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.

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.

How soon after pregnancy can I get a breast augmentation?

Posted on October 23, 2015 by Joyce

When you are pregnant, the developing placenta stimulates the release of hormones, causing your milk glands – and your breasts – to grow and swell. This rapid growth can also cause your skin to stretch. When the milk is gone, your breasts might return to their original size or get smaller, bigger or droopier.

To know your true post-pregnancy breast size and shape, it’s best to wait at least six months from the time you give birth or from the time you stop breastfeeding, whichever is later. At that point, you’ll be able to choose breast implants that will make you proportional.

Breastfeeding itself does not cause the breasts to droop. A study in the journal Aesthetic Surgery identified the following risk factors for an increased degree of breast sagging: body mass index (BMI), the number of pregnancies, a larger pre-pregnancy bra size, smoking history and age. Breastfeeding was not found to be a risk factor.

If you are thinking about having a child in the next year or so, I would suggest that you wait because your post-pregnancy breasts might look different from your current pair. But if parenthood is several years down the road and you are anxious to be more proportional, fit better into your clothes or correct breast asymmetry, you don’t have to wait for a breast augmentation. Just understand that you might need a revision after pregnancy.

Did you know? During pregnancy, hormonal changes cause the nipple and areola to get bigger and darker. Scientists speculate that it is evolution’s way of making it easier for an infant to find and latch onto the breast.

IF YOU ARE DIETING . . .

Like pregnancy, weight loss can take a toll on your breasts. 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, which are made up primarily of fatty tissue. If the skin doesn’t retract when some of the fat disappears from your breasts, you could be left with droopy breasts, stretched skin or empty-looking breasts, which might make you a candidate for a breast lift alone or with an augmentation.

If you are dieting, be sure to save a few dollars for shoe shopping. Some women report that along with losing a cup size, they lose a shoe size.

If you are planning to lose 10 percent or more of your body weight, it’s wise to wait until you have reached your goal before you have cosmetic breast surgery so you’ll know your starting size. That way you’ll have the best chance of getting a satisfactory long-term result.

Breast Implants – By the Numbers

Posted on August 12, 2015 by Joyce

1. In 2010, 1.5 million women around the world had breast augmentation surgery. About 300,000 of them lived in the United States, according to the International Society of Aesthetic Plastic Surgery.

2. Breast implants are measured in cubic centimeters (ccs) rather than 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.

3. The largest standard saline implant is 775 ccs, while a silicone gel implant is 800 ccs. That’s equivalent to about 27 ounces, like this can of salsa.

4. The difference between a 375 cc and a 400 cc implant is less than 2 tablespoons – the amount of oil you would add to boxed pancake mix.

5. Outside of the body, a saline implant would freeze at about 28 degrees Fahrenheit, while a silicone gel implant would ice up at around 170 degrees below zero. Because your breast implants are close to your body, your natural body heat will keep them warm.

6. An implant’s silicone shell would melt at temperatures greater than 392 degrees Fahrenheit. A conventional sauna is typically between 150 and 190 degrees. If you were in an environment where your implants would melt, you’d melt, too.

7. If you get a pair of 350 cc saline implants, they’ll weigh about 1.5 pounds. If you get a silicone gel set, they’ll be closer to 1.7 pounds. To calculate how much your implants weigh, see below:

8. Breast implants are designed to be sturdy, and each manufacturer has its own testing protocol. Allergan tests its implants by exerting nearly 55 pounds of force on them repeatedly, up to 6.5 million times. By contrast, a routine mammogram exerts about 40 pounds of force when it compresses the breast, and if a woman had 50 mammograms in her lifetime, it would be a lot. Watch our video about mammograms and breast implants.

9. The TSA says that liquids and gels are safe to bring aboard an aircraft in limited amounts – 3.4 ounces or less. Thank goodness breast implants are “packed in your luggage,” so to speak, because one 425 cc implant is equal to about 14 ounces. It would be hard to squeeze it into one of those quart-sized plastic bags. To figure out how many ounces your implants are, divide the number of cubic centimeters in each of them by 30.

10. It’s rare for surgeons to charge more for a breast augmentation with larger-sized implants. Manufacturers don’t charge by the cubic centimeter either: There is one cost 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.

Will implants make my breasts look perky again?

Posted on October 14, 2014 by Joyce

Breast implants will only make your breasts fuller. They will not lift your breasts, but they can create the illusion of a lift.

If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the appearance of perkiness. That’s because as the implant fills out the upper portion of the breast, it also fills out the lower part, making it look as if the nipple has moved higher on the breast. It hasn’t. A silicone gel implant placed in front of the pectoral muscle might create the same illusion.

If your breasts are moderately to severely droopy and you get implants, it could look as if you have four breasts – with the breast implants up high and your natural breasts down low. A breast lift (mastopexy) would be a better choice. It would raise and firm up your breasts, giving them a more youthful look. I would accomplish this by moving the nipples to a higher position, removing excess skin, and then reshaping the breasts.

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.

To determine your degree of droopiness, try the pencil test: Place a pencil horizontally along the crease under your breast, where your bra band would rest. Look in the mirror. Is the position of the nipple itself (not the areola) above, at or below the pencil?

If your nipple hangs below the pencil, you would need a breast lift to raise and reshape your breasts. If your nipple is at the crease, the approach is not as clear-cut; it depends on how much of a pick-me-up you are hoping for.

How do you know if you need a 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). Click here to see our before and after photo galleries.

Obviously, there are other measurements done during a consultation – without a pencil – to help you determine the best option for you.

Breasts can start drooping at any age depending on your genes, the elasticity of your skin, and if you’ve lost a significant amount of weight. If the skin doesn’t retract when some of the fat disappears from your breasts, you could be left with saggy or empty-looking breasts. It’s not uncommon for teens to have droopy breasts; some girls say that they were “born with saggy breasts” or that they “just developed this way.”

Age and pregnancy also take a toll. When you are pregnant, the developing placenta stimulates the release of hormones, causing your milk glands – and your breasts – to grow and swell. This rapid growth can also cause the skin to stretch. When the milk is gone, some women are left with less breast volume and/or droopiness. The same thing happens as women age: The skin naturally loses its elasticity, and breasts lose their shape and firmness.

Illustrations by Anoki Casey.

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.

I used to have perky breasts. What happened?

Posted on February 17, 2013 by Joyce

By Dr. Ted

No crystal ball can predict how much and how soon your breasts will lose their shape and firmness, but you can blame the following factors for the droop (medically known as ptosis).

When you are pregnant, the developing placenta stimulates the release of hormones, causing your milk glands – and your breasts – to grow and swell. This rapid growth can also cause the skin to stretch. When the milk is gone, your breasts might return to their original size or get bigger, smaller, or droopier.

Although the number of pregnancies and your pre-pregnancy breast size are factors in post-pregnancy sagging, breastfeeding itself is not.

Significant weight gain and loss – yo-yo dieting – can also affect your breasts. 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 – sometimes dramatically. If the skin and ligaments don’t retract when some of the fat disappears, you could be left with saggy or empty-looking breasts.

As women age and their hormone levels drop, the lobules (the part of the breast where milk is produced) shrink, and breast volume is lost. In addition, the body’s elastin fibers, which keep the skin from drooping, and collagen fibers, which give tissue strength and flexibility, decrease. Smoking can speed up this process. That’s because the carcinogens in the smoke cause those elastin fibers to break down in the body.

Breasts can start drooping at any age depending on your genes and the elasticity of your skin. That’s why it’s not uncommon for teens to have droopy breasts. Some girls say that they were “born with saggy breasts” or that they “just developed this way.” The rate of droop is largely determined by genetics, although pregnancy and weight changes factor in. And while a bra will keep your breasts from sagging while you are wearing it, there is little evidence that wearing a bra delays or prevents breast droopiness.

Did you ever wonder what your breasts would be like in outer space where there is no gravity? (They’d look like they would if you go swimming braless.) Science fiction writer Arthur C. Clarke did. In his book Rendezvous with Rama, Arthur C. Clarke wrote, “Some women should not be allowed aboard a space ship; weightlessness did things to their breasts that were too damn distracting.”

Did you ever wonder what your breasts would look like in outer space where there is no gravity? They’d look like they would if you go swimming braless.

Gravity gets a bad rap. The pull of gravity on your breasts – or your face – isn’t a significant factor in droopiness. It’s more like the skin isn’t as strong as it once was, and it begins to fall down – like a pair of sweatpants that has lost its elastic.

If you are thinking about having breast lift surgery to perk up your breasts, you’ll need to know your true starting size. Losing 10 percent or more of your body weight could make your breasts smaller, so you should wait until you have reached your dietary goal before you have breast augmentation surgery. To know your post-pregnancy breast size, it’s best to wait at least six months after you have stopped breastfeeding or, if you are not breastfeeding, six months after childbirth. At that point, you’ll be able to see if you want more breast volume or if you are a candidate for a lift.

Next time: Learn how to take the “pencil test” to see if you are a candidate for a lift.