Questions About Breast Procedures

Most of your questions will be addressed at your consultation. However here are a few things that you may want to know about the procedures.

What is breast augmentation?

Breast augmentation is a cosmetic procedure which is used to enhance breast contour. This is achieved by placement of breast implants behind the breast or the chest muscle.

Can the areolar size be changed during breast augmentation?

Yes. The areolar diameter could be decreased. But it will result in a scar around the areola and might appear somewhat unnatural because of a sharp demarcation line between the pigmented areola and the surrounding breast skin.

What are different approaches for breast augmentation?

There are a number of techniques utilized for placement of breast implants. The two most common approaches utilize placement through incision under the breast fold (the infra-mammary fold) and through an incision along the lower half of the areola (circumareolar). Other approaches include insertion through the armpit (axilla) and the umbilicus. The umbilical approach is not approved by the FDA.

Is breast augmentation performed through the belly button a safe procedure?

This approach is not approved by the FDA. There are some issues that make this approach less appealing to most plastic surgeons. For one, it is relatively difficult to control the shape of the breast from an insertion site away from the breast. Second, the dissection of tissues is completely blind and done with tactile sensation alone, as compared with other techniques where dissection is performed under direct vision. There is also no way to control bleeding during the operation. Instead of gently dissecting the tissues, usually ripping techniques are used. Furthermore, the newer silicone implants cannot be placed through this approach. Doctor Ali believes in gentle, well-controlled dissection which minimizes post-operative problems.

What is a good cup size for an average woman?

For achieving an aesthetically pleasing breast, it is important to carefully analyze the body structure of the patient. Patient height and weight, along with chest size and shape are always significant factors to be considered. Larger implants placed in small, petite-framed women can result in both immediate and long-term complications. Appropriately sized implants placed correctly can give a long lasting, natural-appearing enhancement for a very long time. Doctor Ali does exactly that. After listening to a patient’s goals and objectives, he helps in the selection of the most appropriate breast implants prior to augmentation.

After breast augmentation, will I need surgery in the future?

The long-term outcome depends upon a number of factors. Pregnancy, weight loss and aging could result in downward migration of the nipples. Corrective surgery could be necessary depending upon the degree of displacement. Some patients can develop capsular contracture which can also necessitate corrective surgery.

Should the implants be placed above or below the muscle?

Both techniques are acceptable. The pros and cons should be discussed with your plastic surgeon prior to surgery.

What are the different types of implants available?

Two types of implants are available: saline or silicone. Implants are available in a number of sizes and shapes. The surface can either be textured or smooth. The best type of implant is selected after a comprehensive consultation with the patient.

When can I return to normal activity after surgery?

You should be able to return to work in a few days, depending upon the nature of your job. Weight lifting is restricted for three to four weeks.

Are the scars visible after surgery?

Initially after surgery, the scars are slightly red and firm. Over the course of several months, the scars will fade and only be visible to a trained eye.

Does breast augmentation interfere with breast feeding?

Generally, breast feeding is not affected by breast augmentation. However, if the implant is placed through an areolar approach, the ability to breast feed could be affected.

Who will perform my plastic surgery?

Your surgery will be performed by Doctor Ali, who is a double board certified plastic surgeon with specialized training in breast surgery.

Where is the plastic surgery performed?

Plastic surgery is major surgery and should be performed at a hospital or accredited facility so that you can receive proper care during and after the surgery. Doctor Ali performs cosmetic surgery at the following centers:

  1. Unasource Surgery Center, which is a state of the art, fully accredited facility
  2. William Beaumont Hospital in Troy
  3. St. Joseph Mercy Oakland Hospital.

Will the nipple sensation be affected?

Nipple sensation after the surgery could be altered. It is relatively rare to have complete absence of sensation.

Is a mammogram necessary before surgery?

A baseline mammogram is recommended between the ages of 35 and 40. Young women, in general, do not need mammograms prior to surgery.

What kind of anesthesia will I need?

Breast augmentation is performed under general anesthesia. This helps to perform the surgical procedure in a controlled, pain-free environment.

What is done to ensure that I have the least pain possible following surgery?

The tissue-handling is very delicate which results in less tissue trauma making recovery as comfortable as possible. In addition, Doctor Ali has devised a special injection technique in collaboration with the anesthesiologist which results in a virtually pain free experience for 8-12 hours following surgery. During this time patients need a minimal amount of pain medication and by day 3 or 4 they are virtually pain-free. Then, in two or three days, when the patient is feeling comfortable, they are back to their usual activity. Patients are often pleasantly surprised when they compare their surgical experience with those of their friends who have had surgery elsewhere.

May I bring my spouse or significant other to the consultation?

It is our policy to encourage any spouse or significant other that may be involved in helping you to make this decision to be an integral part of the consultation process. Their involvement helps them to better understand the procedure and enables them to offer better care in the recovery stage.

Is breast surgery scarless?

There is no such thing as scarless breast surgery. It is only a marketing trick. Any time a device is placed into the body, an incision must be made in the skin. However, these incisions can be well-concealed and can be placed at a site away from the breast itself. A better term perhaps, might be minimal-access surgery. The problem is that when the access point is far from the breast, there is great risk and many dangers associated with loss of control in shaping of the breast. Doctor Ali will not compromise the surgical outcome by utilizing such techniques.

How soon can I resume sexual activity after my procedure?

While we recommend waiting 4-6 weeks, we recognize that emergencies do sometimes occur. In such cases, we advocate a “hands-off” approach.

What are the different types of implants available?

Implants are available in a variety of sizes, shapes and surface textures. Two types of implants are available in the USA at this time, saline and silicone.

What is silicone?

Silicone is a naturally occurring substance found in sand, quartz and rock. It is also part of many products we use every day such as soaps, lotions, deodorants, processed foods and chewing gum. Silicone can be processed into many forms including liquid, gel or a rubber-like substance.

Are silicone gel implants safe?

Silicone implants have been thoroughly investigated for the last fifteen years. All the data collected supports the position that these implants are safe and pose no increased health hazard when compared to women without any silicone implants.

How long do breast implants last?

Implants are not life-long devices and can rupture at any time, though this is more likely to occur the longer they have been implanted. In some instances, implants have remained intact 20-30 years after implantation. Our implants come with a ten-year manufacturer’s warranty and extended warranties may be purchased.