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Michael S. Beckenstein, M.D.
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Answered Questions
Q:
Can the placement of silicone implants be controlled?
I recently had a breast augmentation. The implants were placed over the muscle as I had sufficient breast tissue to allow the surgeon to do this. My surgeon advised me that the only way to position the implants was in the actual breast cavity itself. I wanted the high sort of look - probably what you would call a more fake look. I had the surgery done at the end of July last year. I feel my breasts look a tad droopy - they are of course fuller - I had 310 cc's placed. Is there another way to position the implants? In other words should I seek the advice of another surgeon and have the breasts redone or is what my surgeon said, correct. I'd appreciate your comments.
A:
There are many factors that affect your current result. Skin and breast tissue quality are major influences in the final "resting place" of the implants. Placing the implants above the muscle (subglandularly) should help create the "fake" look you requested. The soft tissues, if lax, will allow the implant to drop down vacating the upper area. The solution again depends on the soft tissue, implant dimensions, and what you ultimately desire. Options may include any or all of the following; wider (diameter) implants, pocket change or alteration, mastopexy.
You should always return to your surgeon to discuss your concerns and see what he/she recommends. You should always feel free to obtain second opinions as well.
Q:
Will breast implants impede the production of milk or the feeding of a baby?
Will breast implants impede the production of milk or negatively affect breastfeeding of the baby?
A:
Breast augmentation should not have any effect on the quality or composition of milk. If the implants are placed beneath the pectorals muscle and through an inframammary or transaxillary incision, no effect on breast feeding should be noted. There is a slight chance of disruption of milk flow through a peri-areolar incision if there is undermining of the ductal tissue.
Q:
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I was a size 34DD and 110 pounds. After being a vegetarian for three years I have gone down to a 32C and now a 100 pounds.. I am a marathon runner, rock climber, boarder, etc. and still want my breasts smaller as they impair my performance. If I get a small reduction to a 32B, will my body adapt to it? For example, will the so called "back flab" I have had to support these large breasts go away? I have heard of female bodies changing due to their breast surgeries. For example, I have had multiple friends who were 98 pounds and size AA's, who have had breast implants to DD's. They start putting on weight along their upper torso and back area as a means to support their heavy implants.
A:
These areas are not related as you think. They are more affected by one's weight than the status of the breasts. Enlarging the breasts will not make these areas grow to support them, nor will reducing the breasts make these areas smaller. These areas usually change with weight fluctuations. When a breast reduction is performed, these areas can be reduced with liposuction or direct removal of the excess tissues.
Q:
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I have a cyst in one of my breasts. Can I have breast augmentation?
A:
You need to make sure this is in fact a benign cyst and nothing concerning. Depending on your age, a mammogram and/or ultrasound should verify that it is benign. It can even be aspirated, or removed if necessary, and the fluid assessed. A true, benign cyst should not preclude you from undergoing a breast augmentation procedure.
Q:
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I am ccnsidering having breast augmentation. Is this a one-time lifetime thing or will I need further surgery at some point down the road?
A:
The re-operation rate for breast augmentation is 13 - 21% at three years and almost 26% after 5 years. There are several reasons for additional surgery; capsular contracture, size change, implant failure, and malposition. There are women who have implants for over 30 years without any issues, and some that require procedures within the first year. The probability for additional surgery is in your favor (almost 75% chance of no additional surgery after 5 years); however, you must be fully aware that you may require one or more procedures if you choose to have an augmentation.