Seattle Doctors

Are Rubbing "Squeaky" Noises 3 Weeks Post op Normal?

I had my BA 17 days ago(sub-muscular silicone). Immediately after the surgery I noticed a lot of squeaking and popping, which I knew was normal and it went away. However, my right breast has begun making a fairly loud rubbing noise when I do my massages or when I move my arm in certain directions. It feels like the implant is rubbing on my chest wall when it moves. Is this normal this many days out? My friend jokes that I have a squeaky toy now - funny as long as it goes away! Thanks.

The "noise" is the shell of your implant rubbing on the rib cage, making friction and that is what makes the squeak.  There will be a smooth slippery layer of tissue forming between these two surfaces soon and the bothersome squeaking will go away. I have never had a patient where it didn't eventually disappear.

If you are still bothered by tis after 6 to 8 weeks be sure to go back to your surgeon

Phillip C. Haeck, MD

Seattle Plastic Surgeon

I Had Implants Done 27 Years Ago, Not Sure if They Are Saline or Silicone. How Can I Tell?

Is there any way to tell if I have silicone or saline implants?

There only two ways to know what you have had done in the past:  Obtain your records from the surgeon's office where you had them put in.  The type of implant will be listed in your file.  Short of being able to do that the only other way is to have a plastic surgeon remove them.  When the surgery is over he or she can tell you what they found.  

Twenty seven years ago the implants weren't made like they are today.  Very few people drive twenty seven year old cars.  I highly recommend getting these exchanged for newer implants soon.

Phillip C. Haeck, MD

Seattle Plastic Surgeon

Borderline Needing a Lift. Are Subglandular Silicone Implants Right for my Ptosis? (photo)

I've had consults with 3 PS's and am considering around 450cc silicone implants placed over the muscle. I don't want a lift at this time and one PS told me this would be my best option for a lifting effect without a lift. I don't have kids yet and would be open to a full lift in the future, instead of just having a circumareolar mastopexy now. Would HP or mod profile implants be best for upper-pole fullness? And would 450cc silicone in the subglandular position be appropriate for me?

Breast implants do not lift breasts, lifts lift breasts. Implants fill breasts out where they are.  It is difficult to tell from your photos whether you are borderline (nipple at level of inframammary crease but not significantly below;  some overhang of breast but little enough that an implant, whose bottom lies at the level of the fold, will fill out the lower pole of the breast adequately so that the breast does not "hang" off of the implant), or whether you are worse than borderline.  If you are truly borderline and want to avoid a lift, I would suggest undergoing the augmentation alone and seeing if you are happy.  The worst that can happen is that you will need to return at some point for a lift, which is essentially a skin operation, does not require reoperating on the implants, and is associated with very little discomfort.  The best that can happen is that you avoided the extra scars and extra expense of a lift, and end up happy with your result.

I would strongly recommend that you do not compromise your breast augmentation result in your attempt to avoid a lift...such as by choosing larger implants than you otherwise would in order to fill out your loose skin (and in the process encouraging post-operative skin and tissue stretching and thinning that is irreversible), or placing the implants over your muscle as you have been told this will better fill our your ptotic skin (in a thin patient leading to a higher risk of a visible upper implant edge, visible implant wrinkles, and longterm stretching and thinning of your tissues).  In my opinion, an implant placed under the muscle with the dual plane technique is equivalent in filling out a loose lower pole to placing the implant above the muscle, but still provides better camouflage and coverage in the critical upper pole.

I have had many patients with borderline or mild ptosis have a good result from augmentation alone with careful and conservative subpectoral dual plane techniques, but if someone needs a lift, then they need a lift.  And if you are on the bad side of borderline and need to be convinced that you need a minor lift, see what the results are from augmentation alone.  Just don't compromise the augmentation procedure trying to avoid a minor lift.

Robert M. Grenley, M.D.

Seattle Plastic Surgeon