1. What is the minimum age to have a breast augmentation?

The ideal minimum age to have a breast augmentation is 18 years of age. At this point, typically a young woman has acquired many important decision making skills that equip her with the proper attitude to decide whether or not it would be appropriate for her to make changes to her body. Sometimes, however, an even younger patient presents for a breast augmentation because of deformities such as tubular breasts, or Poland Syndrome, a condition in which one breast is significantly smaller or even absent. In these situations, I would practice on patients as young as 16, but again, I prefer to wait until the patients are older, especially if it is a purely cosmetic procedure. The most important tool a woman needs to have when making this decision, no matter what her age, is knowledge about what accompanies breast augmentations, such as the effects on breast feeding, and the effects of breast ptosis (drop after pregnancy).


2. Can I sleep on my stomach after surgery and will this be comfortable?

I emphasize with my patients that they need to sleep on their back or on their side for six to eight weeks after their surgery. After this period, the patient can then start moving to their stomach, and typically after this point, if a patient has a normal recovery, she will be able to sleep comfortably on her abdomen.


3. How long will it take my implants to settle into place?

After augmentation, the implants have a tendency to want to move upward. I often have the patients wear a bra band at night as a technique to hold the implants in their normal anatomical position. Rarely do the implants change position after the six-week mark.


4. Should I quit smoking before my breast implant surgery? Can I use a nicotine patch or gum?

I highly recommend that patients stop smoking prior to surgery and that they do not use a nicotine patch. The nicotine causes the blood vessels to constrict, decreasing blood supply to the breast tissue. If the blood supply is limited, there will be a slowing of the healing process and a higher likelihood of scar formation.


5. Will my breast implants feel like natural breasts?

There are two different types of implants on the market today: saline filled implants and silicone filled implants. Both implants have an outer silicone shell. Implants that are placed underneath the muscle tend to have a more natural feel because the overlying tissue protects and covers the implants. The lower edge of the implant oftentimes is outside of the pectoralis muscle and can give a firm feeling. The newer silicone implants tend to have a more natural feel because of the consistency of the inner contents of the implant.


6. When should I stop taking aspirin and vitamin E before surgery? What about drinking alcohol?

In my practice, I emphasize health and nutrition. Our patients are placed on vitamins and supplements two weeks before surgery and two weeks after surgery. I typically ask my patients to stop aspirin and vitamin E a minimum of two weeks prior to surgery, but four weeks is ideal. As for alcohol, I request the patients to stop drinking alcohol one week prior to surgery and abstain from alcohol for a minimum of two weeks after surgery. When the patients asks to start having a drink occasionally, I initially recommend red wine, and then slowly let them move into more mixed drinks and higher carbohydrate related drinks at four to six weeks.


7. If one of my implants deflates, will I know it and will I become flat immediately?

When a patient has a saline implant in place, typically when they rupture they have a near immediate response because the saline quickly leaks out of the implant and is absorbed in the body within days. A slow leak from the saline implant will give a very slow change in the breast, and it is not uncommon for the breast to slightly harden. The newer silicone implants are very firm and dense in terms of their components inside, and these implants are hard to detect if they leak because the silicone is very cohesive to itself, not allowing for immediate deflation. Again, an increase in the hardening in the breast can indicate a possible leak of this type of implant. A CT scan, or more specifically an MRI, will help to make the diagnosis of a ruptured silicone implant.