Breast Augmentation

Prior generations of silicone gel implants lasted 15 to 20 years. Based on improvements in technology and production, we expect gel implants to last on the order of 25 to 30 years, possibly longer. Saline implants are not as durable as silicone and might last somewhere between 15 and 20 years. We will schedule follow-up visits after your surgery to assure that the implants are intact and in good condition. In the rare case that they are not, implant companies fully warranty their implants for three years covering all costs related to implant removal and replacement.

Breast augmentation can improve mild sagging (ptosis) by adding volume to volume deficient areas, improving nipple position, and enhancing breast shape. However, if significant sagging is present, a breast lift (mastopexy) may be recommended in conjunction with or instead of augmentation.

Absolutely! Breasts are “sisters, not twins.” And we know how different sisters can be!

Breasts may differ in volume or vertical/horizontal dimensions. All of these may be corrected with differential implant placement and lifting procedures. Dr. Shermak sizes her patients for breast implants using sizer implants that mimic the real implants and place them in a bra that you can put on during your consultation. You will be able to try on sizes to find the best symmetry and fit, as implant choice is individual and patient-specific.

• When someone is undergoing an implant exchange/size change, and the implant is already in that location and has done well
• When a woman has a developmental deformity that requires expansion of the breast mound
• When an implant has not “done well” under the muscle and requires a position change
• When an anatomically shaped implant is placed
• When there is a good amount of breast tissue that can hide implant contours.

The short answer is “no.” Women with implants are not likely to have missed cancers or more aggressive breast cancers. Be sure to tell your mammography technician that you have breast implants prior to imaging procedures.

Breast augmentation surgery typically takes anywhere from an hour to 90 minutes, depending on the need to obtain symmetry in cases where there is a significant baseline mismatch.

Dr. Shermak does everything she can with operative anesthesia, local anesthetics, and postoperative medications to assure her patients are as comfortable as possible after surgery. Her patients are up and about immediately after surgery.

The FDA last met in March 2019 for its 10-year review of the current generation of breast implants. Overall, breast implants are considered to be safe, and the FDA feels comfortable with the public continuing to have access to breast augmentation. Textured implants were pulled off of the market at that time due to their association with inflammatory syndromes, namely, breast implant-associated lymphoma, which is rare and only occurs with any history of having textured implants. All anatomical-shaped implants have to be textured, so they are no longer available. The FDA will meet every five years to revisit implant safety.

In most cases, breast augmentation is considered a cosmetic procedure and is not covered by insurance. However, exceptions may apply if the surgery is part of breast reconstruction following mastectomy or for certain medical conditions.

Smooth round implants are the implants that we are currently providing. These come either as saline-filled or silicone gel-filled. Both are safe options. Saline tends to be heavier and does not feel as natural as a gel. When you come into the office for a consultation, you will be able to see and feel the difference between these options and can make an informed decision.

Cohesive gel implants, also known as gummy bear implants, are the latest technology in silicone gel breast implants. These implants are more overfilled and have cross-linked gel that is more solid in nature. They resist rippling and wear and are firmer and potentially more projected than the more standard silicone gel implant. You will be able to see the difference between the more traditional gel implant and the gummy bear implant during consultation.

Implant sizing is critically important during the preoperative process. Patients often have a concept of goal fullness. Dr. Shermak measures her patients at the time of the consultation and then will size with implants that are analogous to the ones that would be placed during surgery. The implant selected will be fully based on your choice, with input from Dr. Shermak to allow for professional guidance and the best possible decision. By the end of the appointment, you should be comfortable with your choice, and some return for a second visit to reassure yourself about the size you’ve chosen. Coming into surgery comfortable with the implant outcome is so important to the process of breast augmentation surgery.

Normal day-to-day activity is resumed in the days to week following your surgery. You can shower the day after surgery, but Dr. Shermak insists that you hold off from swimming or vigorous working out for three to four weeks. Dr. Shermak will plan to see you within days after your surgery and in the following weeks to help optimize your postoperative recovery.

There is not typically a great deal of swelling in most cases. After several weeks, the acute swelling should resolve. Your implants may take months (or even years) to completely settle.

In most cases, nipple sensation after breast augmentation is preserved. It’s important to discuss concerns you may have with your plastic surgeon during the consultation.

Yes, in most cases, breast augmentation does not interfere with breastfeeding. The ability to breastfeed depends on the surgical technique used and the individual’s anatomy. It’s important to discuss your plans for breastfeeding with your plastic surgeon during the consultation.

Dr. Shermak recommends that her patients massage round saline or gel implants about two weeks after surgery. She will instruct you on moving your implant upward and inward with compressive massage in a postoperative visit.

Capsular contracture describes the development of firm scar tissue around a breast implant, causing implant firmness, functional tightness, and possibly even a visible difference in the breast. If the breast is stable and comfortable, there is a low likelihood that capsular contracture is present.

This is best determined during your office visit with Dr. Shermak. In cases where a woman wants more fullness, breast augmentation provides that. If there is sagging either from development or pregnancy, a breast lift may be necessary for centering the breast more optimally around the implant. In some cases, women do not desire a breast lift and only desire augmentation, even if the nipple is on the low side.

Yes. Dr. Shermak recommends you wear a soft, supportive bra without an underwire for at least six weeks after surgery. You only need to wear the bra throughout the day and night for the first weeks after surgery.

You may start lower body exercise within weeks of surgery as long as you keep your arms immobile. Upper body exercise may begin about a month after breast augmentation surgery.

Many patients who undergo breast augmentation enjoy the gym. Even with implants placed underneath the pectoralis muscle, gym workouts are totally possible. You will be held from strenuous gym workouts for at least four weeks after breast augmentation surgery.

The risk of capsular contracture is fairly low and is best alleviated with careful surgical technique. Additionally, after surgery, I review implant massage techniques with my patients to help reduce the risk of contracture. Massage and active (nonstrenuous!) range of motion movement after two to three weeks from your surgical procedure will help limit the risk of capsular contracture. All of the breast implant companies have three-year full warranties that cover treatment of capsular contracture if it occurs, including everything associated with care: OR and surgeon fees as well as new implants.

Many patients are driving within five days of their surgical procedure, and as long as there is no strenuous upper body lifting with work, patients can often return to work within one to two weeks after surgery.

Come see Dr. Shermak. She specializes in revision surgery after unsatisfactory breast surgery, having completed a fellowship focused on achieving optimal results for complex breast surgery cases. Some of the unsatisfactory outcomes that Dr. Shermak can successfully address include asymmetry, malposition, capsular contracture, and poor shape and size.