Common Questions Regarding
Breast Enlargement Surgery

The Centre, P.C. offers breast enlargement surgery to patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area, and Chicago.

Breast enlargement is a surgical procedure used to enhance the shape and size of a woman's breast. The procedure is usually performed to enlarge small, underdeveloped breasts or breasts that have decreased in size after pregnancy. It can also be performed in cases of breast deformity or where one breast is noticeably smaller than the other.

Q: Where will the incision be placed?
A: Whether you choose saline implants or silicone gel implants, the incision can be in any of three locations: in the breast crease below the breast, around the lower side of the nipple where the skin changes color, and in the armpit. Incisions are about an inch long for saline implants, and a little longer for silicone implants, as these always come pre-filled, at the size you want. In all three locations, the resulting scar will be barely visible.

Q: Does breast enlargement surgery involve a hospitalization?
A: Breast augmentation is an outpatient procedure; patients return home the same day with either an Ace-type wrap on the upper part of the breasts or a postoperative bra. You will likely feel tired and sore for a few days following the surgery. Post-operative medication will be prescribed to help control the discomfort, which will decrease as the days proceed. Your physician will see you the day after surgery to ensure everything is healing well. You will return within 7-10 days to have your progress checked. You may resume normal activities generally within one week and strenuous activity within 4-6 weeks.

Q: What is the difference between saline and silicone implants? Do I have a choice?
A: Saline breast implants are filled with a salt water solution that matches the saline fluids in the body. This means that if an implant were ever to rupture, which is extremely rare, that saline solution would be easily absorbed by the body. The FDA has approved silicone implants for all women aged 22 and over, as of November 17, 2006. These new silicone implants contain a gel which closely resembles breast tissue in its consistency. They look and feel very natural. If a silicone implant were ever to rupture, which again will be very rare, the gel would continue to hold its shape, and would not leak out as the older silicone gel sometimes did, back in the 1970s and 1980s. You can choose which type of implant you’d prefer to have, as these silicone gel implants are now available for cosmetic enhancement, instead of being restricted to breast reconstruction, as they were before November 17.

Q: Do the cosmetic surgeons at The Centre, P.C. place the implant above or under the muscle?
A: Each situation is evaluated on a case-by-case basis. Implants are generally placed under the muscle when the breast tissue is inadequate to provide good coverage over the implant. However, under the muscle is not ideal when there is sufficient breast tissue and/or more sagging. When implants are placed under the muscle, the recovery time is longer, since the muscle must be stretched during the procedure. Your cosmetic surgeon will review the options regarding implant placement and involve you in the decision.

Q: Will my breast implants have to be replaced at some point in the future?
A: There is no set life expectancy for either saline or silicone implants. Some women do have their breast implants replaced because as we age, the body changes, and some implant adjustment might be necessary. The silicone gel implants which have now been approved for cosmetic use by the FDA have slightly thicker shells than the older ones used before 1992. They also contain an improved gel which does not disintegrate or leak should the implant ever rupture. It will hold its shape and stay put until the shell is repaired. If you have any problems with your implants, you should certainly let your surgeon know immediately, so the problem can be diagnosed and addressed right away.

Q: Can I breastfeed if I have implants?
A: Implants have no effect on the ability to breastfeed. If a woman had the ability before implant surgery, then she will retain that ability following surgery. Likewise, if a woman was not able to breastfeed prior to breast augmentation, implant surgery will not improve her chances.

Q: Will I lose any sensation in my nipples after augmentation?
A: Some change in sensation in not unusual. Some patients have increased sensitivity, others decreased, and still others no change at all. For those who do experience a change, normal sensation may return after several months. Occasionally, partial or permanent loss of nipple sensation does occur.

Q: What results can I expect from the surgery?
A: The best candidates for breast enlargement surgery are women who are looking for improvement, not perfection, in their physical appearance. Before you decide on breast enlargement surgery, think carefully about your expectations and discuss them with your surgeon. An additional procedure that would enhance the result is a mastopexy (breast lift), if the breasts are saggy in addition to being small.

Q: Will I be at greater risk for breast cancer if I get an augmentation?
A: No, there is no evidence that either saline or silicone implants increase the risk of breast cancer. While the silicone gel implants were restricted by the FDA, between 1992 and November, 2006, a great many safety studies were conducted to determine whether silicone implants might help cause any diseases or medical conditions. No study established any causative connection at all between silicone implants and any disease.

Q: Are breast self-exams different for women who have implants?
A: Women who have breast implants should perform breast self-exams monthly on the implanted breast. To do this effectively, ask your surgeon to help you distinguish the implant from your breast tissue.

The following is a list of self-exam steps, as recommended by the American Cancer Society, along with a tip for women who have implants.

1. Lie down with a pillow under your right shoulder and place your right arm behind your head.
2. Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast.
3. Press firmly enough to know how your breast feels. A firm ridge in the lower curve of each breast is normal. If you're not sure how hard to press, talk with your doctor or nurse.
4. Move around the breast in a circular, up and down line, or wedge pattern. Be sure to do it the same way every time, check the entire breast area, and remember how your breast feels from month to month.
5. Repeat the exam on your left breast, using the finger pads of the right hand. (Move the pillow to under your left shoulder.)
6. If you find any changes, see your doctor right away.
7. Repeat the examination of both breasts while standing, with your one arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). This is where about half of cancerous lumps are found. You may want to do the standing part of the exam while you are in the shower. Some breast changes can be felt more easily when your skin is wet and soapy.

For women with implants: Press firmly inward at the edges of the breast implants to feel the ribs beneath, checking for any lumps or bumps. However, be careful not to manipulate (i.e., squeeze) the valve on the implant excessively, which may cause valve leakage and make the breast implant deflate. Any new lumps or suspicious lesions (sores) should be evaluated with a biopsy. If a biopsy is performed, care must be taken to avoid puncturing the implant.

Q: How are mammograms done for women with implants?
A: Mammograms and other imaging techniques are performed the same, whether a woman has an implant or not. There are, however, some slight differences.

Women with implants generally have additional images taken during a mammogram. In addition, implants may obscure underlying breast tissue and/or compress overlying tissue, thus making the interpretation of the image more complicated. It is important to have your mammogram done at an accredited mammography Centre. An imaging Centre that specializes in mammograms will likely have more experience screening women with implants. To find one near you, call the National Cancer Institute at (800) 422.6237.

If you have implants, you should advise your mammography technician of their presence. Prior to your implant surgery – as well as at six months and one year following surgery – you may want to have mammograms done to establish a baseline.

You may also be comforted to know that the chance of an implant rupturing during a mammogram is small. In the past 10 years, the FDA has received only 41 reports of ruptures during screening. The cause is most likely a faulty implant, not the mammogram itself, say experts.

The American Cancer Society recommends that women age 40 and older should have a screening mammogram done every year and should continue to do so for as long as they are in good health. Mammograms for older women (over 65) should be based on the woman’s health and whether she has other serious illnesses. Women in their 20s and 30s should have a clinical breast exam as part of a regular health exam by a health professional, preferably every three years. After age 40, women should have a breast exam by a health professional every year.

Please take the time to review our before and after breast augmentation photos to see if this breast enlargement procedure interests you. (Our physicians have surgically performed all surgical photos in our website. NO modifications or brush-ups have occurred in any of the photos offered at our website. All patients in the photos have generously allowed us to help you better understand the surgical procedures we offer at The Centre, P.C.)

For more information on breast enlargement surgery, contact our plastic surgery staff at The Centre, P.C. We offer the latest plastic and reconstructive surgery procedures to patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area, and Chicago.