Will my breast implants freeze up in the cold?

With the ground blanketed in snow and the thermometer hovering around 18 degrees Fahrenheit, it seems the right time to consider what happens to breast implants in the cold.

Imagine that a saline implant and a silicone gel implant were just chillin’ on your lawn. At today’s balmy 18 degrees, the saline implant would be frozen like an ice cube. (Outside of the body, a saline implant would freeze at about 28 degrees Fahrenheit.) The silicone gel implant would still be soft; it won’t ice up until the thermometer dips to 170 below zero.

Screen shot 2014-01-03 at 2.36.37 PMWhen implants are part of your body, your core body temperature of 98.6 will keep them warm. One blogger conjectured, “Even if theoretically a girl was like a reptile or something and had no body heat, the freezing point of the material used in the implants would be pretty low.” In other words, you would die of hypothermia – dangerously low body temperature – long before your implants froze.

We wonder if any of the 52 passengers who were stranded for a week on a Russian research ship in the Antarctic had breast implants. If they did, they didn’t need to worry about them freezing.

If you swim in a cold pool or skate at an ice rink, your implants could cool to slightly below your body temperature, and they might feel cool to the touch. Likewise, if you hang out in a hot tub or spend the day sunbathing at the beach, your implants might feel warm to the touch. In general, implants change temperature very slowly, and implants that are placed behind the pectoral muscle are less susceptible to temperature changes.

We don’t agree with the woman on Yahoo who answered the question: Do breast implants freeze up out in the cold? With “yes, which is why girls sneak off to the bathroom immediately after those snowmobiling trips to allow for some thawing time.”  We suspect that the girls just need to go to bathroom – and put on lip gloss.

FYI: According to John Castellani of the U.S. Army Research Institute of Environmental Medicine, “The record for the lowest body temperature at which an adult has been known to survive is 56.7 degrees F, which occurred after the person was submerged in cold, icy water for quite some time.”

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.


I’m getting married next year. When should I schedule my breast augmentation surgery?

Dear Dr. Eisenberg,
I got married in May 2008, and as I reflect back on old photos, I cannot imagine the old self-conscious, flat-chested me wearing my strapless, sweetheart neckline gown. My dress was perfect and I couldn’t have worn it without your work. I can’t thank you enough for giving me the chance to choose any gown I wanted for my wedding day.” – Angela

Like Angela, many women come in for a breast augmentation consultation before their wedding: They want to be able to wear the dress of their dreams on wedding day and not be limited because of their cup size. They’ve read sites like TheKnot.com’s Neckline Glossary, which explains that Strapless is bad for “smaller chested women” and Sweetheart is bad for “the décolletage-impaired.” What should they buy? The Jewel (“a t-shirt neckline that sits at the base of the throat”) or the Sabrina (“cut straight across so less of the décolletage shows”), the site suggests.

wedding-dress-necklines-590ac120110It’s not surprising that my patients include a lot of brides-to-be, who want to go bigger before their big day. In the United States in 2012, the average age for women to marry was 27. About half of my patients are in their early 20s; the rest are in their 30s and are coming to me post-childbirth to recapture what they lost after pregnancy.

Often, these prospective brides have been considering breast enhancement surgery for years, and their wedding provides the impetus. They are no different from the vast majority of my patients, who tell me they want to look proportional and have their clothes fit better.

After all, what clothing is more important than a wedding gown? Women know that on their wedding day, all eyes will be focused on them and more pictures will be taken than on any other single day of their life. And it won’t hurt to look great in a bikini on their honeymoon, either.

While you can get your hair and makeup done the morning of your wedding, you need to plan way ahead for cosmetic breast surgery.

Wedding Planning Calendars tell you when to reserve the date, pick your bridal party, meet with the caterer, and order your gown (usually 8-10 months out.) The calendars don’t tell you when to schedule your breast augmentation surgery, so I will!

Ideally, you should pencil in “Have cosmetic breast surgery” in the “12 Months Before” category on your calendar. That way, you’ll be ready for your wedding gown-shopping trip about two months later. You’ll need that much time to heal in order to get a true fit on your gown.

That’s because when implants – especially saline – are placed under the pectoral muscle, the muscle presses the implant flat, as your hand would compress a sponge ball or a balloon, and the implant needs a place to go. It moves toward the area of least resistance – the collarbone and the armpit – which is why the implants are up high right after surgery. They begin to settle down in about 6-8 weeks.

Having your surgery a year before your wedding is ideal, but 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. This will also give you plenty of time to heal before your honeymoon, so you’ll be ready for swimming and other activities.

Looking Your Best
In 1991, I was doing reconstructive surgery, I treated a patient who had lost an eye to cancer when she was a child. She wore eye patches for years to conceal the damage caused by the radiation treatment. Her wedding was approaching, and she wanted to walk down the aisle – and be photographed – with two eyes. In a series of three procedures, I used a new technique to implant an artificial eye prosthesis in her contracted eye socket. I was a guest at the wedding and was asked to make a toast. It was an honor.






Can you add more saline to my implants so I don’t have to have surgery again?

By Dr. Ted

Technically, I could open your incision and add some saline to your implants, but it doesn’t make sense. Here’s why: Implants come in various sizes, like 325 ccs or 450 ccs, and they can’t be expanded an infinite amount. If implants are over-expanded, they will feel hard, like balloons that have been blown up too much. There might be room for a little bit more saline solution (salt water) – maybe two tablespoons at most ­­­– the amount of oil you would add to your pancake mix. This small amount would be barely noticeable. In fact, you could get the same look by wearing your bra one notch tighter.

In 1937, Warner’s introduced its “Alphabet Bra” with A, B, C and D cups. Before too long, these cup sizes got nicknames: egg cup, tea cup, coff ee cup and challenge cup.

In 1937, Warner’s introduced its “Alphabet Bra” with A, B, C and D cups. Before too long,
these cup sizes got nicknames: egg cup, tea cup, coffee cup and challenge cup.

Women come to me with the request to “go bigger” often after significant weight loss (about 10 percent or more of their body weight) or after pregnancy, when their breasts may have changed because of hormonal fluctuations and milk production.

In my experience, women want an increase of about one cup size or more, which would be equivalent to anywhere from 150 to 225 ccs, depending on the size of their frame. To accomplish this, they would need larger implants.

By the way, bigger implants aren’t more expensive than smaller ones. Manufacturers don’t charge by the cubic centimeter: They charge one set price for all off-the-shelf saline breast implants, whether they are 200 ccs or 600 ccs, and another set price (about $1,000 higher) for silicone gel implants.

Breast augmentation is easier the second time around, because the pocket around the implant has already been made and has already healed. During surgery, I would place a larger implant through the initial incision, which was made in the crease below the breast where the breast and the chest meet.

Post-operatively, to protect the incision, I ask patients to wear a supportive bra or a sports bra for three weeks. They report significantly less discomfort than the first time around, and women who have surgery on Friday are usually back to work on Monday if they work in an office setting.

The saline implants used during breast augmentation surgery are different from the temporary tissue expanders used during breast reconstruction surgery. These have a tube that runs from the expander to the skin near the outside of the body. Saline can be added over a period of months to gradually stretch the muscle and skin. The expander is then removed and replaced with a permanent implant.

P.S. While saline implants come empty and are filled after they are inserted, silicone gel implants come filled. There’s no way to add silicone to them.


How saggy is saggy enough to need a breast lift?

By Dr. Ted

“My husband said, ‘Show me your boobs,’ and I had to pull up my skirt, so it was time to get them done!”Dolly Parton

Are you wondering if you are a candidate for a breast lift with or without implants? Try this at home:

1) The Pencil Test: Take off your bra and look in the mirror. Place a pencil horizontally along the crease under your breast, where your bra band would rest. Where does the nipple itself – not your areola – rest in relation to the pencil?
 a. below
 b. at
 c. above

2) Put on your bra and take another look in the mirror. When your bra lifts your breasts, are you:
 a. satisfied with their size
 b. wish they were bigger

At a breast surgery consultation,  the doctor will take measurements – without a pencil – to help you determine the right choice for you, but here is some information to get you started.

1a. If your nipple hangs below the pencil, your breasts would be considered moderately to severely ptotic (or droopy) and you would be a candidate for a breast lift, which would raise and reshape the breasts.

1b. If your nipple is at the crease and your breasts are mildly ptotic, it’s a borderline situation.

Screen shot 2013-02-20 at 8.08.12 AMIf you want a more natural look, you could consider implants alone. A saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. When the implant fills out the upper portion of the breast, it also fills out the bottom portion, which makes it look like the nipple is located higher on the breast. If you took out a ruler and measured, you would see that the nipple hasn’t moved; it is still in the same place.

If you want your breasts to be higher and perkier, a breast lift might be the better option, because during that surgery, the nipple is moved to a higher position and excess skin is removed.

1c. If your nipple is above the crease, relax. You are probably not a candidate for breast lift surgery. Use some of the money you save for some new, uplifting bras.

Lift and Implants?
2a. If you are satisfied with the size of your breasts, a breast lift alone may be the right procedure for you.

2b. If you want more breast volume, you could consider a breast lift and implants (an augmentation mastopexy).

While some doctors prefer to do two separate operations – the lift first followed a few months later by the augmentation, others perform both procedures at the same time (simultaneous augmentation mastopexy). Having one surgery rather than two reduces the time that you are in the operating room and under anesthesia. It is a safe operation that takes about 3-1/2 hours. http://www.lookingnatural.com/breastlift.html

Prefer to take things into your own hands. Some women choose breast lift tape, and others have been known to try duct tape!

Other things to know:
If your breasts are moderately to severely droopy and you get implants, you could develop the appearance of four breasts, with your breast implants up high and your natural breasts down low. Not a good look.

After a lift, your breasts will be the same size as they were before, 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.




What do bras and shoes have in common?

By Joyce Eisenberg

More than you’d expect. Here’s my list:

1. Women own more of each than they wear.

Screen shot 2013-02-02 at 11.58.05 AMThe average American woman has 19 pairs of shoes in her closet, but she only wears 4 pairs regularly, according to a poll that appeared in ShopSmart magazine. Another 4 or 5 pairs have only been worn once. There are similar statistics about bras. According to Britain’s Daily Mail, the average woman owns 16 bras at any given time but only wears 4-6 of them on a regular basis.

2. Our drawers and our closets are stuffed with shoes and bras that we don’t wear but don’t want to give away  – just in case.

Screen shot 2013-02-02 at 11.59.51 AMThese are the shoes that looked great in the store but didn’t quite match the dress you were hoping it would complement, and the bra that was really sexy but made your boobs look bad under your new sweater. These are the shoes that felt okay when you test-drove them around the store for two minutes and the bras that were comfy when you tried them on for a nanosecond. Back at home, in the harsh light of day, they are too uncomfortable to wear. But they’re pretty.

3. Because of traumatic experiences like the aforementioned, women buy comfortable shoes and bras and sexy shoes and bras, and they are rarely one and the same.

Screen shot 2013-02-02 at 11.58.20 AMManufacturers understand this, which is why bra companies market ultra-comfortable styles, like the Coobie Bra, a seamless, stretchy, one-size-fits-almost-all bra that’s so comfortable you can sleep in it. They also sell super-sexy models, like Victoria’s Secret’s Bombshell bra that “adds 2 cup sizes for instant hourglass oomph.” Shoes walk the same path. There’s the Blossom, with 5-inch stiletto heels and a rhinestone studded ankle strap, and comfy Ugg boots with their fleece lining.

I haven’t found any bras or shoes that bridge the gap, but a Chicago Tribune reporter tested shoes marketed as “comfortably sexy day and night.” One tester came close to tears cause the shoes hurt so bad; but there were some success stories. I’m sticking with my sensible Aerosoles.

4. If you lose weight, both your cup size and your shoe size can decrease. If you gain weight, the reverse is true.

“I dropped about 40 pounds – three dress sizes,” one woman wrote in an online forum. “Went from a 36DD to a 36D bra. I’m not complaining about that; I just don”t want to go below a C cup. However, some of my shoes are a little too big now, and that does piss me off as I’m an absolute shoe fiend…”

Screen shot 2013-02-02 at 12.03.51 PMAnother women replied, “35 pounds for me was more than a full cup size. Also, I actually had to get a new helmet for horseback riding because the old one got too big. Weird, huh? Didn’t know I had a fat head…”

Breasts, which are made up mostly of fatty tissue, are often the first indicators of weight change. But all parts of the body of capable of storing fat. So if you are dieting, maybe you should squirrel away the money you’re saving on food shopping to use on shoe, bra and helmet shopping when you’ve reached your goal.

5. At the end of the day, women can’t wait to get their bra and their shoes off.

Nuff said.

Will implants give me more cleavage?

By Dr. Ted

“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.” – Jerry Seinfeld

There’s long been a quest for cleavage. In Europe, as far back as the 1400s, bodices and corsets were designed to push up the breasts. Fast-forward 200 years to the court of Louis XIV of France, where necklines were lowered and cleavage was further exposed. Although it goes into hiding now and then, cleavage has mostly been in style ever since.

Screen shot 2013-01-16 at 10.44.21 AMWhen it’s visible, thanks to a low-cut top or a push-up bra, cleavage draws a lot of attention. Scientists conjecture that the attraction is primal: cleavage mimics the cleft between the buttocks, which we hide from view these days by wearing clothing and walking on two legs instead of four, as our ancestors did. As one headline writer put it, cleavage is a “weapon of mass distraction.”

No wonder that women frequently ask me if implants will give them more cleavage. In fact they won’t.

Let’s start with the facts: Cleavage, or the intermammary sulcus (the less-sexy anatomical term), is the space between your breasts. It’s defined by where the fatty portion of each breast sits in relationship to the breastbone.

Implants don’t change the space between your breasts. In fact, if a surgeon tries to give you more cleavage by loosening the inside bordersor going beyond the natural limits of your breasts, you could end up with a symmastia, also known as a uniboob.

What implants can do is give you more breast volume, which will make it easier for you to push your breasts together to accent the hollow between them. Bra manufacturers are happy to help you enhance your cleavage with a variety of bras, including click bras, air-lift bras, and liquid-lift models, which for some reason have gotten the nickname of “chicken cutlets.” But be careful. It turns out that your bra can give you a uniboob, too.