Is Breast Enlargement for You?

At Minneapolis Plastic Surgery, our goal is to provide a thorough understanding of breast augmentation surgery; many doctors (some of whom are not even plastic surgeons) can claim the capability of placing breast implants, but knowing the following details about breast augmentation will help you understand why we should be your best choice. As leading Minnesota plastic surgeons specializing exclusively in aesthetic plastic surgery, our plastic surgeons have the complete surgical training, board-certification (American Board of Plastic Surgery), and over 50 years of combined experience to help you understand facts and fallacies regarding breast enlargement surgery.

• Breast implants do not increase the risk of developing breast cancer.
• Mammography and breast self-examination can be performed on augmented breasts.
• Skillfully-augmented breasts both look and feel normal in the majority of women.
• Breast implants do not harden, nor do they automatically need replacement after ten years.
• Nipple sensation and the ability to breast-feed are preserved in most patients.
• Breast implants (both silicone gel and saline) do not cause or increase the risk of developing arthritis, lupus, scleroderma, or connective tissue diseases.
• Saline implant leak or deflation is uncommon and can be dealt with when it does occur.
• Since 2006, silicone gel implants are FDA-approved for use in first-time breast enlargement patients. They are “cohesive” and cannot deflate.
• Women age 18-22 can legally and ethically have silicone gel implants placed.

Any patient considering breast enlargement with implants must have a personal consultation, during which her individual cosmetic goals and concerns will be discussed with Dr. Richard H. Tholen or Dr. Douglas L. Gervais at our Minneapolis, Minnesota office. Many of our patients who do not live within driving distance of the Minneapolis / St. Paul area arrange for a breast enlargement consultation and surgical procedure during the same visit. Our staff can help you with arrangements for local lodging, postoperative care and assistance, if desired, and follow-up arrangements.

A complete medical and surgical history will be obtained from all patients interested in breast enlargement or breast implants. This should include information about previous surgeries or allergies to any medications. You must inform your surgeon of all prescription or over-the-counter medications, including herbal, vitamin, nutritional supplements, and appetite suppressants. Some of these can interfere with anesthesia and proper blood clotting and can increase the risk of bleeding or other complications after surgery. Breast enlargement patients must avoid aspirin or ibuprofen-containing products, Aleve™, additional vitamin E (the dose in a single daily multivitamin is acceptable), and any herbal remedies for a full two weeks before and four weeks after surgery.

Your pregnancy, breastfeeding, and mammographic history are important, as is physical examination of your breasts, nipple-areola position, measurements, and skin and muscle tone. Mild to moderate ptosis (breast droop or sagging of the skin caused by loss of breast volume after weight loss, pregnancy, or breastfeeding, and normal to slightly low nipple-areola position) can usually be corrected with implants alone (standard breast augmentation). This is because “filling-out” the loose skin of breasts that have lost volume can give the appearance of raising the nipple/areola position on the breast mound as the implants drop into position behind the breasts and restore fullness. Many women with flattened, deflated-looking breasts think (and are told elsewhere) they “need” breast lifting surgery, when in fact they can achieve beautiful results with restoration of breast volume (implants alone) in many of these borderline cases.

If breast size (volume) is adequate for your goals and body proportions, but your breasts are sagging or nipples are pointing downward, a breast lift is what you need. Only an ounce or ounce and a half of excess skin needs to be removed to create a new, uplifted breast appearance with nipples that are facing forward and in the proper positions on the breast mounds. While many surgeons may tell you that removal of “more” breast tissue will allow the placement of implants, and that this will produce “better upper pole fullness” or give a longer-lasting result, implants and breast tissue are designed to be similar in “feel” and removing some of one to add the other does NOT, in our opinion, enhance results, longevity, or give more fullness superiorly. If you want or need a breast lift plus additional breast size, implants plus breast lift will be necessary. This can usually be done as one operation, not two.

Regardless of pre-existing breast size, if ptosis (sagging) is more severe, or if nipples point downward or are positioned below the infra-mammary creases, a breast lift (mastopexy) procedure will likely be necessary. After examination, our plastic surgeons can determine the exact type of breast lift that is recommended and explain the additional incisions and resultant permanent scars that are involved. Breast lift surgery (with or without breast implants) requires additional operating time, incisions, and cost, but can correct more severe drooping or sagging of the breast skin, as well as raise nipple position. This is done without removal of the nipple-areola complex (though there is a scar around the areola to reposition it higher on the chest), which can preserve both sensation and ability to breast feed in about 85% of patients undergoing breast lift surgery.Large areolas can be reduced in size during breast lift surgery. Removal of the nipple/areola complexes and placing them higher as skin grafts is rarely needed.

Other conditions such as nipple inversion, tuberous breasts, significant asymmetry, Poland’s syndrome, or problems from prior surgery, such as bottoming out, “double-bubble,” symmastia (uni-boob, “breadloafing,” or loss of cleavage), capsular contracture, or malposition can also be corrected or improved.