Saline Breast Implant Registry Questions and Answers

Question:

Is it safe for me to have breast implants? I had a benign lump removed from my breast, but the report said atypical hyperplasia? Thank you

Answer 1:

Yes, the fact you have had a benign lump is no contra-indication for breast implants. In my opinion you should have the implants positioned under the muscle, which will make detection of any future lump easier than if they are over the muscle. David M. Metzner, M.D. 504.885.9555 985.892.4675 866.298.5249 toll free

Answer 2:

Dear Jill, Atypical hyperplasia is a controversial diagnosis with a tendency toward possible future breast cancer. What is the history of breast cancer in your family? How long ago was the lump removed? How old are you? Is your mammogram clear? These are all the things that need to be discussed with your plastic surgeon before having any procedure performed on your breasts.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

i had a breast implant about 2 yrs ago and i was wondering how they enlarge them more if you want them larger.

Answer 1:

You will need another operation to replace your current implants with larger ones. David M. Metzner, M.D. 504.885.9555 985.892.4675 866.298.5249 toll free

Answer 2:

Dear Laurien, The current implants are removed, a larger pocket is created and new, larger implants are placed. This is usually less painful and easier on you than the original surgery. Most of us remove any capsule present at the time of the surgery. Drains are seldom used. The cost is similar to that of the original surgey.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am interested in breast augmentation, specifically breast implants. I am wondering how safe they are and are most clients happy with the results? If I am not happy with the results what are my options? I am also wondering how natural looking and feeling are they, is there a particular implants that is better over another? Just a few questions,Thanks

Answer:

Breast augmentation is a safe procedure. My recommendation is to make an appointment with a plastic surgeon and schedule a visit.

Question:

I have some questions that I would really appreciate a response to. First, I had breast implants done approximately 16 years ago (silicon) I was 25 years old at the time. I now am faced with "capsular contraction" (I believe that is what it is called, hardening and discomfort of the breasts). I would like to know what the success rate is for successfully replacing the implants and not having the problem reoccur. Is it possible to have the upper and lower eye lids lifted at the same time as this replacement surgery? Also, one question that I am very embarrassed about since I have never heard of this problem before, is there any surgery that would alter the appearance of "extremely" long vaginal lips, I take the word "extremely" from an obstetrition who must have felt that since I was in labor that I would not be sensitive to his remark "she has extremely large vaginal lips". Please answer this question, it has made me very self concious even though my husband says its great!

Answer:

Dear Donna, The capsular contracture is a difficult problem and recurrence is common (at least 50% from published studies. It is reduced by the use of textured implants and also by placing the implants under the muscle (a less natural position but one which better "hides" the implant. Eyelid surgery can very safely be performed at the time of explantation, removal of the capsules and replacement surgery. The vaginal lips question is very common. Often women are uneven on the two sides and require evening of the lips. The labia minora (proper term) reduction is commonly performed in my practice (about once or twice per month) with excellent results. Make certain that they are not over reduced, your husband won't appreciate it.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am scheduled for a breast augmentation surgery in one week. My surgeon has given me several choices of incision sites--Under the breast, axilla, nipple, or unbilical region. I am very familiar with the under the breast approach, but not so familiar with the navel/umbilical approach. The staff at the surgeon's office really are pushing for the umbilical approach where there will be no scarring in the breast area, but I am hesistant as I know very little about this procedure. Are you familiar with this approach? Do you think that this procedure is easier to rehab from? Do you think that the implants will be put in with the accuracy as they can be with the slit under the breast?

Answer:

Smaller scars are achieved with a navel operation. Normally, whether I place breast implants in via the inframammary, periareolar, armpit approach, the incision is only about 1.5 inches. I get great exposure and see everything very easily and I am "right there". Is an 1.5 inch incision too big? I do not think so. I see no advantage placing implants in via the umbilicus.

Question:

I had breast augmentation 2/01. It was planned that I would receive textured implants. After the surgery my Dr. advised me I had too thin of skin for textured. I requested my original breast size of 36D (after babies & weight loss I was a 36B). I am 40 years old. My main concern is that the implants look and feel rippled (all the way around), as though they are too large for the size I requested. It is as though there is too much material for the fluid amount. Is this possible?

Answer:

Dear Teresa, Although it is possible it is unlikely. Breast implants are filled within the requirements set forth by the implant companies and sometimes even more so. If your surgery was performed by a competent plastic surgeon with many implants to choose from, it is unlikely that he/she would underfill the implant. I am not certain why you did not receive a textured implant since this is possible to be placed even in very thin individuals and texturing seems to reduce the incidence of capsular contracture down the road. Rippling is an inherent problem with any implant that is filled with saline - as they all are in this country at the present time.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

My wife may be interested in breast implants. Her major concern is that her family has a history of breast cancer. Do the implants "get in the way" when detecting a lump?

Answer:

Dear Scott, Many studies have been done on this subject, most of which showed no delay in detection of breast cancer with implants. Special views are needed by mammogram or, better, MRI in detecting early breast cancer. Depending upon the type of breast cancer and its inheritable characteristics, a better determination can be made of the risk involved. I would suggest that you and your wife visit with a qualified plastic surgeon in your area to determine if the risks are warranted.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Can you tell me more about the "tear-drop" type breast implants? And how much do they typically cost? Are they less dangerous? Thanks.

Answer:

Dear Sheila, Anatomical implants are meant to give a more contoured look to the woman when she is in upright posture. They have largely been overated and can give a strange look to the supine (lying down) chest. They are no safer and are still filled with salt water which will always have problems with looking and feeling natural. They cost more than standard implants and thus the cost of surgery is more as well.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had breast implants in 1989 and am now having extreme severe pain in my right breast, pain, limited and restricted use of my right arm and slight pain in my left breast,as well as numbness in both arms?? I have no insurance as I am current unemployed and single. I need financial assistance from a physican pending the class action settlement, is there any reputable doctor that will help me???

Answer:

Dear Judy, Don't count on much help in the future from the class action suit. Most people with implants will end up receiving very little. Insurance will not cover the costs of any complications from cosmetic procedures such as this. The pain is likely due to capsular contracture. I would suggest that a relatively inexpensive and, likely, curative procedure would be the removal of the implants and capsule removal. I know of no surgeons who will perform this surgery free of charge. You could perhaps approach the surgeon who placed them for you to see if he could help you in some way with your problems.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am wondering if there are any surgeons out the that would perform surgery to remove breast implants that have caused great medical conditions, to the point of my going on Social Security Disability. I would sell my soul the have them removed but am unable to pay for the procedure. So, I am looking for a surgeon that would consider doing this as an act of humanity for a desperate woman? Does anyone out there know of such a person/surgeon/doctor? This is a critical situation. Can someone help me?

Answer:

Dear Shauna, Many of us do and perform charity cases on a regular basis. Since your decision to have breast implants in the first place was a cosmetic decision very few if any would remove them free of charge - especially since there has been no study to show a relationship between breast implants and disease. I would suggest that you visit with the surgeon that placed them and see if he/she would do the procedure for a minimal fee.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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