Daniel C. Mills, II, M.D., FACS
I've had breast implants for the past 11 years. I've lost feeling in the nipple area on one of my breasts. Will this numbness ever go away? If I had another surgery on the breast, would the feeling come back?
I have not had a patient who had feeling in their nipple after having surgery, which then lost feeling 11 years later. Unfortunately, when the surgery is completed, if there is no feeling to the nipple after surgery, and it hasn’t returned in the next year, it is usually lost. This is more frequent with the periareolar incision (5 to 15 percent). The inframamary incision loses nipple sensation less (3 to 5 percent) and least with the armpit incision (1 to 3 percent).
Sorry, but if it is numb now, and has been for years, it probably will not come back.
My areolas are very small, barely 3/8 inch in diameter (not quite 1 cm), of which most is nipple. I am 5 feet tall, weigh 98 pounds and have never had a child. If I were to get submuscular implants filled with 290cc of saline, can I hope for an increase in areola diameter?
Yes, I would expect for your areola to increase in size some. This is variable depending on the size of the implants, and if placed under or over the muscle, and the properties of your own skin and elasticity of the skin. It is impossible to know exactly how much, but it would be wider.
We are the parents of an 18 year old Korean daughter who is built very small by nature. Although she is 18, she looks extremely young (12). She is self-conscious of her small breasts and wants larger breasts “because it will make her happy.” As her parents, we feel that she is very well adjusted and very intelligent. She is in college, still lives at home, (commutes back and forth to college), and presently holds two jobs. We are not in favor of her having breast augmentation surgery at this point in time and would like for her to wait until she is a little older to make this decision. Please offer your advice as to how we go about approaching her with this, and also what facts can we give her about having this surgery at such a young age.
There are at least 3 aspects to this question, not all have the same focus.
Medically---There is probably not much chance of her breasts developing more now, but it could happen. I don’t know if she is or has been on birth control pills. Sometimes that will be the start of hormonal growth that increases breast size. Another would be pregnancy. That could start more breast growth. She probably will not have many other influences on her breast growth.
Legally---She is over 18, and so can, and probably will, have this done on her own. If she pays for it all on her own, she will be tempted to pay the lowest fee that she can find, and that usually isn't the best surgeon (sometimes not even a surgeon). There is no way legally to stop her.
Family---I would encourage you to go with her to consults, and be supportive. Help her pick out a Board Certified Plastic Surgeon, who does a major amount of Aesthetic Surgery. You could have these conversations with her surgeon and her at the same time. If it was me, I would help her with the cost of surgery to the point of picking a good Plastic Surgeon. This way she would be invested into the surgery herself. You said she had two jobs. So if she can do it by herself, by your helping, you gain her confidence more, direct her to a good surgeon, and show that you are being supportive of her ideas.
I had saline implants in 1998. I just went for a yearly physical and my doctor discovered a lump in my breast. He sent me for an ultrasound and I was given a diagnosis of “some irregularity possibly due to implant.” This diagnosis seems very vague. Should I be concerned and can breast cancer be missed because they assume that it is an implant related issue?
I had a patient that had this exact question of me this last week. She was very thin, so we could feel her saline implant valve that was on the front of the implant. There was some small scar tissue imbedded in the valve that showed up on the ultrasound. You could feel it, only because she was so thin. There is no question, that sometimes this scar forms at the valve. There could be other reasons for this diagnosis that should not be ignored. I would suggest that you go see your surgeon with the ultrasound in hand, and have him also do a physical exam. This also is important, as you may have your implants over, or under the muscle. If yours are totally under the muscle, they would not be in contact with your breast tissue but with your muscle. If this is the case, I don’t think that you have to worry as much about the implants hiding breast cancer. This needs to be correlated with a physical exam.
What is the advantage, if any, of removing implants from my breasts and then waiting 3 months to replace them?
I have saline implants that have been in for 20 years. I am experiencing pain in right breast and my doctor says they need to be replaced. He wants to do it in 2 separate procedures 3 months apart. I would like to know the benefits and risks of doing it this way.
I do not know of a reason to wait 3 months after removing the implant for reimplantation other than infection. You should go in for another consultation and see what the physical exam shows. If it is a simple removal and replacement, it could be done at the same time. Good luck