1. What prevents bacteria from getting into implants?

There are several factors that need to be taken into consideration. At the time of surgery we use sterile techniques, the area is prepared with an antibacterial soap, the "pocket" for the implant is bathed in an antibiotic solution ( I use a concentrated solution that stays in place, very different compared to other plastic surgeons). This should be enough to prevent bacteria from "colonizing" the implants, however this is still possible. The patient gets preoperative (before making the first incision) intravenous antibiotics and she will get oral antibiotics for 7-10 days.

After the surgery, days, months to years, the body forms a barrier (scar tissue: capsule) around the implant. However, bacteria can get into this capsule and colonize the implants, hence when a patient gets an invasive procedure(i.e. colonoscopy, dental work and GI surgery) the patient should get oral prophylactic antibiotics.


2. What about mammograms after breast augmentation?

Patients should continue with the current recommendations. Ideally patients should get a mammogram before surgery, then 1 year later, every 2 years to the age of 40 and then yearly. Patients need to inform the radiology technician, there is a special technique that needs to be used. There is a lot of misinformation regarding the interference of the implant with this study.

The areas where the breast cancer is most common will be more visible with an implant, because the glandular tissue will be displaced anteriorly in the chest.

There is an area of breast tissue, the axillary tail, which will be obstructed by the implants, even with the specialized technique; however this area is easily palpable in most patients.


3. What is a "Spectrum" implant and why would someone want one?

This is an adjustable implant, the idea is that you can change the size of the implant up to 6 months after surgery, through a port (much like the chemotherapy ports) Most plastic surgeons do not use these implants in breast augmentation, and some use these in breast reconstruction. The main disadvantages are the price (significantly higher), the increased risks of rupture and the need for another surgery to remove the port.


4. What are the specifications for the different implants?

Implants come in many shapes, sizes and composition. The surgeon needs to explain the patient the differences. The most important is silicone versus saline. Most plastic surgeons like silicone filled implants better ( I am one of them). They are more natural, adapt better to the chest wall but they are more expensive and if rupture happens it is more difficult to detect.


5. Can implants cause breast cancer?

No, this topic has been studied with no scientific proof of the contrary.


6. How do I keep my breast augmentation private?

The goal of breast augmentation surgery is to obtain a natural looking breast, but everybody is different. What a person in the West coast likes as normal (My plastic surgery training was mainly in Southern California) could be very different for a person in the Midwest.


7. How can a woman decide what size implants she wants?

There are many ways to make this decision. What it works the best for me is to allow my patients to try different sizes under their clothes. There are some techniques based on measurements, however some of these patients are not satisfied with their results. In my opinion the patient will decide the size, if they choose an implant which is too large for their body habitus, my role as a surgeon is to explain the risks associated with their decision.