Things You Should Know During Your Breast Augmentation Recovery

Of course you are fully aware that breast augmentation, as with any cosmetic surgery, involves weeks of recovery.  However, you may be surprise that “weird” things—but still considered normal by plastic surgeons—may happen during your healing time.

If you are considering breast implant surgery, these are some of the things you might want to know about:

*  Squeaks and gushes in your breasts

In case that you hear these weird noises coming from your augmented breasts, don’t be alarmed since these are usually caused by air bubbles and/or fluid build-up within the implant pocket.

The buzzing, gurgling, and crackling noises that typically last a few weeks may also be caused by implants as they settle to their natural position.

*  Exaggerated fullness in the upper poles

If the upper poles of your breasts appear unusually round (which gives you the operated, fake look), don’t worry because weeks or months following your breast augmentation, the implants will settle to their natural position.

Some plastic surgeons recommend breast massage and compression exercise after the incision site is completely healed.  The theory is that massaging the breasts would allow the implants to settle naturally, and prevent the scar tissue around the devices to become too tight and dense.

In addition, it is not uncommon for the augmented breasts to be quite firm and sit high up on your chest.  In general, they will soften up and drop to a more natural position.

Your plastic surgeon may recommend strap or elastic bandage wrapped around the upper chest, under the arms, before reaching the top half of the breasts; in this way, the implants will go down.

* One breast sits higher on your chest

The breast implant on your dominant side (right- vs left-handed) may not drop as fast as the other one, leading to asymmetrical appearance.  If this happens, don’t worry since both implants will settle properly weeks or months after your breast augmentation surgery. 

*  Oversensitive nipples

More often than not, oversensitive nipple (right after breast augmentation) is associated with some “erection” which further aggravates the sensitivity.  For this reason, don’t be surprised if your plastic surgeon recommends using Band-Aid (especially if you have large ones) or nursing pads that will protect the area from the abrasiveness of your clothing.

* Numbness in the nipples

While some patients experience oversensitive nipples, others complain about numbness in the area, which is also something normal during the first few weeks or months following the surgery.

For most women, the sensation returns although the process often involves some itchiness, heat, tingling, and sometimes pains, which are all temporary. 

Knowing If Breast Implant Surgery Is Right for You

For the past couple of years, breast implant surgery has been the most sought-after aesthetic operation that in 2011 alone, about 307,000 procedures were performed, according to survey released by the American Society of Plastic Surgeons.

But despite the growing popularity of breast implant surgery, not all people who desire to increase their bust size and/or want to achieve a more prominent cleavage are good candidates for this procedure.

As with any cosmetic surgery, breast augmentation involves some risks, recovery, and of course money.  For these reasons, you should be able to answer these questions before you consult a plastic surgeon:

*  Do you have “healthy” motivations?

If you want to undergo a cosmetic surgery, bear in mind that your motivations should be based on your personal happiness.  But if you want this to please other people (your partner or colleagues), you would most likely end up dissatisfied since physical improvements do not automatically result to “better relationships.”

*  Do you have realistic goals and expectations?

If you have very small breasts (double A cup), desiring to achieve a full D cup is definitely over the top.  Take note that because you have limited breast tissue and fat, “inappropriately” large implants can lead not just to fake look but also to higher risk of wrinkling/rippling and bottoming out.

*  Do you have enough money?

Because breast augmentation is an elective procedure, don’t expect that your health insurance will cover the surgical expenses; this means you have to spend your own savings or seek loans.

Aside from the surgical costs, you should also consider the possibility of a revision breast augmentation, MRI screening (if you would choose silicone implants), and other expenses after your operation.

*  Are you physically healthy?

Your plastic surgeon will interview you and ask you to undergo laboratory examinations to determine if you are healthy and are not suffering from medical conditions that may compromise your recovery.

Be as honest as you can, particularly when your doctor asks you about your previous surgeries, medical conditions, allergies, and current medications.  Also, you should tell the truth if your surgeon raises the topic of smoking and drinking habits.

*  Are you emotionally stable?

If you are emotionally stable and fully understand and accept the ramifications of having breast implant surgery, you can proceed with the procedure as long as you meet the other requirements.  But if you’re suffering from depression and other psychological and emotional issues, talking to a therapist is way better than consulting a plastic surgeon.

Cohesive Breast Implants—Benefits and Disadvantages

In March 2012, the US Food and Drug Administration has approved the cohesive breast implants which use a form-stable gel; this means that unlike the 4^th generation silicone implants, they do not leak in case the shell cracks.

The cohesive silicone implants, also referred to as gummy bear implants due to their firm structure (just like the popular sweet candy), have benefits over the ordinary silicone- and saline-filled implants.  However, they also have shortcomings, which must be considered.

The Main Benefits of Cohesive Breast Implants

*  Less prone to shell collapse

Because the filler material is form-stable, it does not shift from one area of the shell to the other (which is the case in saline and traditional silicone implants).  For this reason, the folds and wrinkles—which are known to affect the device’s durability in the long run—do not occur.

It is safe to surmise that cohesive breast implants can last longer than the other types since they are not prone to folds and wrinkles.

*  Leak is almost not a concern

While the shell is susceptible to breakage, leak is not a problem since the filler material maintain its shape; however some microscopic diffusion of silicone will always occur, but some experts believe that it will be somewhat harmless.

*  Lower risk of capsular contracture

Some studies—while not as extensive as they should be—conducted in Europe suggest that capsular contracture occurs less often with cohesive breast implants.

Capsular contracture happens when a layer of scar tissue becomes too dense and thick that it squeezes the implant.  Some experts say the implant’s cohesiveness, firmness, and/or less diffusion of silicone (than traditional silicone implants) are the reasons why there is a lower risk.

The Disadvantages of Cohesive Breast Implants

*  They only come in teardrop shape

Because the cohesive breast implant is form-stable, it does not come in round version and is only available in teardrop shape, which has more volume at the bottom than the top.

By contrast, ordinary silicone and saline implants are available in round shape because their filler material is affected by the gravity and forces of the breasts.

While teardrop implants provide natural results, some women still prefer the round version which can give them the dome-shaped breast in which there is an exaggerated fullness in the upper poles.  

*  Feel

The cohesive breast implants do feel a little bit firmer than the traditional silicone implants, although the level would depend on how much breast tissue a patient has, how supple or flaccid the tissue is, and how large or small the implant is.

However, most patients—particularly those who would choose implants with an “appropriate” size—do not have problem with the firmness of cohesive breast implants.

*  Cohesive implants require longer incisions

Because the filler material is form-stable, these implants need longer incisions (between 4.5-5.5cm) to squeeze through inside the breast pocket.  For this reason, plastic surgeons rarely recommend the areola incision site when using this type of implant.

Armpit incision is also difficult when using cohesive breast implants, which is why doctors prefer the breast crease technique.

*  Risk of rotation

With the teardrop shape of the cohesive implants, rotation can result to deformity.  Fortunately, this can be prevented with the right pocket dissection and insertion.

But still, rotation is more of a problem for patients wanting to replace their teardrop breast implants with smaller ones.  Meanwhile, round implants do not result to distortion even if they rotate inside the pocket because their sides are all symmetrical.

*  More expensive

As with most new technologies, cohesive breast implants are hundreds of dollars more expensive than older designs. 

Woman Fakes Breast Cancer to Raise Money for Plastic Surgery

In an effort to raise funds for her breast augmentation surgery, a 27-year-old Arizona woman lied to her family, friends, and co-workers saying she had breast cancer and needed double mastectomy and breast reconstruction.

Jami Lynn Toler, who worked at a local hospice, has been charged with fraud and theft, police authorities said.

Toler’s former co-workers said she solicited money by making up stories and even crying in front of her boss to persuade them to give her “funds” for her cancer treatments and reconstructive breast surgery. 

According to police reports, Toler’s boss helped her raised funds amounting to more than $8,000 since September.  Meanwhile, one co-worker said “people were scammed simply because of their good intentions and sincerity to help the suspect.”

Aside from Toler’s friends and co-workers, she also deceived her mother and grandmother who also gave a portion of their savings to help the suspect.  

Meanwhile, Toler’s co-workers and friends became suspicious when one doctor offered to treat her cancer for free but she declined.  She also paid a cosmetic plastic surgery in cash, according to police reports.

When investigators checked Toler’s medical records, they found that she was not suffering from breast cancer.

This is not the first time a woman faked breast cancer to raise funds for her breast augmentation surgery.  A few years ago, Trista Joy Lathern from Texas lied about having the disease and raised about $10,000.

To make her story believable, the suspect has even shaved her head to look like she was receiving chemotherapy.

Asian Breast Augmentation

About 307,000 breast augmentation surgeries were performed in 2011, making it the most popular cosmetic plastic surgery during the period.

In a 2011 survey released by the American Society of Plastic Surgeons, breast augmentation was one of the top three cosmetic surgeries performed on Asian-Americans, which has always been the trend. 

Because Asian women often have a smaller frame than Caucasians, the general rule is to limit the implant size particularly if the aim is to create a natural appearance instead of an operated look.

Small- to moderate-sized breast implants are particularly ideal when dealing with patients who have little breast tissue to prevent or at least minimize the risk of visible wrinkling and rippling. 

Nowadays, the trend is the natural look which can be easily achieved by using smaller breast implants.  In fact, many plastic surgeons have noticed that most of their recent patients asked for implants filled between 300 and 350 cubic centimeter or cc which is often enough to add volume without giving a heavy top look.

Aside from the implant size, Asian women should also consider the implant profile or the projection off the chest wall.  As mentioned earlier, they generally have a smaller frame and chest “band” than Caucasians so these certain anatomical features should be taken into consideration.

In general, patients with a small chest “band” should use high-profile implants which offer more forward projection and smaller base, which is important to avoid the unnatural look. 

On the other hand, petite patients in general should avoid low-profile implants which have a bigger base but offer less projection as they can occupy too much space on the chest band, resulting to “bursting” appearance.

To date, a growing number of women choose silicone breast implant over the saline version because it provides a more natural look and feel with its viscous filling.  Meanwhile, the US Food and Drug Administration has recently approved the fifth generation of silicone implant which has a more cohesive gel than its predecessor, in addition to being form-stable.

But still, salineimplants, which are filled with a sterile mixture of salt and water, can provide a natural look and feel as long as there is an ample amount of breast tissue and fat; but if this is not the case, unnatural contour and higher risk of wrinkling are usually the results.

But despite some concerns, saline implants are still endorsed due to their surgical flexibility and are easy to replace during a revision breast augmentation.

Gummy Bear Implants Seen to Create a New Trend

In March 2012, the US Food and Drug Administration has finally approved gummy bear breast implants (from implant manufacturer Sientra) after several years of clinical trials.  Meanwhile, the new devices have already been around for 10 years in Europe.

Compared to earlier versions of silicone implants, gummy bear implants have a more cohesive silicone gel that even if their shell is cut in half, the filling would not leak.  And with this characteristic, many plastic surgeons around the world believe that the new devices are probably safer than other types of breast implants.

Plastic surgeons coined the term “gummy bear” because the implants’ soft but firm structure is somewhat similar to the sweet candy.

Leading Los Angeles plastic surgeon Dr. Tarick Smaili believes the recently approved breast implants may further push the popularity of breast augmentation surgery in the country.  Last year, the procedure ranked first on the list of the most commonly performed cosmetic plastic surgeries.

In terms of advantages, Smaili said that gummy bear implants are “quite notable” particularly when it comes to safety.

“With the cohesive silicone gel, the possibility of rupture and leak is close to nothing.  Another advantage is that the implant is form-stable and would not lose its shape,” Smaili said.

And because the risk of leak is almost not a concern, regular MRI screening is no longer needed.  (This is a requirement for women with traditional silicone breast implants because their somewhat fluid gel would seep out in the event of rupture.)

Another advantage, Smaili said, is the lower risk of capsular contracture which happens when the surrounding scar tissue squeezes the implant shell to the point that it causes breast deformity, pain, and other complications.

The newest implant is also called “type 5 gel” because it is the fifth generation silicone implant in the market since 1962.  Meanwhile, silicone implants currently produced by Allergan and Mentor fall under the category of “type 4 gel” which is cohesive but not form-stable.

But because gummy bear implants are firmer than the earlier versions of silicone implant, they require a longer incision. Fortunately, patients can choose from four incision sites which are designed to make the scar less visible.

Another consideration is the risk of rotation.  Since the implants come in teardrop shape, they may result to deformity in case they rotate inside the breast pocket (though the textured or “grainy” surface can prevent this problem from happening).

Pricing for Breast Augmentation

Breast augmentation ranked first in the most commonly performed cosmetic plastic surgery last year, with about 307, 000 procedures conducted in the US, or an increase of 4 percent since 2010.

The price for breast augmentation varies, sometimes significantly because it is affected by the surgeon’s fee, location of the surgical center or hospital, and type of implant used during the surgery.  Meanwhile, patients should always bear in mind that the cost should not be the sole factor when choosing a doctor.

Nevertheless, the most expensive breast augmentation plastic surgeon does not necessarily mean that he is the best one to conduct the surgery.

If the surgery uses saline breast implants, the average cost is around $7,000—this already includes all the pre- and post-operative visits, anesthesiologist, surgical facilities, and body garments.  But if the procedure uses silicone implant, the price would be $800 to $1,000 higher.

Silicone is more expensive than saline implant because making it involves a higher manufacturing cost.  Another consideration to make is the plastic surgeon’s fee is usually higher if this implant type is used.

Patients should always bear in mind that the cost of cosmetic plastic surgery is higher in large cities than in most areas because the demand for such procedure is quite high.

People should always be cautious with extremely cheap or discounted plastic surgery because this is often a red flag; the surgery is most likely to be conducted by a non-specialist, or it may be an attempt to fill an empty O.R schedule—which should be a concern.  And in some cases, a very low price is just an advertising hype and may not be the inclusive cost of surgery.

Because breast augmentation and most cosmetic surgeries are quite expensive here, some patients are tempted to go abroad (in Thailand, the cost of breast implant surgery is said to be 50 to 70 percent less).  While there is nothing wrong with “medical tourism,” they should be extra careful since not all countries are as strict as the US.

Patients should always bear in mind that in case their surgery abroad leads to botched results, it may be difficult—or sometimes even impossible—to go after the doctor.  By contrast, the US is very strict when it comes to medical malpractice law; in fact, the records of doctors who have been sued or charged with a disciplinary action can be easily accessed via Internet, although some states require a letter of request before they disclose such information.