Doctor, I'm worried that my breasts will be too large after the surgery!
This is a common fear, and can sometimes lead to disappointment, depending on which implants you choose. It is a good idea to try sizers (gel-filled implants) at the surgeon's office or bags of rice at home to give you an idea of the size of implants you want.
There are many factors to be considered: your height and weight, the width and shape of your chest, and your existing breasts. Your surgeon can explain which implants (gel, saline) are available, their shape (round, teardrop) and external surface (smooth or textured).
Often patients regret not going for a slightly larger implant. The surgeon is there to help you make the right choice for you, thanks to his experience.
Are implants guaranteed? What happens if they break?
Saline implants have a lifespan of about 15 years. Since the 1992 moratorium on silicon implants, the vast majority of plastic surgeons have placed saline implants in thousands of patients. To date there has been a very low rate of such implants deflating. Should an implant rupture, the saline water will be reabsorbed by the body and eliminated without causing any problems. A breast with a defective implant will gradually shrink, and the asymmetry between the two breasts will become apparent. The implant can be replaced quickly, sometimes under simple local anaesthesia. A magnetic resonance scan of gel implants can be done every three or four years, as recommended. A firmer scar may form around a defective implant.
Doctor, I want my breasts to be closer together. I want to have some cleavage.
Breasts can't actually be moved. They sit on a semi-curved thoracic cage and face forwards and somewhat to the side. To bring the two breasts more toward the middle, the surgeon has to measure the space between the middle of the chest and the outside of the breast. The implant chosen must be large enough to fill this space, with a bigger contour all around.
How does the surgeon ensure the proper results – a supple breast of the right size that feels natural to the touch?
First of all, the surgeon must measure the breasts and chest to detect any anatomical anomalies and asymmetries to be corrected. The implant chosen must be adapted to the patient's chest and the space to be filled. Many types of implants, with low, medium or high profiles, are available, and your surgeon can advise you on the best one for you. Once the surgery is completed, breast massages can help keep them supple. Wearing a chest band high on the chest in the first weeks after surgery helps to keep the implants in place behind the breast and prevent them from being pushed up by the pectoral muscle. There are also drugs that can reduce internal scarring around the implant. Your surgeon will advise you during the healing process.
Why are implants placed above or below the muscle?
Saline implants, because of their thicker, more rigid shells, must generally be placed under the pectoral muscle to cover them properly. They can still be felt beneath the breast and sometimes on the side.
Cohesive gel implants, because of their flexibility and more natural feel, can be placed on or under the muscle. Body builders prefer to have implants on top of the muscle, so that they do not visibly shift when the pectoral muscle contracts. Patients with more delicate builds and less fat under the skin may wish to go with a gel implant, which is less palpable when placed under the muscle and less likely to ripple beneath the skin.
My breasts are sagging from my pregnancies. Do I really need a breast lift, which leaves more visible scars?
During your interview, your surgeon will take all the necessary measurements to analyze the problem to be corrected. There are standards to be applied in aesthetic surgery for proper results, but your surgeon will adapt the surgery to your needs, based on his experience and judgment. There are many factors to be considered, from your weight and height to the size of your chest, skin type and personal tastes.