Breast Augmentation

How much weight will I gain from breast implants?

It depends on the size of the implants you chose, but usually around a pound.

What size implant will give me a C cup bra?

Bra cup size after breast augmentation depends upon the bra manufacturer, your chest width, implant size, and how much breast tissue that you start out with. Our office consultation will include a detailed sizing process to give you the most accurate expectation of final cup size. But even with these processes, determining final cup size is not an exact science.

Will I lose sensation if I have a breast augmentation?

Some temporary numbness of the nipple or breast is common for a short time after surgery. Most patients have completely normal sensation when recovery is complete. The nipple incision may have a slightly higher risk of decreased sensation, but we have not observed that in our patients despite the fact that it is one of the most common incisions we use. So, while technically possible, the risk of permanently decreased nipple sensation from breast augmentation with any incision is extremely low.

Which breast augmentation incision is best?

Dr. Kirn allows the patient to choose where the incision is located - armpit, nipple or under the breast. Since every patient is unique, one incision may have a particular advantage, and if that is the case, this will be discussed in the consultation.

Does one breast augmentation incision hurt more than the others?

Most of the discomfort from breast augmentation is due to stretching of the muscle and breast tissue to accommodate the new implant, not the incision. fdTherefore, no particular incision hurts more or less.

What happens if I get pregnant after breast augmentation?

During pregnancy, your breasts will behave normally. They will increase in size as the gland enlarges during pregnancy. Implants generally do not affect the patient's ability to breast feed. After the pregnancy, and nursing, are completed, the breast will shrink back down to its normal size. The implant remains unchanged throughout this process. Sometimes the stretching of the breast will result in shape changes of the breast. If the shape change is significant or troublesome to the patient a lift operation may be beneficial.

Can I breast feed after breast augmentation?

Yes, implants do not affect your ability to breast feed, although there may be a very slight risk of interference with breast feeding with a nipple incision.

What happens if there is a leak / deflation of the breast implant?

This depends on the type of implant. A leaking implant should be replaced regardless of whether it is a saline or gel implant. Usually, a leaking saline implant eventually deflates leading to an obvious decrease in breast size. Sometimes this happens quickly - over a few hours, other times it takes a few days. Very slow leaks (over months, for example) are uncommon. The saline which leaks out of the implant is IV saline and is absorbed by the body causes no harm. It can be difficult to tell if a gel implant is leaking, so usually some type of diagnostic study is required - ultrasound, mammogram, or MRI. If a leak is found, the implant should be replaced.

Are breast implants safe?

Breast implants are the most tested medical device in history. They have been used since the 1960's in millions of women. There is no increased risk of breast cancer with implants. Although implants have a great safety record, they are not without problems such as the potential for leak, capsular contracture, and other occurrences. Despite these risks, the problems are limited to the breast and concerns about systemic disease from breast implants have been scientifically proven invalid.

Do I need to replace my breast implants?

Replacement is only needed if you are having a problem or desire to make a change for some reason. There is no mandatory replacement of saline or gel breast implants.

Should I use a gel or a saline breast implant?

Dr. Kirn uses both saline and gel implants, and prefers to leave this choice to the patient. During the consultation visit, the individual patient’s needs and goals will be discussed and a thorough examination performed. Sometimes, there are patient specific reasons why one type of implant might be a better choice for a particular patient. In those instances, the patient will be informed. We want every patient to be comfortable with the choice and get the very best result which will serve them well over time.

Can I break a breast implant?

Implants are really sturdy, but they can be broken. It would take a substantial amount of force to break an implant. We have had patients be involved in car accidents, fall off horses, and more without breaking an implant. Normal activity even aggressive exercise should have no impact on breast implants. So, having implants should not mean you have to restrict yourself from any activity.

Do breast implants wrinkle?

Both saline and gel implants can have visible wrinkling, but it is a little more common with saline implants in slender people. The more slender you are and the less body fat and breast tissue you have, the more likely you are to see visible wrinkling. Similarly, the larger the implants are, the greater the risk of wrinkling. Implants placed under the muscle are less likely to wrinkle than those placed on top of the muscle unless there is a significant amount of breast tissue over top of them. Minimizing the amount of muscle release is another way we strive to decrease the risk of wrinkling.

Will I have cleavage after breast augmentation?

The amount of cleavage generated by breast augmentation depends not only on implant size, but mostly on how far the breasts are spaced apart before surgery. Patients with breasts located far toward the outside of the chest are unlikely to get a lot of cleavage. Patients with normally positioned breasts where the nipple sites roughly mid-way between the center of the chest and the outer edge of the chest usually get very nice cleavage even with a modest size augmentation.

Will I look like natural after breast augmentation?

This depends mostly on what you chose. The larger implant used the less natural the breasts will look. For women with smaller breasts before surgery, implants placed on top of the muscle tend to look less natural than those placed under the muscle. Lastly, the more natural breast tissue there is, the more it will drape over the implant and give a natural appearing result.

Which type of breast implant weighs more - saline or gel?

The weight of saline and gel implants is nearly identical for the same size implant.

Breast Lift

Can I have my breasts lifted without any scarring?

All breast lift operations involve creation of some sort of scar. Our goal is always to keep scars to a minimum and hide them as best as possible. The more droopy the breast is, the more scarring there will be. At a minimum, there will only be a scar around the areola. At a maximum breast lifts use an anchor shaped pattern which includes an incision around the areola, a vertical incision, and an incision underneath the breast.

Will I lose nipple sensation with a breast lift?

Loss of sensation is very uncommon with breast lifts. However, the more droopy the breast is, the more tissue will need to be moved and therefore the greater the risk of disturbance of sensation.

Will the breasts droop again after breast lift?

After the lift operation, the breast will age naturally. Patients who do not have substantial weight fluctuations or pregnancy after a breast lift should maintain the result for many years.

What should I put on my incisions after breast lift surgery?

We will instruct you on care of the incisions after surgery. Although there are many products marketed to apply to scars, we have not found any of them to improve an incision which is healing normally.

Will my breast size be smaller after a lift operation?

All lift operations work by repositioning tissue and then removing skin to create a tighter envelope to hold the breast up. Unless desired, no breast tissue is removed during a lift operation. The breast might be fractionally smaller, but frequently they will appear the same or larger size due to putting the tissue back where it belongs.

Will my breast sit higher on my chest after a breast lift?

There is no operation which picks the entire breast up and moves it to a higher location on the chest. The inframmary fold (fold at the bottom of the breast) is a fixed landmark which does not move in a lift operation. The breast tissue is brought up to this level.

Augmentation / Lift

Will implants lift my breasts?

Implants fill out the breast, but they do not lift it. If the breast appears droopy just due to lack of volume, simply placing an implant will correct it. If the nipple is sitting below the fold at the bottom of the breast, then a lift operation will be needed either with or without simultaneous implant placement. This determination is a key component of the consultation.

Will using an implant decrease my incisions for a breast lift?

Under some circumstances, adding an implant may decrease the number or size of incisions needed for a breast lift. These options are discussed with the patient at the time of the consultation.

Breast Reduction

Will a breast reduction help my back, shoulder, and neck pain?

Although breast reduction is not a direct treatment for back pain, shoulder pain, or neck pain, these symptoms are almost always improved by having a breast reduction. Some patients have other reasons for these symptoms in addition to large breasts, such as arthritis. In those cases, the breast reduction will likely lead to an improvement, but not a resolution of the problem.

Will insurance pay for breast reduction?

Each insurance company has their own criteria to determine whether or not they will pay for a reduction. Many companies require that the patient has completed a course of "conservative management" - physical therapy, non-steroidal anti-inflammatory medications, and evaluation by an independent physician before they will cover a breast reduction. Breast size relative to body weight calculations are also used by many carriers. Therefore, it is usually in the patient's best interest to contact their own insurance company first to see what sort of criteria must be met before seeking surgical consultation.

Will I lose nipple sensation if I have a breast reduction?

Nipple sensation may be increased, decreased, or remain unchanged by breast reduction. Most commonly, nipple sensation is unchanged. It is rare, but possible, to lose nipple sensation altogether with a breast reduction.

Breast Implant Revision

When should I have my breast implants replaced?

There is no mandatory replacement of breast implants. However, if you are experiencing a problem, have had a leak diagnosed, or wish to make a size or shape change, then breast revision may be a desirable option.

I have very old silicone implants which have ruptured, how are they removed/replaced?

The same incision used for the initial implant placement is usually used for the exchange procedure. For ruptured old gel implants, Dr. Kirn attempts to remove both the leaking implant and the scar capsule around it intact together. Sometimes, the old implants and scar are so fragile that this is not possible, and some free silicone gel will escape into the breast tissue. Other times, free silicone gel has escaped before surgery. During the operation, every effort is made to remove all of the gel, but it is usually impossible to remove every drop of it. Leaving a small quantity of old gel in the breast usually causes minimal, if any, problem. The goal is to create as clean of a pocket for the new implant, if any, as possible.

How do I determine if my breast implants are leaking?

Generally speaking, when saline implants leak, they deflate over a relatively short time period - hours or a few days. Leaks in silicone gel implants are more difficult to diagnose, and usually cannot be determined on physical exam. Diagnostic studies such as MRI, ultrasound, and mammogram are usually necessary to determine if a gel implant is leaking.

Is it possible to place new breast implants after removal of old ruptured gel implants?

Yes, the most common procedure is to remove the old gel implants and place new ones during the same operation.

What will my breasts look like if I remove my implants and do not replace them?

Appearance of the breast after implant removal (explantation) varies dramatically from patient to patient. Many times, Dr. Kirn will combine a lift operation at the time of removal of implants to improve breast shape if the implants are to be left out permanently. Other times, it is better to simply remove the old implants, clean out the scar and allow the breast to shrink down before doing anything else. Always after implants are removed and not replaced, the breast will contract and it usually requires a six months to a year for this process to be complete.

Should I change my current saline implants out for the new gel implants?

As stated above, there are no mandatory requirements for implant replacement so long as you are not experiencing a problem. However, many patients who have had saline implants for a long time do choose to have them replaced before a problem occurs. Many patients prefer the feel of a gel implant over a saline implant and this can be another reason to consider surgery in addition to a desire for size change, shape change, or an improvement in symmetry.