After four months, Angela’s implants have now settled.  Seeing people in the office at this point gives a rough idea about how the implants are going to look over time, although one must keep in mind that breast tissue will continue to change.  Skin, breast gland, and breast fat all undergo alterations that occur with normal aging, not to mention rippling, contracture, and other changes that may take place with time.

As you can see from the following before and after pictures, we accomplished our preoperative goals well.  Angela was initially a small B, and desired a full D cup.  She is now very pleased with her results, and eagerly awaits swimsuit season.

Like many plastic surgery procedures, breast augmentation comes with risks and benefits that are best understood by consulting with an actual surgeon.  When I discuss options with patients, I strive to help them understand many things, including what is possible, what will look good for their particular body, and what they should expect before and after surgery.  I truly enjoy educating, collaborating with, and improving the lives of my patients.  If you are interested in breast augmentation, I encourage you to come in and see me.  Through the end of the year 2013 your consultation is complementary, and the potential benefits can be sizable.  Go ahead, give it a try!

Between the 1-month and 4-month appointments, many changes were afoot.  Around the 2-month mark, I got an update that Angela’s implants were just starting to drop, but they were doing so unevenly.  This was a cause of concern.  Looking at her picture, this unevenness is apparent.   This is not uncommon, however.  Whether this is because of being right- or left-handed or because of differences in tightness of the pectoralis muscles, sometimes implants do tend to drop at different rates.  This does not mean that the implants will wind up being in different positions.  Here she is around two months:

The left side has begun to drop into proper position, and the right remains high; but now look at things a month later:

The position of the implants has now evened out, giving her a nice, symmetric look.  At this point she breathed a sigh of relief, and her buyer’s remorse was replaced with excitement for the coming bikini season.  Also, some decreased nipple sensation, which is transient in some patients (due to nerve stretch  because of the size of the implants), was now relieved, making her even happier with her results.

Tomorrow I’ll post her pictures we took at her 4-month follow up appointment.  Angela’s case is a good one in that it illustrates that not everything goes according to patient expectations, but this doesn’t mean results are compromised.  For those interested in breast augmentation, come in and see me – for those who schedule augmentation consultations before the end of the year, you can get 1/2 off the surgeon’s fee for your surgery, and you, too, can be excited for the coming bikini season!

Ah, buyer’s remorse.  That nauseating feeling that something is wrong – that what you have experienced isn’t normal, and that you may have just made a huge mistake.

Somewhere about a month out, I saw Angela, and she was concerned.  Normally by that time, the implants have started to drop, but hers continued to be positioned high, and her implants appeared very tight.  Perhaps she was comparing her results to friends who had implants, who didn’t seem to still have breasts up to her collarbones a month out.  Doubt started to creep in, and the possibility of revision surgery loomed in her thoughts.  We talked for a while about possibilities, and I encouraged her to hang in there.  Her concerns were logical and realistic, but over time I have found some people, particularly petite women, have tighter musculature, and it takes longer for their implants to drop.  She seemed to match that profile.

Around this time she started taking occasional pictures to document her progress.  With this picture, you can compare her appearance with where she was right after the procedure and you can see not much progress has been made.  In fact, some may even say her implants seem to have shifted upwards.  This is not uncommon, and as you’ll see, truly does improve with time.  Over the next few days, pay close attention to how the breast volume, position, and symmetry can change.

So your big day of excitement comes.  You’re a little nervous.  Not quite sure what it means to be operated on.  You want things to go well, not knowing exactly what “well” means.  Don’t fret – you’re not alone!  On the day of surgery patients generally show up about an hour before we begin.  An IV is started, and you’ll get some pain medicine before we even begin.  The nurses help you prepare every little thing.  The anesthetist will talk to you, and I’ll talk to you.  We go over your operative plan, to make sure we’re on the same page, and then I draw my map to help me do things just the way we’ve agreed.  After that, you walk into the operating room, you become sleepy, and then we prepare for the operation.  To let you know how things look at this stage, it’s something like this:

Here’s Angela just before we begin.  As you may be able to surmise, we’ve chosen to place her incisions in the inframammary folds – the folds where her breasts hit her chest wall.  The incisions are about 3.5 cm long – around an inch and a half.  We placed 450cc silicone implants below her pectoralis muscles, using high profile implants (relatively narrow width but more projection).  After the procedure she looked something like this:

You’ll notice a few things about this picture.  You can already see that the implants look very large, and that they look like they come up to her collar bones.  This can be alarming to some people, but is very normal.  With time, the implants will settle, and will take on a more normal appearance.  Some people take longer for this to happen, as was the case with Angela.  As the days progress you’ll be able to see the implants’ position change.

Up next – that goofy in-between period!

Yes, I admit it.  Perhaps the purveyor of this blog has become derelict in his responsibility to post new and exciting plastic surgery updates.  But guess what?  Doctor’s gonna make everything all better, because I have yet another weeklong series based on a patient’s experience.  This time – Breast Augmentation.  Everyone please meet a girl we’ll call “Angela.”  No silly, that’s not her real name, but that’s ok.  We keep everything confidential, and you benefit because Angela has done us all a great favor and has recorded her experience with her iPhone.

During my consultations with patients, I discuss how things change over time, with the normal progression being something as follows:  regarding their shape and volume, on the day the breast implants are put in, they appear something like their eventual outcome.  Because of swelling and muscle tension, the implants tend to rise soon after surgery, giving the breasts a constricted but high-riding look.  With time this resolves, giving people the cosmetic outcome they were desiring.  This takes time – usually about a month, but sometimes longer.  The natural tendency is for people to want their “new” boobs right away.  Angela was no different.  Unfortunately for her, but fortunate for us, this process took her a little longer, thus providing her the incentive to document her progression.  She is petite and active, and it took a few months for her implants to really find their new home.  Each day this week I’ll add a picture to the series to show you what you can expect with a breast augmentation.

Some initial information: Angela is 26, initially had small-B cup breasts, and desired D to DD.  She desired silicone implants, and we chose to place these underneath her pectoralis muscles.  Here are her initial preoperative pictures:

Tune in this week as we take you through Angela’s journey.  For those of you who are interested, come in and see me.  Right now we’re offering 1/2 off the surgeon’s fee for breast augmentation patients who come in for their consultation during November and December!