Julius W. Few, M.D., FACS
- 875 N. Michigan Avenue
Chicago, IL 60611
- Tel: Click for phone number312-202-0882
- Fax: 312-564-4585
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I have size 36DDD breasts which have become saggy after having four children. I would like to have a breast lift, but I love my breast size and I’m concerned that I would lose size or volume by getting a lift. Does this happen? Also, I have pierced nipples – can the surgeon work with this or would I have to get re-pierced after surgery?
As a plastic surgeon, certified by the American Board of Plastic Surgery, I appreciate the changes that occur to the breast after multiple pregnancies. In general, it is possible to lift sagging breasts and maintain the approximate breast volume, assuming the skin has loosened. The most important thing is the affect of a heavy breast on future sagging of the breast. If the breasts are very heavy, the skin will stretch out and sag against the heavy weight of the remaining breast tissue. I typically recommend that women find a breast size that matches their frame but also allows the breast to maintain a "perky" appearance. If the breasts are sagging, typically due to heavy size, but the skin is not loose, the breast size must be reduced to allow for lifting of the breast. Regarding the nipple ring, my patients are expected to remove the ring during the immediate surgery period, usually only 5 to 7 days. It is possible that the piercing will close, but unlikely, requiring re-piercing. On a side note, I usually recommend women get close to a reasonable weight for their height to allow for the best results.
I will be having lumbar spinal fusion surgical procedure soon. Would it be possible to have a tummy tuck that tightens my abdominal muscles in combination with the fusion? Wouldn’t it make sense to relieve that pressure or extra abdominal weight that pulls on my lumbar region to prevent further injury?
I would not recommend an abdominoplasty at the time of a spinal fusion for several reasons. Technically, the combined procedure would be compromised by the relative inability to flex the table which is necessary in order to remove the appropriate tissue and achieve the best possible result. Second, the braces often worn after spinal surgery can rub and cause difficulty for the patient. Pressure or friction on freshly operated skin should be avoided. I would recommend that you determine which issue is more significant and treat the problem initially.
I am 18 years old and would like to know what the risks are with having breast augmentation. I've read a lot about it on the internet, but need a doctor’s answer. I’ve heard that breast implants have to be replaced after a couple of years – is this true and if so, how often? Are there any additional risks because of my young age?
I will focus the discussion on saline (sterile salt water filled) implants. Typically, saline implants are very durable and retain their form very well. The primary risk unique to breast implants includes leakage, which is not a health risk, and scar tissue formation around the implant, leading to a change in the feel or appearance of the breast. Fortunately, these complications do not happen very often and your board certified plastic surgeon can assist you if these problems occur. Breast implants that are currently approved for use do not have expiration, so you do not remove them unless there is a problem. It is important to understand that breast, with or without implants, age like the rest of the body. The heavier the breast, relative to the support of the skin, the greater is the tendency for sagging over a lifetime. Your surgeon will help you find the right size to minimize these changes. The most important thing to remember is that with realistic expectations and understanding of the risk/benefits, the vast majority of breast augmentation patients are very happy. For additional information, refer to www.surgery.org and www.plasticsurgery.org.
I am 16 years old and want to have breast augmentation. What is the optimal age to get breast augmentation and why?
In general, it is best to have breast enhancement surgery when you are at least 18 years of age, if it is done for purely cosmetic purposes. The breast can take 18 years or more to reach full development, which is the best time to consider surgery. The second issue is consent. Breast enhancement surgery is very safe and rewarding, but there are risks that exist. At 16 years of age, your legal guardian must consent to breast augmentation for you. This may make your family and your surgeon uncomfortable. The last major issue is the likely change in your desires after high school. I have followed young women, who ultimately have breast enhancement at 19 or 20 years of age. Their desired size and shape changed over time. They also seem to appreciate the process more when they are making all the key decisions with the surgeon. Ultimately, I recommend you wait.
I had saline implants 12 years ago and have had no problems or complications with them. However, I am considering having them removed and a breast lift done. I am guessing I would be a size C without the implants. As I have gained weight over the years, I am presently a bra size DDD with a spillover. By having the implants removed, would I be left with indentations in my breasts – if so, could I have fat taken from another area of my body and injected into my breasts to get rid of the indentations? Would this be my only option if I no longer wanted to have implants?
Thank you for asking such an important question. Breasts with implants change with time and weight fluctuations. It is very likely that your implants can be removed safely and a breast lift performed. Often the remaining breast tissue can be rearranged to fill in the space made by the implant. Women are able to get smaller, up-lifted breasts without deformity. It is important to know that in some instances, your surgeon may want to do surgery in two steps. If your surgeon thinks that your breasts will pull up/fill in after the weight of the implants are removed, that may be an option. It is important to seek a surgeon certified by the American Board of Plastic Surgery and to discuss all of the risks and benefits of surgery.