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George Marosan, M.D., FACS
- Suite E-190
11820 Northup Way
Bellevue, WA 98005 - Tel: Click for phone number
- Fax: 425-284-1803
- Send E-mail
- www.bellevueplasticsurgeons.com
Answered Questions
Q:
How can you tell the difference between breast hardening from augmentation or cancer?
I've had my implants since I was 23; I'm now 36. My right breast is starting to feel more firm than the left one. I don't notice it so much when I'm leaning forward but lying on my back is when it feels much firmer. I can't tell whether this would be a capsular problem or firmness of the breast caused by cancer. Please advise.
A:
Thank you for your question. You have your implants in for 13 years and if capsular contracture is the issue, most likely this affects the whole breast. If it is a possible cancerous grows, this most commonly affects a smaller area on the breast. You do not state if you have silicone gels or saline implants. You need to make an appointment with your plastic surgeon to be evaluated and examined. He/she will recommend the appropriate treatment based on their observation/examination. You might need a mammogram or MRI of the breasts to help guide the diagnosis. Do not panic, it is not an emergency, but you need to act on it within the next 1-2 weeks. This will also put your mind at ease and avoid unneccessary worries. Good luck.
G. Marosan, MD
Q:
Can I have my belly fat injected into my breasts?
I'm a 34B cup and I want to go up one cup more. I don't even fill the present cup the way I want to. I'm trying to look as natural as possible. I have some fat in the abdomen. Can I have my own abdominal fat injected into my breasts?
A:
Thank you for your question. Yes fat grafting to the breasts is an excellent procedure for a natural augmentation. You do not state your height and weight and without this information and/or photo it is difficult to guestimate how much fat you have for this purpose. I usually harvest fat from all over the body, especially if the person does not have a lot of fat in one area. One cup size increase is normally achievable with one surgery. There are different techniques (using the BRAVA external expander or serial grafting). Also, about 60-65% of the injected fat volume will stay long term. See a board certified plastic surgeon who is well trained in this technique. Good luck.
G. Marosan, MD
Q:
Should I be concerned about a trans-areola augmentation affecting breastfeeding?
I had my breast implants with a trans-areola incision which I have regretted all my life. I am now pregnant and extremely worried about complications with breast feeding. I want to know is it just a matter of being unable to breast feed or are there other issues like milk rotting in the glands because it cant flow? What can I do to avoid risks?
A:
Thank you for your question. First of all, not all women are able to breast feed with or without implants. I personally know five of my patients who breast fed successfully after a periareolar augmentation. The ducts which are divided with a periareolar augmentation come from the lower pole of the breast. Most of the milk glands and ducts are in the central and upper pole of the breast. If you develop mastitis from blocked ducts, this can be treated with warm compresses or occasionally aspirating the milk from the blocked ducts. Talk with the lactation specialist about your concerns. I'm sure they have experience with this situation. There are over 300,000 women who get breast augmentation yearly and many become pregnant after their surgery. You are not alone! Good luck and congratulations with the baby.
G. Marosan, MD
Q:
Is it OK to have an implant explantation and breast lift at same time?
I have 800 cc's Mentor smooth round implants placed over the muscle. According to the plastic surgeon I saw last year, I have severe ptosis, thin skin, the cc's worth of breast tissue I started with is gone, and I do not have much fat in the breasts. My concern is some doctors say I have to take the implants out and wait several months before a lift, while others say they can drain them, then do it after a month or so. The doctor I plan to use is Board Certified, specializes in this procedure, and does it all at the same time. Which is correct?
A:
Thank you for your question. Without the benefit of photos or an examination it is difficult to give specific advice. As you state, you have very large implants (saline?) and very little, thin breast tissues. I personally like to deflate the implant and allow your tissues to recoil from being overstretched. I prefer to come back later (1-3 months)and do a short scar breast lift and possible fat grafts to the breasts, which are mainly intramuscular fat injections. It is possible that it can be done together, but you need to discuss with your surgeon the risks and potential complications. Doing a breast lift at the time of removing very large implants and having very thin tissues places you at a much higher risk of nipple loss.
Good luck!
G. Marosan, MD
Q:
Will a tummy tuck help my C-section incision heal?
I had a C-section 19 months ago. I had a lot of excess skin hanging over after the pregnancy. A small opening has occurred at the end of the initial incision. Apparently, due to moisture being held under the excess skin, it never had time to heal properly. I have been approved for a tummy tuck to remove the skin and allow the C-section incision to heal. Will this help ? *Yes, I am a smoker as well*
A:
Thank you for your question. I would closely review your insurance approval so you will not end up with surprises after your surgery. Insurance companies do not cover tummy tucks or abdominoplasties. This operation removes lower abdominal loose skin, repositions the belly button, plicates or sutures your front abdominal muscles together to give you a flat abdomen and in most cases involves liposuction based on your surgeons training and comfort level. What you are covered for is known as a panniculectomy. This means excision of the lower abdominal loose skin ONLY. Since you are a smoker, this operation can be done without undermining the skin flap, thus reducing the risk of wound healing. Dissolvable sutures should be used, not to leave a permanent nidus for a possible future infection and non-healing wound. This procedure is often done by general surgeons. I personally do not do panniculectomies. Patients often tell their friends that they had a "tummy tuck" instead of a panniculectomy. Good luck.