Frequently Asked Questions.

Q: "What are the main areas of focus for your practice?"

A: Our practice is divided into three main areas: Aesthetic Surgery, Reconstructive Surgery, and Procedures Following Massive Weight Loss.

 

Q: "What is the typical recovery time for a breast augmentation (enlargement) procedure?"

A: This depends on patients' normal daily activities, but a lot of patients return to work within one week, and most resume full physical activity within 2 - 3 weeks.

 

Q: "What about silicone implants?"

A: After a fourteen year moratorium, the FDA has once again made silicone gel breast implants available for cosmetic surgery. In late November of 2006, the FDA gave approval, with conditions, to the two implant companies to go forward with a new program. This was a result of numerous investigational studies, scientific meetings and governmental reviews. The conditions imposed on the companies require them to continue to track the histories of individual implants through registries, for another ten years. Implants are available to anyone over the age of 22 years.

Most surgeons and patients feel that silicone gel implants are cosmetically superior to saline implants. Rippling is much less evident, particularly in thin patients, and they are more natural in appearance and feel. However, silicone implants are more expensive than saline implants. In addition, knowing when a silicone implant ruptures can be very difficult. A saline implant simply deflates, the body absorbs the saline and the fact of rupture is obvious. However, when a silicone gel implant ruptures, the capsule which formed around the implant contains the leak, and the shape and size remain the same. If it is a traumatic break, as in a car accident or other major injury, the silicone gel may be extruded through the capsule into the soft tissues around the implant, causing scar tissue to form around this material. The body does not absorb this material and it must be removed surgically. Although rarely is a significant extrusion seen, it can be a significant problem. Mammograms and physical exams are notoriously bad at diagnosing silicone implant ruptures, MRI scans are often suggested as a means of diagnosis. The problem is their expense; this is rarely covered by insurance. Both implant types have an average life span of about fifteen years, therefore our recommendations too asymptomatic implants is to replace silicone implants every 15 years as a routine; saline implants may remain in place until obviously deflating.

Other concerns about implants are the development of capsule contracture (scar hardening around the implant) and implant effect on mammograms. Both types of implants are identical as to these potential risks.
We believe that silicone implants are an improvement over saline implants, however you may have some significant concerns in your own mind about silicone gel. Keep in mind that over the last fourteen years, most implants used were saline, and that the large majority of women have been very satisfied with them. If cost or safety issues are a concern to you, saline implants do a fine job and should meet your expectations.

 

Q: "I've heard that implants can deteriorate with age. Is this true, and if so, what can happen?"

A: Yes and no. All implants have a finite lifetime; they will all break eventually. The average is around 15 years. Implants do not fall apart, or dissolve, but do get folds in the casing, or envelope. These folds move inside you as you do; after a period of time they will get a stress fracture in the fold. This can happen in two years, or twenty, whenever it gets enough movement to do so. The good news is that replacing them is easy, and complications from breakage is minimal. On the downside, replacing them does require surgery.

 

Q: "Can implants correct breast sagging?"

A: Breast sagging, or ptosis, cannot always be improved with implants. If the ptosis is not too advanced, often an implant alone will suffice. More advanced ptosis must be repaired with a breast lift, or mastopexy in order not to have the breast simply hang off of the implant; this problem does not look good. Please see our mastopexy section for more information.

 

Q: "Will implants affect my ability to breast feed?"

A: No. You may still breast feed following surgery.

 

Q: "What are the risks of breast reduction?"

A: Sometimes sensation can be lost in the nipple; this is about a 10% risk. The good news is that if sensation is lost, it usually returns within 1-2 years. Breast feeding after reduction can be affected. A certain number of women cannot breast feed afterwards, and who will experience this cannot be predicted. If you are able to breast feed after surgery, great! But you must be prepared to accept the possibility that you might not be able to do so.

 

Q: "Will insurance cover breast surgery?"

A: Insurance will often cover breast reduction. Some plans, however, do exclude breast reduction from benefits - please check your policy book. The many plans that do cover breast reduction do so under certain conditions. Most commonly, they require your primary care physician to document your symptoms (neck / shoulder / back pain, rashes, painful strap marks), and require your surgeon to remove around 500 - 600 grams (1 pound) from each breast.

 

Q: "Can I do several procedures at one?"

A: Yes, within reason. Depending on your health and age, and depending on what procedures you are considering, they can be combined for one anaesthesia. Common combinations are breast augmentation and abdominoplasty, eyelids and facelift, breast lift and arm lift. Individual situations vary from person to person, so discuss this carefully with your surgeon.

 

Q: "How soon after breast feeding can I consider a breast augmentation or lift?"

A: Wait until the breasts have finished their changes. Typically this is about 3 months after breast feeding stops.

 

Q: "I’ve lost a lot of weight and want to have a breast lift or tummy tuck, but I may want to lose more. What should I consider?"

A: First, realism is to be considered. Any more loss over 10-15 lbs will loosen the results of lifts and tucks. If you are really going to loose more than 15-20 lbs then you should do that first.

If you have had a surgery for weight loss (bypass or banding) then reach a stable point for 3-6 months. This is no arbitrary time to wait, but a stable period after weight loss is best.

 

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