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

Posted on April 18, 2013 by Joyce

By Dr. Ted

Technically, I could open your incision and add some saline to your breast implants, but it doesn’t make sense. Here’s why: Breast 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, 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?

Posted on February 20, 2013 by Joyce

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.

If you want a more natural look, you could consider breast 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.

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.

Do You Get a Lot of Exotic Dancers?

Posted on January 3, 2013 by anoki123

By Dr. Ted

That’s one of the questions that men most frequently ask me, although many women are wondering the same thing. The answer is no. Only about 1 percent of my patients are exotic dancers.

A few notes about that 1 percent: Exotic dancers could make a case for deducting their breast implants as a business expense. The precedent was set in 1994 by Cynthia Hess, who goes by the stage name Chesty Love. When she tried to write off the cost of her breast augmentation, the IRS objected, so she took her case to tax court. A judge ruled that her breasts were necessary stage props.

Patients who are dancers tell me they can “prance” as early as 7-10 days after surgery; it takes about three weeks until they are comfortable again using the pole.

About the 99 percent: My patients range in age from 18 to 63 and include bartenders, nurses, hairstylists, veterinarians, housecleaners, doctors, construction workers, ballroom dancers, stay-at-home moms, company executives, waitresses, fitness trainers, 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 have e-mailed us from Iraq and Afghanistan to set up appointments for when they are back in the United States. This is not a complete list.

You can’t make generalizations about the women who get breast implants, and there are a lot of them: In 2010, about 336,000 women in the United States had breast augmentation; worldwide that number exceeded 1.5 million. Women who live in Brazil (which ranks right behind the U.S. in number of breast augmentations done each year) are lucky; breast augmentations are deductible there.

Neither should you make assumptions about the reasons women get implants. Sorry, guys. Women don’t get implants to please you. That might be an outcome, but it’s not the motivation. They get them to please themselves – to make themselves feel more feminine and sexy, to have a figure that’s more proportional, and to fit better in their dresses, bikinis and tank tops.