Breast Augmentation: What to Expect the First Week After Surgery

Posted on November 17, 2018 by Joyce

“From small beginnings come great things.” – author unknown

From resting and eating to lifting and love-making, here’s what you can expect – and do – from the first day after your breast implant surgery to your first post-op visit one week later. Top tip: Listen to your body.

RECOVERING
How will you feel after getting breast implants from Denver breast augmentation surgeons? Women most often describe the feeling as discomfort, not pain. Those who have had children say they feel like they did when their breasts were fully engorged with milk after childbirth. Women who haven’t had kids describe the feeling as tightness, burning or pressure. The discomfort usually starts to ease up on the fourth day after surgery. Until then, you can take the medications that are prescribed to make you comfortable during the recovery period. Read more about breast augmentation here.

RESTING
You’ll be home the same day after your surgery, and you need time to rest and heal. That doesn’t mean you have to stay in bed, but you should take it easy for one week. Listen to your body and the instructions given to you post-op – not to the voice in your head that tells you the living room needs vacuuming. If you need an excuse note from chores, your doctor should be happy to write one for you.

♥ “I was so scared of having extreme pain and I only had a little discomfort. It’s just been 8 days and I feel great, sexy and beautiful.” ♥

EATING
Although patients very rarely report nausea and vomiting after their surgery, it’s best to start off with clear soups the first evening. Although it might be tempting to order a pizza, avoid fast food for the first day. By lunchtime the day after surgery, you can eat whatever you want – even a big meal.

DRESSING
Generally, patients will wear a sports bra day and night the first week after surgery, except for when they take a shower. The band at the bottom of the bra helps to re-establish the crease under the breast. View our Before & After photo gallery to see what this looks like.

♥ “The recovery was way faster then I thought.” ♥

SLEEPING
You don’t have to sleep on your back or sit up all night after breast augmentation surgery. You can sleep any way you want from the night of surgery on, including on your stomach, if you are comfortable enough. You won’t pop or displace your breast implants by sleeping on them; they are extremely durable. [WATCH OUR VIDEO: Do I Have to Sleep on My Back?]

WASHING
You can take a shower the day after surgery, but you should wait until the third week to take a bath. If you soak in a tub, the water could penetrate the incision and cause an infection. By contrast, the shower water runs off the incision and doesn’t soak into it.

♥ “I went home shortly after surgery, had absolutely no nausea (ever!) and ate dinner regularly. The next day I was up and walking around, even left the house to get a mani pedi. The recovery has been incredibly easy.” ♥

DRIVING
Anesthesia stays in your system for at least 24 hours after surgery, which means you’ll be a little groggy. You might also be taking medication for discomfort the first few days. If you aren’t taking any narcotics, you can probably drive as early as Day 3.

LIFTING
For the first few days, you will need to depend on someone else to lift your baby or toddler. On the third day (if you had surgery on Monday, Day 3 is Thursday), you can pick up your child to transfer them to a crib, high chair or car seat. This rule is to ensure your comfort and minimize the risk of bleeding around the implants. You should not carry your child for extended periods until a couple of weeks after surgery

LOVE-MAKING
No sex for a full week. Sexual activity could raise your blood pressure and cause bleeding around the implants. At the first postoperative visit, your doctor should examine you to make sure you are healing well – before they give you the go-ahead.

♥ “My recovery was smooth with very little discomfort.” ♥

WORKING
Most patients are back to work in an office setting by the fifth day after surgery. Patients who use their arms a lot – including hairstylists, waitresses, and nurses – are comfortably back to work by the end of the second week.

Note: Each doctor has his or her specific post-operative protocol, and it’s imperative that you follow your doctor’s instructions, which might vary from what I have written here.

Redditors Asked Me Anything: Breast Implants, Cadavers, Rockin’ Hooters & More

Posted on January 1, 2018 by Joyce

I’ve answered hundreds of questions about breast implants in my office and in my book, The Scoop On Breasts: A Plastic Surgeon Busts the Myths, but answering questions on Reddit? That’s another story!

On Dec. 13 at 4 p.m., I hosted a Reddit AMA (Ask Me Anything!) session. I was introduced like this:

IamA Guinness World Record Holding Breast Surgeon. I’ve examined at least 56,000 breasts during my 25-plus-year career as a plastic surgeon. I’m an expert knife and tomahawk thrower. AMA!

I might not have gotten as many questions as Barack Obama, Jerry Seinfeld or Arnold Schwarzenegger did when they were on Reddit, but I probably had as much fun. Here are a handful of the questions I was asked and my responses.

♦ Tinkletwit: Did you train on cadavers? If so, was the former person aware that they’d be getting implants in the afterlife?

Drted: Two years ago, I trained other surgeons on a cadaver in a workshop at Louisiana State University. They wanted to learn my approach to simultaneous breast augmentation and lift. About the afterlife? I didn’t know so I googled it and found this on HuffPost: “Most programs won’t allow you to donate your body for a specific purpose. You give them the body and they decide how to use it.” So I guess the person didn’t know she would be getting new, perky breasts.”

♦ Nine_2_nine: I’ve nursed three babies in four years for 12 months each, so my boobs are pretty much shot. I’m considering fixing them sometime in the next 7 years or so. How would my boobs age as I age? Would they eventually sag? Would I be an old lady with rockin hooters?

Drted: As you age, you lose skin elasticity. Everything begins to droop a bit and go south. If you have breast implants, they won’t stay up high. They’ll move south, too, along with your breasts. You’ll be a rockin’ old lady with normal hooters!

♦ DrPolitick: What’s the farthest someone has traveled to get boobs from you?

Drted: India first, and then Ireland. (My office is in Philadelphia.) A woman from Oregon rented an RV and took a family road trip to Philly so I could do her surgery. I’ve had patients from many places in between, but these are pretty much the farthest.

Jerry Seinfeld didn’t talk about breasts during his Reddit session, but he did on Episode 56 – The Shoes – of Seinfeld. Watch it here.

♦ ChamberofSarcasm: How often do techniques change? In the 80s we had silicone and big scars on the underside of breasts. Then they went in the nipple, then the armpit. Do you think there’s a best method? Is there still a challenge or complication to be addressed or solved?

Drted: Techniques change maybe once a decade. For example, the silicone implants of the 1980s were more liquidy. Now they are more cohesive – like the gummy bear candy that doesn’t leak. Breast implants are always being studied and researched for safety. I feel that the best incision is in the crease under the breast because I don’t have to go through any breast structures to place the implants.

♦ Guacamole Bay: Have you ever done breast with with a tomahawk?

Drted: For breast surgery, I prefer to use smaller, sterile and balanced instruments. But if I were ever sculpting a wooden totem pole, I would consider using a tomahawk!

♦SameArkGuy: Have you ever not wanted to work on someone’s breasts because you thought they were already good?

Drted: There have been times when I thought a woman’s breasts looked good as they were, but she wanted enhancement and I felt I could accomplish her goals. My experience is that women know what they want, and my job is just to listen.

♦ ChamberofSarcasm: Do you feel a sense of competition with other surgeons? Like a brain surgeon or ortho?

Drted: With other surgeons I feel more camaraderie than competition because they understand what’s involved in the responsibility of cutting into a person.

♦ 2009_G8GXP_for_sale: What’s the youngest and the oldest age of patients you’ve done the procedure on?

Drted: The youngest was 18, which is what the FDA recommends, and the oldest was 72. She wanted to feel as good on the outside as she did on the inside.

♦ Solutionsfirst: What’s the #1 thing that would significantly make the overall process of surgery or surgery in your field significantly better?

Drted: Although it’s important to keep improving surgical equipment and techniques, what’s most important, I think, is improving doctor/doctor and doctor/patient communication. For example, some doctors think that patients might be discouraged by hearing about the risks and be prepared for them. We’re all grownups, and we want to know all that can happen so we can make an informed decision and know what to expect.

To read Dr. Ted Eisenberg’s entire Reddit, conversation, click here.

Breast Augmentation: Lessons Learned From 56,000 Breasts

Posted on October 2, 2017 by Joyce

I’ve examined a lot of breasts – at least 56,000 – during my career as a plastic surgeon. How’d I get to that number? About 7,000 women have come to me for breast augmentation surgery. On average, I see each woman about four times – once before her surgery and three times afterward for post-op visits.

So, 7,000 women x 2 breasts x 4 visits = 56,000. That’s not a problem that would have been on your sixth-grade math homework.

Through the years, I’ve observed every variation in breast size and shape, in breast perkiness and nipple size, and in women’s thoughts about their figure and their surgical goals.

If I could sum up what I’ve discovered in one sentence, it would be this: You shouldn’t make assumptions about who gets breast augmentation – and why.

Don’t assume that . . .

. . . many of my patients are exotic dancers. Only about 1 percent of my patients are exotic dancers. The other 99 percent include teachers, nurses, hairstylists, construction workers, doctors, ballroom dancers, stay-at-home moms, company executives, waitresses, fitness trainers, bartenders, cheerleaders, policewomen who want to know how soon they can put their bulletproof vests back on, and women in all branches of the military who email us from Iraq and Afghanistan to set up appointments for when they are back in the United States. This is not a complete list.

. . . breast implants are just for younger women. True, the large number of breast augmentation patients are in their 20s, women who come in because they want to feel more feminine and self-confident. “It’s pretty bad when your 13-year-old sister can already wear your bra,” one woman told me.

The second largest demographic is in their 30s. Many women in this age range come in because they liked the fullness of their breasts during pregnancy and want to recapture that look. Others have lost weight and with it their breast volume.

Women 40 and older – and even in their 60s – come in for breast augmentation surgery, too. They want to look as good on the outside as they feel on the inside. They tell me they’ve been taking care of everyone else for years and now they’re ready to do something for themselves. Many have been thinking about breast augmentation for years. View our Before & After Photo Galleries.

. . . women get breast implants to attract attention. “Do you want to be proportional, turn heads or stop traffic?” That’s what one of my colleagues asks a prospective breast augmentation patient to see what she has in mind. I’ve tried it. Most women tell me they want their figure to be more proportional, and they want to fit better in their sweaters, bikinis and tank tops. Some comment that they wouldn’t mind turning heads now and then. Not many want to stop traffic. Ironically, some of my patients are policewomen who literally stop traffic – but they would rather not do it with their breasts.

. . . women get breast implants to make men happy. Only two women out of 6,000 have ever told me that their partner wants them to get implants. Instead, women have consistently told me that their partners love them exactly the way they are, and they are having surgery to make themselves look and feel better. So, sorry guys. Women don’t get implants to please you. That might be an outcome, but it’s not the motivation.

. . . a woman’s breasts are the same on the right and left side. Breasts are sisters, not twins. Few women have identical breasts; the difference might be slight or more obvious. Nipple position, chest diameter, the amount of breast tissue, the location of the breast on the chest wall, and how high or low a breast hangs all contribute to the appearance. With all these variables, it is no surprise that no one has identical twins.

. . . women need much guidance from me. Women know what they want. During medical training, we are taught that we should know the answers, that we are the authority. But I have discovered that women know best. My job is to listen carefully and to determine if there is a match between their goals and what I can accomplish. I believe I am an expert at figuring that out.

What’s Love Got to Do With It?

Posted on February 18, 2017 by Joyce

In honor of Valentine’s Day, you’ll find some questions and answers below about cosmetic breast surgery and relationships. They are excerpted from The Scoop on Breasts: A Plastic Surgeon Busts the Myths, which I wrote with my wife, Joyce, my childhood sweetheart.

Can I see your license and registration?
On Valentine’s Day, famous pairs come to mind, like Romeo and Juliet, Hillary and Bill, and Beyonce and Jay-Z. Here are some other pairs that we read about in online forums, where women shared the names they chose for their “girls.” In many cases, they called their breasts by boys’ names! Breast nicknames don’t seem to be interchangeable: Women were specific about which name went with their right breast and which went with their left breast. Here’s a sampling:

License and Registration
Shock and Awe (Dolly Partons’ choice)
Ben and Jerry
Tweety and Sylvester
Thelma and Louise
Bill and Ted (“because they have excellent adventures”)
Bogie and Bacall (“old style but still a classic pair”)
Dyan and Pachelbel (“two great canons”)

Can you keep a secret?
Lauren (not her real name) got when she was married to her first husband. When she remarried, she kept it a secret from her second husband, which created a challenge when she decided to get bigger implants. Husband No. 2 thought it was her first surgery and asked to come to the consultation with her. When Lauren called to schedule her appointment, she asked us to pretend that we had never met her.

Stephanie (not her real name) was one of my breast augmentation patients. When her 22-year-old daughter expressed interest in implants, Stephanie recommended me but didn’t tell her daughter why. She never admitted that she had an augmentation because she was afraid her daughter couldn’t keep a secret, so I had to.

Will my boyfriend know that I have breast implants?
Most women look natural and proportional after their breast augmentation surgery and can keep it a secret if they are so inclined. If they are ever in the mood, they can choose to show off “the girls.”

One patient told us that she had been with her boyfriend for more than a year. When he complimented her on her “perfect breasts,” she simply said thank you. He didn’t find out that she had implants until he looked through one of her old photo albums and saw a picture of her at the beach – before her surgery. He still thought her breasts were perfect! See breast augmentation before and after photos here.

After my augmentation, can I let my partner touch my breasts?
Your breasts may look like a masterpiece, but there’s no need to hang a “Please Don’t Touch the Art” sign on them. Breast augmentation is an investment that you can enjoy. There’s no need for a “You Break It, You Buy It” sign either. Your breast implants aren’t fragile.

My partner wants me to get breast implants. What do you think?
If you said this to me in consultation, I would ask if you wanted breast implants. If you said you were happy with how you look, I would tell you to go home. The surgery has to be for you, not to please someone else. Only a few women out of 6,000 have ever asked me this question. Although many men have the fantasy that women get implants to make them happy, they are wrong. Women get implants to make themselves happy. Sorry guys.

Here’s an excerpt from a letter written by the husband of one of my patients: “My wife was unhappy with the size of her breasts for years, basically as long as I have known her. I honestly didn’t understand it: I knew she was smaller than most women, but I didn’t care. I liked her how she was. She never complained, but she did mention it every so often. After 25 years, I still didn’t “get it,” but knowing how important it was to her, I finally agreed to support her idea to get surgery.

“If I were to give advice to the partner of a potential patient, I’d say the following: If this is important to your significant other, support and embrace the change, because the benefits of this surgery for us extended way beyond any cost of time, money and recovery.” You can read more letters like this here.

Ashes to ashes, dust to bust: When her husband died in a car accident, a young Australian woman allegedly had his ashes sewn into her breast implants so she could keep him close to her heart. The news generated a lot of online comments, such as, “Now his relatives will always look at her boobs and cry.”

What Are the Odds?

Posted on October 23, 2016 by Joyce

Breasts come in twos. So do shoes, socks, gloves and earrings. Many other things come images in threes: a three-ring circus, primary colors, the little kittens that lost their mittens, and the number of blind mice in a group.

Over the last five to 10 years, when I’ve reviewed charts in the operating room before I begin surgery, I’ve been noticing that, “Oh, look, everyone is from out of town today,” or “Everyone’s Asian today.”

My cosmetic breast surgery patients seem to come in clusters. In other words, they share some distinguishing quality. Is it a cosmic biorhythm, an unexplainable phenomenon? What are the odds?

Austrian biologist Paul Kammerer studied salamanders and toads – and coincidences. In 1919, he published a book recounting all of the coincidences he had collected. He wrote: “Coincidences aren’t coincidences at all but the result of an invisible force in nature that – like gravity, magnetism, symbiosis, and so on – favors unity, symmetry and coherence.” He called his theory the law of seriality.

I don’t know whether these patient groupings are statistically inevitable or proof of Kammerer’s law, but I do know that my staff does not arrange the surgical schedule this way. Women choose their surgery date according to their convenience; we don’t choose it for them.

Some of the coincidences can be related to the seasons. We see large numbers of teachers and students who have the same school breaks. Many other clusters aren’t seasonally related.

donuts-643277_1920 Does this phenomenon occur in other settings? Does a hairstylist notice that one day all her clients are redheads; on another day everyone says, “Just cut it a little bit”? At Dunkin’ Donuts, is one day all about glazed jelly donut? Do the chocolate frosted donuts sell out on another day?

Even though my patients range in age from 18 to 67, on some days everyone is in their early 20s; on another day they’re in their 30s, on another in their 50s.

Here are some other clusters I’ve noticed: One day everybody might have children; whereas on another nobody has kids. One day all the women who live in the Philadelphia area close to my office, while on another day everyone came from out of town.

I’ve also had days where all the patients were Spanish, and others where they were all Italian or all Russian.

I’ve had days where everybody was a nurse and others where all were a stay-at-home mom.

Sometimes, the women’s choice of implant size is the common denominator: Everyone seems to be choosing bigger implants one day, while others are “smaller size day” and “average size day.” This might correlate with the stature of the patients, which is another common denominator. They might all be tall and have big frames or all be more petite.

I’ve also had days where all the patients were perkier and other days where all were droopier. And even though breasts are sisters, not twins, some days all the women are fairly symmetrical and on another day they are more noticeably uneven.

Maybe I’m observing these similarities because I’m solely performing cosmetic breast surgery, and that’s making the coincidences more statistically possible. But on a recent surgery day, when I was chatting with the OR staff and I asked them their favorite ice cream flavor, they all said mint chocolate chip.

There might just be something to this theory of seriality after all!

Some Breast Augmentation Statistics:
To measure women’s interest in breast implants across the United States, RealSelf.com analyzed millions of searches on its website by region for its 2011 Interest Index. (They assumed that women were doing the searching.) Interest in breast augmentation surgery was 74% higher than the national average in Salt Lake City, followed by Fresno, Honolulu, Oklahoma City and Mobile. It might just be a cosmic phenomenon (or a lot of patient referrals) but I think Philadelphia would be on the list if they conducted the survey in 2016!

Timing Your Breast Augmentation Surgery

Posted on June 15, 2016 by Joyce

Whether you are planning a beach vacation or a wedding, hoping to get pregnant or lose weight, or entering a sports competition, timing is everything when you are considering breast augmentation surgery.

Taking a Beach Vacation
Around three weeks after your breast augmentation surgery, you can go in a hot tub, swimming pool or the ocean. At that time, Screen Shot 2016-06-15 at 7.27.01 PM the incision will be healed enough so that water won’t penetrate it and possibly cause an infection. You can go tanning as early as three weeks after surgery, too. Ultraviolet light, whether from the tanning bed or the sun at the beach, can make a scar redder for a longer period of time, so protect your incisions with sunscreen that has a sun protection factor (SPF) of 15 or higher.

It’s best to wait at least eight weeks before making a major investment in new bras and swimsuits. At that time, you will be able to more accurately determine your postoperative size and shape and get a truer fit.

Wedding Planning
It takes about eight weeks for breast implants to begin to settle into their new size and Screen Shot 2016-06-15 at 7.28.34 PM shape. If you want to get a true fit, it would be unwise to go wedding gown shopping before then. Since wedding planning calendars usually recommend that you order your gown 8-10 months out, it means your surgery should be a year before the big day. If you can’t plan that far ahead, you could schedule surgery anywhere up to about four months before the wedding. That way, you’ll be able to get your gown’s bodice adjusted at the fitting, which is usually done about 6-8 weeks before the ceremony.

Pregnancy and Breastfeeding
If you are thinking about having a child in the next year or working on it now, I would suggest that you wait because your post-pregnancy breasts might look different from your current pair. During pregnancy, your breasts will enlarge from hormonal changes and milk production. Afterward, they might return to their original size or get smaller, bigger or droopier. You won’t know the verdict – and if you’re a candidate for a breast lift – until six months after you have stopped breastfeeding or, if you are not breastfeeding, six months after childbirth.

If parenthood is further in your future and you are anxious to enjoy new breasts now, you don’t have to wait. Just understand that you might need a revision after pregnancy.

Weight Loss
When you lose weight, it not only reduces the size of your waist and thighs, but it might also reduce the size of your breasts, because breasts are made up mostly of fatty tissue. If this happens, you might be left with saggy breasts and stretched skin. If you are planning to lose 10 percent or more of your body weight, it makes sense to wait until you have reached your goal before you have breast augmentation surgery. In order to choose breast implants that will make you proportional, you need to know your true starting size.

Training for a Competition
Three weeks after surgery, it’s OK for you to do aerobic activity (treadmill, stationary bike, Screen Shot 2016-06-15 at 7.26.45 PM etc.), running and lower-body weight training. Women are usually comfortable doing arm exercises (upper-body weights) starting about six weeks after surgery. I have Triple Crown bodybuilders and kickboxers who go back into competition after getting implants. They start with light training at six weeks and heavier training after eight weeks. None of their implants has deflated.

For more information about breast augmentation surgery, click here.

10 Things to Consider Before Breast Lift Surgery

Posted on April 28, 2016 by Joyce

Are you a candidate for a breast lift? Should you also also get implants? What can you expect during recovery? Here are 10 things to consider.

1. A breast lift, or mastopexy, raises and firms the breasts, giving them a more youthful look. I do this by removing the excess skin, moving the nipples to a new, higher position, and suturing the remaining tissue together to create a sling – essentially a natural support bra – that raises and reshapes the breasts. I use the I.D.E.A.L. Breast Lift technique, which I created and have been teaching to doctors from around the world.

2. To determine if you are a candidate for a lift, try the “pencil test.” Take off your bra and look in the mirror. Place a pencil horizontally along the crease under your breast where Screen Shot 2014-10-13 at 10.02.39 PM your bra band would rest. Does your nipple – not your areola – rest above, below, or at the pencil?

3. If your nipple is above the pencil, relax. You are probably not a candidate for breast lift surgery. Use some of the money you save for new, uplifting bras.

4. If your nipple hangs below the pencil, your breasts would be considered moderately to severely ptotic (or droopy) and you would need a breast lift to raise and reshape your breasts.

5. If your nipple is at the pencil and your breasts are mildly droopy, it’s a borderline situation. You might get a good result with an implant alone because a breast augmentation can give the illusion of a lift. As the implant fills out the upper portion of the breast, it also fills out the lower portion, which makes it appear as if the nipple is located higher on the breast. After about 9 months, when the implant has settled, you’ll have a better idea if you are perky enough. You can always get a lift later if needed.

Titbit: In medical lingo, ptosis is the word for a drooping body part;
breast ptosis is classified as mild, moderate or severe. Hint: The “p” is psilent.

6. After a lift, your breasts will be the same size as they were before surgery, because only excess, stretched skin is removed during a breast lift; no breast tissue is taken away. You’ll look exactly how you look before surgery when you are wearing a good bra.

7. To determine if you need a breast lift and implants, put on your bra and look in the mirror. If you are satisfied with the size of your breasts, then a breast lift alone might be the right procedure for you. If you wish your breasts were bigger, you are probably a candidate for a breast lift and implants (an augmentation mastopexy). To get an idea of the results, check out some of my before and after photos of breast lift surgery and breast lift with implant surgery.

8. Women report minimal discomfort after breast lift surgery. That’s because a breast lift involves removing only loose, stretched skin. If implants are added at the same time, the skin and muscle will be stretched, which may cause a little more discomfort.

When a Philadelphia DJ came to me for breast lift surgery,
she recorded her experience from start to finish in this intimate video blog.

9. More than 90 percent of my patients are back to work on the fifth day after surgery if they work in an office setting. Women whose work requires lifting, pushing or pulling usually go back to work toward the end of the second week. They might be a little sore at the end of their workday, but by Week 3, they feel pretty much back to normal.

10. It’s very likely that breast lift surgery won’t affect your ability to breastfeed because your milk ducts, which run from the mammary glands to the nipple, are not disturbed. Only skin from the perimeter of the areola is removed, and there are no milk ducts there.

Breast Augmentation: The Second Time Around

Posted on March 19, 2016 by Joyce

Times change. And so may your breast size.

When women come in for a breast augmentation consultation, I tell them about two circumstances that could change their surgical results in the future: pregnancy and significant weight change.

During pregnancy, breasts enlarge from hormonal changes and milk production. Afterward, they could return to their original size or get smaller or bigger. And because breasts are made up mostly of fatty tissue, they will get bigger or smaller as you gain or lose weight. Often, they are the first indicators.

Although your breasts may change, your implants will remain the same. They don’t need to be replaced every 10 years. In fact, I’ve changed a woman’s implants after 19 years – she had a child, got smaller and wanted to go bigger – and the implants looked the same as they did the day I put them in.

About 10 percent of my breast augmentation patients come in for a consultation to get information about making a change. The average time elapsed is about 10 years, though it varies greatly.

They tell me, “I’ve gained a lot of weight, and I’m much bigger than I want to be. I’d like to go a little smaller.”

Or, “After my two children, my breasts got smaller. I just want to get my pre-pregnancy size back – and maybe a little extra.”

Others say, “I went for the gusto 15 years ago. I’ve enjoyed them and they served their purpose, but now that I’m 50something, I just want them a little smaller.”

Like the first time, we look at before and after photographs of women who started out similar to them in height, weight, frame size and breast volume. They tell me, “too big,” too small” or “just right” so I know what size implants to order.

Breast augmentation surgery is easier the second time around. Here’s what’s involved in upsizing or downsizing:

Less discomfort: To change each implant, I go through the same incision that I made initially in the crease beneath the breast. I don’t have to make a pocket beneath the chest muscle for the implant, so there is less manipulation of breast tissue and therefore less discomfort post-op. All you’ll feel is the incision. Consequently, you’ll likely need less medication after surgery for discomfort.

Shorter procedure time: This second surgery takes less time than your initial breast augmentation surgery, which means less anesthesia and a lower possibility of post-operative nausea and vomiting.

Shorter recovery time: You should still take it easy for a week, but you could probably get back to work on the third day because there is much less chance of bleeding. So if your surgery is on a Friday, you could return to work on Monday. First-timers are generally back to work in an office setting in 5 days. And you don’t have to wait until the sixth week to do upper body weights. You can start up again after three weeks.

Quicker results: Because your skin and chest muscle have already stretched to accommodate your implants, the implants won’t start off high like they did the first time. You’ll pretty much see the final result when you get home. After surgery, I’ll have you wear something supportive like a sports bra for three weeks to protect your incision. At that time, you’ll be able to wear and do anything and everything you want. No waiting eight weeks this time to go shopping for new bras and bathing suits.

“I love my implants, but I wish I went bigger.”

Posted on January 31, 2016 by Joyce

“Worth it but kinda wish I went bigger.” “Love ‘em but wish I went bigger.” Breast augmentation forums, such as RealSelf.com, are filled with comments like these.

After doing thousands of breast augmentation consultations, I’ve identified four reasons that women hold back from choosing the size they really want to be. If you can avoid these traps, you’ll likely be satisfied with your choice after surgery.

Holding back based on concerns that people will “know.”
Some women don’t want others to know they had a breast augmentation, so they choose smaller implants: “I don’t want to look fake.” “I don’t want people to notice.” “I don’t want people to judge me,” they say. They need not worry.

I assure patients that most women look natural and proportional after their breast augmentation surgery and can keep it a secret if they are so inclined. Patients tell me that their most observant friends and family members are often aware that something is different. They ask questions: “Are you just back from vacation?” “New haircut?” “New outfit?” “Are you working out now?” They can’t figure out exactly what has changed.

Choosing breast implant size by looking at pictures taken at 3 months after surgery or earlier, instead of looking at fully settled breasts.
When post-op photos are not labeled, you don’t know how far along a woman is in the Screen Shot 2016-01-19 at 9.12.18 AM healing process. If you are looking at online photos taken 3 months or less after surgery, consider this: The breast implants have not yet settled into their final position. They are pressed up high, like your breasts would be in a push-up bra. They are not fully settled until 9 months post-op, and at that point they often will look smaller than they do at 3 months. You’ll likely be disappointed if you choose your implant size from pictures that were taken three months after surgery.

In general, your breasts look smaller when you are dressed than when you are undressed. So my before and after photo book includes pictures of women 9 months after surgery both unclothed and clothed, in a bra, tank top or blouse.

Making a decision based on cup size.
Our last blog post explained that being proportional doesn’t mean wearing a C cup bra. Click here to read “Can you make me a full C cup?”

Making a decision based on Internet forums and input from friends.
You might like the 375 cc implants you saw online, but are you comparing apples to apples? The woman whose breasts you were admiring might have started out with breasts that were larger or smaller than yours, and she might be a different height and weight, too.

If you’re starting with a full B cup and that woman started with a mid-A, you won’t end up the same size when you both get 375 cc implants. You’ll be about 1-1/2 cup sizes bigger – the extra cup you started with.

Likewise, friends who have implants might weigh in on your choice: “One of my girlfriends who has implants said that the implants I selected are too large for me. She has me second-guessing myself,” a patient told me.

My advice is that after you’ve looked at pictures of women who are similar to you and your frame, and you’ve chosen the size that seems right to you, trust yourself. Go with your gut or your heart – not your head. Remember that you’re the expert for yourself.

Can you make me a full C cup?

Posted on January 20, 2016 by Joyce

When they come in for their breast augmentation consultation, most women tell me that they want to be a “full C cup” and they want to look proportional. They think this means they will wear a C cup bra after surgery.

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Problem #1: There is no standard bra cup-sizing system.
“C cup” can mean one thing if it’s made by Victoria’s Secret and another if it’s made by Vanity Fair. You might wear a B cup in a full-coverage bra and a C cup in a demi bra, even if the same company makes both styles. Your cup size is also affected by how tight you wear your bra band. If you wear it tighter, it will push your breasts deeper into the cup and you will need a larger cup size.

Problem #2: What looks proportional varies from person to person.
I prefer to describe proportional as a “C look” instead of a “C cup.” To achieve the C look, a 5-foot woman with a small frame might only need a B cup while a 5-foot-8-inch woman with a large frame might need a D cup.

During each breast augmentation consultation, I show prospective patients before-and-after photographs of women who started out similar to them in height, weight, frame size and breast volume. Every photo notes the size of the implants that I used. Women look at the pictures and tell me, “too big,” “too small” or “just right.” It’s like looking through a magic mirror into the future. A woman is almost always consistent as to the number of cubic centimeters (ccs) she likes, so I know what size breast implants to order to give her the look she wants on her body.

Screen Shot 2016-01-19 at 9.08.28 AM When we are finished the process, women almost always ask, “What cup size will I be?” This is where they can get into trouble. Again, the letter doesn’t matter. It’s a cup size look. They chose a look, and it looked right to them.

Here is an example of that trouble: A 5-foot-9-inch woman with a large frame wanted to be a full C. She liked eight different pictures. They all had the C look on her body type and were all the same number of cubic centimeters (ccs). I asked her if she liked the look, and she said, “Yes.” When I told her she would probably wear a D cup, she said, “I don’t want to be a D.” She was stuck on the cup size. She decided to go smaller and was disappointed after surgery.

A woman with a small frame also wanted to be a full C. After voting on the pictures, she asked for her final cup size. I told her she would probably wear a B. “Can you show me something bigger?” she asked. She had looked at larger implants, and she didn’t like the pictures that were even a tiny bit bigger. She decided to stick with the size she liked in the pictures, and was happy with her decision.

What implant size is equal to a C cup?
Breast implants are measured in cubic centimeters (ccs), not cup size. On a woman who is completely flat-chested and has a medium-sized frame, a 450 cc implant would be equivalent to the average C-cup bra.