Breast Augmentation: The Second Time Around
Times change. And so may your breast size.
When women come in for a breast augmentation consultation, I tell them about two circumstances that could change their surgical results in the future: pregnancy and significant weight change.
During pregnancy, breasts enlarge from hormonal changes and milk production. Afterward, they could return to their original size or get smaller or bigger. And because breasts are made up mostly of fatty tissue, they will get bigger or smaller as you gain or lose weight. Often, they are the first indicators.
Although your breasts may change, your implants will remain the same. They don’t need to be replaced every 10 years. In fact, I’ve changed a woman’s implants after 19 years – she had a child, got smaller and wanted to go bigger – and the implants looked the same as they did the day I put them in.
About 10 percent of my breast augmentation patients come in for a consultation to get information about making a change. The average time elapsed is about 10 years, though it varies greatly.
They tell me, “I’ve gained a lot of weight, and I’m much bigger than I want to be. I’d like to go a little smaller.”
Or, “After my two children, my breasts got smaller. I just want to get my pre-pregnancy size back – and maybe a little extra.”
Others say, “I went for the gusto 15 years ago. I’ve enjoyed them and they served their purpose, but now that I’m 50something, I just want them a little smaller.”
Like the first time, we look at before and after photographs of women who started out similar to them in height, weight, frame size and breast volume. They tell me, “too big,” too small” or “just right” so I know what size implants to order.
Breast augmentation surgery is easier the second time around. Here’s what’s involved in upsizing or downsizing:
Less discomfort: To change each implant, I go through the same incision that I made initially in the crease beneath the breast. I don’t have to make a pocket beneath the chest muscle for the implant, so there is less manipulation of breast tissue and therefore less discomfort post-op. All you’ll feel is the incision. Consequently, you’ll likely need less medication after surgery for discomfort.
Shorter procedure time: This second surgery takes less time than your initial breast augmentation surgery, which means less anesthesia and a lower possibility of post-operative nausea and vomiting.
Shorter recovery time: You should still take it easy for a week, but you could probably get back to work on the third day because there is much less chance of bleeding. So if your surgery is on a Friday, you could return to work on Monday. First-timers are generally back to work in an office setting in 5 days. And you don’t have to wait until the sixth week to do upper body weights. You can start up again after three weeks.
Quicker results: Because your skin and chest muscle have already stretched to accommodate your implants, the implants won’t start off high like they did the first time. You’ll pretty much see the final result when you get home. After surgery, I’ll have you wear something supportive like a sports bra for three weeks to protect your incision. At that time, you’ll be able to wear and do anything and everything you want. No waiting eight weeks this time to go shopping for new bras and bathing suits.
healing process. If you are looking at online photos taken 3 months or less after surgery, consider this: The breast implants have not yet settled into their final position. They are pressed up high, like your breasts would be in a push-up bra. They are not fully settled until 9 months post-op, and at that point they often will look smaller than they do at 3 months. You’ll likely be disappointed if you choose your implant size from pictures that were taken three months after surgery.
