Breast Augmentation

Yes, you can always have your implants removed. Sometimes, patients choose to have a removal and replacement of their implants. This is known as breast revision surgery. These concerns can be reviewed in consultation with Dr. Gray. 

The FDA (Food and Drug Administration) has found no increase in breast cancer from breast implants. However, textured implants have been linked ALCL (anaplastic large cell lymphoma), a cancer of the immune system. For this reason, Dr. Gray does not offer textured implants.

Capsular contracture is a risk, although it’s not particularly common. Everyone has a capsule, but capsular contracture is when the capsule begins to harden and sometimes squeeze the implant. Most contractures can be treated conservatively, and treatments for bad contracture are now better than they were in the past.

There is a risk for any implant to deflate, but this is very low. Silicone implants generally have a lower rate than saline. All manufacturers have warranties for deflation and contracture. 

For silicone implants, there are two detection options: physical exam and MRI. When saline implants deflate, they physically shrink, making them much easy to detect visually. Saline implants will deflate much quicker and are absorbed by your body naturally and safely. Silicone implants can be detected with an MRI. Both types of implants are covered under warranty.

The no-touch technique in breast augmentation refers to a surgical method where the breast implant is handled with minimal contact to the skin and surrounding tissues. The goal is to reduce the risk of bacterial contamination during the surgery, which could potentially lead to complications like capsular contracture.

I use this technique with every breast augmentation case. By minimizing direct contact between the implant and skin or surrounding tissues, the risk of introducing bacteria into the surgical area is reduced. Capsular contracture occurs when the scar tissue that forms around the implant tightens and squeezes the implant, causing discomfort and distortion.

Using the no-touch technique with every case indicates a commitment to patient safety and the prevention of potential complications. This technique, along with proper post-operative care, can contribute to better outcomes and lower risks of complications for breast augmentation patients.

An “internal bra” or a material like Galaflex may be used in breast augmentation surgeries to provide additional support and reinforcement for the breast implants. Galaflex is typically used in breast augmentation revision cases where the breast implant pockets have become stretched out.

Breast implant pockets can stretch over time due to factors like natural aging, pregnancy, weight fluctuations, or trauma. Galaflex, a type of surgical mesh or scaffold, can be used to reinforce the weakened tissue and help maintain the desired position of the implants. 

If you’re considering breast augmentation and have questions about whether an internal bra or similar technique might be beneficial for your situation, discussing your concerns and goals with me is key to making an informed decision.

Galaflex Lite is a newer variation of the Galaflex material that offers improved characteristics, such as being thinner, lighter, and more flexible. This version aims to provide similar benefits as Galaflex, such as reinforcing weakened tissue and providing support in breast augmentation surgeries, while also offering a smoother and more comfortable feel. The comparison to silk suggests that Galaflex Lite aims to offer a more natural and pleasant texture when used in surgical procedures.

No, I do not use drains for breast augmentation surgeries.

I use absorbable sutures for closing breast augmentation incisions. These sutures are designed to be gradually broken down by the body, eliminating the need for suture removal. In addition, a no knot technique is used to avoid wound healing problems in the post-operative period.

This technique, using sutures without knots and leaving a short tail that protrudes from the skin, allows for easy identification of the sutures and makes it simpler to trim them after a certain period. This “cat whisker” technique ensures that the sutures are easily accessible when it’s time to remove the small protruding portion, which is typically done around two weeks post-surgery.

Using absorbable sutures with this technique offers a few advantages, including avoiding the discomfort associated with suture removal and minimizing wound healing problems.

Following breast augmentation surgery, there will be a scar where the incision was made to insert the implants. The goal is to place the scar in a location that is least noticeable and blends with the natural contours of the body. The preferred location for the scar is often where the inframammary fold is, although its placement might differ from the fold’s original position before surgery. This is more popular than the areolar incision today because the capsular contracture rates are lower, although both can be well hidden.

After the surgery, there are measures that can be taken to help minimize the appearance of the scar. The use of biocorneum, a topical silicone preparation, can aid in promoting scar healing and reducing scar visibility.

Additionally, treatments such as micro-needling with devices like the Potenza can be utilized at a later date to further improve the appearance of scars. Micro-needling involves creating controlled micro-injuries to the skin, stimulating collagen production and potentially leading to smoother and less noticeable scars over time.

Ensuring that you achieve the desired breast implant size involves a collaborative process.

• Sizing Consultation: During your in-person consultation, a sizing consultation will be done. This will give you the opportunity to see, touch, and try on actual silicone implants of all profiles in order to make the best decision for you.
• Patient’s Choice: Your input is highly valued. You’re given the opportunity to select the implant profile and type of gel implant that aligns with your preferences and desired outcome.
• Width Matching: The width of the implant is determined at the time of surgery to ensure that it matches the width of the breast implant pocket. This consideration helps achieve a more natural and balanced appearance. 

This approach ensures that I consider both your preferences and the technical aspects of achieving the best fit for your body. Communication during the sizing consultation is crucial to ensure that your expectations align with what can be realistically achieved. By actively participating in the decision-making process and sharing your goals, you increase the likelihood of getting the size and results you desire from your breast augmentation surgery.

Matching the width of the breast implant with the width of the breast implant pocket is a surgical technique that aims to achieve a specific outcome, which in this case is generating approximately one centimeter of cleavage. This technique involves placing the implant in a position that optimizes the appearance of cleavage between the breasts.

By ensuring that the width of the implant is in harmony with the width of the breast implant pocket, I can create a balanced and natural-looking result that includes the desired amount of cleavage. This precision in positioning the implant contributes to achieving your aesthetic goals.

I always provide patients with a range of implant options during the consultation process. Showing patients different implant sizes, styles, and projections helps them make informed decisions about their desired outcome. This approach of allowing patients to choose the style and type of implant they prefer, while determining the specific implant size based on the width of the pocket during surgery, reflects a customized and patient-centered approach.

This technique ensures that the final implant selection is tailored to the individual’s anatomy and surgical plan. By adjusting the implant size based on the pocket’s width, you can achieve a result that is both aesthetically pleasing and proportionate to the patient’s body.

My dedication to involving patients in the decision-making process while still maintaining the flexibility to adapt based on surgical measurements contributes to achieving personalized and successful breast augmentation outcomes.

After breast augmentation surgery, it’s common to experience a sensation of tightness in the chest area. This tightness is due to the presence of the implant and the natural swelling that occurs after surgery. Over time, as the swelling subsides and the tissues gradually adjust to the new implant, this tight feeling will lessen.

The low activity guidelines after breast augmentation surgery are designed to support a smooth and successful recovery.

• Lifting Restrictions: Limiting lifting to no more than one pound is crucial during the initial recovery period. Lifting heavy objects or engaging in activities that strain the chest muscles could put stress on the surgical area and potentially compromise the healing process.
• Exercise: Restricting exercise to flat walking is a cautious approach that minimizes the risk of complications. Engaging in low-impact activities like walking helps maintain circulation and promotes healing without putting undue strain on the chest muscles.
• Duration of Low Activity: Following the low activity guidelines for six to eight weeks is a common timeframe for many breast augmentation patients. This allows sufficient time for the surgical area to heal, reduces the risk of complications, and ensures that the implants settle properly.
• Bra Support: Wearing the recommended Simone Perele bra, 24 hours a day for two months, helps maintain proper implant positioning and provides support during the initial healing phase. This can contribute to optimal results and prevent complications.

Adhering to these guidelines is crucial for achieving the best outcome and minimizing the risk of complications. Keep in mind that individual recovery experiences can vary, and it’s important to follow your surgeon’s specific instructions and recommendations for a safe and successful recovery from breast augmentation surgery.

The most common complications of breast augmentation are:

• Capsular Contracture: Capsular contracture occurs when the scar tissue that naturally forms around the implant tightens and compresses the implant. This can lead to discomfort, distortion of the breast shape, and a firmer feel. While your experience indicates a low rate of occurrence, factors such as implant type, surgical technique, and patient characteristics can influence the risk.
• Deflation: Deflation typically refers to saline implants rupturing or leaking. While modern silicone implants are more commonly used, saline implants can still experience deflation due to implant failure. It’s important to note that your rate of less than one percent aligns with relatively low instances of this complication.
• Infection: Infection is a concern with any surgical procedure. In breast augmentation, infection can occur around the implant, leading to potential complications. Careful adherence to sterilization protocols and post-operative care can help mitigate this risk.

These complications occur in less than one percent of my cases, reflecting a well-executed surgical approach and emphasizing the importance of proper patient selection, surgical technique, and post-operative care. While the risk is low, it’s still essential to understand the potential complications associated with any surgery and to follow instructions to ensure a smooth and successful recovery.

Breast implants, being man-made implantable devices, do have a finite lifespan, and there is a possibility that you may need to have them replaced in the future. The timeline for when replacement might be necessary isn’t precisely defined by specific intervals like 10, 15, or 20 years. Instead, it varies from person to person and can depend on several factors, including the type of implants used, your individual body response, and potential complications.

The general principle is “if they’re not broken, don’t fix them.” In other words, if you’re not experiencing any issues with your implants and they’re still functioning well, replacement might not be necessary. However, in the event of complications such as implant rupture or deflation, addressing the problem through replacement is recommended.

Regular follow-ups and periodic imaging, such as MRI for silicone implants, can help monitor the condition of your implants over time. Staying informed and maintaining open communication with me will ensure that you receive personalized guidance about when or if implant replacement becomes necessary. It’s important to be aware that while the potential for replacement exists, many women enjoy long-term satisfaction with their breast implants without experiencing complications.