Common Myths and the Facts

 

Myth #1

Augmentation of the breast is a simple operation-any surgeon can do it!

The truth? Augmentation is NOT a simple operation. Any surgeon may be
able to do it, but how well? Chapter 6 reviews the details of the many surgical
options available-why it's not simple. Chapter 9 tells you in detail how
to find qualified surgeons, and Chapters 10, 11, and 12 tell you how to
evaluate the information you get from surgeons, how to prepare for your
consultations, and how to compare and evaluate the surgeons you consult!

 

Myth #2

If a surgeon does augmentations only one way, that's better.

The truth? Surgeons who do all augmentations one way usually only
know one way to do an augmentation! Only a surgeon skilled with all
of the options can offer you all of the options. If a surgeon is doing all
augmentations one way, it's probably because it's the only way the surgeon
is comfortable with and the only implant and incision the surgeon has experience
with! Women's breasts are very different. Women's desires are also different.
Women's choices are often different. One way isn't best for every woman!
Chapter 6 lists all of the surgical options that should be available to
you. If you aren't getting the choices, go to Chapter 9 to find other qualified
surgeons!

 

Myth #3 

Cup size is a predictable way to measure the size of a breast.

The truth? Look in your bra drawer! Are all the bras one size? Ever buy
bras that are labeled with different sizes, but both fit your breast? Is
a B cup the same in a 34 as it is in a 36? Although bra cup size is a popular
way of discussing breast size, it is extremely variable from one bra manufacturer
to another. Although we discuss cup size with patients, we have many more
accurate ways to discuss desired breast size, based on measurements and
on demonstrations with your own tissues. See Chapters 4 and 6.

 

Myth #4 

There is one best way to do an augmentation-one best implant, incision,
and pocket location that is better than the other options.

The truth? If there were really one best way, all augmentations would
be done the same way. Different sets of options fit different women's needs
and desires. The key is finding a surgeon who has experience with all the
options and can offer you all the options. Chapter 5 reviews all the implant
options (and the tradeoffs of each one-they all have some tradeoff!), and
Chapter 6 reviews all of the surgical options that should be available to
you.

 

Myth #5 

I like the result my friend got. If I choose the same surgeon and the same
implant, I'll get a similar result.

The truth? Are your breasts exactly the same as your friends' breasts
BEFORE she had her augmentation? Of course not! And if your breasts weren't
the same before, even if you choose the same surgeon and the same implant,
your breasts won't be the same as hers AFTER! Your breasts and your tissues
don't match any other woman! They're unique. And your tissues are what your
surgeon must work with! If a surgeon doesn't recognize and explain to you
how your tissues are unique, and explain to you which options will take
the best care of your tissues over your lifetime, go to Chapter 9 and look
for some other qualified surgeons! Chapter 4 helps you understand how your
choices now can affect your tissues as you get older.

 

Myth #6 

The bigger the breasts, the better.

The truth? Think about an 18 year old girl with gorgeous D cup or larger
breasts (no augmentation). What will her breasts look like when she is 40?
Where will they be located? It's very important to get what you want when
you have an augmentation, but it's also important for your surgeon to make
you aware of how those choices may affect your breast as you get older.
Are larger breasts more likely to sag? More likely to require more surgery
in the future? Are you more likely to see the edges of your implants, or
see visible rippling with larger implants? Is there a way to get full, beautiful
breasts without running excessive risks of problems in the future? All of
these are questions that are answered in Chapters 4, 5, and 6. 

 

Myth #7 

The most important decision to make is where the scar is located.

The truth? Actually, scar location is one of the things patients are
most concerned about before their surgery, and least concerned about
after their surgery. If a woman has a beautiful breast, no one pays attention
to a stretch mark, or a small blemish, or a scar. If the quality of a scar
is good, it's no more apparent than a stretch mark

 

Myth #8 

Implants last a lifetime.

The truth? Name a device that lasts a lifetime! There aren't many. Today's
most state-of-the-art implants are the best implants that we have ever had,
but they aren't perfect, and they won't necessarily last a lifetime! For
the details, see Chapter 5: Breast Implants-The Devices and the Choices.

 

Myth #9 

A certain number of cc's in a breast implant produces a certain cup size
breast.

The truth? This is a very popular misconception, but it is absolutely
not true! The size of the breast following an augmentation consists of 1)
what was there before the augmentation PLUS the implant that was
added at the operation! What this means is that a 300cc implant might make
a C cup breast in a woman with very little breast tissue before augmentation,
and the same implant might make a D cup breast in another woman who had
more breast tissue before the implant was placed. If you want the most accurate
size after your operation, your surgeon must measure and estimate how
much breast tissue you have before the augmentation! Then choose the
most appropriate implant! Chapters 4, 5, and 6 provide a more in-depth perspective
of all the issues involved in selecting implant size.

 

Myth #10 

Putting implants "under muscle" helps support the implants
better.

The truth? There is absolutely no evidence that putting an implant under
muscle supports the implant better. The two major issues that affect implant
support (and therefore, how much the breast will eventually sag) are 1)
the genetic characteristics of your tissues, and 2) the size of the implant
you select. The thinner and more "stretchy" your tissues, and
the larger the implant, the more you can expect your breast to sag over
time-guaranteed! Chapters 5, 6, and 11 help you understand the important
issues that are involved in selecting an implant and pocket location that
meet your desires while protecting your tissues as you get older.

 

Myth #11 

Implants should never be placed over the muscle.

The truth? Neither over the muscle or under the muscle is right for every
woman. The three most important considerations are:


  
1) the thickness of your tissues that will be covering the implant (everyone
  is different, and the thickness should be measured),
  
2) how the particular implant you select will affect your mammograms,
  and
  
3) which set of tradeoffs (implant edge visibility, effects on mammography,
  and control of implant position) are most acceptable to you. All of the
  issues are addressed in Chapters 5 and 6. 


 

Myth #12 

Round implants produce more upper breast fullness compared
to anatomic implants.

The truth? If ROUND implants are filled to current manufacturer's recommendations,
when they are upright (when you are standing), the implant collapses and
shortens vertically, allowing the shell to fold and decreasing upper breast
fill. If you overfill the implants to prevent shell collapse, you void the
manufacturer's warranty! McGhan Style 468 and 410 ANATOMIC implants have
manufacturer's fill volumes defined so that shell collapse and vertical
shortening does not occur-you can maintain fill in the upper breast and
not void the warranty! The overall size of the implant also affects upper
pole fullness-the bigger the implant, the more fullness! But can you expect
the fullness to STAY in the upper breast when you use larger implants? There
are definite tradeoffs and long term implications that you should understand
thoroughly before selecting your implant! See Chapters 4, 5, and 6.

 

Myth #13

Textured shell implants are easier to feel inside the breast compared to
smooth shell implants.

The truth? Whether you can feel an implant inside your breast really
depends on two factors: the thickness of your skin, fat, and breast tissue
overlying the implant, and 2) whether the implant is placed over or under
muscle. If you want an implant to last longer, you want a thicker shell
on the implant. The differences in thickness between textured and smooth
implants is only a few ten thousandths of an inch-not as important an issue
as the thickness of your tissues. Read more in Chapters 4 and 6.

 

Myth #14 

Textured shell implants are more likely to produce visible rippling compared
to smooth shell implants.

The truth? The two most common causes of rippling are 1) underfilling
an implant (underfill rippling)-all ROUND implants are underfilled by manufacturer's
recommendations), and 2) LARGE implants in patients with thin overlying
tissues where the implant pulls downward on the thin envelope (traction
rippling). Textured or smooth shells have very little to do with rippling-the
amount of fill the surgeon places in the implant, and choosing an appropriate
size implant for your tissues are more important! Check out Chapters 4,
5, and 6.

 

Myth #15 

Silicone gel filled implants are dangerous and cause diseases.

The truth? Several large scientific studies and the findings of an expert
panel appointed by Judge Sam Pointer (the judge in charge of class action
implant litigation) show conclusively that SILICONE IMPLANTS DO NOT CAUSE
ANY KNOWN DISEASES. Chapter 2 and Appendix 1 give you the answers in detail,
and provide Internet references to all of the most important scientific
studies, FDA recommendations, and links to important additional information.

 

Myth #16 

Saline implants are better than silicone gel filled implants.

The truth? Saline implants are not necessarily better or worse than silicone
gel filled implants, but they are different! Every type of implant filler
material has advantages and tradeoffs-there is no such thing as one best
type of filler! Which is best for you depends on what you want and which
tradeoffs you are willing to accept. Before you select any type of implant
filler or implant design, you need to know about the tradeoffs of each type
of filler, which fillers are currently available in your country, and important
issues about how implant fill (saline or silicone) can affect the life of
your implants. Chapter 5 gives you comprehensive information about all of
these issues-read it carefully before you select an implant!

 

Myth #17 

If one breast is smaller than the other (and it always is), all you need
to do is to put a larger implant (more fill) in the smaller breast to make
it match the larger breast.

The truth? It's not that simple. The smaller breast has less skin compared
to the larger breast. When you try to put too much additional fill into
a smaller skin envelope, you risk significant SHAPE differences. Every woman
has breasts that are different sizes-different is normal-different is what
you see every time you look at a woman's breasts! If you try to put too
much volume in a small skin envelope, the SHAPE change that results creates
more visual difference than a SIZE difference. The key to matching breasts
as closely as possible (and they NEVER totally match!) can be very complex-not
as simple as putting a larger implant in the smaller breast. Chapters 4
and 6 address many of the issues.

 

Myth #18 

You shouldn't lift your arms above your head, drive your car, and lift normal
objects for at least a week after your augmentation.

The truth? We encourage all of our patients-with implants over or under
muscle to begin these activities IMMEDIATELY! Over 90% of our patients do
all these activities in the first 2 days! What you should or should not
do after surgery depends on HOW THE SURGERY IS DONE! Get all the details
from Chapters8 and 14.

 

Myth #19 

You should expect to have bruising after your augmentation.

The truth? Over 98% of our patients have NO BRUISING following augmentation.
Bruising is bleeding from underneath that stains the skin. The amount of
bleeding that occurs during and after an augmentation, though not totally
controllable by your surgeon, can be dramatically reduced or eliminated
in most cases using specific techniques to create the pocket for the implant.
Learn more from Chapters 6, 8, and 11-know the right questions to ask about
recovery before having surgery that will tell you a lot about how
the operation is done (Chapter 8)!

 

Myth #20 

You may need to have drain tubes coming out of your body after your augmentation.

The truth? Drain tubes are almost NEVER NECESSARY in a first time augmentation,
provided specific, state-of-the-art techniques are used to create the pocket
for the implant. Drains are commonly necessary following reoperations. To
understand why, see Chapters8 and 14. 

 

The Three Greatest Lies in Breast Augmentation

1) The biggest possible breast is the best breast

2) A certain size (ccs) implant creates a certain cup size breast

3) What is good today is good tomorrow

 

What do you get with a large natural breast compared to a large augmented
breast?

Large normal breast with time: You get a large, sagging breast

Augmented breast: You get a large, sagging breast with any or all of
the following: tissue thinning, visible implant edges, visible traction
rippling, stretch marks, and tissues with higher risks if a reoperation
becomes necessary.

 

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