How Often Do I Need to Change My Breast Implants - Berman Blog

How Often Do I Need to Change My Breast Implants?

This is a very common question that I receive in my consults and that I often answer on Real Self. As we all know, anyone can write an article on the internet and oftentimes, people assume that the author knows what they are talking about about and the advice is accepted. A very poorly educated person wrote an article that I keep hearing about which states, “You should change your implants every 10 years.” I categorically think this is ill-conceived. I have seen plenty of my own patients, as well as other plastic surgeon’s patients with breast implants, that are more than 10 years old and they both look and feel excellent! Why would I want to suggest that they change them?

There are only 3 reasons why I feel implants should be changed:

  1. There is an obvious and significant leak.
    If you have saline implants, this means that your implant has deflated. How will you know that? Because you will go back to looking like you did before you had your breast implants. Usually this leak happens overnight and most times, has nothing to do with trauma or any causative factor. There will be an obvious difference from side and side. There will also be an obvious side difference from what it looked like a few days ago. With silicone implants, the decision is much less clear. With all of the newer silicone implants, the silicone is cohesive and tends to hold its shape. It is much less clear how to handle a small tear in the shell, since the material is far less likely to leak out.
  2. They have gotten hard to the point of being uncomfortable and not looking good anymore.
    The implants can be changed and the scar tissue removed (capsulectomy). There is a risk that the capsule (firm scarring) can return, despite the surgeon’s best efforts. This risk increases with the passage of time. However, I have seen many breast implants that are older than 15 years that look and feel excellent and occasionally will see this to be true for even older implants.
  3. You want to go either larger or smaller.
    It is important to remember that with time, things tend to go south and skin loses its elasticity. It is not uncommon that with time, your breasts will gradually sag. This does not necessitate changing your implants. Rather, you can get a breast lift (there are different types of lifts) to put the breast back up and centered on your implants.

If you’d like further information specific to your situation, please call my office at 703-406-2444 to schedule a complimentary, private consultation with me.

Tanning After SmartLipo: What You Need To Know - Berman Cosmetic Surgery and Skin Care Center Blog

The Best Time to Get Your Body Ready for Summer? Now!

A very common question I get is when to get cosmetic procedures done in order to look great for bathing suit season.

There are 4 operations/procedures that are going to be extremely popular in preparation for getting your body ready for summer:

  1. Breast Augmentation
  2. Smartlipo
  3. Tummy Tuck
  4. Sculpsure

Let’s discuss briefly the time frame for improvement for each of these procedures.

Breast Augmentation
After a Breast Augmentation (BA), there of course is an immediate improvement in your appearance. From day one, you will have a much better figure, both in and out of clothes. However, there is usually some upper pole swelling (more pronounced with saline implants) that is more noticeable if you are without any clothes. This can be easily hidden with clothing. You need to allow 3 months for your implants to drop into place. In general, the swelling is much milder with silicone and this allows you to look more natural sooner.

SmartLipo
I stress to my patients that after Smartlipo, you will continue to improve for 6 months. Of course, you can enhance the results by also exercising and by dieting, so as to decrease your total body fat. Smartlipo will reduce the fat in the treated areas. Multiple areas can be treated and you can generally return to work the next day. Only one treatment is required per area.

SculpSure
Sculpsure is done in the office and no sedation is required. You can even do this on a lunch break. I went to the gym immediately after I treated my love handles! A treatment session only takes 25 minutes and you can return to work immediately. You can treat multiple areas one after another during a single office visit. However, you should treat each area at least twice, usually with 6 weeks between sessions (it can be reduced to 4 weeks however). Once again, you will get more dramatic changes if you can also reduce your total body fat (through diet and exercise), as we reduce fat in the treated areas.

Tummy Tuck
A Tummy Tuck will show a dramatic change immediately after surgery. You can return to work after 10-14 days and usually to more intense workouts by 6 weeks. You can usually start exercising gently after about 3 weeks (sometimes even sooner). Your scars will continue to improve and fade with time. Your appearance will also improve with time so it is good to have some time between your TT and donning your bikini. If you know which bathing suit you want to wear, you can bring it along at the time I mark you for surgery, so I can do my best to try and design the incision scars to be hidden by your swimsuit.

Want to know more about cosmetic procedures and what might be right for you? Please call my office at 703-406-2444 to schedule a complimentary, private consultation with me.

w Soon After a Breast Augmentation Can You Work Out - Berman Cosmetic Surgery Blog

How Soon After a Breast Augmentation Can You Work Out?

This is a great question and one that comes up very, very frequently. It comes up a lot because many of the women that I perform a breast augmentation (BA) on exercise regularly and want as little interruption as possible.

In general, I am more progressive than most other surgeons in that I allow my post BA patients to get back to exercising sooner . I do ask that they don’t significantly elevate their heart rate for prolonged periods of time for the first week. A suggestion here is going for long walks, at a comfortable pace, but nothing more strenuous than that.

After the first week, they can do things like take a spin class or use the elliptical machine  essentially, anything that will elevate their heart rate but without a lot of bouncing movement. The elliptical or spin bike provide a much more comfortable experience than trying to jog, as an example. They can also begin strength training for their lower body, as well as for biceps and triceps. At this stage, they should avoid chest exercises or difficult back exercises. I believe gentle stretching is very helpful from the beginning, and should become easier after the first week.

Most of my hard core runner patients will start running after 2.5-3 weeks. I always advise starting easier (shorter distance and shorter time) for the first few times out running.

Chest exercises such as push ups should be held off until  4 to 6 weeks post-surgery. Start lighter and go easier during the first few sessions. When you are contracting your pectoral muscles, it is very normal for your breast implants to be displaced upwards, while the muscle is contracting. They will return to normal immediately, and it does not do any harm.

Two of my most notable patient stories on the topic – and these women certainly represent the exception, not the rule!

  •  I performed a breast augmentation on a very close friend of mine. She and her husband were the couple that got me into doing triathlons and Ironmans. I did a BA on her before she moved to Florida. She did a half Ironman (1.3 mile swim, 56 mile bike ride and 13 mile run) after only 5-6 weeks from her BA. She is the exception, not the rule!
  • A number of years ago, I performed a breast augmentation on a woman who clearly did a lot of weight lifting. I saw her a week after her BA and she mentioned that she never stopped doing her pull ups after surgery. I have never had a patient do this before. She did no harm, so this does show you that it is hard to really hurt things. She did run the risk of increased bleeding or bruising, but she experienced no problems, despite her pull-up regime.

Have questions about this procedure? Please call my office at 703-406-2444 to schedule a private, complimentary consultation with me

Berman Blog - Breast Augmentation or Breast Lift: Which One is Right for Me

Breast Augmentation or Breast Lift: Which One is Right for Me?

This is an extremely common question and a good one. The answer really depends on where your nipple-areolar complex (NAC) lies relative to where your breast meets the chest wall when viewed from the side (lateral view).

If your nipple is positioned at or above the crease, when viewed from both the front and side, then you probably do not need any type of lift.
If it is just at the crease, then you may need a lift in order to achieve your desired result.

If the nipple is at the bottom of your breast and it points to the floor, you’ll likely want a breast lift for a more balanced shape.

The question of whether or not get an augmentation is really a question of, “do you want more volume, i.e. larger breasts?” For the most part, a beast augmentation makes the breasts larger, but does not really change the position of the NAC on the breast. The lift alters the position of the NAC, but does not change the volume – though it is true that a lift can sometimes make the breast look larger since it is less droopy.

Of course, many women want and need both an augmentation and a lift to get their desired look, and these can be done at the same time. It is important to note that it is always a more predictable outcome for the final shape if a woman only requires a straightforward augmentation, than when we perform a combination of an augmentation and a lift. This is especially true for one of the more complicated lifts, such as a vertical mastopexy.

Have additional questions? Please do not hesitate to schedule a complimentary, private consultation with me to discuss your individual needs.

Berman Cosmetic Surgery Blog - The Evolution of Breast Implants

The Evolution of Breast Implants

Let me first note that is  meant as a guide and not a historical thesis. However, I could not resist adding the paragraph below from Wikipedia:

From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.

The first “breast filler” surgery took place in 1895, and involved fat being transferred to the breast.The main thing to note is that today, we largely have only saline and silicone implants. There has been a variety of different fill substances and coatings. but those have largely been discarded due to a variety of problems.

What has changed is that there are two basic coverings for the implants: smooth and textured (small spikes or velcro-like). Also, there now are options in the profile of the implant. This means that the base diameter gets smaller as the implant projects more forward. Over time, the options in this area have increased considerably. Although there are certainly instances where it is helpful to have a smaller base diameter and to have an implant that projects more prominently, I often feel that there are variations between each model. When it is only measured in millimeters, it is driven more by a marketing desire (so a woman can feel that she is more in control) than of any practical reasoning. In my opinion, one cannot possibly notice difference of this small amount.

The other big change is in the “cohesiveness” of the silicone implant. This means that the silicone implant gets firmer – and subsequently, more expensive. This could be beneficial for the woman with very thin skin and soft tissue so that it is less likely to show rippling. In general, the greater the cohesiveness and firmness, the more the company is charging for the implant. But again, depending on the skin condition, that may be the more desirable option, if you’re already taking the time and effort to improve your appearance in this area.

The good thing is that we now have implants that we believe to be both safe and effective, and with a variety of options, so that everyone should be able to find an implant that will be effective for them and give them their desired end result.

Are Breast Augmentations Still Taboo?

The quick answer is NO!

In the United States alone, there are literally millions of women who have had a breast augmentation. Based on the sheer number of women getting the procedure, we can clearly concur that it is not taboo. From young women wanting to look a little fuller, to weight loss success stories, mothers and grandmothers looking to get their lift back, there are no limits to age and circumstance of women getting this popular procedure done.

There is also a shift I’m seeing, especially in the past few years. Women are feeling much more comfortable being open about having had this surgery. I suspect that social media has helped to create this culture of authenticity and openness. There have been endless articles written in popular magazines available everywhere. There are a plethora of videos featuring them – both medically and for entertainment purposes. Many models and athletes have augmented their breast size – and have been very open about that fact.

There are also some changes in implants. They are  getting more and more natural to the touch since silicone implants re-entered the market in 2006. Numerous medical studies were done between 1992-2006 confirming that there appear to be no additional medical risks from silicone implants. The public is also realizing that there is no need to change out your breast implants after 10 years, provided they feel and look good. I have seen a large number of women who have had their implants in much longer than 15 years with no problems. I have a number of women I placed breast implants in over 15 years ago who are doing great. I personally have seen two patients who have kept their same implants from the 1970’s! (Note: I did not perform those procedures – I’m not quite that old.)

I also believe that society has finally realized that while you can diet and exercise all you want, if you want larger breasts or a little lift, the only way to get that is with a breast augmentation. As cosmetic procedures have become safer and safer, we are allowing people to fearlessly, and unapologetically, make changes to their bodies as they see fit. We can change our clothes and we can make changes to our bodies – and remain the same person. We have not sold ourselves out- but rather, we have had the strength in our convictions to get what we want, when it has not been handed to us.

If you are considering a breast augmentation yourself, please do not hesitate to call my my office at 703-406-2444 to schedule a private, complimentary consultation or click here to book online.

Is a Mommy Makeover Right for You?

It’s important to understand that a Mommy Makeover is not a specific set of operative procedures. It refers to the surgery one might undergo after having a baby. Most commonly, it involves having a tummy tuck and a breast augmentation with or without a breast lift. However, it could refer to just one of these procedures or could include SmartLipo, a mini Tummy Tuck or a breast lift.

There is no way I can help you determine via a blog post whether or not a specific surgery is right for you. You really need to visit a board-certified plastic surgeon for a  personal consultation (note: a “cosmetic surgeon” is NOT a plastic surgeon – there is no Board certification for this).  

Having said that, there are some considerations you can take into account to determine if a Mommy Makeover might be right for you: 

 

If you are thinking of a Tummy Tuck:

  • Have you allowed enough time since delivery or C-section to see how much the skin will tighten on its own?
  • Have you lost all of the weight that you think you are going to lose? You don’t have to get down the very last pound, but all things being equal, it is better if you have lost most of the weight you are planning to lose.
  • Are you planning on having another child any time soon? If you know you are going to have another child in the next 1-2 years, you may want to hold off doing your TT until you are finished having babies and instead just go for SmartLipo. However, if having another child is just a remote possibility, then this is something that should be discussed with your plastic surgeon. Often in this case, I will perform the tummy tuck, but not tighten the fascia.

 

If you are thinking of a Breast Augmentation:

  • Are you still breast feeding? You should hold off until at least 3 months after you have stopped breastfeeding and your milk has dried up. You should also wait until your breast size has stabilized after you stop breastfeeding.
  • A breast augmentation will not prevent you from breastfeeding in the future, nor will it interfere with sensation.
  • Sometimes, only a breast lift is required – and depending on what type of lift, it may be able to be carried out in the office under local anesthetic with just oral sedation (i.e. a donut mastopexy).

 

What about doing the Breast Augmentation and Tummy Tuck in the same surgical procedure?

  • These procedures are often  done together in the same surgery and it works out very nicely. The advantage of this approach is that it allows you to recover from both at once, meaning less days off of work.  Most people should be able to return to work in 2 weeks (some will go back in 10 days). There are also cost savings when doing both at once. 
  • It should be noted that there is a higher risk of Deep vein thrombosis, or DVT. However, I put my patients that have both procedures on Lovenox after surgery and I get them up walking immediately, which significantly decreases any risk of DVT and pulmonary embolus.
  • It does take a few days longer to bounce back from the combined procedure than it would from either procedure alone.

If you have any questions, I highly recommend calling my office at 703-406-2444 to schedule a private consultation with me.

Breast Augmentation: Post-Operation Do’s and Don’ts

Curious about what you should and shouldn’t do following a breast augmentation? Below are my top tips for a speedy recovery:

  1. Almost all of the discomfort after a BA (Breast Augmentation) comes from the muscle being stretched over the implant. I strongly recommend that you stretch your arms to the sky, then out to the sides and then put them around your back – similar to the same motion you would do if you were clasping your bra closed.
  2. Some women find that they feel more comfortable if they put ice packs or frozen fruit/vegetables on their upper chest.
  3. You will feel more comfortable wearing a sports bra. However, the bra should feel comfortably snug. I have had several patients buy bras that were far too small with the swelling and they were very uncomfortable. There is no reason for this. If the bra feels very tight, go buy a larger one that is comfortable.
  4. Absolutely everyone swells too much in the upper part of their breasts. Some women swell much more than others. This swelling will increase for 3 days. It will gradually come down over time.
  5. It generally takes about 3 months for them to lose their swelling and get their final shape. However, if you had a vertical or lollipop breast lift (mastopexy) it can take much longer. You just have to be patient and there is little you can do to speed this process up.
  6. You can and should shower the day after your surgery. Yes, I know that your breasts will get wet. It will not hurt them. Don’t worry:)
  7. If you have some bruising, it usually takes 2-3 weeks to go away.
  8. You will bounce back much quicker if you are up and around after surgery. However, you will be more tired so give yourself time to rest.
  9. You may can resume sexual relations after surgery but use common sense.
  10. You should be able to return to work on the 4th day after surgery (ie. if your surgery is on Thursday, you should be able to return to your office the following Monday).
  11. It is not unusual to get a small amount of bleeding from your incision.

As always, if you have any concerns, do not hesitate to text me on my personal cell number which you will be given before your surgery.

Breast Feeding After a Breast Augmentation

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 Is Breast Feeding Appropriate After Having a Breast Augmentation?

Whether or not one can engage in breast feeding after a breast augmentation is one of the most commonly asked questions for patients considering the procedure. The basic answer is YES.  It is very unlikely that a breast augmentation will interfere with your ability to breast feed.  The reason is that even if a periareolar or inframammary incision is used, it is unlikely that the ducts from the milk glands will be cut.

It is important to know that approximately 10% of all women will have trouble breastfeeding, so if you have trouble breast feeding, it is probably NOT due to having had a breast augmentation.

What About Breast Feeding After A Breast Lift?

The answer can be a bit more complicated with an associated breast lift.  A donut mastopexy, because it is just removing skin and sliding the nipple areolar complex upwards, is very, very unlikely to interfere with breastfeeding.

The vertical mastopexy, because it is re-arranging the breast architecture, has some small probability of interfering with breastfeeding but I think this is fairly unlikely as well.

Thinking about a breast augmentation or breast lift? Please contact us to schedule a complimentary consultation with Dr. Berman. He’ll address any questions or concerns you may have about the procedure.

And be sure to check out our videos below for a look inside the procedure as well as some information from Dr. Berman on things to consider when getting a breast augmentation.

You can also check out this video testimonial from one our recent breast augmentation patients![/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/1″][vc_text_separator title=”Breast Augmentation Videos”][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/2″][vc_video link=”https://youtu.be/HkRmNKg6-e0″][/vc_column][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/2″][vc_video link=”https://youtu.be/ivKiHrY1Vok”][/vc_column][/vc_row]

Breast Augmentation Cost

It is impossible to give you a single monetary number for you to aim for when considering a breast augmentation. There are multiple variables that can affect the cost of your breast augmentation.

First, there is the cost for the surgeon himself. It goes without saying that you should only use a board certified plastic surgeon. Usually, a more experienced surgeon will charge more for his/her services. Although some patients will fly to destination medical centers, such as India or Thailand, I personally think you are taking a huge risk. It is especially problematic if you have problems following surgery and then expect a surgeon here in the US to be able to address complications you acquired by your surgery in another country. The price for the surgeon will vary by geographic region. You can expect to pay more in a place like New York City compared to a smaller town in the South. It should also hopefully go without saying that rarely will a decent plastic surgeon put his services on a discount website like Groupon. This is not an oil change for your car. Although it is reasonable to be aware of costs, not all surgeons are equal, and you should never select a surgeon on price alone.

Breast augmentation is done under a general anesthesia, so you will also need to consider the cost of the anesthesiologist or nurse anesthesiologist. There is also the cost of the operating room. Even if the surgery is done in the surgeon’s office, there is still an overhead cost associated with this which will be passed on to the patient.

Another factor is the type of implant used. Silicone implants cost more for the surgeon to buy, and again, this cost will be passed on to the patient, either directly or indirectly. Additionally, certain types of silicone implants can cost more than others. However, contrary to what many patients think, the size of the implant does not affect cost – only the type of implant.

Some women will also need a breast lift. If a woman’s breasts are significantly saggy (the medical term is “ptotic”), you must have a lift to get your desired look. Also depending on how much ptosis there is, different types of lifts will add to the time and cost of the surgery. If the surgery requires more time, then so will the surgeon, the operating room and the anesthesiologist.

All of these factors contribute to why it is very hard to give you an accurate estimate of how much your breast augmentation should cost. When you see a plastic surgeon for a consultation, they should give you the total cost of your surgery and include these in the estimate.

Most surgeons, if not all, will include follow-up for a year or more at no additional expense.