Breast Augmentation (Breast Implants) Questions and Answers

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Question:

Are the methods for breast enlargement other than surgery(i.e., creams, other methods) worthy of my time? Meaning--do they work? If so, what do you recommend?

Answer:

Dear Jennifer, They do not work. I have had literally hundreds of patients who have tried all of these and none have found any effect other than to lighten the billfold. Sorry that the answer is not that easy.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had breast augmentation done 18 years ago. About 2 yrs ago I developed a golf ball size lump on one breast. They have done mamograms, sonograms, etc. and and found nothing "wrong." Occasionally this causes some minor pain. I was told by one doctor that this could be scar tissue forming around a tear. I want to have them replaced. The doctor who did them originally has retired and I don't care for the doc who bought his practice. I'm not sure where to start or where to get recommendations. Also, can my situation worsen?

Answer:

Dear Marlys, You do not mention if you have silicone or saline-filled implants. I will take it that they are silicone and that you do have a tear in one with silicone extrusion. There is often a capsule around implants and this contains the contents when rupture occurs. This can slowly work its way out and the contents can migrate quite extensively. I would suggest replacement of all ruptured implants. They will be replace with saline-filled implants which do not look quite as natural as the silicone-filled ones (in my opinion - all else being equal. I would suggest that you visit with several plastic surgeons and use this web site to find one in your area that you do like. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am inquiring about a procedure that entails transfering fat from one part of the body (stomach) to another (breasts). I would like to know if such a surgery is possible, the name of the procedure, estimated cost, risks involved, and any other information you are willing to give. My goal in researching this type of procedure is to have more natural looking and feeling breasts. I have had two breast augmentation surgeries to achieve the size I want. I have gone from a small A-cup to a large D-cup with saline implants. I am very pleased with the results, compared to my appearence prior to the surgeries. However, it is obvious that I have implants when my breasts are touched and they are also very round. My plastic surgeon explained to me that this would be the result, I'm just wondering if there is anything that can be done to make my breasts look and feel more natural. I also would like to reduce the size of my breasts from my current D-cup (with implants) to a C-cup. Please let me know what you can about the procedure I mentioned and anything at all that may help accomplish my goal. Thank you very much.

Answer:

Unfortunately, fat grafting to the breast for enlargement purposes fails to work and can cause problems. Breast implants remain the best operation for breast augmentation even though this to can have imperfections. Perhaps, you are a candidate for silicone gel implants that are available to those women deemed saline implant unsuitable. Ask your physcian about this option

David Ross, MD
Chicago, IL

Question:

I had a breast augmentation done a year ago. (300 each side, saline). The results were bad: One side dropped and passed the infra mammary line and it looked bad. My doctor agreed to do it again (He claimed it was "my body's fault..") and I had another surgery done in the left side 3 month a go. It does look better then before- but I'm definitely not satisfied. You can see clearly that the implants are located in 2 different places (One implant is much higher). Besides that, one implant (The old one) feels much harder than the other one, and I'm worried about that. I'm pretty desperate, I don't know if it's even worth fixing and I don't trust my doctor anymore. What do you suggest? Can the hardness of the implants be dangerous? Would you recommend another surgery?

Answer:

The hardness is not dangerous and yes I would recommend seeing another doctor because it is possible to repair your problem. Call the American Society or Plastic Surgery to locate a qualified surgeon iin your area. The number is 1-800-635-0635.

David Ross, MD
Chicago, IL

Question:

I have a severe pectus excavatum (sp?) and am also considering breast enlargement. Any advice or information you can give I'd appreciate.

Answer:

These are opeartions that go together nicely in one operation.The best advice I can give is to be sure you choose a well trained board certified plastic surgeon. Call the American Society of Plastic Surgeons at 1-800-635-0635 for a qualified surgeon in your area.

David Ross, MD
Chicago, IL

Question:

I've had breast augmentation and my left breast doesn't look like it dropped as well as my right. Can this be repaired and how?

Answer:

Of course, you should consult with the surgeon that performed the operation but generally there is recourse for improving the problem you are experiencing. Provided, enough time has passed since the surgery to allow the implant to settle naturally than a surgery to reposition the left implant will be the solution.

David Ross, MD
Chicago, IL

Question:

Are silicone breast implants legal in any state? If so, where?

Answer:

If your question concerns silicone gel implants the answer is both yes and no. No, they are not legal for women seeking breast augmentation for the very first time. These women can only receive the silicone-saline implant. Yes, they are legal for women needing to replace their existing silicone gel implant or those needing reconstruction after mastectomy or for congenital(birth) defects of their breasts.

David Ross, MD
Chicago, IL

Question:

I have gone for several consults for breast augmentation. Some want to use smooth saline implants and others want to use textured saline implants. What are the advantages/disadvantages to either of these? What is the difference?

Answer:

Too long a discussion for an answer on e-mail. If you have gone on several consults for breast augmentation, why didn't you ask the surgeons these questions? Since you have not yet chosed which surgeon to perform your surgery, maybe you haven't seen your right surgeon. If interested, give us a call. 561-495-2705 and ask to speak with Debbie to set up an appointment.

Question:

I am considering breast augmentation and wanted to know if there is a doctor in the Atlanta GA area that has heard of and performs a procedure called Trans -Auxillery...where the implant is placed under the pectoral muscle in the chest. This is the procedure I am interested in having and wanted a listing of doctors in the area that have perfected and perform this technique. Any assistance/informationis greatly appreciated. Thank you in advance.

Answer:

Breast Augmentation can be performed a variety of different ways. One of them is the trans-axillary approach that you discuss. It may not be the optimal operative approach for you. It would be a good idea to find a good qualified Plastic Surgeon and discuss the operation that you want and the approach that you want. He/she may agree or disagree with you. Unfortunately, I do not know many plastic surgeons in that region. Check out the plasticsurgery.org website and select one that is in your area. Good luck. Maybe you would want to travel to Boca Raton Florida and have the operation performed by me! Good luck to you! JRBerman drb@drberman.com

Question:

Hi! I'd like to know if you could tell me how to choose the best place/doctor for having breast sugery. Is it best to go to a hospital, clinic, or elsewhere? Or does it not really make a difference. Are the fees more expensive with one than the other? Also, How do I find out if the doctor is "well-known" or the "right" doc for the job? I live in San Diego-- and have NOT a clue about anything here other than the Naval Hospital. If not mistaken, military insurance (TRICARE) doesn't cover this procedure, correct?? After child birth in Dec 97 I lost severel inches-- I've tried 2 different non-surgical ways (herbs) to get my size back, no such luck! I am scared to death of going to the doctor much less having surgery but will do it (after all I did have a child!) if I knew exactly how to go about finding all info needed, a great doc, and also depending on the final cost and if possible payment arrangements if they can be made and/or if my insurance covers any. Thank you for your time! I hope you can help. On another topic-- mole removal (if can be answered) What's the best procedue to remove them and the cost of removal. They are located on my stomach. Would there be a noticable scare left afterwards and/or would it leave a spot that woul no longer tan with the rest of my skin. (can ya tell me how painful/painless the procedure would be LOL) Thanks so much!

Answer:

Dear Jamie, Insurance will not cover any portion of a breast augmentation or breast lift procedure since they are cosmetic in nature. I would suggest that you look on the web on this site as well as ebody.com for board-certified plastic surgeons in your area. Then I would suggest that you visit with at least three of them. This may cost you some additional money in terms of consultation fees but it is well spent. I would then ask them for a few patients that you could call and discuss the procedure with them. There are many choices to make including placement of the incision, size and placment below or on top of the mucsle. Each surgeon may give you a different answer on these subjects but go with the one that makes the most sense to you. I always suggest that you be conservative in terms of size. Leave the details to hospital vs clinic to your surgeon since he/she must be competietive in your market. Do not go with the cheapest surgeon just because of price. Hope this helps you

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Are those so called breast enhancer pill really effective? and if you have implants what are the effects or is there any?

Answer:

Breast enhancer pills are generally very low levels of hormone which have been found ineffective for breast growth. There are many effects and possible complications from having breasts implants, the most common of which is the development of firm breasts over time and the need for futrther operations. I would suggest that you visit with a qualified plastic surgeon to discuss if the possible risks are overshadowed by the benefits of breast augmentation surgery - they are for many women.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Do herbal breast enlargement tablets, creams or estrogens really make breast bigger?

Answer:

No, not at all. If these worked, we would much prefer them to the use of implants. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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