*Individual Results May Vary
Before & After Breast Augmentation:
Breast Augmentation with silicone gel (gummy bear implants)
Subpectoral (under the muscle) breast augmentation with silicone gel (gummy bear) implants, EXTRA HIGH profile
Do you also need a breast lift?
One of the many important measurements that Dr. Wong uses to assess whether you need a breast lift is the level of your nipple. Typically, if your nipple below the level of the breast crease, it means that your breasts are saggy (or ptotic). Saggy breasts may need a lift in addition to a breast augmentation. In really saggy breasts, placing an implant alone will make a bigger, saggy breasts, which is not attractive. Dr. Wong will discuss your goals and examine you to see if a breast lift is necessary. Please read the Breast Lift section of this website for more information.
Returning to work
Dr. Wong will see you within a week of your surgery to check your surgical sites. Depending on what type of occupation you have, most patients take 1 week off from work. For patients who have more strenuous, labor-intensive jobs, they should ask for light duty or be excused from work for the full 4-6 weeks. You do not want to do any heavy lifting or extreme exercising during this recovery period. This is because your implants are placed under the pectoralis major muscle, which has attachments to your arm. This does not mean you should be lying in bed all the time or under house arrest though; walking is encouraged!
Do not go and buy expensive new bras immediately after surgery. Implants needs some time to settle and you may still have some normal postoperative swelling that needs to be taken into account. You can typically go bra shopping in approximately 2-3 months.
How to pick a size
Picking a size is the most important decision in this process. For this reason, Dr. Wong has 2 different sizing systems in her office. She will take several important measurements of your chest and give you a safe range for how large your implants should be. You can pick any size within this range. It is important to stick to this range because if the implant is too large, then it will be disproportionate to your frame and either form a “uni-boob” (symmastia) and/or create “armpit boob” (where the implant contour is visible from the back and on the side). Breast implants that are too large are also very heavy. The skin and tissue under the weight of heavy implants eventually thins over the years and will lead to sagging and an unattractive appearance over time.
You will be given appointments to come in and try on physical sizers. When you come in to try on your sizers, one of our patient care experts work with you to help you select the size that will be the most flattering and achieve the look you want. There are software capabilities that generate computer images of patients’ torsos, but we have not found these to be very helpful. All of Dr. Wong’s patients like to try on sizers in their bras, look at themselves and their entire body in the floor length mirrors and see how they look at different angles and in different tops. Body proportions is very important to take into account when selecting a size. Patients also want to feel how implants fit on their bodies. For these reasons, the tried-and-true traditional methods of sizing breast implants are far superior to new computer-generated images.
Silicone versus Saline
Breast implants all have a silicone shell, but are filled with either silicone (an inert substance) or saline (salt water). Patients who are at least 18 years old can pick to have saline breast augmentation whereas patients who are at least 22 years old can have saline or silicone breast implants. Saline implants tend to feel and look like water bags because that is essentially what they are. Thin patient with saline implants may have wrinkles in their skin when they lean forward or bend over. These wrinkles (or rippling) are less likely seen with silicone implants.
Back in the 1990s, it was unknown whether silicone implants were safe. As a result, many studies were performed and in 2006, the FDA declared that silicone implants were safe. If a silicone implant were to get a leak, the silicone will typically stay in the confines of the internal scar that naturally has formed around the implant. If a saline implant were to get a leak, the saline gets absorbed by your body and then you urinate it out over the next few days. However, the downside is that you will have very asymmetric breasts one implant will be completely deflated and you would need surgery to fix it. Dr. Wong will discuss these options with you at your consultation to see which is the right one for you.
Where your scar will be
There are a few different places incisions (or scars) can be placed. Dr. Wong typically chooses the inframammary incision, which is at the lowest part of your breast near or in the crease. This gives Dr. Wong excellent and precise visualization of the breast pocket, is well-hidden under the shadows of your breasts, and has a lower risk of infection as dissection through breast ducts is avoided. Other incisions that have been described are the transaxillary, transumbilical and periareolar incisions.
How long do implants last?
Depending on your age and whether there is an implant leak identified, implants may not necessarily need to be replaced. However, implants are like tires on a car, they will eventually go bald or go flat from wear and tear; they don’t last forever. It is important to keep seeing Dr. Wong at least annually for a breast examination and implant check up.
Should you have your implants under or over your muscle?
Breast implants can be placed either on top of the pectoralis major muscle (subglandular approach) or under the muscle (subpectoral approach). Each has its pros and cons. Subglandular approach is an option for patients who have adequate thickness of their soft tissue to create a smooth transition from the chest wall to the implant. For patients who are very thin, they may prefer a subpectoral approach. However, creating a pocket over the muscle may involve dissecting through breast ducts and has been associated with a higher chance of capsular contracture (scar around the implant which contracts down and causes deformities and pain). Placing the implant under the muscle theoretically helps to decrease this risk. Dr. Wong will discuss which of these pockets/approaches is right for you.
As you can tell, there are many aspects of breast augmentation surgery which are important to consider in achieving an attractive and natural result. Call and schedule an appointment with Dr. Wong today so she can optimize and personalize this surgery to your body frame and size. She looks forward to meeting you!