Breast Implants | Matthew Schulman, M.D.

Archive for the ‘ Breast Implants’ Category

Celebrity Looks to Avoid – “The don’t-wannabe list”

It is common for my patients to request specific body parts of celebrities. Topping this list is Angelina Jolie’s lips, Kim Kardasian’s butt, and Jennifer Aniston’s breasts. This is common in plastic surgery, and plastic surgeons have come to expect (and accept) this because many of these body parts represent what we consider the aesthetic ideal.

Just as frequently though, patients request not to look like well known celebrities. This list of celebrity “don’t-wanna-be” changes a few times a year, but here is a list of the most common celebrity no-nos and tips to avoid looking like them. (more…)

“Fixing” Breast Implants Gone Bad

Breast augmentation remains among the most common cosmetic surgeries performed each year. While commonly done, it is also commonly done “badly.” Revising breast augmentations is among the most difficult procedures that plastic surgeons perform. Unfortunately, revising breast augmentations from other surgeons remains common in my practice.

In order to understand how problems can be fixed, we must first understand where problems can occur. I like to categorize these problems into 4 major areas: (more…)

It is Possible to Get “Natural-looking” Breast Implants

Many women desire breast augmentation but decide not to have the surgery because they fear looking “fake.” There are ways to avoid having breasts that announce to the world that they are implants. It is possible to have breast augmentation surgery that gives a natural-looking result. Here are things to keep in mind: (more…)

Will Breast Implants Affect Breastfeeding?

Because the majority of my new york city breast implant patients are young women of childbearing age, the issue of breast implants and breastfeeding is an important one. I am routinely asked if the presence of breast implants affects the ability to breastfeed. While many people think that they do, the answer is “No.” Breastfeeding with breast implants also does not place the baby at any risk.

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Why Your Breasts Change – Observations from the Beach

As I lounged on the beach this weekend (with my SPF 50), my eyes wandered to all the breasts around me. It’s ok, because as I tell my wife, it’s all “research” and I assured her it was for my latest blog entry. Breasts can be found in a variety of shapes and sizes. But the point is that the breasts that I observed are likely not the same size and shape that they were five years earlier. Breasts are extremely susceptible to changes – they change with age, weight, pregnancy, and breast feeding. To understand why, we have to examine the physiology of the female breast.

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New Breast Funnel Improves Breast Augmentation Results

I perform a lot of breast augmentations, especially as we approach the warm summer months. While my results have been excellent, there are a few things that we as plastic surgeons have little control over: the development of capsular contracture, implant rupture, and poor scarring. Of course, we use a variety of techniques to reduce the incidence of these things, but there still remains a large unknown component. (more…)

How To Choose Your Breast Implant Size

Selecting the size for your new breast implants can be a difficult task. Many women allow this decision to “stress them out” because they fear making the wrong decision. I will start out by saying that while the decision is important, it should not be a major source of anxiety. Many women are too focused on the volume number (or “cc’s”) when the truth is that there is very little noticeable difference between close volumes – only your plastic surgeon (maybe) will be able to tell the difference between a 330 cc implant and a 350 cc implant after it is implanted. In general, people only notice volume differences of at least 50 cc’s.

Here are a few guidelines to help you choose your implant size.

Determine your personal preference of size – This is done by looking at magazines and photographs in order to determine “how big” you want to be. You should find 3 photographs: “just right”, “too big”, and “too small.” You should bring these photographs with you so that your surgeon will have a sense of what you are looking for.
As implants get larger, they also get wider – This concept is important in choosing a size implant that fits your body. If you are very small framed, then large implants may be too close to each other in the center or may protrude off the side of your chest. Your doctor will measure the width of your chest to determine you “base diameter.” This will help him guide you towards a size that fits your body shape and size. Breast implants are now available in several different shapes such as low projection and high projection. This gives you added ability to have an implant that fits your body.
You may not be able to be as large as want – It is not possible to make a big jump in breast size in all women. This is because there may not be enough tissue (breast and skin) to allow for a very large increase in size. Your doctor will examine you to be sure, but size increases of more than 2 full cup sizes may not be safe. If you are an A cup, and desire to be a DD, this may not be possible in a single operation. You may have to increase to a full C, than a few years later (after your tissue has stretched out) have the implants increased in size to a DD.
Small volume differences may not be noticeable – Most people only notice volume changes of at least 50 cc’s, so if you cannot decide between a 330 cc implant and a 350 cc implant, so not stress because the difference will be difficult to tell once they are placed. When trying different sizes, you should increase and decrease by 50 cc volumes
Larger implants are heavier – As an implant gets larger, it also gets heavier. This means that very large implants may result in shoulder and back pain, similar to the complaints of women requesting breast reduction surgery. Also, heavier implants may increase the likelihood of future breast sagging, or ptosis.
Take your time – You should not feel rushed or pressured into choosing your implant size. Your surgeon should allow you time to “try on” the implants and examine yourself in clothing. It is best to try them with a simple, non-padded, non-push-up bra, and a tight t-shirt. This will give you the best idea about your post-operative result. Many surgeons will also allow you to borrow the sample implants so that you can see how you feel about the size of the implants over a few days. I routinely tell my patients to wear the implants for a few days, go out to dinner, visit friends, or wear them to work – this is the best way to determine how you feel about the size.

So, implant size is a combination of personal preference and your body’s shape and size. You should have an idea of what size breasts you ultimately want to have, and your doctor should be able to tell you if that size is safe for you. Many Plastic Surgeons now have the ability to use computer simulations to show you what you will look like with different size implants. This may be helpful, but there is nothing better than wearing the implants for a few days.

Silicone or Saline – Which is the better breast implant?

Several times each day I am asked the question, “Is silicone or saline a better implant?” I explain that I cannot say which is “better” because it is impossible to define “better.” Also, breast implant selection is a very personal decision. I do tell my patients that silicone implants tend to look more natural and feel more natural. They then must decide if this constitutes “better” in their mind.

Silicone implants have used for a long time. In the 1980s and 1990s there was immense controversy surrounding silicone implants. There were accusations that silicone implant carried with them a risk of cancer and auto-immune diseases. In response, these implants were removed from the market, except for the use in breast reconstruction after mastectomy. During this time, plastic surgeons began to gather an incredible amount of data about these silicone implants and the patients who have had them implanted. After 14 years of data collection, the data was analyzed and there was no evidence that any systemic or chronic illnesses can be attributed to silicone implants. In 2007, the FDA removed the restrictions and silicone implants were again approved for use in cosmetic breast augmentations.

In my practice, approximately 80% of women select a silicone breast implant. They find the implant softer, more natural, and without the common “rippling” that can be seen in saline implants. Also, many patients who previously hassaline implants placed, have returned to have the implants exchanged to silicone.

The rate of implant rupture and leaking is no different between saline and silicone. The only difference is that a ruptured saline implant is very obvious – the woman will “deflate” within days as the body absorbs the salt water. Detecting a silicone implant rupture is more difficult. Because silicone is not absorbed by the body, the breast will not “deflate.” Rather, there may be a slight change in the overall shape and feel of the breast. This change may be so slight that it can go undetected for motnhs. An MRI is needed to absolutely detect a ruptured silicone implant.

The other difference is that a silicone implant is supplied pre-filled, as opposed to a saline implant which is empty and inflated after it is put in the body. This means that a larger incision is needed to place a silicone implant. It also makes silicone implants more difficult to place through the underarm and impossible to place through the belly button.

As stated earlier, implant selection is a very personal decision. As a physician, I provide the details of each implant type, giving enough information so that my patient can make an informed decision for herself.