1. Am I a good candidate for breast enhancement or breast enlargement?

Good candidates for breast augmentation include women who wish to make their breasts larger for personal or psychological emotional reasons. The following are some common reasons why you may want to consider a breast augmentation:

  • You want to correct size differences between the breasts.

  • You want to return to a breast size they were before breastfeeding or pregnancy.

  • You want more fullness of breasts.
  • Breasts that lack substance or firmness.

  • Breasts that are not equal in size.

  • Breasts that are relatively small.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

2. What will be expected of me to get the best results?

At the conclusion of your breast augmentation procedure, you will be placed in a surgical dressing that may include a support bra or garment. Prior to your discharge, you will be given detailed instructions about your post-surgical care including breast tissue massages and, the normal symptoms you will experience. 

3. What shape, size, surface texturing, incision site and placement site are recommended for me?

Incision site: 
To insert the breast implant, Dr. Hsu will make a single cut (incision) in one of three places:
  -  In the crease under your breast (inframammary fold)
  -  Under your arm (transaxillary)
  -  Around your nipple (periareolar)

Dr. Hsu typically prefers to use the inframammary incision site because the incision is not only well concealed underneath the breast, but also decreases the likelihood of developing capsular contractures. However, he will determine which incision site is best for each patient after the initial consultation. After making an incision, he will separate your breast tissue from the muscles and connective tissue of your chest. This creates a pocket behind the outermost muscle of the chest wall (pectoral muscle).

Dr. Hsu will insert the implant into this pocket and center it behind your nipple. Saline implants are inserted empty, and then filled with sterile salt water once they're in place. Silicone implants are pre-filled with silicone gel. When the implant is in place, the incision will be closed with stitches (sutures) and bandaged with skin adhesive and surgical tape.

Types of breast implants: 
There are two types of breast implants: silicone breast implants and saline breast implants. Saline implants are filled with sterile salt water. They are inserted empty and then filled once they're in place. Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Most women feel that silicone breast implants look and feel more like natural breast tissue.

Shape and size: 
Breasts implants come in a variety of shapes, surface textures, and sizes. Breast implant size is measured in cubic centimeters (often referred to as cc’s). The larger the implant, the higher the volume of cc’s will be. For example, a 300cc implant is larger than a 250cc implant. Breast implant sizes do not correspond to traditional bra cup sizes. Choosing the right size implant is generally the most important decision a woman and her surgeon will make. For an accurate, in-person visualization of how different implant sizes will affect your shape, we recommend you bring a sports bra to the initial consultation to try the different size implants and see which implant size best fits your ideal body shape. Dr. Hsu will also evaluate your existing breast tissue to determine if you have enough tissue to accommodate the desired size of breast implant. 

The profile of a breast implant refers to the level of forward projection from the chest wall in relation to the base width of the implant. In other words, the profile indicates the distance the implant will project from your body. A higher profile breast implant will create a more prominent silhouette than a lower profile breast implant. There are two different types of breast implant textures: smooth and textured. Dr. Hsu uses all implants from Sientra, Mentor, and Allergan and will choose which type, shape, and size per individual. In conjunction with implant manufacturers' warranty for implants, Sientra offers a guaranteed replacement in the case of capsular contracture within two years of the implantation. 

Most silicone implants are available in 2 distinct shapes: teardrop and round. Teardrop shaped implants are thinner at the top and gently slope to a fuller projection point near the implant’s bottom, mimicking the silhouette of a natural breast. Round breast implants are circular and able to shift slightly once positioned without distorting the shape of the breast. Dr. Hsu prefers round breast implants to avoid the problems that arise when teardrop implants rotate. 

4. How long of a recovery period can I expect, and what kind of help will I need during my recovery?

You should be walking under your own strength immediately after your breast augmentation surgery. The first 2-5 days following your breast augmentation surgery you may feel stiff and sore in the chest region. Any dressings will be removed within several days, and Dr. Hsu recommends wearing a support bra to aid recovery. While it will take several days to return to more normal activities after your breast augmentation, it is important to your recovery that you get up and move around. After breast augmentation, it is often possible to return to work within just a few days or a week, depending on the type of activities that are required at your job. Physical activity should be avoided for at least the first six weeks following surgery. After that, care must be taken to be extremely gentle with your breasts for at least the next couple of months. 

5. What are the risks and complications associated with my procedure?

Risks and complications vary depending on patients’ health history and can be discussed with Dr. Hsu on an individual basis. Some of the potential complications include reactions to anesthesia, blood accumulation (hematoma), and infection. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant. Changes in nipple or breast sensation may result from breast augmentation surgery, although they usually are temporary.

When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast's appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.

Breast implants are not lifetime devices and cannot be expected to last forever. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours. A definite change in the size of the breast is clearly noticed. Rupture can occur as a result of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant, if desired.

6. How are complications handled?

In the case of capsular contraction, the implant may be removed and replaced if the patient wishes. Treatment of a hematoma includes putting a tube in the breast to drain the blood. This procedure often requires a trip back to the operating room. Sometimes, if the collection of blood is small, no treatment is required and the body is able to clear the hematoma on its own. Dr. Hsu may treat an infection with antibiotic pills, or if the infection is severe, by having the patient go to the hospital for intravenous antibiotics until the swelling and redness go away. For infections of the implant itself, surgery to remove the implant is often the only option.

7. How many additional implant-related operations can I expect over my lifetime?

Due to the effects of aging and gravity, some women will go through further breast surgeries to reshape their breasts while other women will simply go for a breast lift. There are also the lucky women out there who won’t need any further surgeries at all. 

8. How will my ability to breastfeed be affected?

Some women who undergo breast augmentation can successfully breastfeed and some cannot. Women who undergo mastectomies and then have breast implant reconstruction surgeries may not be able to breastfeed on the affected side due to loss of breast tissue and the glands that produce milk.

9. How can I expect my implanted breasts to look over time? After pregnancy? After breastfeeding?

Except in the event of implant deflation requiring surgical replacement with a new implant, the results of your breast augmentation surgery will be long-lasting. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast "lifting" to restore their more youthful contour. Also, women are free to breastfeed without the concern of affecting the appearance of their breast augmentation.

10. How will my breasts look if I choose to have the implants removed in the future without replacement?

It is impossible to predict with certainty how you will look after a breast implant removal. This is highly dependent on the nature of the scar and if the implant got ruptured or damaged. Breast asymmetry may also occur after the breast implant removal. This is very disappointing for most women. Some women will go through further breast surgeries to reshape their breasts while other women will simply go for a breast lift. 

11. What if my implants rupture?

If the silicone breast implant is leaking, the gel needs to be removed before placing a new implant. The ruptured material is removed using a series of dry sponges on a long instrument that holds the sponge in place and allows the silicone gel to cling to the dry sponge. Free sponges are not used and an accurate sponge count is always taken before closure of the incision. This is repeated until all visible gel is removed. Any residual gel does not appear to be harmful.

When a saline implant has ruptured, the silicone shell simply collapses and is easily removed. The saline from the breast implant is absorbed by the body.