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Cosmetic Breast Surgery Challenges

cosmetic breast model

First, let’s cover the ‘easy’ part: If you look in the mirror and like what you see, but it’s only a bit small, consider yourself blessed, as only an implant should serve you well. The main challenge here is to find the anatomically appropriate, proportional implant size for you, which is best done during surgery. Keep in mind that the main goal is to optimize your beauty, not just make you bigger, and an implant that looks great on a friend may not be the best choice for you.

If your initial implant size exceeded your anatomical boundaries due to your or your surgeon’s choice, future and potentially avoidable challenges are courted. This can include excessive thinning of the breast, premature sagging, rippling, and palpable implant edges - to name a few. Bigger is not always better when it comes to implants. Oversized implants will likely increase the difficulty of future surgery when replacing or removing aged implants.

Some patients develop symptomatic internal scarring around their implants (“capsular contracture”) that can be a challenge to manage and may require scar release or other surgery.

Some patients wait too long to renew their implants, usually because they are happy with them. But implants simply become old after 10 to 15 years and need to be replaced or removed. All implants eventually deteriorate, i.e., rupture. Silicone implants do so silently, unlike saline implants, which deflate quite obviously. So, don’t forget your ‘preventative maintenance.’ A broken silicone implant often requires additional surgery to remove the silicone-impregnated scar membrane (“capsule”) around the implant. It’s always easier to replace implants before their “expiration date,” involving minimal discomfort and downtime.

Quite a number of young patients have developmental issues with their breasts. Some simply grow too large and disproportionate, causing discomfort and interfering with their lifestyle. These can be helped, almost dramatically, with breast reduction surgery, an artistically challenging operation as the goal is not just smaller breasts, but beauty as well. Of course, this operation also helps non-adolescent patients whose previously pleasing breasts may have become heavy and sagging with nursing and time.

Not a small number of young patients suffer from ‘Tubular (aka Constricted) Breast Deformity,’ a congenital condition. This can vary from mild, requiring only an implant, to distressingly severe, requiring several challenging surgeries to arrive at an acceptable result. Hallmarks are significant asymmetry, underdevelopment, a tube-resembling (or constricted) breast appearance, along with disproportionate areolar dimensions.

Major (“bariatric”) weight loss also presents breast challenges. Usually, the severe atrophy and sagging require substantial volume replacement with silicone implants plus major breast lifting.

The normally aging breast can present with varying difficulties. If you were an A or B when young, then a small implant alone can do wonders for the deflation incurred after breastfeeding or simply with time. Patients who were happy with a full B or C or larger cup in earlier years typically develop undesirable sagging in later years, with or without heaviness. These are helped with either a breast reduction or a breast lift, or a combo of a lift and silicone implants. The latter presents its own unique challenges as the tightening forces set into motion with the breast lift run opposite to the expanding force of the implant.

On the cryptic topic of ‘Breast Implant Illness’: there are patients who, for unknown reasons, just don’t seem to do well with implants. They report a number of difficult-to-explain, non-specific symptoms. If these symptoms cannot be medically explained or treated, despite a thorough medical workup, it’s probably best to remove such implants, at least to find out if the symptoms disappear. After all, you choose to have implants to make yourself happier. If implants don’t accomplish this goal, for whatever reason, removing them makes sense, even though you might need a breast lift to restore your aesthetics. However, it’s worth mentioning that the majority of patients have no significant problems and are happy with their choice to have implants.

Overall, cosmetic breast surgery is highly variable and always challenging, as creating beauty is never easy. But it’s worth all the effort.

As always, research and reflect carefully before proceeding with any cosmetic plastic surgery.

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