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 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, 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.


Will breast 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 breast 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.

Do You Get a Lot of Exotic Dancers?

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.