of breast implants may make such changes worse than they would be if implants were not present.

The ability to successfully breast feed varies for all women with or without breast implants. However, studies have found that breast augmentation can interfere with a woman's ability to breast feed (lactate). One study published in 1996 by Hurst compared 42 women with implants and 42 women without implants. The study found that "a significantly greater incidence of lactation insufficiency was found in augmented women compared with nonaugmented women (P < .001). Among 42 augmented women, 27 (64%) had insufficient lactation, compared with only three (less than 7%) of the 42 nonaugmented women. Augmented women who experienced sufficient lactation were equivalent in age, ethnicity, type of delivery, smoking, previous breast-feeding experience, and lactation course compared to augmented women with lactation insufficiency. However, the type of breast incision was significantly associated with lactation outcome. More specifically, it was the periareolar approach that was most significantly associated with lactation insufficiency.

In addition, a review published in 2007 by Michalopoulas concludes: "with good surgical technique and proper postoperative management, most of the complications associated with surgery that may result in insufficient milk production can be minimized but not always avoided. Compared with nonaugmented women, women who have had augmentation surgery have a higher incidence of lactation insufficiency."

We generally place the breast implants in the subpectoral space, also known as "under the muscle." However, there are a number of important considerations that factor into this decision and in some cases we do place implants in the subglandular location, known as "above the muscle." For detailed information please click this link: Learn more about breast augmentation muscle placement.

This depends upon multiple factors, such as the type of breast implant you receive, the natural shape and size of your breasts and whether or not there is any degree of capsular contracture. In most cases, breast implants are soft and fluid and move naturally. However, in women with very small and tight breasts and skin, or in those with capsular contractures, the implants may be somewhat firm and immobile and not move like a naturally large breast.

Insertion of implants can cause stretch marks, but this is not a common problem. Choosing a small to moderately sized implant will help to minimize this risk.

This depends on the characteristics of your breasts. Most of the major swelling will resolve with the first 6-8 weeks and the implants will be in good position. However, this is true in those women with soft and slightly loose skin. In patients with small breasts and tight skin, it often takes 3-6 months for the tissues to relax and for the breast implants to settle. We have seen, in some very tight breasts, the implants take 9-12 months to fully settle. To illustrate this point, please see breast augmentation recovery photos.

We advise that you perform implant massage twice daily, beginning about one week after surgery. You will push down (toward your ribs) on the edge of the implant to displace it in all directions around your breasts. We recommend that you hold the implant in a displaced position for about 15 seconds and that you repeat this five times in all directions. You should be lying down (supine) when doing these, as the implants will move much easier in this position, as the overlying muscles will be relaxed. Note: in some cases Dr. Connall will recommend a certain pattern of massage based on your specific case and needs. We ask that you don't begin massage until we review this with you during you first or second post-operative visit.

Breast Massage Instructions

We recommend that you massage your breasts, beginning about one week after your surgery. This implant displacement massage is to keep the soft tissue "pocket" around the implant open, soft and supple. It is hoped that with massage the pocket and developing soft tissue capsule around the breast implant will stay a little bigger than the implants, allowing the implant to move freely and naturally with your breast. Also, we like for the pocket to stay open, especially early on while the muscle and skin are still relaxing and the implants are "settling". Finally, it is hoped that massage will limit your risk of the soft tissue capsule from shrinking and squeezing on the implant. Such shrinking of the capsule is termed: capsular contracture. Implant massage is the only thing that may help prevent capsular contracture, so we definitely recommend it.

At least until your implants have fully settled, usually about three months. However, it is reasonable to continue this practice, at least a few times a week, for as long as you have implants.

Generally, a soft, comfortable bra, without under-wires is most appropriate. In many cases we want the implants to "drop", so we want you to avoid a lot of support. In fact, many women wear camisoles and tank-tops with soft built-in bras. After your implants have settled, you may then wear any type of bra. However, in some cases when the implants are in good position early on, we will recommend a very supportive bra to hold the bases of the implants in place. This is especially true in complex cases where the lower breast fold must be adjusted or reconstructed. In each case we will give recommendations on your bra choice.

For the first week, don't worry because we will provide you with your first post-operative bra.

Yes. These noises have been described as anything from a squeaking to a sloshing or gurgling. Noises from the breasts after breast augmentation are the result of air bubbles or fluid in the space around the implants. Within a few weeks after surgery, the air and fluid completely absorb the noises and the noises cease.

No, Dr. Connall does not use drains after breast augmentation.

No. With our gentle surgical technique we find that our patients do well with pain control and do not require the added, risk, hassle and expense a pain pump causes.

No. You will simply be placed in a comfortable post-surgical bra that we supply.

Yes, and for any surgical or invasive medical procedure. For women with breast implants standard antibiotics should be given before the procedure and can be prescribed by your dentist or doctor.

Inverted nipples are not corrected with breast augmentation and will generally be unchanged from their pre-operative state.

Yes, during breast augmentation inverted nipples can be corrected with an additional procedure. However, for breast lifts and reduction, a case by case decision is needed on the safety of including inverted nipple correction.

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