Breast implants are to be placed when you are physically mature and have allowed some time for development. The possible exception to this rule is in cases of marked asymmetry of the chest or breasts such as to affect social life (changing in the gym) of a young but fully grown person. These cases fortunately are rare. The placement of breast implants should not affect the ability to nurse a child. Many women can bear two children, nurse them and be OK with their breast implants so long as they have kept in shape, and stayed close to their youthful weight. Some women after nursing 2-3 children loose their breast mass and need to have the volume restored. No all breasts droop with time and gestation. For these people an implant is good restoration of a youthful breast. In my opinion, aesthetically, a breast should fit the person. The implants should cover the front of the chest without extending under the arms or too far down the chest, allowing good cleavage with or without a bra. When implants are too big, they tend to make a woman look matronly, particularly in a T shirt.

Surgery time: 1-2 hours

Preparation: You want to prepare for surgery by avoiding anticoagulants and having a high protein diet for weeks before the surgery. You should be well rested. You need some one to take you to your first appointment since you can’t drive for the first five days after surgery. You may need some help with childcare in the first week or so.

Procedure: You decide on the size of your new breast enlargement well before the surgery by looking at volumes of fill. You place that amount of fill in your bra and try on clothes, shop and walk around with this size to be sure you like it and are comfortable with the change. With the patient marked for positioning and asleep, the implants are placed through a nipple incision. A saline or gel implant can be placed that way. When the surgery is over, a soft bra like dressing is placed.

Care: At the time of surgery you need to be quiet and rest for a few days. You want to sleep on several pillows so you do not roll over on your side. You should not drive for five days after surgery. You should not do strenuous exercise or go back to the gym for 3-4 weeks. You can go back to work soon if it is not strenuous and does not involve manual work with your arms.

Results: The incision can be well hidden once it is healed. I prefer a nipple approach. Salt water (saline) filled implants can last a long time but there is a leakage rate, and they have an incidence of becoming firm as well as deflating. A textured gel implant is softer and more natural feeling and will last longer as well. They should be considered as a favorable option when thinking of breast augmentation surgery. Breast implants are very individual and should take a patient’s specific needs into account. They need to fit and should not be too small (limiting shape and cleavage) or too big when they do not look natural or fit properly on the front of the chest.

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