Breast Surgery FAQ Inland Empire

Breast Augmentation

How can I decide what size implant is best for my body?

The size of the implant that would work best for you depends a lot on how wide your chest and breasts are. During our consultation I will measure the width of your chest along with the placement of your natural breasts. Once you have a size you are happy with the profile of the implant can come into play. If you desire a look that gives you a lot of top cleavage and volume then you may benefit from a higher profile implant. If you are seeking a more natural, less projecting look, a lower profile implant would be a better option. All of these variables can be discussed once you are measured. When I meet with a patient interested in breast augmentation with implants I usually like to take the measurements and review the different options together until we find one the fits what each patient is individually looking for. Together, we want to find the option that is safest and has the best cosmetic result.

Should I choose Silicone Gel or Saline Implants?

The choice between the two relies mostly on your own preference. Each implant has its own benefits and disadvantages. The main benefits of choosing saline implants are that they are slightly less expensive than silicone, and in case of rupture, your body will simply absorb the salt water. The disadvantages of saline implants are that they tend to feel slightly less natural than modern gel implants, and are at greater risk for rippling. The benefits of silicone gel implants are in their softness and natural feeling. If you have extremely small breasts you may feel more comfortable choosing silicone implants because they are softer and you will be able to feel the implant. The last difference between the two is in the size of incision necessary to insert the implants. Saline implants are inserted while they are in a deflated state, so they can be inserted through the smallest incisions. Silicone breast implants are pre-filled and measured so they must be inserted in their usual size.

Should I choose textured or smooth implants?

Most women tend to imagine smooth silicone shells when they begin to envision their implants. Although smooth implants are most popularly selected, there are also textured silicone or saline implant options. The shell of these implants has a fine, sand-paper like texture. Studies suggest that textured implants are less likely to form excess scar tissue (capsular contracture) around the implant than smooth shelled implants. Some surgeons prefer textured implants when they are placing the implant above the pectoralis muscle. There are drawbacks to the textured implant as well. Textured implants create a higher risk for developing ridges on the implant and can even develop tissue growth within the textured shell of the implant. When this occurs the breast is unable to move normally within its pocket. If placed under the muscle, there is no longer a significant reduction in capsular contracture in textured breast implants versus smooth-shelled breast implants.

Which Breast Implant Profile should I choose?

Deciding the projection of your implant is one of the most defining choices you will make about your breast enhancement surgery. Along with size, the projection of your implant will create the overall character of your breast implant. As you select larger breast implants, at some point the diameter of the breast implant will exceed the diameter of your natural breast. Women with average chest diameters who desire small to moderate breast implants will typically choose a standard “moderate” profile implant. If you have a particularly small chest diameter or if you select a breast implant diameter that is too large for the width of your chest your breast implants will either touch each other at the center of your chest (synmastia) or extend too far into the area beneath your arms. In order to minimize the event of synmastia, or breast implants moving into the underarms, I choose implants with a narrower diameter containing the same volume. Profile projections are chosen between moderate, moderate plus and high profile, all depending on the patient’s preference, chest size, and the volume of implant. I encourage you to discuss your size preference during your breast augmentation consultation at our Inland Empire office. I will guide you through the selection process of finding an ideal breast implant based on your anatomy and desired outcome.

Should my implants be placed above or below my breast muscle?

There are benefits and disadvantages associated with both choices. Many studies have demonstrated that placing an implant under the pectoralis muscle creates lower risk of becoming hard or developing excess scar tissue than one placed above the pectoralis muscle. The extra layer of tissue or muscle covering the breast implant can also camouflage any rippling of the breast implants. The disadvantage of placing the implant under the muscle is that it weakens the pectoralis muscle when it is cut for placement. Another potential problem is what is called “animation deformity” This occurs when the breast shape is distorted every time you tighten the pectoralis muscle. If you have droopy breasts, or desire a slight lift, a breast implant placed over the muscle is the better option because it is able to lift the breasts.

Where will my implant incisions be located?

There are several options for incision sites. I will discuss each location at length during your consultation, but here is a list of options with a brief description.

  • Areola- This is the most common method of inserting breast implants because the transition between the darker areola and the regular skin on your breasts is a perfect place to hide a scar.
  • Under the Breast- The fold under the breast is another common site for insertion because as the breasts enlarge the breast tissue will typically fold over at theat the bottom covering any scarring. Scars are however more visible while lying down.
  • Underarm- This incision is popular because no scars are seen on the breast itself. It is a modern technique that employs endoscopic equipment that involves pencil thin lenses and camera systems.

The scar is well hidden in the natural folds of the underarm creases.

How long does it take for the swelling to go down enough to seen the final shape after breast enlargement surgery?

The final shape after a breast augmentation can take up to 6 months to take effect. Often times there is swelling of the upper portion of the breast, which is worse when the implant is under the muscle. Also the implant can be high on the breast and take a few months to settle into the appropriate position. This has to do with the breast stretching out and the swelling going down enough to allow the tissues to stretch.

Breast Reduction with Lift

Is breast reduction surgery right for me?

It is ideal for women hoping to reduce the size of their breasts for either aesthetic of medical purposes, and very helpful for women suffering from back pain due to overly large breasts. As with any surgery, it is important that the patient be mature enough to maintain healthy and realistic expectations for their breast reduction surgery.

Can breast reduction surgery correct asymmetry in my breasts?

Yes, during breast reduction surgery to correct asymmetry I am able to reduce the size and shape of your larger breast or enlarge the smaller breast. Where are the incisions made for breast reduction? Incisions are usually made within the folds under the breasts, around the areolae and in a line from the crease to the areole. The most common incision is made around the areola and down through the center of the crease. This type of incision is commonly known as the “lollipop” incision.

Will my insurance cover my breast reduction surgery?

In many cases breast reduction surgery can be demonstrated a medical necessity, therefore most insurance companies will cover your surgery.

Breast Reconstruction

Do I need to have breast reconstruction?

Breast Reconstruction surgery is not medically necessary. It is considered an elective procedure, meaning you can choose whether or not you would like reconstruction after your cancer is removed. Some women choose to have a mastectomy (removal of all breast tissue) without reconstruction. Although it is considered an elective surgery, it not solely cosmetic. Federal Law mandates all insurance plans pay if a mastectomy is indicated.

What Options Do I have for Reconstruction?

The most popular option for breast reconstruction is to use breast implants. Form-stable cohesive silicone implants (also known as gummy bear implants offer a beautiful choice for reconstruction. The implants are shaped like natural breasts, and look and feel the most natural. Flap reconstruction is another option using tissue taken from either the back of the shoulder or the abdomen in order to reshape the breast. This method is performed on its own, but is also commonly combined with implants. I may need (or have already had) radiation to my breast area.

Can I still have implants?

Radiation and its impact on implants is something that I will discuss in depth with you during your consultation. It is true that women who have had radiation are at higher risk for multiple implant complications including capsular contracture. Fat injections rather than implants are often the best option for women who have undergone extensive radiation.

Will my insurance cover my breast reconstruction?

In October of 1998, Congress passed the “Women’s Health and Cancer rights Act” which requires that group health and individual health insurance cover reconstructive surgery following a mastectomy. In general, the law states that insurance should cover reconstruction of the breast following mastectomy to reconstruct the breast in order to produce a symmetrical appearance as well as prosthesis and treatment of physical complications at all stages of mastectomy.

Breast Lift

Am I a candidate for Breast Lift Surgery?

Ideal candidates for breast lift surgery should be in good physical and emotional health. Breast lift surgery is a great option for women whose breasts have changed in size due to excessive weight loss or have lost the volume in their breasts with age.

Can I combine a Breast Lift with Breast Augmentation?

A breast lift will reshape and lift the existing breast tissue, but will not add volume or increase the size of your breasts. For women who would like to increase the size and shape of their breasts, a breast lift with augmentation using either implants or fat injection can deliver the most comprehensive results.

What are the breast lift incisions and sizes?

The most common incision made is called the “lollipop” incision which is made around the areola and down the center of the breast. In some cases all incisions can be made around the areola. The specific technique used during surgery will depend on the level of correction needed and whether or not a breast augmentation will be included as part of the procedure.

Is there an Age Restriction?

There is no official age limit for Breast Lift Surgery. Patients considering a breast lift should have fully developed breasts. Younger breasts may require revision later on due to further changes in breasts that are common after pregnancy, nursing or weight fluctuation.

Male Breast Reduction

How Do I know if I have Gynecomastia?

Gynecomastia is the presence of any excess tissue on the male breast. It is often breast tissue mixed with fatty tissue. Gymecomastia can occur due to various factors including hormonal irregularities, anabolic steroids, or side effects to a variety medications. Oftentimes there are strong heredity factors as well. Gynecomastia is not related to obesity but may coincide with it. Gynecomastia can range from a small area of firmness around the nipple or as large as a DD cup breast.

Can I determine if I have Gynecomastia simply by feeling my chest?

The simple answer is No, breast tissue can either feel hard or soft. It is important to see a surgeon for a diagnosis of gynecomastia.

Can I treat my Gynecomastia with diet and exercise?

Diet and exercise are strongly recommended for overall health; however, they will do very little for your gynecomastia. Weight loss through diet and exercise will reduce the fatty tissue surrounding the breast tissue but it will not reduce the breast tissue itself. Many times men with gynecmostia have worked their chest muscles only to be disappointed in their contour. The excess tissue on the chest actually sits on top of the muscle and is therefore pushed outward as the chest muscles become larger. It is only after the excess tissue is removed that the muscular contour can be seen.

What do scars look like after surgery?

In surgery every effort is made to minimize scarring. Incisions are usually made on the side of the chest, just down from the armpit. Incisions often heal so well that they end up resembling a blemish more than a scar. Other common incisions are made around the nipple.

Will my insurance cover male breast reduction?

Unfortunately, many insurance companies have adopted the position that gynecomastia is a purely cosmetic procedure. It can be difficult to obtain coverage, however, some insurance companies will provide coverage if you can prove medical necessity. For example, if it is gland related or due to underlying causes.

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Fly in for Surgery

Out of Town Patients Desiring Plastic Surgery Procedures

At Plastic Surgery Socal we are dedicated to the highest ideal of patient care and surgical expertise. Due to our numerous patients from other cities and countries around the world we make it easy to travel to our Inland Empire practice. Whether it’s arranging aftercare, recommending the best local restaurants, shopping or nearby accommodations our staff is devoted to providing the best care possible from the time you step off your plane until you leave us post-surgery.

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