Breast Augmentation FAQ

The Center for Cosmetic Surgery

Questions About Breast Augmentation

What is the waiting period for pool/hot tub submersion after a breast augmentation?

You may submerge your incision once the surgical tape is off, and the incision is sealed over (there are no open areas to the incision). This is usually around 2-3 weeks post op.

Does every consultation come with a vectra 3D screening?

The VECTRA® 3D imaging machine can be used on all breast augmentation consultations that are done in our Golden office. It is included at no additional charge with our complimentary consultations.

Where you do you perform your breast augmentation surgeries? Is it in a hospital?

Drs. Wolfe and Vath opened their own surgical facility in December 2010. They wanted to be able to provide their patients with access to state of the art equipment and a highly trained surgical staff. Apex Surgical Facility is accredited by the AAAHC (Accreditation Association for Ambulatory Health Centers). This is a voluntary accreditation that holds our staff and surgical equipment to the highest standards, ensuring our patients’ safety in the OR as well as allowing us to provide superior surgical outcomes. Apex is also a class C operating room. This means we are equipped for major surgical procedures that require general or regional block anesthesia and support of vital bodily functions. All equipment is tested and serviced on a strict schedule. A hospital grade generator supplies uninterrupted power to the facility in the case of a power failure. Patient safety is at the core of everything that we do. Our surgical facility is solely dedicated to cosmetic surgery, and all staff members have years of experience in supporting the unique needs of aesthetic patients. We understand that maintaining your privacy is of the utmost importance. Once you are checked in for surgery, you may wait in our cozy, private surgical lounge. When you exit the building after your procedure is complete, you will leave by way of a private exit.

Is it possible to replace implants under the muscle?

It is possible to remove your saline implants that are on top of your muscle and replace them with silicone implants under the muscle. The combination of material (silicone) and placement (under the muscle) will give a much more natural result; most patients do not have any rippling in this situation.

When will nipple sensation return?

A decrease in sensation around the time of surgery is not uncommon. The nerves get stretched, and may take 12-18 months to fully recover. In some cases there may be residual numbness, but many patients do experience return of sensation.

How long should you wait to replace a deflated saline implant?

There is no medical rush to replace a deflated saline implant. There is no harm in leaving the shell in place. In fact, we have had patients wait many months or years for replacement. It is true, the capsule (or pocket) will begin to close almost immediately, but it is a very simple procedure to reopen the pocket and place the new implant.

Is it possible to combine breast augmentation and a laser skin treatment?

Yes, it is possible to combine breast augmentation and a laser treatment for the face. Many of our patients opt to do this, as the laser procedure is much more comfortable under sedation. Additionally, it does not cost much more to add on these types of procedures.

I already have implants, but they are starting to sag. Would I be able to get a lift without replacing the implants?

Yes, we can do a breast lift without replacing your current implants.

I have been doing a lot of research and your website offers the best and the most before & after photos than any other practice. I was wondering if I would still be eligible due to having Hashimoto’s Thyroiditis since 1997.

You are not disqualified from being a candidate for breast augmentation surgery due to your condition. As long as your thyroid levels are normal, you are not at greater risk for complications from the surgery.

I have breast implants and one of my breasts has started to get firm. If I have a capsular contracture, can this be fixed and if so, is this urgent?

Capsular contracture does not cause any harm to you or your breast implants. It can cause discomfort and sometimes pain and will not resolve without surgery. Your breast will continue to get firm and eventually hard. The only solution is to remove the scarred capsule, most often using the same implants. This is a relativly easy surgery and short recovery with the end result being a soft breast.

I live in South Dakota and want a breast augmentation.Can a consultation take place 1-4 days before surgery ?

We have many patients who travel to see us from around the country, and we make every effort to facilitate the process. Most patients will email us a photograph of their breasts and then set up a phone consultation with Doctors Wolfe or Vath. Should you choose to undergo surgery, a phone history will take place approximately two weeks prior to your operation. Pre and postoperative care, medications, and labwork will be discussed at this time, as well. Ideally, the surgeon will have an opportunity to examine you in person a few days before surgery, at which time you will choose your implant size and shape, discuss details such as incision placement, etc. We prefer to have patients stay in town for at least one week postoperatively to ensure that the postoperative recovery is going well before leaving town. These are general guidelines, however, and every effort will be made to keep the process as smooth and worry-free as possible. Thanks again for contacting us.

Would I be able to have a tummy tuck done the same day as a breast augmentation?

Many women have tummy tucks and breast procedures at the same time, this is commonly referred to as a mommy makeover. Take a look at our before and after pictures and you’ll see that many patients have chosen to undergo these two procedures in one surgical setting. This means only one recovery and less overall cost to you.

Are breast implants safe? What happens later on if you have a baby? Would I still be able to breast feed?

Yes, breast implants are safe. There is no convincing evidence that serious illness or disease is a consequence of Breast Augmentation surgery. Breast implants are the most studied device in the history of the FDA. Pregnancy as well as the normal aging process can affect the appearance of your breasts whether or not you have had Breast Augmentation Surgery. As far as breast feeding goes, most women can breast feed after having Breast Augmentation surgery. A small percentage may have difficulty or cannot breast feed at all.

How difficult is it to remove implants under the muscle and put new ones in? Is it possible to have them replaced in conjunction with a breast lift?

It is not a difficult procedure to remove implants or remove and replace implants. The recovery time is usually much easier than the initial surgery. It is also possible to have a breast lift (mastopexy) done in conjunction with either of these procedures.

I have had a breast augmentation but now that the breasts have had time to settle they feel smaller than I wanted.

It is not necessary to change from silicone to saline when exchanging breast implants.

Will stretch marks on the breast be improved with a breast augmentation.

The appearance of stretch marks on the breast can be improved upon by filling out the breast with an implant.

Will smoking affect my recovery?

Smoking adversely affects wound healing. The small vessels that supply blood to the tissues shrink up and prevent the necessary nutrients for healing to get to the wound. The incidence of having a wound complication such as an open wound or skin death is much higher in smokers. Furthermore, the rate of wound infection is also significantly increased in smokers for the same reason of limited blood flow. Because of this, a patient must stop smoking for a minimum of two weeks prior to surgery to decrease the risk of these complications.

I’m two months post op lift and 600cc implants under the muscle…implants still have not dropped. Does it take longer because I have larger implants?

Implants take up to 6-9 months to fully drop. By 2 months they should have changed a little, but still can look very high. With a larger implant it can take a little more time and with a lift. If you had surgery with Dr. Wolfe or Dr. Vath you are welcome to come in for a visit or you can e-mail one of the nurses a current photo and we can call you to reassure you what you are experiencing is normal.

If your breast implants need to be replaced do you need to pay for the breast augmentation all over again?

The cost of replacing breast implants greatly depends on the reason and when the initial surgery was done. Your implants may be under warranty by the implant company if there is a rupture and this may possibly include some financial assistance. The surgical requirements are usually much less than the original surgery, therefore decreasing the cost and the post operative pain involved with the initial breast augmentation surgery.

How long do I have to wait after giving birth to have breast augmentation and a tummy tuck?

It is best to wait 6 months after giving birth to have breast and tummy surgery. If you are breast feeding you should wait until 3 months after you are finished nursing.

Do you perform asymmetry surgery?

Both of our physicians do breast augmentation surgery, breast lift surgery and/or breast reduction surgery to correct asymmetry. You will need to have a physical exam to address your individual needs.

Hello I am interested in getting a breast augmentation. I would be traveling from TX and staying with a friend. I am a small B and would like to be a small to full C with silicone implants.

The decision to have a breast enhancement procedure is a very personal one. At The Center for Cosmetic Surgery, Dr. Vath and Dr. Wolfe respect each woman’s individuality, and they tailor every breast enhancement to the unique needs and desires of each patient. Many women choose breast enlargement to simply increase the size of their breasts while other women have breast enhancement to balance asymmetrical breasts. Often, young mothers choose to have breast augmentation because they have lost breast volume or “deflated” after child bearing and they want to regain the fullness they experienced before or during pregnancy. Regardless of your motivation to have a breast augmentation, this procedure can not only increase your bra size, but may change your self image and possibly your life.

What is your honest opinion about women having breast augmentation w/ or w/o breast lift before having children? Is it a bad idea? Should you just wait until you’ve had a child?

Breast augmentation makes the breast bigger and many women have this before children. The only risk regarding pregnancy is that breast feeding may be affected. Pregnancy will cause the breasts to get much bigger and then, after the pregnancy is over, the breast tissue shrinks and the expanded skin doesn’t, so many women sag and need a lift. This is true with or without implants having been placed before. If you already sag now and have a lift and then get pregnant, you may need another lift after pregnancy, so you may want to wait. But putting implants in now doesn’t change the possibility of needing a lift after pregnancy.

When would be the right time for my first consultation if I am currently pregnant?

Thank you for contacting the Center for Cosmetic Surgery and your interest in a Tummy Tuck and Breast Augmentation. We would recommend seeing you about three months after the birth of your baby. You will want to be finished nursing and your breasts have finished changing before having surgery. This may be anywhere from 1 to 6 months after nursing.

Can I have breast augmentation if I am currently diagnosed with seronegative inflammatory arthritis and am taking an immunosupressant agent (methotrexate)?

Your condition does not eliminate you as a candidate for Breast Augmentation surgery. However, taking immunosupressants may increase your risks of infection and wound complications.

Can you have the procedure done if you are under 18, but have a parent’s permission?

We can do a consultation and possibly surgery if you are under 18 as long as you have a parent or guardian present with you for all of your appointments and if you are a good candidate for surgery.

Brand you use for breast implants, which looks and feels best after surgery?

We order both saline and silicone implants from Allergan/Natrelle. Ideal implant type and style varies from person to person. When you come in for a consultation with one of our doctors, they will make recommendations based on your body type and what it is that you desire.

Hi, your website is very informative and the results are amazing. i have few questions for you. can i choose not to have the lollilop scare for breast augmentation ? i prefer to have the circular one. how long does it take to recover after Mommy Makeover ?

The lollipop scar is only necessary for women who need a full breast lift, with or without an implant. A cirucular incision is used for women who would like to reduce the size of their areola and/or if their nipple is low on the breast. The incisions used for a breast augmentation alone are around the lower part of the nipple or in the fold of the breast and both of those incisions are approximately 3-4 centimeters long. Recovery after a Mommy Makeover varies from person to person. Most people need to take 1-2 weeks off of work and at that time are able to do normal daily activities that do not increase heart rate and blood pressure or involve core muscles. Women are able to start excercising by 3 weeks and are restriction free by 6 weeks. The final results after a Mommy Makeover take up to 9 months, however, the body is drastically transformed from day one and the results are very impressive. Sexual activity can be resumed by 10-14 days. The bra and binder are worn for 2-4 weeks after the surgery. All of the sutures used in a Mommy Makeover dissolve, so no sutures need to be removed.

Do breast implants ever need to be replaced?

After having implants placed, there is no maintenance or preventative care to speak of. In other words, unless you have a problem, there is no need to routinely replace the implants at a particular age. With that in mind, many women will eventually need their implants replaced due to breakage of the shell. With saline implants, you’ll know right away because your body absorbs the saline and you “deflate” quickly on that side. With silicone implants, when the shell breaks, the gel remains in the breast capsule that your body creates around the implant and you may not know that the shell is broken. The capsule may harden over time creating the need to remove it and replace with a new implant. Keep in mind that breakage of an implant, saline or silicone, is not dangerous and it is very simple and relatively pain-free to replace.

How much time passes between the initial consultation and surgery?

Once you have had your complementary consult with one of our surgeons, it is typically 2-4 weeks before surgery. However, this can vary significantly.

Do the implants rupture, pop, or deflate?

Liquid saline implants can rupture, but this is not harmful to you. The salt water is merely absorbed by the body and the breast deflates. This happens at the rate of at least 1% per implant per year. Therefore, after 10 years, with 2 implants, you have a 20% chance of having a deflation. It is a simple procedure to remove the implant and place a new one into the pocket which is already present. The newer, FDA-approved silicone gel implants can rupture as well. If this happens, the semi-solid material inside does not leak. To detect these “silent ruptures,” the FDA advocates women have regular screening MRI examinations in the years following implant surgery. The physicians at the Center for Cosmetic Surgery will assist you in understanding the pros and cons of each implant.

Can I get a breast augmentation and tummy tuck at the same time? If so, what is the recovery time?

You can absolutely have a tummy tuck and breast augmentation at the same time. This is commonly referred to as the “mommy makeover” and is a combination procedure we do often. Most people are out and about by 7-10 days and are able to return to work by 10-14 days. You can resume low impact exercise at 3 weeks and are restriction free at 6 weeks.

My Family Physycian says I have a leak in one of my implants. What is the procedure to determine if there is a rupture?

The answer to your question depends upon which type of implants you have-saline or silicone? If you have saline implants, the deflated side would be unquestionably smaller and no procedure other than a physical exam is necessary to determine this. If you have silicone implants, a rupture is often more difficult to determine, as the silicone stays within your breast capsule and doesn’t get absorbed by the body the way that saline does. The best study to determine if you have a silicone rupture is an MRI which is costly and usually doesn’t change the management. If it has been a while since silicone implants were placed (>15 years), and you have some reason to believe that one has ruptured, replacement would be indicated. But, if everything feels and seems OK, then there is no need to go through the hastle and expense to replace the implants. Remember, a silicone rupture is not related to any systemic disease processes such as connective tissue disorders or cancer, as has been claimed in the media in the past.

Can I still have breast implants being on methadone for pain?

The surgeons would need more information regarding your overall health in order to determine if elective surgery is a safe option for you. You should check with your primary care physician and pain specialist as well. Being on methadone is not an absolute contraindication for surgery. You may just have a more difficult time with pain control after the procedure. Our patients on Methadone have done quite well.

Should I have saline or silicone gel implants?

The decision to have saline vs. silicone breast implants is a personal one. We do not recommend one over the other and both are reasonable choices. Silicone is our more popular choice, probably due to its more natural feel and significantly less “rippling”. The benifit to Saline is the cost.

How extensive is the scarring from a breast lift? Do implants fix the problem of pendulous breasts?

The goal of breast lift or mastopexy surgery is to minimize scarring as much as possible while creating the best shape achievable. If your nipple is below the fold of your breast, you would need a mastopexy. Implants alone would not give you the desired result. The necessary scarring differs depending upon the degree of sagging. Usually, a short or “lollipop” scar around the areola and down to the breast fold is employed to get the best breast shape. As you can see from our photos, the trade off is a positive one.

How big should my implants be to become a full “C?”

Any given implant volume size can produce a different breast size in different women depending upon how much breast there is to start. A 300 cc implant may make an “A” cup breast a “C,” but may not make a “B” cup breast into a “D.” You must also remember that the different bra manufacturers have not precisely standardized cup sizes, so using this terminology is fairly inaccurate.

Does breast augmentation affect nipple sensation?

Approximately 15% of women can have a decrease in nipple sensitivity after implant placement. At our Denver medical center, care is taken during surgery to avoid harming the nerves that provide sensation to the nipples.

What shape implants should I have?

The shape or style of implant is dependent upon your breasts and your goals. Most women will get the best aesthetic result from round, moderate profile implants. High profile implants may be helpful in women with thin chests who require a smaller breast width for a given projection. Although anatomic or “teardrop” implants may intuitively seem to be ideal in their design, they are rarely useful. Studies have shown that round implants are equally anatomic and natural appearing once implanted. Additionally, there is considerable concern regarding rotation of the anatomic implant causing an obvious deformed look. The type of implant certainly must be individualized to the patient, but most often, round, moderate profile implants achieve the best shape.

Should the implants be placed above or below the pectoralis muscle?

There are several advantages to placing the implants below the muscle. The extra coverage of the implant in the upper portion of the breasts assists in achieving a more natural contour and appearance. The implant is also less likely to be as palpable in the position under the muscle. There is maximal preservation of the nerves that supply nipple sensation. There is evidence that capsular contraction (heavy scar tissue forming around the implant) is reduced. Lastly, there is less interference with mammography because the implant is partially separated from the breast tissue by the muscle. For these reasons, at our Denver, Colorado, medical center, we generally feel that it is advantageous to place the implants below the muscle. However, breast surgery must be individualized and there are some scenarios, such as mild breast deformities, where placing the implant above the muscle may be more appropriate.

Is breast augmentation safe?

Yes. There are possible complications associated with the surgery and implants which are discussed below, but there is no convincing evidence that serious illness or disease is a consequence of breast augmentation.

Will I look “natural?”

There are several factors that contribute to a “natural” result. At our Denver medical center, we avoid offering any procedure that will give you the fake appearance of having two round “balls” on your chest. The goal is to have soft, perky breasts that slope gently from the upper chest with some slight cleavage which can be accentuated by a bra or bikini top. By placing the implants centered under the nipple-areolar complex underneath the pectoralis muscle, this can be achieved. The muscle assists in providing soft coverage for the implant in the upper portion of the breast so that the implant does not appear to abruptly stand out on the upper chest. Additionally, avoiding a disproportionately large implant is essential to achieving a more natural breast contour. Clearly, placing huge “DD” cup sized implants in a very thin “A” cup woman with tight chest skin will not look natural. When working within certain reasonable parameters individualized to your breasts, you can expect a natural looking result. Our photo gallery shows the outcome of breast enlargement procedures performed on many Denver area residents. Please take some time to evaluate their results for yourself.

Is breast augmentation for me? Am I a good candidate?

Breast augmentation can be used to enlarge smaller breasts, fill out breasts that have lost volume after childbirth and aging, or fill out underdeveloped or deformed breasts. How well breast augmentation will suit you depends upon your personal desires and your individual consultation at the Center for Cosmetic Surgery in Denver, CO. As long as there is an informed and clear understanding as to the reasonable expectations of the procedure, you can anticipate a satisfying benefit from breast enhancement surgery.

Are there shapes of implants other than the round ‘fakey’ looking ones?

There are round and anatomic (tear drop shaped) implants. The round implants come in various profiles, meaning the amount of projection for a given width varies. The anatomic implants do not provide a better, less fake appearing breast. Occasionally, the anatomic implants can rotate creating an abnormal and unattractive breast shape. Round implants will assume a natural, “tear drop” shape when placed correctly and the proper profile of implant is used. During the consultation, Dr. Vath and Dr. Wolfe take measurements to accurately determine the appropriate size and profile of implant to create the most natural breasts.

Can a breast augmentation be performed on an 18 year old?

Breast augmentation surgery can be performed on an 18 year old as long as she fully understands the risks and complications associated with the procedure.

Is it possible to have breast implants and never need to change them?

It is possible, but deflation happens approximately 1% per implant per year, so it is not uncommon that women need an implant replaced at some point in their lives. Most women who have implants end up having further surgery down the road, either to replace the implants or lift the breasts. Becoming fully informed about the risks and complications of breast surgery is essential prior to undergoing any procedure.

Is there a limit to how big I can be after breast augmentation?

There are limits, but these vary depending upon each patient’s anatomy and aesthetic goals. Larger implants may not fit beneath tight skin and may create a less natural looking breast. Additionally, the risks and complications associated with breast augmentation slightly increase as the implant size increases. As long as the patient is well informed and understands the goals, there is a large degree of flexibility in the size of implants that can be used. Size is largely dependent upon the patient’s desire.

What are the pros and cons of having implants after a breast lift?

A breast lift or mastopexy will lift the breast and nipple restoring a youthful, perky breast shape. Once healed after a mastopexy, it is unlikely that any further surgery will be necessary. Women after a breast lift generally feel that their breasts are smaller even though no breast tissue has been removed. Only skin is removed during a lift; however, because the breasts no longer “hang,” they look and feel smaller to the patient. Because many women desire increased size or fullness after sagging, they opt for an implant with the mastopexy. Implants, although medically safe, carry many risks, including deflation, that may necessitate further surgery. The decision is ultimately the patient’s, as long as she is well informed of the risks, complications, and goals associated with the different options.

I’m a 23 year old diabetic and roughly 40 lbs overweight. Am I a candidate for a tummy tuck and breast augmentation?

If your diabetes is controlled with diet and oral medication and you are otherwise in good health, this may be a reasonable consideration for you. Certainly, at your complementary consult with one of our surgeons, your medical history will be discussed. All risks will be reviewed and you will be examined with the surgeon explaining what you might expect as far as achieving your goals. We call these procedures a “Mommy Makeover”, and after having children, it is a very common combination. We always encourage patients to lose as much weight as they can before surgery, but you certainly may schedule your appointment and use the information as part of your goal setting. Patients often have their tummy tucks and go on to lose more weight and tone up their bodies!

What are “gummy” implants, and who can have them?

Silicone gel-filled breast implants are made of a semi-solid, cohesive material which does not leak throughout the body if the implant ruptures. These implants are often referred to as “gummies” or “gummy bear implants” due to their semi-solid, cohesive form. The FDA has now approved these silicone gel implants for all women at or over the age of 22. Many will choose the soft, natural look and feel of silicone gel implants over liquid saline implants. A consultation can give you much more information concerning your various options.

Can you still breast feed after having implants?

After breast augmentation, most women are able to breast feed. A small percentage of women may have difficulty or not be able to breast feed at all.

Where should the incision be?

There are three main choices for incision location: the crease below the breast called the inframammary fold, around the areola called pariareolar, and in the armpit called transaxillary. It is ultimately your decision. The periareolar incision heals with an extremely inconspicuous scar because of the natural color border present between the areola and surrounding breast tissue. The periareolar incision can be used in almost all patients and most choose this location. However, the inframammary fold location is very comparable and some patients prefer this route. Although the transaxillary approach is not as widely applicable and has certain limitations, this works well for some patients.

How does the surgeon know what size implants to use?

It is extremely important that you and your plastic surgeon are on the same page regarding your desired breast size and shape. Using named cup sizes is inaccurate because bra sizes vary among manufacturers. At the Center for Cosmetic Surgery in Denver, a combination of approaches is used. First, measurements of your chest wall and breast are taken. This is followed by getting a preview of your proposed look by trying on implants under a bra in our office. Finally, pictures of breasts that match your desire can help your surgeon give you the look you want.

What is capsular contraction? How do I avoid it?

Capsular contraction is when the capsule that your body forms around the implant becomes thick and heavily scarred. This is not dangerous to you but can cause the breast to become tight, hard, and unattractive. Evidence supports breast expansion exercises (massage) after surgery to decrease the tendency towards capsular contraction. Additionally, submuscular implant placement can reduce the incidence of contracture.

How do I handle screening mammography?

Women with breast implants should follow the same mammography schedule as women without implants. Mammography technicians are well versed in compression and displacement techniques used to maximize the efficacy of mammograms on women with implants. It is recommended that all women 35 years of age or older have a baseline mammogram prior to undergoing any breast surgery.

Will breast implants increase my risk of breast cancer?

The breast implants themselves do not cause cancer. There is a slight decrease in mammographic breast tissue visualization after implants; however, there is no worse prognosis for augmented women who develop cancer versus nonaugmented women. Mortality from breast cancer is not increased in women with implants versus those without.

Where is the surgery performed?

Breast augmentation is performed at the Denver West Surgery Center in Golden, Colorado. This is an accredited outpatient surgery center which ensures the highest degree of safety and the lowest infection rates.

What kind of anesthesia is used for the procedure?

General anesthesia is the preferred method of achieving adequate sedation and pain control. You will be entirely asleep for the duration of the procedure and awake in recovery before you know it. Board-certified anesthesiologists deliver the anesthesia and care for you before, during, and after surgery so that you have a comfortable and safe experience.

What is the recovery period?

You will able to go home after surgery. You will be walking around the day of surgery. The degree and duration of discomfort varies from patient to patient. Most women are able to stop taking pain medication after 2-3 days and are back to work and non-strenuous activity at 5-7 days. Low impact activity and exercise may begin at 3 weeks and unlimited activity at 6 weeks.

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