If you are dissatisfied with the size and appearance of your breasts, breast augmentation surgery might before you.
Breast augmentation is a procedure to place implants in the breast(s) to:
Enlarge naturally small breasts
Restore volume to the breasts following breast-feeding or weight loss
Achieve symmetry in breasts that are moderately different in shape and size
Enhance confidence and self-esteem
Dr. Peter Hyans, board-certified plastic surgeon and director of Summit Medical Group's Plastic Surgery Center, discusses the procedure and what you can expect.
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Are You Considering Breast Augmentation?
Featured Speaker:
Dr. Hyans believes that well-informed patients have realistic expectations and feel confident about their procedure. That is why all his consultations are thorough and thoughtful, why he listens to each patient's concerns, and why he provides honest, expert recommendations about what will yield the best results.
Plastic Surgery Center - Summit Medical Group: Dr. Hyans
Peter Hyans, MD FACS
Peter Hyans, MD, FACS, is Medical Director of the Plastic Surgery Center and Chair in the Department of Surgery and Surgical Specialties at Summit Medical Group. A board-certified plastic surgeon, Dr. Hyans has more than 20 years' experience in plastic surgery. His expertise includes facial rejuvenation, body contouring, and cosmetic and reconstructive breast surgery. He is the author or coauthor of articles about plastic and reconstructive surgery, which are published in prestigious, peer-reviewed scientific journals and popular regional lifestyle magazines. In addition, Dr. Hyans is a contributing author of the book, Be Your Best: A Comprehensive Guide to Aesthetic Plastic Surgery, which offers patients expert advice on all aspects of cosmetic plastic surgery. A gifted speaker, he has participated in local and national invited presentations in his field.Dr. Hyans believes that well-informed patients have realistic expectations and feel confident about their procedure. That is why all his consultations are thorough and thoughtful, why he listens to each patient's concerns, and why he provides honest, expert recommendations about what will yield the best results.
Plastic Surgery Center - Summit Medical Group: Dr. Hyans
Transcription:
Are You Considering Breast Augmentation?
Melanie Cole (Host): Do you have a desire to enlarge a naturally small breast or restore the volume in your breast that you may feel that you’ve lost during pregnancy or any number of reasons that you would like to consider breast augmentation? My guest is Dr. Peter Hyans. He is the Medical Director of the Plastic Surgery Center at Summit Medical Group. Welcome to the show, Dr. Hyans. Tell us a little about why some women would consider breast augmentation.
Dr. Peter Hyans (Guest): Thank you for having me, Melanie. I think that you, in your introduction, described the most common reasons that women would come in for breast augmentation. It’s usually younger women that have always had small breasts that have made them self-conscious and want to have them enhanced so that they feel more natural in clothing or bathing suits and more feminine. And the other reason is that a lot of times with pregnancies, women will lose a lot of volume in their breasts and they just want to have that volume restored so that they can again feel more comfortable in their clothing.
Melanie: Okay, so it is about making us feel better about ourselves.
Dr. Hyans: Absolutely. I am always taken back by women that come in. They’re very shy, very self-conscious about their appearance. And then after surgery, just by improving the volume of their breast, they feel so much more comfortable in their clothing and much more confident.
Melanie: Of course, in the media, you’ve seen changes that are just unbelievable on some people. Sometimes it’s noticeable, sometimes it’s not. How difficult a surgery is this and how do women get started with it?
Dr. Hyans: If a woman was interested in a breast augmentation, they would come in for a standard consultation. We would discuss their concerns and what they hope to achieve with the surgery. We would take some measurements. Then we would have a detailed discussion about what type of implants we would recommend, the approach, the incision that we would use, what size they would expect it to be, the recovery process, and then formulate a plan and go from there in terms of scheduling the surgery. There are different types of implants that are available, and there are different ways that a surgery can be performed. It’s not uncommon that a woman, when they come in for this type of surgery, may require a small breast lift at the time of the augmentation. Or, they may have some asymmetry of the two sides which may need to be addressed. These are all discussed at the original consultation.
Melanie: Now, over the years, we’ve heard about different implant types and risks and things. Tell us about the types of implants that you use and which one you recommend based on what the woman wants.
Dr. Hyans: Well, today there are three main types of implants. There’s a saline or water-filled implant, there’s a silicone gel-filled implant, and there’s a cohesive gel type of implant which is more of a solid silicone implant. They all have their advantages and disadvantages. In the ‘80s and ‘90s, there was the breast implant controversy which really revolved around problems related to silicone gel implants. That was an early generation implant that had a very flimsy shell that was very porous and the gel was very liquid. Those implants had problems with breaking down and leakage. There have been many studies to show that these implants did not really cause any generalized health problems but they did cause some localized problems if those implants would break. The implants today are now of a third and fourth generation product. They are much more durable in terms of the shell. The gel inside is either a very thick, heavy gel, or a solid gel. So it’s much less likely to break or rupture. So the complication rate has dramatically decreased. In terms of which implant I would recommend, it really depends on what the patient hopes to achieve. If the patient has a little bit larger breast to start with, then a saline implant is perfectly adequate. If the patient has a very small or very tight breast, then a gel implant would probably be a better implant because it’s going to feel and look a little bit more natural and it’s harder to hide with their natural breast.
Melanie: So if someone has naturally dense breasts, then you’re going to make a particular recommendation on the way that it’s going to look the most natural, the way that they’re going to feel, like if they are wearing a form-fitting dress that it’s going to not show odd parts?
Dr. Hyans: Absolutely. And part of that discussion is in terms of size. I always tell patients that we try to go as large as we can but we want to keep it natural. So I do not feel that making breast implants overly large is very aesthetically pleasing. I’d like to try and go for a more natural look. Most women will go for the most common differences, like from an A to a C, or a B to a D – something like that. I don’t recommend going too large because the larger you go, the more unnatural it’s going to look, the more you’re going to take on the shape of the implant and lose the natural shape of your breast. And that’s part of the discussion that we have when the patient comes in. Again, part of the discussion also would involve whether we need to tighten the skin or lift the skin because that also will change the appearance of the breast and try and keep it natural.
Melanie: If someone is going to have an implant, is their ability to breast feed affected?
Dr. Hyans: Absolutely not. Most times, the implant is placed below the muscle to protect the implant. It makes it easier for mammograms, and it lessens the chance of the implant getting hard or firm over time. With the implant behind the muscle, it’s unlikely that it would have any effect on breastfeeding.
Melanie: Let’s talk about the recovery period. What is the recovery period for augmentation these days?
Dr. Hyans: Most of these surgeries are performed on an outpatient basis unless they are combined with other plastic surgery procedures. The surgery to perform augmentation alone usually is about an hour long. The patient is asleep and they go home the same day. Usually, a day or two after surgery, the patient will have some swelling for the first couple of days and some discomfort which they may need to take a pain pill. But most patients are able to return to work within a week and most exercise within about three weeks.
Melanie: Now, are there some people, Dr. Hyans, who are not candidates for breast augmentation?
Dr. Hyans: Well, certainly we want to make sure the patient has no evidence of any other breast diseases. So women that are over 30 or 40, we would want to make sure that they have the most recent mammogram and had an evaluation by a breast surgeon beforehand to make sure they have no evidence of any other diseases. I would also probably not recommend an augmentation to a woman that is planning on having children within a short period of time afterwards just because her breasts are going to change with pregnancy and it’s probably best to reevaluate her once she is finished having children and do the surgery. If she was 20 years old and wasn’t going to have children until she’s in her late 20’s or 30’s, that’s a different story. I would not do breast augmentation right before you’re going to have children because your breasts are going to change and it would probably be better to have that evaluated once you’re finished having children.
Melanie: Dr. Hyans, is breast augmentation typically a reversible procedure?
Dr. Hyans: It is reversible. If someone comes in and decides, “You know what? I don’t feel comfortable with this size breast,” we could either reduce the volume or make other adjustments or you could even remove the implant without any harm to the breast.
Melanie: Wow, so this is something you don’t want to go into thinking that that’s the option.
Dr. Hyans: It would be highly unusual. I’ve been doing this surgery for 20 years and I don’t think I’ve ever had a patient come back to me and say, “You know what? I’m not happy with my new breasts. Can you please take out these breast implants?” It is very unusual for a patient to want to have her breast implants removed. Patients are usually very happy and feel very good about themselves after the surgery and the complication rate with the surgery is exceptionally low.
Melanie: What do you expect of patients before this surgery? Do they have to lose weight? Is there anything you’d like them to do before they go in for breast augmentation?
Dr. Hyans: I think the most important thing is to have a realistic outlook about what to expect in terms of the results. You want to make sure that the patient and the surgeon are on the same page in terms of the size and shape and what can be achieved. Often, patients will have some asymmetries that they’re not aware of. And I think those things need to be brought out in the original discussion. Generally, if a patient is in good medical health, then it’s a very low-risk procedure. There’s not any particular activity or diet that the patient would have to do in terms of preparing for the surgery. Usually, we just recommend they be holding off on some aspirin products or things that could cause bleeding just around the time of surgery.
Melanie: Is this something that is permanent or do they need to get the implants touched up 20 years later?
Dr. Hyans: The implants that we put in today are meant to stay in there. I usually tell people that unless they have a problem with their implants, the implants have changed shape, or moved, or they’ve gained, or lost a lot of weight, or the implants have gotten hard, if any of those things occur, we would certainly want to reevaluate the patient and we may need to exchange the implant or do some corrective surgery. But in general, with most patients, the implants, as long as they have not changed or they’re just as soft, I would not exchange them for any reason. They do not need to be necessarily exchanged just because of the age of the implant.
Melanie: Dr. Hyans, please give us your best advice for women considering breast augmentation.
Dr. Hyans: Breast augmentation is a terrific option for women that desire to have a larger, more enhanced appearance to their breast, whether it be something that they’ve been dealing with all their lives in terms of small breasts, or changes that have occurred in their breast after having had children. Breast augmentation can be combined with other surgeries such as a lift to give the patient a very natural look with a very limited recovery and complication.
Melanie: You’re listening to SMG Radio. Thank you for listening.
Are You Considering Breast Augmentation?
Melanie Cole (Host): Do you have a desire to enlarge a naturally small breast or restore the volume in your breast that you may feel that you’ve lost during pregnancy or any number of reasons that you would like to consider breast augmentation? My guest is Dr. Peter Hyans. He is the Medical Director of the Plastic Surgery Center at Summit Medical Group. Welcome to the show, Dr. Hyans. Tell us a little about why some women would consider breast augmentation.
Dr. Peter Hyans (Guest): Thank you for having me, Melanie. I think that you, in your introduction, described the most common reasons that women would come in for breast augmentation. It’s usually younger women that have always had small breasts that have made them self-conscious and want to have them enhanced so that they feel more natural in clothing or bathing suits and more feminine. And the other reason is that a lot of times with pregnancies, women will lose a lot of volume in their breasts and they just want to have that volume restored so that they can again feel more comfortable in their clothing.
Melanie: Okay, so it is about making us feel better about ourselves.
Dr. Hyans: Absolutely. I am always taken back by women that come in. They’re very shy, very self-conscious about their appearance. And then after surgery, just by improving the volume of their breast, they feel so much more comfortable in their clothing and much more confident.
Melanie: Of course, in the media, you’ve seen changes that are just unbelievable on some people. Sometimes it’s noticeable, sometimes it’s not. How difficult a surgery is this and how do women get started with it?
Dr. Hyans: If a woman was interested in a breast augmentation, they would come in for a standard consultation. We would discuss their concerns and what they hope to achieve with the surgery. We would take some measurements. Then we would have a detailed discussion about what type of implants we would recommend, the approach, the incision that we would use, what size they would expect it to be, the recovery process, and then formulate a plan and go from there in terms of scheduling the surgery. There are different types of implants that are available, and there are different ways that a surgery can be performed. It’s not uncommon that a woman, when they come in for this type of surgery, may require a small breast lift at the time of the augmentation. Or, they may have some asymmetry of the two sides which may need to be addressed. These are all discussed at the original consultation.
Melanie: Now, over the years, we’ve heard about different implant types and risks and things. Tell us about the types of implants that you use and which one you recommend based on what the woman wants.
Dr. Hyans: Well, today there are three main types of implants. There’s a saline or water-filled implant, there’s a silicone gel-filled implant, and there’s a cohesive gel type of implant which is more of a solid silicone implant. They all have their advantages and disadvantages. In the ‘80s and ‘90s, there was the breast implant controversy which really revolved around problems related to silicone gel implants. That was an early generation implant that had a very flimsy shell that was very porous and the gel was very liquid. Those implants had problems with breaking down and leakage. There have been many studies to show that these implants did not really cause any generalized health problems but they did cause some localized problems if those implants would break. The implants today are now of a third and fourth generation product. They are much more durable in terms of the shell. The gel inside is either a very thick, heavy gel, or a solid gel. So it’s much less likely to break or rupture. So the complication rate has dramatically decreased. In terms of which implant I would recommend, it really depends on what the patient hopes to achieve. If the patient has a little bit larger breast to start with, then a saline implant is perfectly adequate. If the patient has a very small or very tight breast, then a gel implant would probably be a better implant because it’s going to feel and look a little bit more natural and it’s harder to hide with their natural breast.
Melanie: So if someone has naturally dense breasts, then you’re going to make a particular recommendation on the way that it’s going to look the most natural, the way that they’re going to feel, like if they are wearing a form-fitting dress that it’s going to not show odd parts?
Dr. Hyans: Absolutely. And part of that discussion is in terms of size. I always tell patients that we try to go as large as we can but we want to keep it natural. So I do not feel that making breast implants overly large is very aesthetically pleasing. I’d like to try and go for a more natural look. Most women will go for the most common differences, like from an A to a C, or a B to a D – something like that. I don’t recommend going too large because the larger you go, the more unnatural it’s going to look, the more you’re going to take on the shape of the implant and lose the natural shape of your breast. And that’s part of the discussion that we have when the patient comes in. Again, part of the discussion also would involve whether we need to tighten the skin or lift the skin because that also will change the appearance of the breast and try and keep it natural.
Melanie: If someone is going to have an implant, is their ability to breast feed affected?
Dr. Hyans: Absolutely not. Most times, the implant is placed below the muscle to protect the implant. It makes it easier for mammograms, and it lessens the chance of the implant getting hard or firm over time. With the implant behind the muscle, it’s unlikely that it would have any effect on breastfeeding.
Melanie: Let’s talk about the recovery period. What is the recovery period for augmentation these days?
Dr. Hyans: Most of these surgeries are performed on an outpatient basis unless they are combined with other plastic surgery procedures. The surgery to perform augmentation alone usually is about an hour long. The patient is asleep and they go home the same day. Usually, a day or two after surgery, the patient will have some swelling for the first couple of days and some discomfort which they may need to take a pain pill. But most patients are able to return to work within a week and most exercise within about three weeks.
Melanie: Now, are there some people, Dr. Hyans, who are not candidates for breast augmentation?
Dr. Hyans: Well, certainly we want to make sure the patient has no evidence of any other breast diseases. So women that are over 30 or 40, we would want to make sure that they have the most recent mammogram and had an evaluation by a breast surgeon beforehand to make sure they have no evidence of any other diseases. I would also probably not recommend an augmentation to a woman that is planning on having children within a short period of time afterwards just because her breasts are going to change with pregnancy and it’s probably best to reevaluate her once she is finished having children and do the surgery. If she was 20 years old and wasn’t going to have children until she’s in her late 20’s or 30’s, that’s a different story. I would not do breast augmentation right before you’re going to have children because your breasts are going to change and it would probably be better to have that evaluated once you’re finished having children.
Melanie: Dr. Hyans, is breast augmentation typically a reversible procedure?
Dr. Hyans: It is reversible. If someone comes in and decides, “You know what? I don’t feel comfortable with this size breast,” we could either reduce the volume or make other adjustments or you could even remove the implant without any harm to the breast.
Melanie: Wow, so this is something you don’t want to go into thinking that that’s the option.
Dr. Hyans: It would be highly unusual. I’ve been doing this surgery for 20 years and I don’t think I’ve ever had a patient come back to me and say, “You know what? I’m not happy with my new breasts. Can you please take out these breast implants?” It is very unusual for a patient to want to have her breast implants removed. Patients are usually very happy and feel very good about themselves after the surgery and the complication rate with the surgery is exceptionally low.
Melanie: What do you expect of patients before this surgery? Do they have to lose weight? Is there anything you’d like them to do before they go in for breast augmentation?
Dr. Hyans: I think the most important thing is to have a realistic outlook about what to expect in terms of the results. You want to make sure that the patient and the surgeon are on the same page in terms of the size and shape and what can be achieved. Often, patients will have some asymmetries that they’re not aware of. And I think those things need to be brought out in the original discussion. Generally, if a patient is in good medical health, then it’s a very low-risk procedure. There’s not any particular activity or diet that the patient would have to do in terms of preparing for the surgery. Usually, we just recommend they be holding off on some aspirin products or things that could cause bleeding just around the time of surgery.
Melanie: Is this something that is permanent or do they need to get the implants touched up 20 years later?
Dr. Hyans: The implants that we put in today are meant to stay in there. I usually tell people that unless they have a problem with their implants, the implants have changed shape, or moved, or they’ve gained, or lost a lot of weight, or the implants have gotten hard, if any of those things occur, we would certainly want to reevaluate the patient and we may need to exchange the implant or do some corrective surgery. But in general, with most patients, the implants, as long as they have not changed or they’re just as soft, I would not exchange them for any reason. They do not need to be necessarily exchanged just because of the age of the implant.
Melanie: Dr. Hyans, please give us your best advice for women considering breast augmentation.
Dr. Hyans: Breast augmentation is a terrific option for women that desire to have a larger, more enhanced appearance to their breast, whether it be something that they’ve been dealing with all their lives in terms of small breasts, or changes that have occurred in their breast after having had children. Breast augmentation can be combined with other surgeries such as a lift to give the patient a very natural look with a very limited recovery and complication.
Melanie: You’re listening to SMG Radio. Thank you for listening.