In general breast implants have no impact on a woman’s ability to breast feed. The exception is when breast implants are part of a larger breast procedure such as a breast lift and breast implants, or breast reconstruction. These complex surgeries often require relocating the nipple, which can disrupt the milk ducts and limit the ability to breastfeed. But, straightforward breast augmentation (regardless of the location of the implant or the placement of the incision) does not interfere with the ability to produce milk or transport milk through the milk ducts.

Rupture of a breast implant is rare, but does happen. The leaking of saline (salt-water) or silicone will not contaminate the breast milk and harm the baby. Also, breastfeeding does not increase the risk for implant rupture.

It is true that there are women out there who have had breast implants placed and now find themselves unable to breastfeed. Most likely the women would have had difficulty breastfeeding, regardless of the breast implants. Women with small breasts may have difficulty producing enough milk to successfully breastfeed. Many women who choose to have breast augmentation do so because they have small breasts and desire an increase in breast volume. Therefore, there is a statistical increase in the number of women with breast implants who report difficulty breastfeeding – but as described above, this is unrelated to the implants.

As with everything, there are a few exceptions. If your breast augmentation surgery damaged the nerves of the nipple and areola, your ability to breast feed may be compromised. This is because nipple sensation is required to stimulate milk release.

Overall, breast implants surgery, when done correctly by a board certified plastic surgeon in new york city, is extremely safe and should have not interfere with breastfeeding or place you or your child in harms way.

The internal support of the breast is composed of a network of dense collagen fibers termed “Coopers Ligaments.” This internal bra is responsible for maintaining the shape of the breast, independent of the quality of the overlying skin. As you age, the support structure naturally weakens. The weight of the breast also places strain on the ligaments, thereby “stretching” them over time. This is why it is rare to have naturally large, “perky” breasts. While there is no known way to “strengthen” Coopers Ligaments, wearing a well supporting external bra, especially during exercise, may delay the normal weakening that occurs as you age.

The actual composition of the breast is also important. The breast is composed of a combination of breast tissue and fat. The ratio between the two varies dramatically among women. Women who have heavy, dense breasts may have a breast tissue to breast fat ratio of 2:1. Women with soft, less dense breast have twice as much fat as breast tissue. This ratio between breast tissue and breast fat is very significant in how the breast changes and what breast contouring procedures you may require.

Breasts with a majority of dense breast tissue may be more likely to droop over time. This is because the weight of the breasts causes weakening of the internal support of the breast. As you age, the breast will continue to droop, making a breast lift necessary.

Breast tissue will also change with hormonal changes. So, dense breasts may be more likely to enlarge during pregnancy and breastfeeding. After the hormonal surge of pregnancy is over, the breast tissue may shrink in a process called “post-partum involution”. Correction may require a breast augmentation with implants and sometimes a simultaneous lift.

Breasts with a majority of fat are lighter and less likely to droop. However, the fat in the breast is extremely sensitive to changes in your body weight. Gaining weight may cause your breasts to enlarge and this often does not regress if you are to lose the weight in the future. This may make a breast reduction necessary.

Breast fat is also not as sensitive to the hormonal changes of pregnancy, so enlargement and involution from pregnancy hormonal changes is unlikely. However, weight gain that often accompanies pregnancy may result in enlargement of the breasts. Conversely, weight loss can cause loss of fat in the breast, and make the breast “deflate”. Correction of this may require a breast enlargement with implants.

So, breasts size and shape will changes throughout your life. Understanding the internal support of your breasts, and the ratio of breast tissue to breast fat will help you anticipate these changes. Fortunately, breast contouring has evolved so that there is a procedure for virtually every complaint. New techniques allow for shorter incisions that are more easily hidden, and a more rapid recovery from surgery. Also, implant technology has evolved so that modern implants look and feel more natural, and are more durable then earlier generations of breast implants.

If you are interested in learning more about a breast procedure, contact my office to schedule a consultation.

Recently, I came across a new device to be used in breast augmentation. It is called the Keller Funnel, developed by a Texas Plastic Surgeon. The device resembles a pastry bag. A silicone breast implant is placed inside this bag and essentially squeezed into the surgical opening in the breast.

While very simplistic in its actual design, the concept is exceptional. It allows for a truly “no touch” implant technique. This device allows the surgeon to place the implant, without having it come in contact with his hands or the patient’s skin. This reduces potential bacterial contamination, reduces infection risk, and more importantly, may reduce capsular contracture. Capsular contracture is the development of abnormal scar tissue around the implant, resulting in an implant that looks distorted and feels hard. No one knows why capsular contracture develops in some people, but a leading theory is that a small amount of bacteria on the implant may lead to the development of this abnormal internal scar tissue. It may also be the result of the talc commonly found on a surgeon’s glove. The “no touch” technique is an important concept and until this funnel, was only possible through very large incisions.

In addition, a large amount of pressure is needed to force a large silicone implant through a small incision. This immense force may contribute to a weakened shell and a delayed rupture of the implant years later. The rupture rate has been estimated to be as high as 7% over the first 10 years. The breast funnel allows insertion of the implant with much less force, thereby potentially reducing the incidence of implant rupture.

Lastly, using the breast funnel, I am able to place the implants through a significantly smaller incision. This shorter incision means a shorter scar, and a happier patient. I have reduced the length of my incisions 1 cm.

I am still among a small group of plastic surgeons who have incorporated the breast funnel into their practice. Since I began using it, my incisions are smaller, my operating time has decreased, and my patients have been extremely pleased. In terms of the potentially reduced rate of implant rupture and capsular contracture, only time will tell. The funnel is now a routine part of my breast augmentation procedure and the reason why patients choose me as the surgeon when there are hundreds of other surgeons nearby to chose from.

To learn more about breast augmenation, contact my New York City office to schedule a consultation.

First, let me dispel the myth that ten plastic surgery procedures cannot be performed in one operation. While I will admit that this is a lot, you must keep in mind the complexity of each procedure. 

From what I understand, her procedures included things like a revision of her nasal tip, fat injections to her cheeks, breast implant exchange, liposuction, etc.  These may seem like complicated procedures to the general public, but as a board certified plastic surgeon I know that these are relatively small, quick procedures.  Each procedures carries minimal anesthetic risk or risk of major port-operative complications – especially when performed on a young and healthy person.  While the media likes to focus on the seemingly large number of procedures, the complexity of each and the required anesthetic time is most important.

To give an example, facial rejuvenation surgery in my practice often includes a facelift, necklift, upper blepharoplasty, lower blepharoplasty, browlift, and chemical peel.  This is common combination of six procedures performed widely by qualified plastic surgeons.  The actual operating time of all these procedures may be less than performing one breast reconstruction.

The point is that the most important thing is the total length of the surgery, not the number of procedures. I have no personal knowledge about how long Heidi’s surgery lasted, and if it was an exceedingly long surgery (in excess of 6 hours), than one may argue that it was “too much” – but the fact that ten procedures were done should not be the sole reason for the uproar.

Many people also point out that Heidi is only 23 years old.  Her young age and good health make her a good surgical candidate for an elective surgery (or ten). She has an extremely low risk of complications.  Also the fact that she is so young does not place her at risk for future complications. Yes, as she ages, it is likely that some of her surgery will need to be redone as her body changes. Her surgeries only affect her appearance, not the function of her body or her overall health.

The real issue is whether or not these surgeries should have been performed at all.  The fact that she desires such radical changes in her appearance at such a young age does raise suspicion about her mental state. Body Dysmorphic Disorder (BDD) is a serious condition that involves a person’s intense dislike of the appearance of his or her own body.  In order to truly have BDD, the person must have the perception of a problem, in the absence of a real problem.

For example, if someone has a crooked nose with a large hump, it is understandable that they may be unhappy with their nose and desire surgery.  However, if a person has no obvious deformity, yet they cannot stand they way the nose looks in the mirror and perceive a crooked, humped nose that is not there, then this is a sign of possible BDD.  Plastic surgeons are always on the lookout for these patients because these patients will never be satisfied with the outcome of a surgery, no matter how successful the operation.  They will always perceive a deformity.

I do not mean to imply that Heidi Montag suffers from BDD.  In fact, it is more likely that she simply has a strong idea about how she wants to appear and happens to have the resources and connections to make it a reality.

My personal opinion is that her surgery was a bit excessive in that it dramatically changed her appearance to the point where she looks like a different person. But, as a plastic surgeon that routinely performs cosmetic surgery, I understand that cosmetic surgery is a matter of taste.  It is our job to perform surgery in a safe and ethical manner, without imposing our own sense of taste on our patients.

Sometimes, though, a surgeon needs to say “no” and not be affected by fame or money. Fortunately for my sense of well-being (and unfortunately for my wallet), I say “no” very often in my practice.  I just seem to sleep better at night.

A breast lift, or mastopexy, does exactly what it says – it lifts the breasts. It does nothing to change the size of your breasts.  You may notice a change in your bra size, but this is likely the result of a change in breast shape.  You may also feel like your breasts are larger, but this is because they are “perkier” and higher on your chest wall. I tell my patients that a properly performed breast lift should make your breasts appear as if they are held with a push-up bra….but without the need for the bra.

Breast implants, or breast augmentation, will increase the size of your breasts.  The increase in size will depend on the size of the breast implants placed.  While your breast size will increase, there will be minimal “lifting” of your breast tissue. 

To help women decide which procedure is best for them, a New York City plastic surgeon will perform an exam.  The key to this exam is to determine if you have breast “ptosis” or sag.  This is determined by your nipple location. The normal youthful location of your nipples is at the level of the breast fold.  As the breast begins to droop (from aging, weight changes, or post-pregnancy changes) the nipple begins to descend below the level of the breast fold.  Your plastic surgeon can categorize your degree of breast ptosis depending on the distance below the breast fold.

Only a breast lift will correct ptosis and result in a breast with a nipple located at its youthful location at the breast fold.  A breast implant will improve only the smallest degree of ptosis. 

If your breasts are not ptotic and you desire an increase in size, then a breast augmentation is the procedure for you.  Your surgeon will help you decide what implant type and size is best for your needs.

What if your breasts are ptotic but you also desire for them to be bigger?  This is common, and a simultaneous breast lift with breast implants will solve both problems.  This combined procedure is among the most difficult elective breast surgeries that plastic surgeons perform, so make sure you choose a surgeon experienced in this complex procedure 

Dr. Schulman uses the strength of his refined surgical techniques and creative talent to provide a life enhancement for women interested in breast augmentation. Dr. Schulman offers both saline and silicone breast implants to achieve breast augmentation.

During private consultation with Dr. Schulman, you will learn about every facet of the breast augmentation procedure. You will jointly decide on the right breast implant type and size, placement location such as under or above the pectoral muscles, anesthesia options, patient comforts and facility choices. You will also learn about the option to have a breast augmentation breast lift combination procedure if you are interested in improving breast sagging and droopiness as well as increase overall breast size. In fact, Dr. Schulman uses the most advanced breast lift techniques that offer maximum lift with the smallest amount of scarring. You may also learn about other common procedures that women who receive breast augmentation are interested in such as liposuction, tummy tuck, facial fillers, and eye lid surgery.