Brad Herman, MD

There is no secret formula. In fact, everybody’s idea of a Full C-cup varies. What I have found most useful in my practice, is a simple exercise. I have my patients try on an unpadded bra and then fill the cups with samples of the actual implants that they are considering. They can even try their clothes on top. This gives me and the patient a better idea of what they are calling a Full “C”.

It is always possible to have "too much" Plastic Surgery. If your Plastic Surgeon does not understand the results that you a seeking, leave immediately and find another doctor. Communication between the patient and the physician is as important as the physician’s skills. If your doctor does not understand what it is that you are trying to achieve, he or she will never be able to deliver the results you seeking.

The big advantage of fat grafting is that it is much longer lasting. Where fillers like Restylane and Juvederm last about 6 months or so, fat can last a decade or more. Laser skin resurfacing serves a different purpose than fillers. It is best for the improvement of the fine lines rather than the deep lines and folds that fillers like Restylane, Juvederm and fat grafting treat.

Many patients are confused as there is lots of misleading information out there...

 

The truth is, there is no exact "shelf life" or expiration date when it comes to breast implants. It is a common misconception that implants need to be replaced every ten years. I've seen patients whose implants have lasted 20+ years trouble-free, but have also seen patients who have experienced implant leakage after only a few years. If you are not having any problems with your implants, there is no need to replace them no matter how much time has past.

 

With saline implants, a leak is easily identified, because patients will notice the breast deflating and becoming smaller in size. It is not painful or harmful as the saline (or salt water) is just absorbed by the body. Although not critical to your health, replacement is recommended as soon as possible. Saline implants do not require any special monitoring.

 

A rupture or leak is a harder to tell with silicone implants. The silicone gel tends to stay in the area of leakage and the volume or size of the implant is maintained. The newer generation of implants do have lower rupture rate than older implants, but detection is still difficult.

 

The first way to evaluate the silicone breast implant is with a physical examination by your plastic surgeon. Very often the first sign of a leak or rupture is thickening or hardening in the tissues surrounding the implant. Confirming a leak can best be done with an MRI of the breast, as a mammogram is not very good at detecting leakages. With silicone breast implant leakage or rupture, it is recommended that the implant be replaced or removed as soon as possible.

 

My recommendations for monitoring silicone implants are a yearly physical examination by a plastic surgeon and an MRI every other year.

 

The answer is yes. The ability to breastfeed post breast reduction is dependent on the type of technique used during surgery. The reason you sometimes hear that breastfeeding isn't possible after a reduction is because a breast reduction surgery can impede full milk production if milk ducts are severed or nerves are damaged.

There are two main types of breast reductions. With the pedicle technique, the nipple and areola remain attached while the excess breast tissues is removed, maintaining breast function and nipple sensation. The free nipple technique requires both the nipple and areola to be removed, thus severing glands and in turn, losing complete function, sensitivity and obviously lactation.

If breastfeeding is important to you, it is important to select a board certified plastic surgeon that has experience in the surgical techniques needed to preserve the ability to nurse.