Adjusting to Your "New" Breasts

from plastic surgery

Getting used to your new breast size may be easy or difficult. Some women are immediately pleased with their size. Others may take months to adjust. Some women are disconcerted that their inner arms brush against their breasts during normal movement. This is to be expected. It is not uncommon for a woman to initially be concerned that her breasts are too large, only to be disappointed after the swelling has resolved. The best way to prepare yourself for this is to choose the largest size that you find acceptable and also anticipate that you might initially perceive yourself as too large. Be patient, and stop staring at your breasts in the mirror.

Telltale Signs

There are a number of telltale signs of breast augmentation that you should be aware of.

Spherical Breast

Moderate or severe capsular contractures can cause the breasts to appear unnaturally round. Severely affected breasts can resemble coconuts. If you peruse Sports Illustrated's swimsuit issue, you are likely to see a variety of examples.

Postpartum Droop

During pregnancy, breast skin stretches to accommodate the enlarging breast. Following pregnancy, the breast returns to normal size. If the skin does not regain its tone, the breast droops. Because the implant does not droop, the breast may appear to have fallen off the implant. A breast lift is required to restore the breast to its natural position.

Not all women who become pregnant following augmentation suffer this cosmetic problem. Those who have modest change in breast size during pregnancy and those with good skin tone are less likely to have postpartum droop. Be aware that droop following pregnancy is due to the pregnancy, not the implants. Hence, if it occurs, it likely would have done so whether or not implants were involved—it just looks worse when implants are in place.

Symmastia

Symmastia is the merging of the breasts into an indistinct mass (Figure 7-7). It occurs if the skin between the breasts loses its attachment to the breastbone during or after surgery. This can be the consequence of trying to achieve tight cleavage for women who have widely spaced breasts. This is a challenging problem to fix, and revision surgery may not be successful. Fortunately, symmastia is rare. More common is a condition known as bread-loafing, in which the breasts appear separate and distinct unless they are being manually pushed toward one another, at which time the distinction is lost.

Duration of Results and Need for Further Surgery

The Internet is flooded w ith claims that breast implants last ten years, at which time they must be replaced. This simply is not true. Whether your implants are ten, twenty, or thirty years old, you need not replace them unless there is a problem. Many of the problems that lead to revision or replacement are usually evident within the first three months (e.g., infection, hematoma, asymmetry, displacement, malposition). So if these problems do not occur within the first few months, they might never occur. Other problems, such as rippling and wrinkling, can become evident early on, after weight loss, or as you age. Rupture for silicone implants, deflation for saline implants, and capsular contracture for any implant can occur at any time and are the primary things you need to be concerned about as you and your implants age. Yet if none of these things occurs, you need not have revision surgery or new implants. Of course, some women seek revision for a change in size as they age, but this is not due to a problem with the implant. Finally, some problems, such as persistent numbness or pain, do not lend themselves to surgery, as surgery does not improve them.

Not all women with implants require further breast surgery, but it is prudent to assume that sooner or later, revision surgery will be required for one of the preceding reasons.

Changing Your Mind

Breast implants can be removed at any time. However, you may find your natural breasts have changed due to breast shrinkage and skin stretch. Breast shrinkage, or atrophy, occurs to varying degrees in response to aging and pressure exerted on your breast by the implant. Do not expect this to improve following implant removal.

After breast augmentation, your skin may stretch to accommodate the new implant. Following removal of the implant, your skin may tighten somewhat or not at all. The degree of skin tightening depends on your age, the length of time the implant was in place, and the volume of the implant. An older woman with large implants placed decades earlier should expect little tightening of breast skin. A younger woman with smaller implants can expect more tightening. If spontaneous tightening does not occur to a satisfactory degree within six months, breast lift is an option.

Satisfaction

Breast augmentation is one of the most requested procedures in plastic surgery. As with all cosmetic surgery, there are no guarantees regarding outcome or satisfaction. If you understand and accept the risks of this operation and still choose to proceed, you most likely will be glad you did.

Concluding Thoughts

The decision to proceed with breast augmentation is not a simple one, particularly in light of the fact that those who receive implants should anticipate future revision. Although breast implants do not cause medical illnesses, numerous risks are associated with their placement. Those who understand these issues and choose to proceed with breast augmentation are among the most satisfied patients in any plastic surgery practice.