Richard A. D'Amico, M.D., FACS
Five years ago I had saline breast implants inserted. Since then, I have decided that they are too large for my small frame. What are my options at this point to reduce them? What are the risks and recovery time second time around?
Assuming that the only issue is the size of your breasts, I will describe the options available to you. Other complicating situations like scar capsules (excessively "firm" breasts), implant displacement, or sagging of breast tissues would require additional surgical procedures.
Your implants could be removed under a light anesthetic -- either conscious sedation, or a light general anesthetic -- and new implants placed which you feel are more proportional to your body frame. Currently, most plastic surgeons use saline-filled implants. They can be placed either behind the breast tissue, or beneath the pectoralis muscle. For my patients, I prefer submuscular placement (beneath the pectoralis muscle), because this placement may interfere less with mammography and provides a natural-looking result.
I am 18 years old and am embarrassed by my large breasts. I want to have a breast reduction. Is this a good time or should I wait until I am a little older?
Age 18 is a common time for breast reduction and can be very helpful for a young woman who is self conscious. You should seek out an American Board of Plastic Surgery certified plastic surgeon and have a thorough consultation. You should feel free to bring your mother or trusted confidante to the consultation and ask the surgeon any questions that you need answered before making a decision to have the procedure.
I had subpectoral silicone implants placed in 1990. I was able to nurse twins for five months in 1999. I've recently heard that implants should be changed after 15 years. Is this true? I'm still happy with mine and do not notice any obvious problems. My mammograms and ultrasounds have been negative except for benign cysts. I had one MRI of them years ago which was fine at the time. What do you recommend?
There is no "scheduled maintenance" for breast implants. Patients should have regular breast exams, mammography, ultrasound or MRI, as recommended by her treating physicians.