Do breast implants interfere with mammograms?

It is more difficult to detect breast cancer on a patient who has breast implants. The technician uses additional views and special techniques to locate suspicious breast lesions. It is important to know that breast implants do not increase your chances for developing breast cancer.

Can I breast-feed with breast implants?

Women with breast implants can breast-feed. However, not all women are able to breast-feed with or without implants. The implants will not hurt the infant or the ability to produce milk. From a cosmetic point of view, breast-feeding may alter the shape of the breasts. However, for the best interest of the infant, breast -feeding is recommended for maternal bonding and infant antibody production.

What will pregnancy do to my implanted breasts?

Pregnancy causes undesirable changes in female aesthetics. There are factors that increase the possibility for changes such as increased age, excessive weight gain, and breast-feeding. Most patients will have a cosmetically acceptable breast shape after pregnancy. A small percentage may need additional surgery to maintain breast beauty, but this is independent of your decision to undergo breast enlargement.

Do breast implants cause autoimmune or collagen vascular disease?

There is no clinically proven increased incidence of auto immune or collagen vascular disease in implanted women. The development of such diseases is independent of breast implants.

How can I determine breast size?

Chest dimensions and preference determine breast size. There is no correct breast size. Most women prefer to be a 'C' cup size. Implant sizes are measured in volume ( 200cc's, 300cc's etc). Remember, your new size is a combination of your current breast size plus breast implant volume. Excessively large breasts tend to look unnatural and may lead to shoulder and neck discomfort.

Are saline breast implants safe?

As with any surgery complications can arise. Breast implants are foreign bodies and therefore are not naturally occurring. However, saline implants are particularly safe. In the event of a rupture, the body simply absorbs the salt -water solution. The silicone envelope tends to be stationary in the breast pocket and can easily be removed or replaced. At the present time there is no known illness associated with saline-filled implants. There are more than two million women with implanted breasts. Most women are happy with their results.

What happens if my saline implants rupture?

The replacement of a saline-implant (unlike silicone implants) is relatively simple. The surgeon can usually go through the same incision, remove the deflated bag, and replace it with a new implant. The operation is usually quicker and with far less discomfort than the original surgery.

What happens if I want to remove my implants when I am older?

From my experience, most women do not opt to remove their implants. However, if implants are removed at a later time, the breasts are older and also have been stretched by the implants. When the implants are removed, the breasts may look droopy and will definitely be smaller. Some patients may have a cosmetically acceptable breast mound and nipple position, while others may need a breast lift.

What happens if I am unhappy with my breast size?

After surgery, some patients are initially concerned about breast size. They may be nervous that the breasts are too big, while others are concerned that the breasts are too small. My suggestions to my patients are to wait a minimum of six months to one year to allow the breasts to drop and take a more normal shape, as well as allow sufficient time to adjust to this change. If after a one -year period, the patient is still unhappy, implants can be exchanged for a larger or smaller size.

Should I have my implants placed over or under the muscle?

In most cases, I recommend placing implants under the muscle for the following reasons: there is more padding of the implant under the muscle thereby leading to less rippling, and a more natural feeling breast and it is easier to detect a breast mass on mammograms. Also, this method provides more support to the implanted breast giving an improved shape over a longer term. However, it may be necessary to place the implants under the breasts (sub-glandular) in particular cases. Sub-glandular placements are usually recommended for patients who have droopy breasts and refuse breast lifts. These patients tend to have more breast tissue and therefore are able to pad the implant. There is however, less discomfort when the implant is placed sub-glandular, as compared to under the muscle.

Which implant type should be used?

Each surgeon has his/her own opinion about implant type and manufacturer. Two popular U.S. companies are Mentor and McGhan. Implants can be round or pear shaped, textured or smooth. A study that compared pear shaped to round implants demonstrated the round implant is more like a natural breast than the pear shaped implant when placed in the body and subjected to positional changes. It is the opinion of Dr. Farella that smooth, round implants, when properly filled and placed under the muscle have less rippling and appear more natural in most cases. At the time of consultation implant type and manufacturer can be individualized to your needs.

What is your opinion about silicone implants?

Silicone implants are superior when compared to saline implants as far as feel and look. The FDA recommends that silicone implants should not be used for primary breast enlargement. However, permission to use these implants can be obtained through special studies for various situations. Silicone implants can be used on secondary breast enlargements, enlargements with breast lifts, and for breast reconstruction through controlled FDA studies. Since silicone has been used medically in the body and ingested as a legal food additive, there has not been an epidemic of silicone toxicity. Even saline implants have silicone as the outer shell or envelope. Since the bankruptcy of Dow Corning, studies have supported the safety of silicone. Dr Farella has operated on several ruptured silicone implanted patients. At the time of rupture, the silicone is gelatinous and difficult to remove unlike saline implants. Since the ruptured silicone implants are less contained, it acts more like free silicone. Migration may be more of a factor. As a result, Dr. Farella rarely uses silicone implants. If silicone implants are used, it is recommended to change the implants every ten years.

Call for a complimentary consultation: John F. Farella, MD., F.A.C.S (914) 241-7111 Lexington Avenue Suite 104 - Mount Kisco, NY 10549 (914) 997-9090 311 North Street Suite 408 - White Plains, NY 10605 (718) 548-5200 3333 Henry Hudson Parkway Suite 1-A - Riverdale, NY 10463 http://www.drfarella.com