Breast Enhancement FAQ

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"Breast enhancement" is a blanket term that covers a variety of surgeries related to improving the appearance or symmetry of the breasts. From breast reduction to breast augmentation, our patients in Chicago have a dizzying array of information and options available. To help patients make informed decisions about their care, Dr. Steinwald has gathered the questions he hears most often from his Chicago-area breast surgery patients.

Meet Dr. Steinwald

Paul M. Steinwald, MD, is one of the few plastic surgeons in Chicago who is double board certified in both plastic and general surgery. Read On

If you don't see your question answered here, or if you'd like to meet with Dr. Steinwald, request a consultation online and save $50 off the regular consultation fee. Or, call the Lake Forest Plastic Surgery office at (303) 278-2600.

Does Dr. Steinwald work with the new "gummy bear" implants?

Dr. Steinwald does offer cohesive silicone implants, nicknamed "gummy bear" implants, for his Chicago-area breast augmentation patients. These implants differ from previous models because they hold their shape more effectively with less risk of folds or rippling. Their cohesive nature ensures that, even in the rare case of rupture, the silicone filling will hold its shape.

What incisions does Dr. Steinwald use for breast augmentation, and why?

Dr. Steinwald prefers to use inframammary or periareolar incisions when he performs breast augmentations. Each incision has its own set of advantages.

  • A periareolar incision goes around the dark skin surrounding the nipple, called the areola. This location minimizes the appearance of scars. Because of its small size, this incision is usually used with saline implants, which are filled once they're inside the body. Smaller gel implants can be used with this incision, as well. Women who receive periareolar incisions sometimes have long-term numbness and are less likely to be able to breastfeed following surgery.
  • An inframammary incision is done along the crease under the breasts. Depending on the type of implant used, this incision may only be 1½ inches wide. This incision will also be well hidden, even in swimwear.

Dr. Steinwald primarily chooses these incision types because he has concerns about axillary (armpit) incisions, in that they may interrupt lymph flow and node sampling should a patient develop a breast mass later in life. He also prefers not to use transumbilical (belly button) incisions because they are not practical for control of the breast implant pocket (or bleeding), and they do not facilitate the placement of silicone implants.

Dr. Steinwald will help you determine which incision is right for you based on the specifics of your anatomy and procedure.

How long do breast implants usually last?

It is a common myth that breast implants last forever. Most implant manufacturers assign a "life span" of about 15 years to their products. Your results may vary depending on your lifestyle.

Women who have breast implants need to have regular checkups to ensure their results are maintained for as long as possible. Once your doctor determines that your implants have developed issues such as rupture or capsular contracture, you may need to undergo surgery to replace them or remove them altogether.

Should I get silicone or saline implants?

The choice to get saline or silicone implants is a personal one that is dependent on many factors. Some women prefer silicone because they believe the implants look and feel more natural, while others may choose saline to eliminate the potential exposure of their bodies to foreign material that may cause problematic scarring in the case of rupture.

In the case of rupture, which is rare, the saltwater inside saline implants will be naturally absorbed by the body. Leaked silicone generally will remain in the breast capsule indefinitely and has not been found to cause any long-term harm (arthritis, for example), although it may cause local scarring, discomfort, or distortion.

Ultimately, the decision between saline and silicone is up to the patient. Dr. Steinwald will provide guidance and make recommendations based on your body, preferences, and lifestyle.

How safe is breast augmentation surgery?

Any surgery carries some risks. These risks, which can include infection, bleeding, or asymmetry, can be attributed to anesthesia issues (such as coughing upon emergence or postoperative nausea and vomiting) or poor surgeon skills. When undergoing any kind of surgery, including cosmetic procedures, it's very important to find an experienced, board-certified surgeon who uses sensitive, board-certified anesthesiologists in a safe environment, such as Northwestern Lake Forest Hospital.

Risks specific to breast augmentation include early rupture from defective implants or infection issues, as well as later untoward developments such as late rupture (about 1% chance per year) or the development of excessive scar tissue (capsular contracture). Even rupture of gel implants is largely contained in the capsule that every woman forms around implants, and this can be well tolerated for years. In general, breast implants are very safe, and Dr. Steinwald — who has exceedingly low complication rates and can manage all of these issues — uses only implants that have been approved by the FDA.

Dr. Steinwald also uses the Keller Funnel™ to introduce implants into their pockets in touch-free manner, to minimize the potential for contamination.

Can I combine breast procedures with other procedures?

Yes! Many women undergo breast enhancement surgery at the same time as other cosmetic surgery to minimize downtime and create a more dramatic transformation. Be advised, though, that the recovery process following a combinational procedure will likely be different than if you had had just one surgery.

Breast enhancement is often performed in conjunction with facial procedures, body contouring procedures, and even other breast procedures. For example, a patient undergoing breast reduction surgery may also have a breast lift in Chicago to maximize her results.

These combination procedures known as Mommy Makeovers can be performed safely in our hospital setting. They are beneficial in that they can minimize downtime and save the patient hundreds or even thousands of dollars.

Why does Dr. Steinwald use the anchor incision when doing breast lifts and reductions? Are other approaches available?

The anchor incision is one of the most established and reliable incisions used for breast reduction patients in Chicago and around the world. Though it does leave visible scars, an anchor incision is usually the best option for women whose breasts are very large or have severe ptosis (drooping), as they can manage the excess skin in all directions and create a rounder, more naturally shaped breast. Other incisions, such as the vertical ("lollipop") or periareolar, might be better choices for breasts that do not droop significantly or where the nipple needs to be elevated only a few centimeters.

What are Dr. Steinwald's breast reconstruction specialties?

Dr. Steinwald specializes in autogenous tissue breast reconstruction, which uses the patient's own existing tissue and fat, usually from the lower abdomen. This approach creates a more natural-looking breast and doesn't carry the same longer-term risks as implants. This procedure is best performed on younger women who are physically able to undergo the surgery. Recovery from autogenous tissue reconstruction lasts between 2 and 4 weeks.

Dr. Steinwald also performs more common implant-based reconstruction techniques, including skin-sparing or even nipple-sparing approaches. In these cases, some women are even candidates for direct-to-implant single-stage breast reconstruction, performed in Chicago at only more sophisticated centers, such as Northwestern Lake Forest Hospital. Dr. Steinwald will work with you and your surgical oncologist (breast cancer surgeon) to determine which procedure is a better fit.

Breast reconstruction is a big decision, often on short notice. Do I have to have it done right away?

No. Reconstruction is often performed at the same time as a mastectomy because tissue planes are "fresh" and there is less scarring. This option may not be practical for all women, though, usually because of cancer treatment. For these patients, breast reconstruction can also be performed some time after a mastectomy, usually at least 3 to 6 months later and after chemotherapy and radiation are completed. This is called "delayed" reconstruction. Your surgical oncologist and your plastic surgeon will help determine which is right for you based on your specific situation.

Does Dr. Steinwald perform revisionary breast enhancement?

Yes, fairly often. Corrective breast surgery is performed on women who are either unsatisfied with the results of a breast augmentation performed by another doctor, or who want to "touch up" an existing breast procedure that may be several years or even decades old.

Breast revision for Chicago-area women performed by Dr. Steinwald can address complications such as implant rupture, capsular contracture, and asymmetry. It also often involves lifting procedures to reposition the nipple or better match the "skin envelope" to the implant replacement desired.

Your Next Step

Do you have more questions? Simply request a consultation online with Dr. Steinwald and save $50 off the regular consultation fee. Or, call The Center for Cosmetic Surgery at (303) 278-2600 to schedule your visit. Dr. Steinwald looks forward to helping you achieve your optimal appearance.

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