Frequently Asked Questions (FAQ's) Concerning Breast Augmentation
Things You Should Know About Your Tissues
Q: You're always emphasizing how important a patient's tissues are. What is important about my tissues, and how will my implants affect my tissues?
A: Here are some important principles to consider:
1) You only have one set, and for practical purposes, they can't be replaced
2) You won't think much about your tissues until you begin to age-then you'll notice that:
3) Your tissues get worse with age-they definitely don't get better! The choices (especially implant size) that you make NOW will affect your breasts significantly AS YOU AGE!
4) If you damage your tissues, you'll pay a price! Maybe soon, maybe later, but you'll pay!
5) The price you pay depends on the extent of damage and how good your tissues were before they were damaged.
6) The "quality" of your tissues depends on genetics and aging-you can't control either!
7) No two women's tissues are the same. Because of this, you can't expect to get the same result your friend gets, even if you do everything exactly the same.
With respect to a woman's breasts:
1) The larger the breast, the more it will sag with time, whether it is augmented or not. Think about the 18 year old with large, perfect breasts. How do they look and where are they located when she is 40?
2) The larger the implant, the more weight you are adding to the breast, and the more that weight will stress your tissues, now and as you age.
3) A very large breast may look great now, but what happens to ALL large breasts as you age? And yes, it also happens in augmented breasts, based on 20 years of following augmentation patients!
4) The thinner your tissues and the larger your implants, the greater the risk of your having complications from augmentation (like visible traction rippling, visible or palpable implant edges, and premature, excessive stretching).
5) The thinner your tissues and the larger your implants, the more the implant will exert stretching and thinning effects on your tissues, and the faster that will happen! Putting implants over or under muscle, or any other technique or option, won't change this! You can't escape the effects of gravity (not even with a 24 hour a day bra!) over time with a large breast. If a surgeon tells you that a magic technique or option will prevent those effects, ask for a written guarantee!
6) Based on my personal experience using every type of implant available in the past 20 years through every incisional approach and pocket location, any implant that is over 350cc volume has the potential to cause excessive stretch, thinning of tissues, traction rippling, visible edges, increased risk of your needing another operation, and shrinkage of whatever breast tissue you have.
7) You certainly have the right to have any size breast you want. I can create anything you can imagine, and have created many very large breasts. But when you request a breast larger than your tissues are likely to support over time, I require that you sign a permit saying that you understand and accept all of the items in #6 above. Any experienced, expert surgeon will want you to fully understand the tradeoffs of any option you choose. If you don't hear about tradeoffs and the effects of an implant on tissues over time from surgeons you consult, there's a message!
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