The mother tends to persuade a smaller sized breast implant. Perhaps this is the mother’s maternal instinct to “protect” and she feels that large breast implants will portray an image that is not “daughterly”. I have watched many battles occur in my office between mother and daughter about implant size.

On the contrary, the husband tends to recommend larger implants. This is probably due to man’s attraction to large breasts. Husbands can at times attempt to mold their wives into their ideal image, and if that husband is a “breast-man”, than he will suggest larger implants. It can be quite interesting when I see a woman alone in consultation and we select a small-moderate sized implant, but when she returns with her husband, she is suddenly trying on large sized implants.

Implant size is a matter of personal taste. You need to choose and implant size that you will be happy with. Of course, the person who helps you in the decision process may have a different opinion about which implant size is best, but you need to ultimately make your own decision.

To learn more about breast implant augmentation in New York City with Dr. Schulman, contact me or call 212-289-1851.

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:

1. Problem with the implant itself
2. Problem with the size of the implant
3. Problem with the procedure choice
4. Problem with healing

Choosing the implant is of crucial importance and I have written specifically about this in previous blog entries. The shape, texture, and size of implant must be carefully chosen to match your body. Many problems that can occur can be the direct result of choosing an implant that is too big for your body. This can result in implants touching each other in the center (synnmastia), implants appearing to “hang off” the sides, or augmented breasts that now appear “droopy”. Breast implants have a specific width, depending on the size. Your doctor should carefully measure the width of your chest (“base diameter”) so that the proper implant size can be chosen.

Implants must be placed within a carefully created implant pocket. If the implant pocket is too big, then the implant may move around in an unnatural position. If the pocket is not centered under your nipple, then the implant will be positioned too much to the center of your chest or the side. If the pocket is too small, then your implant may be “constricted” and take on an oval shape instead of the natural round shape.

There are also several variations in the type of breast augmentation that is performed. The implants can be placed above or below the muscle. Also, some women come to my office because they want “perkier” breasts and mistakenly think that breast implants will give them a lift. While breast implants do result in a slight lift of the breast tissue, breast augmentation primarily makes the breast larger and will not adequately correct a “drooping” breast. This would require a breast lift, possible with the simultaneous placement of implants. There is complex decision making that must occur, even before you get to the operating room.

Even if your surgeon chooses the right procedure, the correct implant size, and does everything perfectly in the operating room, your body still must heal. Not only must your body heal correctly on the outside (the incision), it must heal correctly on the inside. Abnormal scar formation on the inside may result in capsular contracture – or hardening around the implant. We now know that bacteria and blood can place you at increased risk of this abnormal scar formation, but there are some women who seem to be “predisposed” to capsular contracture. If it can be recognized early, there are some things that we can do to slow the progression.

So, “fixing” the problem relies on the surgeon’s ability to identify what the cause is. Revisional surgery may include exchanging implants to a sixe better suited for your body, enlarging or reducing the implant pocket, removing abnormal scar tissue, or performing a completely different operation than had been done originally (i.e. a breast lift). Some of these complications are avoidable by selecting a surgeon who understands the complexities of breast surgery. However, sometimes problems can occur that are not preventable, but revisional techniques are evolving and surgeons experienced in these complex revisional surgeries can improve things.

Contact us if you have any further questions about fixing bad implants. We will be happy to help!

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.