By Dr. Rosenblatt
What qualifications should I look for in a surgeon to do my breasts?
Ideally, a board-certified plastic surgeon with many years’ experience doing breast surgery is usually the best. This surgeon will know how to judge what kind of implant is the best for you and where it should be placed.
Where are the incisions?
I usually use a small incision that goes partly around your areola. Sensation is preserved and the scar almost completely disappears. Scars under the breast are usually not aesthetically appealing, and other approaches (eg, through the armpit) have inherent problems.
What kind of implants should I have?
The new silicone implants achieve the most natural results. In my opinion, the “Gummy Bear” implants are too firm and saline implants are too round and ripple. If they break, the fullness of your breast disappears.
Can’t you just put my own fat in my breasts to enlarge them?
Fat injections into the breast can be done; however, they need to be repeated since fat often goes away. The results can give you lumpy breasts and the increase in size is minimal. I do not recommend this procedure.
What kind of anesthesia do you use for breast surgery?
I usually use a mild general anesthesia and place local anesthesia in the breast to reduce post-operative pain. You are asleep, feel no pain, and are not aware of the surgery taking place. At the end of the surgery, I use a long-acting local in the breast so you have almost no pain for 12 or more hours.
Where do you place the implants?
Implants can go either above or below the muscle. We used to put saline implants below the muscle to hide rippling, but now that we are using better silicone implants, I place most of them above the muscle. This minimizes pain and gives you more natural looking breasts. Having them placed under the muscle can be more painful and often results in a longer recovery.
Will I need any other surgery on my breasts?
If your breasts are droopy (ptotic), you may need to have a breast lift at the same time. A breast lift will result in more scars, but implants alone rarely give a good result when you have ptotic breasts.
How long is the surgery and do I stay in a hospital?
The surgery is usually done in my AAAASF-certified operating room; you rest in the recovery room for a couple of hours and go home with a companion later in the day. The only bandage is a special bra and some gauze over the incisions.
What can I expect after I go home?
You should rest for the first day or two; there is usually only minor discomfort and you will be given an analgesic if you need it. You will be given an appointment to return in 5-7 days. You can remove the gauze over the incision after 48 hours and shower. Keep the bra on 24/7 until you come for your follow-up appointment.
What is the recovery like?
On your first post-op visit, I will inspect the incisions. There are usually no sutures to remove as I put them all on the inside. Your breasts may look fuller, but they will round out and drop over the first few weeks. It usually takes 3 months for all of the swelling and remodeling of the breasts to occur.
When can I go back to work or the gym?
It all depends on the type of work you do. Usually you can return to work within the first week. I recommend you wait 2 to 3 weeks before starting strenuous activities or exercise. There is minimal down time with a well done augmentation.
Can I be allergic to the silicone implants?
No one has reported a true silicone allergy; silicone is considered one of the safest substances placed in the body. However, some people will form scar tissue around the implants called a capsule, which makes the breast feel firm. The occurrence of this ranges from 2%-10%. Capsules can be minimized and treated.
Are most patients happy after breast augmentation?
Yes. If a patient has a complaint, it is usually that they wish they chose a bigger implant. We try to pick the perfect size with you and work to make sure you are delighted with the result.