Valentine's Special

What Implant Size is the Best for My Breast Augmentation?

Whether you have already decided on breast augmentation surgery or are still gathering information about the procedure, a critical step in the pre-operative process is determining what implant size would be best for you. Your plastic surgeon should be your main point of contact when weighing the potential benefits and considerations for this decision. Still, there are some things you will need to decide on your own depending on your personal goals for breast augmentation.

There are many medical and cosmetic reasons for breast augmentation, including changes in your breast size following pregnancy, medical procedures, or weight loss. Asymmetrical or small breast size may affect your confidence or clothing options. Regardless of your reason for pursuing breast augmentation, the appearance and feel of breasts can significantly impact a women’s confidence and self-image. Therefore, it is crucial to choose a trusted professional to guide you through the breast augmentation procedure.

Factors to Consider

Breast augmentation, also called augmentation mammoplasty, involves a plastic surgeon making an incision in the skin and placing an implant underneath the breast area to create the appearance of a larger breast. When choosing the right implant size for your breast augmentation, some factors to consider include body type, body shape, and lifestyle goals.

Body Type

Your body type and size can significantly impact the outcome of your breast augmentation. For example, if you are a petite woman with smaller natural breasts, the skin surrounding your breasts may not fully cover the area if your surgeon inserts very large implants. One adverse effect of this is implant rippling, which can create the appearance of ridges, wrinkling, or scalloping on the implant and potentially through the skin.

Body size and shape can also impact a woman’s ability to carry breasts of a specific size without adverse health effects. For example, a woman who has a more robust build will be able to support larger breasts than a woman who has a leaner physique. If implants are too large relative to a woman’s body shape, it could lead to neck, back, or shoulder pain due to increased weight of breasts following augmentation.

Lifestyle Goals

Lifestyle goals may affect the implant size you wish to choose. For example, if are uncomfortable with increased attention in social settings due to larger breast size, then dramatically large implants may not be the right choice for you. Additionally, during pregnancy, many women may experience swelling of the breasts and increased breast size due to breastfeeding. If you are unsure of how your implants may be affected during this process or how they will look, it is best to consult your board-certified plastic surgeon.

Discuss Your Implant Size with a Breast Augmentation Surgeon

If you are considering breast augmentation but are unsure of which size implants may be best for you, consider having consultations with a few plastic surgeons in your area to find the right fit. If you already have a plastic surgeon, bring pictures to your consultation of what you are looking for regarding desired implant size and shape. At The Centre, P.C. we employ 3 dimensional imaging to assist in managing expectations.

In addition to discussing your body type, body shape, and lifestyle goals, it may also be beneficial to ask your surgeon about the available types of procedures, as well as any risks and recovery time. These steps will help you feel more confident making an informed decision about your breast augmentation.

Which is Better: Mastectomy and Reconstruction or Two Separate Procedures?

Breast cancer is the most common cancer-related death in women after lung cancer. It is also one of the most commonly diagnosed cancers in American women, second only to skin cancer.

Battling cancer is hard, but having breast reconstruction surgery can make it harder. This struggle leaves many women unsure if they should have breast reconstruction in conjunction with their mastectomy or as a separate procedure.

Though you should consult with your doctor regarding what decision is best, the following information may to provide some insight as to which course of action may be right for you.

When to Consider Breast Reconstruction

To some women, losing one or both breasts isn’t a big deal. They mourn the loss and move on. For others, it has a profound effect on their emotional and mental state. This can lead to depression, anxiety and lowered levels of confidence.

Most women who had mastectomy are good candidates for breast reconstruction. The decision to have reconstruction surgery, and which kind to have, comes down to the patient’s needs and their doctor’s recommendations.

Here are some of the advantages and disadvantages of breast reconstruction to keep in mind as you consult with your doctor.

Advantages of Breast Reconstruction

  • Your breasts may feel more balanced (weight and look).
  • You may feel more normal in and out of clothes.
  • You may feel more feminine and attractive.
  • You may be less likely to think about your battle with cancer.
  • Breast reconstruction does not impede monitoring for cancer down the road.
  • You will not need to wear a breast prosthesis.

Disadvantages of Breast Reconstruction

  • Regardless of the type of reconstruction used, your new breast(s) will never look exactly as they did before cancer.
  • You won’t know how the reconstruction looks until you’ve fully healed.
  • Your new breast(s) will feel different.
  • If reconstruction is only one side, you may need additional procedures to make your original breast look more like your reconstructed breast.
  • Breast reconstruction cannot restore the permanent feeling loss after a mastectomy.
  • You subject yourself to risks associated with any surgery.
  • Breast reconstruction can be expensive without insurance.
  • You will take longer to heal and may need to take more time off work.
  • You may have more scars than you would have had otherwise.
  • In rare cases, complications like infection, hernias, or ruptured implants can occur years after reconstruction.

Types of Breast Reconstruction

There are two types of breast construction surgeries: breast implants or tissue flap reconstruction. In some cases, your plastic surgeon may combine these procedures for more desirable results. They may also recommend multiple procedures to reconstruct your breast(s), nipple, and areola.

You need to understand the differences between implants and tissue reconstruction so you can make the best decision. Below is a brief overview of both types of breast reconstruction.

Breast Implants:

  • Prosthetic breast filled with saline or silicone and implanted under existing skin
  • Less likely to look and feel like a natural breast
  • Some sensation loss in breast
  • Shorter and less extensive surgery
  • 1 to 2 night hospital stay
  • Implants may need to be replaced
  • Fewer scars
  • 3 to 4-week recovery time

Tissue Flap Reconstruction:

  • Reconstruction of the breast using skin, fat, and muscle from another part of the patient’s body
  • More likely to look and feel like a natural breast
  • Some sensation loss in breast and tissue donor site
  • Longer and more extensive surgery performed by microvascular surgeons
  • 3 to 4 night hospital stay
  • Tissue flaps do not need to be replaced
  • More scars
  • 4 to 6-week recovery time

Deciding When to Schedule Your Breast Reconstruction

Once you and your doctor decide which reconstruction is right, you have to decide when to have surgery. Some women do their reconstruction while they have their mastectomy and some don’t. This choice is personal but can be based on whether cancer treatment will continue after the mastectomy.

Most patients have three options when it comes to scheduling their reconstruction surgery: immediate, delayed or staged reconstruction.

Immediate breast reconstruction is performed at the same time as a mastectomy. Immediately after your natural breast is removed, a plastic surgeon begins reconstructing it, either with implants, tissue flaps, or a combination of both. In many cases, most of the reconstruction can be performed in one operation.

Immediate reconstruction is a good choice for patients who do not need further cancer treatment or those having a prophylactic (preventative) mastectomy.

Delayed breast reconstruction is done 6 to 12 months after a mastectomy but can be performed years later if desired. It is delayed to allow patients who need to continue radiation, chemotherapy, or targeted cancer treatments. These treatments can cause the reconstructed breast to lose volume and/or change color, texture, and appearance.

Delayed breast reconstruction is for women who are unsure if they want reconstruction or not. It gives them time to experience what it’s like to “go flat” or experiment with wearing a breast prosthesis. Since it can be scheduled at any time, delayed reconstruction gives women time to make the decision they feel is best.

Staged breast reconstruction, also called delayed-immediate reconstruction, is done by performing partial reconstruction during mastectomy and finishing reconstruction at a later date. During the mastectomy, the surgeon will place a balloon-like device called a tissue expander under the chest muscles. The device is left in during any remaining radiation or chemotherapy treatments and is filled with a salt-water solution to preserve the breast’s skin and natural shape.

After treatment is completed and the tissues have been allowed to heal for 4-6 months, the tissue expander is removed and the breast is reconstructed using the flap technique or implants.

A staged breast reconstruction is a great option. It allows those who need more treatment time to do so. At the same time, it also provides those who don’t need additional treatment with more options.

Delayed vs. Immediate vs. Staged Reconstruction

Many patients struggle with deciding when to have their reconstruction performed. We’ve laid out the pros and cons of each type of reconstruction to help you make this difficult decision.

Pros of Delayed Reconstruction

  • More time to focus on treatment
  • More time to research reconstruction
  • Additional cancer treatments won’t affect the reconstruction site
  • It gives patients more time to cope with losing their breast(s)

Cons of Delayed Reconstruction

  • Living without your breast(s) can be emotionally trying
  • Having another surgery or multiple surgeries can be stressful
  • Reconstruction can be more difficult due to scar tissue formation
  • Results may not be as optimal as those seen in immediate reconstruction
  • You may go through two periods of emotional adjustment (one to mourn the loss of your breast(s) and one to accept the reconstructed breast(s))
  • It may not be an option if you are a smoker, have high blood pressure, or have certain pre-existing medical conditions

Pros of Immediate Reconstruction

  • When you wake up from your mastectomy, your reconstruction will have started
  • You won’t have to see what your body looks like without your breast(s)
  • It can, in some cases, prevent the patient from being under anesthesia multiple times for additional surgeries
  • It may provide better cosmetic results than a delayed surgery
  • Does not affect the rate of cancer recurrence
  • Does not affect the ability to detect cancer recurrence
  • Reconstruction is easier because your body has not generated scar tissue
  • Your breast skin can better maintain its original size and shape

Cons of Immediate Reconstruction

  • Mastectomy surgery will last longer with reconstruction
  • Recovery will take longer than it would have had you only had a mastectomy
  • If you need cancer treatments in the future, your reconstruction could be compromised
  • It may make it harder for your surgeon to identify skin problems associated with mastectomy
  • Depending on where incisions are made, you may have more scar tissue than you would with just a mastectomy

Pros of Staged Reconstruction

  • Because the tissue expander preserves the breast skin and shape, the results you achieve with later reconstruction surgeries may be more symmetrical and natural looking
  • Additional cancer treatments can continue with the tissue expander in place
  • You and your surgeon can be sure that your cancer is in remission before finishing reconstruction 

Cons of Staged Reconstruction

  • The process of reconstruction must continue with several small revision surgeries
  • “Matching” surgeries may be required to make your natural breast look more like your reconstructed breast
  • Cancer treatment may take longer to complete
  • Your breast(s) will not look natural with the tissue expander in place

Making the Right Choice for You

There are a lot of factors that influence your decisions on breast reconstruction, including:

  • Your overall health
  • Natural breast size
  • The size, location, and stage of your cancer
  • The effects reconstruction may have on other body parts
  • Whether you need additional cancer treatments or not
  • How much time you can take off work/away from other duties
  • How quickly you’d like to recover
  • Surgical costs
  • Insurance coverage
  • Whether you really want breast reconstruction or not
  • Your desire to feel “normal” after a mastectomy
  • The amount of extra tissue available (if opting for tissue flap reconstruction)

We know how stressful it can be to think about breast reconstruction when you’re fighting cancer. At The Centre, P.C. we will do whatever we can to make this difficult time easier for you and your family. Our plastic surgeons work with you and your oncologist to determine which kind of breast reconstruction meets your needs.

If you’d like to learn more about breast reconstruction options available at The Centre, P.C. call us at 574-621-3141 or contact us through our website to schedule a consultation.

Bra Size After Breast Augmentation

By far, one of the most common questions I get asked is “What size will I be after surgery?”

Here at The Centre, PC we try to encourage our patients not to think of size in terms of a cup size.  Most of you will agree that the size you wear at one department store may be very different from what you may wear at a specialty lingerie boutique.

According to a September 2006 episode of the “The Oprah Winfrey Show,” approximately 80% of American women are wearing the wrong size bra.  I think this is a result of several common misconceptions.

The first misconception is one that I, myself, am guilty of.  Many women have never had a bra fitting and we continue to buy the same size our whole lives despite changes in our bodies.  Women’s bodies are constantly changing.  Weight gain, weight loss, puberty, gravity, pregnancy – all these things will affect your bra size on an ongoing basis.

In addition, many women go through breast augmentation, opting for breast reductions or undergoing breast reconstruction following surgery for breast cancer.

Consequently, there is a demand for a wide variety of sizes and shapes. The good news is that manufacturers are doing a much better job of working with the changing bodies of women and are creating choices where once there was none.

For example, Fruit of the Loom’s Pick Your Perfect Pair™ bra comes in “just about” and “exactly” sizes.  You can buy exactly C for one side and just about D for the other, and snap the two together.  For only five dollars a cup, you get a customized undergarment.

Another reason why many women are wearing bras that don’t fit is that they have “letterphobia.”  They have some deeply rooted idea, that having to wear a DD size is somehow synonymous with licentious moral convictions. This phenomenon has been dubbed by the bra fitting community as ‘letterphobia,’ or an irrational fear of the suggestion of a D-plus bra size.

Hailed as the “bra fit guru” by the New York Daily News, Jené Luciani is a nationally acclaimed fashion journalist and author of “The Bra Book.”  Luciani states that bra fitting measurements should be used as general guidelines and not an absolute.

See her appearance on the Today Show by clicking here.

Why Are Women Unhappy With Their Breasts?

We know that the majority of women are unhappy with their breasts, but a new study is striking in its revelation that about 70% of women are unhappy with the size or shape of their breasts.

The survey showed that, although women’s concerns about their breasts changed with age, the overall fact did not change:  at all ages, most women are unhappy with their breasts.

The study also made one explanation seem unlikely: women are not unhappy with their breasts because their partners are. Overall, the majority of men (56%) are happy with their partner’s breasts.

So, what makes women unhappy with their breasts?

One hypothesis states that it is media that makes women uncomfortable with their breasts.

In the words of the study, “Women’s breasts, perhaps more than any other aspect of women’s bodies, are widely presented for evaluation in television, movies, and popular magazines.”

Certainly, this is true and comparison with supposedly ideal breasts may make women unsatisfied with their breasts and several studies have associated more television viewing with an increased desire for plastic surgery.

But this is likely only one part of the story. Another part is probably that women are overestimating the importance of larger breasts to men. Studies have shown that women overestimate the size of breasts preferred by men.

Finally, breasts are very important to women, more so than to men. As one researcher put it, “Women’s breasts are invested with social, cultural, and political meanings. . . .  Breasts are seen simultaneously as a marker of womanhood, as a visual signifier of female sexualization, as synonymous with femininity.”

With this level of significance, it seems that women would feel more pressure to have perfect breasts.

Women’s dissatisfaction with their breasts is a common, but personal and individual problem, but also one with a solution. Women who feel their breasts are too small (28% overall, 38% of women aged 18-25) can have breast enlargement. Women who feel their breasts are too droopy (33% overall, 47% of women aged 56-65) can have a breast lift.

So Your Daughter Asked For A Breast Reduction

It is becoming more and more common for teen girls to request breast reduction or other plastic surgery for a graduation present.

You may find yourself taken aback. Your daughter is smart and pretty and should feel no need for surgery to be self-confident. You may look at your daughter with the loving eyes of a parent, unable to see why she should want to change.

But if your daughter asks for breast reduction, it is best not to be judgmental. You may not understand how she feels, but you should try. A recent study showed that about 65% of women aged 18-25 are unhappy with their breasts, and many wish their breasts were smaller.

You may think plastic surgery is too frivolous a gift for graduation, but if you are looking for a gift that will facilitate your daughter’s transition to the complex social and academic world of college, you could do worse.

During their college years, women are under the most pressure to uphold social standards of beauty. If your daughter feels she is falling short, it can seriously impact her self esteem, maybe lead to daily stress and worry.

Large breasts can lead to unwanted attention and distraction. Think of it as removing a potential obstacle: when she spends less mental energy worrying about her breasts, she will have more to devote to schoolwork and positively adapting to college society.

But what do you do if you still feel uncomfortable with her request, even if you sympathize with her feelings?

As with many things, a flat denial is often not a good decision. If your daughter seeks out plastic surgery without the benefit of your support and input, she may go to a doctor who offers low prices but is not adequately qualified.

Instead, work with her to figure out if this is really what she wants. Help her adequately research the procedure and attend surgeon consultations with her. Give her the benefit of your wisdom in understanding the risks and complications of breast surgery and selecting the right surgeon.

And if you still feel uncomfortable, it might be best to make the final decision hers. Decide what you would like to spend on a graduation present, then give her the money to do with as she will. After all, a graduation gift is partly a celebration that your little girl has become a woman and will have to start making decisions for herself.

To talk to board-certified plastic surgeons about breast surgery, please contact The Centre, P.C. today to schedule a consultation at our South Bend location.

See What Your Breast Implants Look Like BEFORE Surgery

Oh, to have the ability to actually see your results before you commit to breast implants. To be able to see yourself—a three-dimensional you, the real you from every angle—enhanced to what-could-be through surgery.

Truth be told, who wouldn’t want that opportunity? As a culture, we spend so much time second-guessing even our desire for cosmetic enhancements or corrections. At The Centre, P.C., when we see patients at their initial consult, often they want to be told that what they want is ok.

Until very recently, cosmetic surgeons could only help their patients visualize themselves post-surgery through before-and-after photos of other women’s bodies, or with testimonials. Yet nothing could really help patients see what their very own body could look like.

It was the reason our founder Dr. Ronald Downs brought the first (and only) digital image technology to our area. Through the VECTRA ® 3D system, patients can finally see realistic previews of their post-op bodies prior to surgery.

The cool part about the VECTRA® is that it’s not just for breast augmentation. Rhinoplasty patients, people who are considering chin implants, even those who want a tummy tuck can all take a digital look at what a change could look like. So good is this technology, our cosmetic surgeons can adjust sizing and re-sculpt the images during your consultation, so when you enter our surgical suite, both you and your surgeon have the same expectations for the results.

The imagery from the VECTRA® is stunningly realistic, says Dr. Downs. “The patient becomes very comfortable with the expected results of their surgery. And frankly, as plastic surgeons, we get a very good understanding of our patients’ personal expectations because we see those expectations right in front of us on the screen.”

The VECTRA® 3D does add a cost to a typical augmentation; however, our patients have told us that having the chance to collaborate with their doctor on their results with amazing precision was worth it.


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