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Breast Enlargement

Breast Enlargement Surgery Frequently Asked Questions Answered By Dr. Ralph Bashioum

There are a lot of questions that go along with choosing to enhance your bust line, and we want to make sure you feel comfortable and confident in your decision to undergo a breast enlargement. Dr. Bashioum has compiled a list of Frequently Asked Questions that he has routinely been asked over the past 30 years. We also encourage you to read through our information on Before and After Surgery Care.

What is breast enlargement surgery?

Breast enlargement surgery (AKA breast augmentation, augmentation mammoplasty, breast implants, or boob job) enhances or increases a woman’s breast size. An implant is surgically placed to increase breast volume. Women with diminutive breast size after having children and/or adolescent development turn to breast enlargement surgery to give a more natural breast appearance that matches their body proportions.
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How much will it cost?

Please call my office for an accurate price quote or, better still, come in for a personal consultation. My suggested quotes include professional fees, anesthesia fees, operating room costs, equipment fees, and before and after care. They do not include hospitalization costs, prescriptions, home nursing care, preoperative history and physical examination, laboratory costs, or pathology fees. If you compare prices, make sure that you consider all these costs and fees. Also, most cosmetic surgery procedures require some time off work for a safe recovery.
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What can I do to enhance my breast size?

When a woman is sensitive about her diminutive breast size, breast enlargement is considered. If there is sagging of the nipple below the fold beneath the breast, then breast lift surgery is suggested to give a natural result.
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Is it abnormal to have different breast sizes and shapes?

It is not abnormal to have differences in breast size and/or shape. In fact, most women, and men for that matter, have some asymmetry. It is common for women to be self-conscious about this. Some women are so self-conscious that they are always covered except when bathing. Fortunately, breast enlargement can be considered to improve these differences. If the differences in breast size and shape are large enough, breast lift, reduction, and enlargement can be combined to make both of a woman’s breasts closer to the same shape and size.

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Will I ever be exactly the same on both sides?

It is normal to have differences in breast size and shape. Surgery can reduce these differences but not eliminate them. It is possible to place different size implants to reduce volume differences. It will be necessary for you to adjust to some breast asymmetry after your surgery.
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What other choices do I have?

Other than acceptance of your current breast size or wearing external pads to enhance the breast size in clothing, there are no other consistent and safe choices. Recently, fat graft injections into the breast have been discussed. I do not recommend this for breast enlargement surgery due to its cost and experimental nature. This can lead to difficulties in interpreting mammograms. Alternate implant location, implant shape, and incision placement can all be considered. Always understand all you options before having breast enlargement surgery.
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What additional procedures can I consider that will enhance the result?

Surgeries can be combined to yield dramatic and complimentary results. For safety reasons, I recommend the length of surgery be limited to six hours. Except for liposuction, I suggest no more than one area of the body be treated at the same time. Liposuction and/or fat graft injections can be added in the breast area to enhance the results of breast enlargement.
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Will there be scars after surgery?

Scars are part of all surgery. It is important to understand where breast enlargement scars will be placed. Breast enlargement surgery leaves inconspicuous one-inch scars near the fold beneath the breast. They are easily covered with clothing. Even when your breasts are uncovered, the scars are hidden in the shadow beneath your breast.
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Will my bathing suit hide the scars?

My goal is to place the scars in a position that can be covered by the bathing suit of your choice. However, fashion always offers bathing suit styles which may reveal some of the scars.
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Will I be able to feel the implant?

Usually, you will be able to feel the implant along the outer aspect of your breast. Saline implants are felt more readily than silicone gel implants.
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What implant sizes are best for me?

You are the best judge of this. You understand what kind of clothing you wear, how flamboyant you are, what size you were before having children, and what size you want to be. I recommend you try on implants in my office to determine what size implants to use. Another way is to fill balloons with rice and wear these in a bra to see the change in your figure. Remember, 80% of women state after their breast enlargement surgery that they wish they had picked a larger size.
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What cup size will I be after surgery?

Unfortunately, it is impossible to predict exactly what bra cup size you will be after surgery. Cup size varies with bra manufacturer, bra style, and chest size. It is important for you to try on implants before your surgery. Your consultation will give you some idea how your figure will change.
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Will this lift my breasts?

Lifting of the breasts refers to nipple repositioning to a higher position (above the fold beneath the breast). Breast lifting surgery (mastopexy) must be done to accomplish this. Breast enlargement will only restore the fullness of the upper part of the breast which has been lost as a result of pregnancy. This gives the illusion of lifting of the breast.
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What are the risks of breast enlargement surgery?

There are risks with any surgery. Infection, excessive bleeding, abnormal scarring, poor healing, slow healing, skin loss, changes in skin sensation, and muscle or nerve injury, although uncommon, can occur. Tightness of the scar tissue around the implant can lead to breast firmness. Also, implant failure or deflation is an inherent risk with all man-made implants. Fortunately, most problems that result from such complications are correctable with additional surgery. You must understand your risk of complications completely before you choose to have breast enlargement surgery.
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Will I lose feeling in my nipples?

Although unusual, complete loss of nipple feeling can occur due to nerve injury. This may interfere with sexual arousal and breast-feeding. Ten to fifteen percent of patients experience some change in breast feeling. This can include loss of nipple sensation.
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Will my breasts be hard after surgery?

Breast firmness after breast enlargement is a result of a tightening of the scar tissue around the implant. Current implant technology, implant placement, and surgical technique have reduced the incidence and severity of this condition. If this occurs, secondary surgery can improve the condition. Persistence of firmness may increase the incidence of implant failure or rupture.
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What material is used to make the implants?

The implants are solid silicone bags that are filled with normal saline (salt water with a concentration that matches that of your body) or viscous silicone gel. They are placed beneath the breast through a small incision. Saline implants are inflated after they are placed. A small valve seals once the implant is inflated. This allows the use of a smaller scar.
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Do implants break?

All man-made implants will eventually break once they are implanted in the body. This is a result of material fatigue. Once an implant is placed, the body stresses it. Living tissues like bone and muscle can make up for this by growing stronger. Man-made implants cannot do this, so they will eventually fail. Saline implants simply deflate, your breast returns to its small size, and the salt water is naturally passed from your body. Silicone gel rupture will lead to small amounts of silicone gel accumulating around the implant, which will eventually lead to inflammation. Due to the difficulty in diagnosing silicone gel implant rupture, the FDA (Food and Drug Administration) strongly recommends an MRI test ($750 to $1000) the third year after surgery and every other year thereafter.
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I have heard about so many bad things on television, is it safe to have breast enlargement?

There are always risks to having breast enlargement surgery. Serious problems or complications are usually related to excessive surgery and/or undiagnosed medical conditions. I believe breast enlargement surgery can be done safely with a high degree of patient satisfaction.
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Are silicone implants legal to use?

Silicone gel breast implants have never been removed from the marketplace. The FDA (Food and Drug Administration) has released silicone gel implants for use as of December 2006. Currently, they are available to patients undergoing breast enlargement surgery for the first time. Understand all of the FDA recommendations regarding their use.
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What can you tell me about this new technique that I saw on television?

Everyone in the United States wants the latest in medical care. This is not always the best medical care. At times, media presentations will leave out critical information about potential complications, quality of results, and FDA regulations. I am open-minded when it comes to new technology, but I would rather not use my patients to try out the newest techniques. Saline implants and silicone gel implants have been available for forty to fifty years.
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How old do I have to be to have this surgery?

Breast development can continue into the early twenties. When surgery is done before this time, there is a chance the surgery will have to be repeated. In addition, it may be difficult emotionally to adjust to the surgery during teen years. For these reasons, the FDA (Food and Drug Administration), implant manufacturer, and I recommend that breast enlargement surgery be postponed until eighteen years of age.
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How long must I wait after breast-feeding before I can have breast enlargement?

You must wait for three to six months after breast-feeding before you can proceed with breast enlargement. Reasons for this are increased risk of blood and/or milk collections. In addition, it is impossible to predict what the size of your breasts will be until all the milk formation has passed.
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Will breast enlargement increase my risks of breast cancer?

Two studies have examined this very question. Breast enlargement surgery does not increase your risk of developing breast cancer. However, all women are at risk for breast cancer. If you have family members that have had breast cancer, your risk is increased. Examine your breasts monthly and have mammograms as suggested by your primary care physician. Remember that breast cancer can occur at any age and a physician must properly evaluate all breast lumps.
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Do I need a mammogram before surgery?

I recommend that you have a pre-operative mammogram if you are older than 34 years. I also recommend that you have a mammogram if you have any significant breast problems or breast lumps. Breast cancer can occur at any age and a physician must properly evaluate all breast lumps.
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Will breast enlargement interfere with mammograms?

All breast implants interfere with the interpretation of mammograms. Placing the implant under the muscle reduces this interference. It is important that you continue with monthly breast self-examinations. When you do have a mammogram, be sure to tell the physician or the x-ray technician that you have had breast enlargement so they can do extra x-ray views to try to make up for the implant. These are called Ecklund views.
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Should I stop smoking?

For general health reasons, yes I recommend that all my patients stop smoking. It is clear that smoking increases your risk for developing all sorts of cancers. Breathing problems like emphysema and circulatory problems, including heart attacks, are also linked to smoking. Smoking can increase the risk of coughing after your surgery, which may lead to unwanted bleeding. Finally, the chemicals released from burning tobacco also reduce blood flow, which can result in skin loss during the healing period. It is always best to stop smoking.
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Am I a good candidate for the surgery?

This is a question that can only be answered after a personal consultation. Breast enlargement surgery is suggested to women with a small breast size. There are other things to consider as well, including psychiatric conditions, life stress, medical illness, obesity, and motivation. You should be a healthy nonsmoker within twenty pounds of your ideal weight. Major life stresses (i.e. grieving a death or divorce) must be absent from your life. The ideal candidate is motivated by internal desires to look better.
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What should I do if I need a breast biopsy after breast enlargement?

When a breast mass is discovered, a biopsy is usually necessary. Care must be taken to avoid damaging the underlying implant. Sharp instruments must not come in contact with the implant due to the risk of implant rupture. Tell your physician that you have had breast implant surgery so they can take appropriate precautions. Sometimes a breast biopsy can be done with a needle using radiographic guidance.
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What kind of anesthesia will be used?

Breast enlargement surgery in my office is completed under general anesthesia. Patients are completely asleep during the surgery and remember little or nothing of the experience.
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How is breast enlargement done?

Breast enlargement can be separated into four parts. First, a plan is outlined on your breasts. Second, a small incision is made in the new fold beneath the breast so that the subsequent scar is easily covered. Next, the breast and muscle are lifted away from the ribs and the implant is placed. Finally, absorbable stitches are placed to close the incision in the skin.
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How long will I be in the operating room?

Surgery takes about one hour to complete. You will spend about four to five hours in my office.
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Can I breast feed after a breast enlargement?

Yes provided there is not complete loss of nipple sensation. Although rare, this can occur due to nerve injury. You should attempt to breast feed if this is your goal.
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  • Member, American Society of Plastic Surgeons
  • Member of the American Society for Aesthetic Plastic Surgery
BASHIOUM COSMETIC SURGERY CENTER 445 Lake Street, Suite 210 Wayzata, MN 55391 877-647-6882

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