After surgery, do I have to sleep on my back?

By Dr. Ted
The information below is what I tell my patients to do and to expect after breast augmentation surgery: Each doctor has his or her specific postoperative protocol, and it might vary greatly from what you read here. It’s imperative that you follow your doctor’s instructions.

There’s a myth that after breast augmentation surgery, you’ll need to sleep on your back for a week or longer. Many of my patients believe it, and they are worried that they won’t be able to get to sleep, because they normally lie on their side or their stomach.

They are not alone. According to the Better Sleep Council, fewer than 15 percent of people prefer to sleep on their back.

Screen shot 2013-08-28 at 3.10.12 PMLet’s bust this myth: You don’t have to sleep on your back after breast augmentation surgery. You don’t have to stay up all night to make sure you don’t doze off and turn over onto your stomach. You can sleep any way you want.

The implants won’t pop if you sleep on them; they are extremely durable and can withstand a lot of weight. In fact, Allergan, an implant manufacturer, tests its implants by exerting 55 pounds of force on them repeatedly, up to 6.5 million times. (That would be equivalent to sleeping on your stomach for the next 17,808 years.)

Just as your contact lens can’t slip behind your eye, your breast implants can’t disappear into your body. They are carefully positioned in a space (a pocket) behind the pectoral muscle. Just like contact lenses, the implants can’t go anywhere because they bounded by muscle and strong tissues. The normal movement in the pocket won’t disrupt your healing.

I instruct my patients to wear a sports bra for one week after their surgery, and they sometimes think that the bra’s purpose is to keep their implants in place. That’s not true. As stated above, the implants aren’t going anywhere!

The bra simply gives the bottom of the breast and the incision a little more support to counteract gravity as you sit, stand and walk around during the day. When you wear a bra, there is less pressure on the incision, which can make you feel more comfortable. The incision, which is made in the crease beneath the breast, won’t pop open, either. It’s closed by three layers of dissolvable stitches, which provide strength to the incision for months until it is completely healed.

Screen shot 2013-08-28 at 3.04.59 PMThe only factor limiting your sleep position is comfort. Most women tell me that they are fully comfortable sleeping on their stomach in about three weeks on average. They are comfortable sleeping on their side much sooner.

Sweet dreams.

 

Will my implants boil, melt, or keep me afloat?

By Joyce
photo
Summer officially arrives this Friday, June 21, which means it’s time to tan, swim, dive, sunbathe and unveil your new bikini. If you are also unveiling a new set of ta-tas, it’s time to get answers to some pressing questions like these:

When can I go tanning?
You can start working on your tan as soon as three weeks after surgery, but be sure to protect your incisions with sunscreen that has a sun protection factor (SPF) of 15 or higher. Ultraviolet light, whether from the tanning bed or the sun at the beach, can make a scar redder for a longer period of time.

Will my implants cook in a tanning bed?
If you want to get a tan before you head to the beach, you can go to a tanning salon without worry. Tanning salons use ultraviolet rays, which don’t cook anything. They don’t use microwaves, even though some people think they do. This was proved by a 2005 episode of MythBusters when the crew placed two raw chickens in a tanning bed for one hour. The skin got a little darker, but the chickens were still raw inside.

Will my breast implants keep me afloat in the ocean?
Screen shot 2013-06-19 at 2.56.48 PM
Don’t count on it. Here’s why: Most people are neutrally buoyant, which means they don’t float up or down; they hover. More fat makes you float; more muscle makes you sink. It is gravity that eventually pulls you down.

Saline implants are filled with salt water in about the same density as the ocean water you are swimming in, so they are neutrally buoyant, too. You will float more easily in the ocean than in a pool because salt water is heavier than fresh water, but the same basic principles apply.

Silicone gel implants are slightly denser than water. Although they won’t make you sink, you might have to doggie paddle just a little bit harder. That’s why it is recommended that after getting silicone gel implants, a scuba diver does a checkout dive to see if she needs to adjust her dive weights.

Will scuba diving harm my breast implants?
A research team at Duke University Medical Center placed silicone gel and saline implants in a hyperbaric chamber to simulate the pressure experienced by scuba divers at various depths. When a diver is underwater, the increased pressure causes nitrogen, a component of the air we breathe, to build up in the blood and body tissues. If a diver surfaces too quickly, the nitrogen gas can form dangerous bubbles, similar to the bubbles you see when you first open a bottle of soda.

The moon jelly, a species of jellyfish, is round, translucent and gelatinous. That’s why, when it washes ashore, it’s easily mistaken for a silicone breast implant.

The moon jelly, a species of jellyfish, is round, translucent and gelatinous. That’s why, when it washes ashore, it’s easily mistaken for a silicone breast implant.

So what happened to the breast implants? The medical experts at DAN, the Divers Alert Network, summarized the findings on their website: “The bubbles that formed in the implants led to a small volume increase, which is not likely to damage the implants or surrounding tissues. If gas bubbles do form in the implant, they resolve over time.” No implants were harmed in the study.

Do breast implants melt in a sauna or in the sun?
Implants have a silicone shell, which would melt at temperatures greater than 392 degrees Fahrenheit. A conventional sauna is typically between 150 and 190 degrees. Unless you are sunbathing on the sun, you’ll be fine. If you are really worried, expose them only at dawn and dusk.

Can my implants boil in a hot tub?
Your implants are inside of your body, and you would have to boil the outside of your body before the inside boiled. The average hot tub temperature of 102 degrees Fahrenheit isn’t hot enough to do that.

Nuff said. Have a great summer. And if you find some men staring at your cleavage, remind them of what Jerry Seinfeld had to say: “Looking at cleavage is like looking at the sun. You can’t stare at it. It’s too risky. You get a sense of it and then you look away.”

 

Why did “The Scoop on Breasts” go to Hollywood?

Because it got an offer it couldn’t refuse! GBK Productions of Hollywood invited us to participate in their pre-Oscar luxury lifestyle gift lounge in honor of the 2013 Academy Awards. That meant our book would be part of the “swag bags” and we’d be there to hand it out.

Wayne Knight (Newman)

Wayne Knight (Newman)

The event took place in beautifully designed suites in the Sofitel Hotel in West Hollywood on Feb. 22 and 23. Gifts included exotic all-inclusive trips, expensive watches, dazzling jewelry, silk bedding for dogs, Viva Diva wines, gourmet cookies from Cookie Daddy, a $3,000 gift certificate for a ride on a private jet – and our book about breasts.

College age men and women were hired to escort each star from room to room and to carry their very duffle bags that were so big they could hold a body. By the end of the day, the bags were so heavy with gifts that some of the escorts had to drag them down the hall.

CCH Pounder (Law & Order, Avatar)

CCH Pounder (Law & Order, Avatar)

As each star arrived, their escort would hold up a clipboard with their name and most important roles on the back, so we could see who was coming. We couldn’t help noticing that when people entered our room, their eyes were drawn right to our 6-foot-tall banner displaying our book cover and breasts that were almost 2 feet tall!

We gifted each celebrity with a copy of the book and a $1,000 gift certificate toward cosmetic breast surgery performed by Dr. Ted. (Maybe they can use their jet gift certificate to get to Philadelphia.) We also asked them to autograph our banner.

Most people signed their name around the outside of the sign until Tony Dennison (Major Crimes) broke the ice and autographed the right breast. He noted that it wasn’t the first breast he had ever signed. Next up? Sugar Ray Leonard, who was in attendance to promote his foundation that supports Juvenile diabetes research. He wrote “Be a knockout!” right across the cleavage.

Sugar Ray Leonard

Sugar Ray Leonard

The actors and actresses were friendly, gracious and generous with their time. Some asked serious questions: How long do implants last? Can you breastfeed after you get them? What inspired you to write the book? Others joked a bit and Dr. Ted joked right back. How could he resist telling a joke to Richard Kind, who played cousin Andy on Curb Your Enthusiasm, or to Terry Crews, who made him laugh out loud in White Chicks and The Expendables.

Terry Crews

Terry Crews with his wife and the authors

Although we wanted to give the stars the scoop on breasts, many of them already had it. Raphael Sbarge (Once Upon a Time) and Pamela Adlon (Californication) both had roles in the 1997 film Breast Men, which starred David Schwimmer and Chris Cooper as the doctors who created breast implants. The movie was promoted as “Two young doctors with a dream of making it big  . . . really big.”

We are certain that Wayne Knight (Newman on Seinfeld) is acquainted with breasts. He might have been hanging out in Jerry’s apartment when Jerry said, “Looking at cleavage is like looking at the sun. You can’t stare at it. It’s too risky. You get a sense of it and then you look away.” And he probably saw a pair or two when he appeared on Nip/Tuck, the show about two Miami plastic surgeons. Evan Handler now plays Charlie Runkle on Californication. He was one of the stars of HBO’s Sex and the City – he was Charlotte’s divorce lawyer and later her husband. We suspect he saw plenty of breasts on that set.

Dr. Ted was tickled to meet Chazz Palminteri, who he loved in Analyze This, and Bruce McGill, the sheriff in My Cousin Vinny. He’s seen both movies so many times that he can recite their lines.

Camilla Luddington  (Grey's Anatomy)

Camilla Luddington
(Grey’s Anatomy)

I was thrilled to meet Newman (he makes me laugh just by looking at him) and Bruce Greenwood, who I had seen two nights earlier starring opposite Denzel Washington in the film  Flight. We gave our book to Jayson Blair, a handsome young actor on The New Normal; soon after he tweeted this: “My lady @TheRue has been reading this book for the last hour non stop. It’s brilliant!” TheRue is Rumor Willis, daughter of Bruce Willis and Demi Moore. We love to imagine the book sitting on her coffee table.

Back at home, we turned on the TV and were excited to see some of our new celebrity “friends” on Scandal and Shameless and House of Lies. It was a once in a lifetime opportunity for us. We’ve almost used up our 15 minutes of fame.

“At what age were you the happiest with your breasts?”

Ultimo Beauty, best known for its “Miracle Solutions Plunge Bra with silicone gel that can add up to two cup sizes,” recently conducted a study on women’s views on their assets. Results showed that “women are most happy with their breasts in their mid-20s, with 38 percent saying that was when they were most satisfied.”

When they crunched the numbers further, they discovered that “British women rate their boobs most highly when they hit 26.” What’s a 26-year-old look like? Think Lindsay Lohan, Megan Fox or Lady Ga Ga.

Screen shot 2013-01-21 at 10.58.39 AMWhen I think back, I remember some things about my 26th year: my job (I worked at the Jewish Exponent in Philadelphia), my apartment (a townhouse in Roxborough), my husband (that same Dr. Ted who I’m still married to!), and my dog Ginger (a Cairn terrier who looked like Toto in The Wizard of Oz,) but it’s hard to imagine my 26-year-old boobs and how they looked compared with my 24- or 28-year old boobs.

So I brought out an old photo album and searched for my 26-year-old self. I found a picture of me in a bikini on the beach at a Club Med in Guadeloupe, and I looked damn good. I guess I could vote for 26, too.

THE TEEN YEARS
Next, Ultimo found that “a wistful 28 percent of women admitted they thought theirs were best during their teenage years.”

I wouldn’t agree: My breasts didn’t amount to much in my teen years. I was envious of  the friend in my middle-school crowd who was the first to develop and wear a bra. If she were British, she would have been one of the 28 percent, I suspect, because when I saw her as an adult, it turned out she was an early starter, rather than a strong finisher.

What changed for me between ages 16 and 26? I gained a little weight, and my breasts, which are made up primarily of fatty tissue, were the beneficiaries. Unfortunately, these days when I gain some weight, it goes straight to my butt or my hips, not to my chest. Not fair.

THE 30s
Finally, Ultimo’s survey revealed, “One in seven (14 percent) claim they were at their best in their 30s.” My breasts were at their peak, so to speak, when I was in my 30s, specifically at ages 32 and 35 when I was pregnant with my son and then my daughter. Thank you, children. However, the size increase was not long-lasting. After I stopped breastfeeding, I returned to my pre-pregnancy size.

What does the future hold? It doesn’t hold up your breasts. “Generally things start heading south after women hit their late 20s,” the survey concluded.

You could consider options, like a breast lift or a good support bra that does the lifting for you – bras with names like “Ultimate Lift” or “Magic Lift.” The survey didn’t talk about what happens to breasts when they turn 65. But we know that they’ll get some good “perks” – like $2 off on a movie ticket and a discounted cup of coffee at McDonald’s. Now that’s something to look forward to.

Do you mind that your husband looks at breasts all day?

Some people ask outright. Others just think it.

When my son and daughter were in middle school and their friends heard their dad’s cosmetic breast surgery commercial on the local radio station, their first question would be: “Does your mom mind what your dad does?”

I don’t mind. I’m not a jealous type of person in any way, and I know that my husband is professional and appropriate. I know that a doctor can view a body part as just a body part. Countless breast exams and pap tests have proven that to me.

At work, Ted considers breasts like Stedman’s Medical Dictionary does, as “two large hemispheric projections situated in the subcutaneous tela over the pectoralis major muscle on either side of the chest.” At home, they are more like “like two fawns, twins of a gazelle, that graze among the lilies, as King Solomon wrote in Song of Songs.

Okay, so he’s not that poetic, but he does like breasts, and seeing more than 16,000 of them in his lifetime has not ruined it for him, as some people think.

At work, Ted is objective, which my Webster’s dictionary defines as “neutral, detached, uninvolved, and evenhanded.” Strike “evenhanded.” I’m not so fond of that adjective. At work, breasts are measured from side to side and nipple to crease; skin elasticity is judged, size is evaluated.

At home, Ted is subjective, which the dictionary defines as “personal and emotional.” When people ask him if I mind that he looks at breasts all day, he tells them: “No. Because hers are the ones that speak to me, the ones I come home to.”

And when he comes home, he is not judging and measuring. He is simply appreciating. When I demand, “Look at mine objectively. Do you think my breasts are a little droopy?” he says, “They are perfect just the way they are.” I know that’s his subjective opinion. I like to think it is his professional opinion as well.

The Breast Blog Ever

Our goal is to augment your reading pleasure with a great blog about breasts inspired by our new book “The Scoop on Breasts: A Plastic Surgeon Busts the Myths.”

Dr. Ted will draw on his experience with over 5,000 breast augmentations, which has earned him a Guinness World Record for most breast augmentations performed in a lifetime. He’ll answer patient questions and share his experiences. Joyce will offer up fun facts – the titbits and extra padding.

We hope you’ll find this blog amusing and revealing, as well as educational and entertaining. We look forward to hearing from you.

– Dr. Ted and Joyce Eisenberg