1. Can a woman breast-feed after breast augmentation?

Women can generally breastfeed after breast augmentation, especially if care is taken to avoid cutting the ducts that supply the nipple. However, there is an increased chance of not being able to breastfeed due to possible disruption of these lacteriferous (or milk) ducts. When placing an implant through the nipple/areola, care needs to be exercised to avoid undermining the nipple to prevent injury to as many ducts as possible. Patients also need to be aware that a certain percentage of women cannot breastfeed even without any surgery.


2. Is it true that there is usually no loss of sense of touch of the nipples?

Normal or nearly normal sensation to the nipples is generally preserved in breast augmentation patients. As in the case of breastfeeding, some nerves supplying the nipple may be injured during the surgery, but care can be taken by the surgeon to avoid injury to as many sensory nerves as possible. Some patients may experience some loss of sensation due to bruising during the first few months after surgery, but most or all sensation returns in the majority of patients over time. A small percentage of patients may have permanently diminished sensation.


3. Can implants achieve some lifting of sagging breasts?

Yes. Implants do result in some lift to the breast. This lift is generally modest at about 2 to 3 cm. Patients with excessive sagging, or ptosis, of the breast may require a lift to the breast in addition to the implant.


4. What about getting insurance to pay for the breast augmentation?

Insurance does not cover cosmetic breast augmentation. Breast implants placed for reconstructive purposes after breast cancer surgery may be covered by insurance.


5. Will my breast implants feel like natural breasts?

The newest generation of breast implants are improved over previous ones in terms of their feel and the leakage rates. Some palpability of the implant may still be possible, particularly along the lower portion of the breast or in women who start with very little breast tissue. Silicone implants usually feel more natural than saline implants.


6. What is the difference between breast implants placed under the pectoralis muscle and implants placed over it?

The choice of implant placement either above or below the pectoralis muscle should be tailored to each patient ' s anatomy as well as preferences. Placing the implant under the muscle will provide some additional coverage of the implant that may make it less palpable or visible in patients with less breast tissue. It also may interfere less with mammography. Placement over the muscle, also called subglandular placement, is typically a less painful procedure with an easier recovery period, and may provide slightly more lift to the patient who has some mild sagging.


7. Will smoking affect my recovery?

Although not an absolute contraindication to breast implant surgery, smoking may delay healing as well as increase the chance of infection and wound complications due to its effects on the blood supply.