Dr. Sigalove Answers Common Questions About Breast Augmentation

You asked, Dr. Sigalove answered!

Dr. Sigalove, board-certified plastic surgeon in Scottsdale, AZ, shares his insights into commonly asked questions about breast augmentation. He shares his insights on what to expect after breast augmentation, what it’s like to recover from breast implant surgery and how breast implants settle after surgery.

Do Breast Implants Get Bigger As They Heal?

Immediately following a breast augmentation, the breasts and local soft tissues will be quite swollen which will make the skin appear tight. This tightness makes the breasts look smaller and less natural. Then, as the swelling resolves over the first 6-8 weeks following surgery, the skin appears softer and more supple which allows the complete shape of the implant to be seen.

Some people call this the “drop and fluff” phenomenon, as the breast implants drop into their final position at the bottom of the pocket and the soft tissues and skin assume their normal feel and appearance.

It is important not to judge your result too early because of the standard swelling, higher positioning, and skin tightness which most patients observe during the first few weeks following their breast augmentation surgery. As the swelling and inflammation diminish and as the implants settle in the pocket, the breasts take on a new and improved look and they often look more natural and soft, almost larger than immediately following surgery.

Why Is There a Large Gap Between My Breasts After Breast Augmentation?

More likely than not, the gap between the two breasts (intermammary sulcus) was there prior to the breast augmentation surgery. This space is anatomical, and is defined by your breastbone (sternum), the breasts, and the pectoralis major muscles. This space varies from patient to patient. Some have a very large distance between the breasts, and some have an extremely narrow gap. The key is that the plastic surgeon recognizes the degree of gap prior to surgery so that an appropriate surgical plan can be made in order to maximize the overall breast aesthetics.

The amount of dissection of the pectoralis muscle can be adjusted based on the desired ultimate positioning of the implant. Many women have a large space between the two breasts which makes the final cleavage line seem too wide and separated. In these patients, I typically discuss subfascial breast augmentation which will provide improved closeness of the breasts/implants because they will not be placed below already far apart muscles.

If patients have a wide gap pre-op, I also will discuss the option of fat grafting, where I inject the patient’s fat along the cleavage line as well as the upper poles to create the illusion that the implants are actually closer than they are.

For patients who have extremely close breasts pre-op, I am very cautious when dissecting the medial/inferior pec attachments to ensure that the implants don’t sit too close to each other.

Additionally, breast implant selection plays a key role in maximizing breast aesthetics as narrow and highly projected implants will potentially expose an underlying large gap even more, almost making the situation worse. Appropriate implant width selection is critical in order to either camouflage a large gap or to NOT highlight it even more.

Discussing these and other technical aspects of breast augmentation is crucial during the initial consultation. Patients should have an understanding of their own anatomy prior to surgery and more importantly, the plastic surgeon should be able to create a customized surgical plan which will take the anatomy into consideration with the ultimate goal of having the patient wake up from surgery with beautiful breasts.

How Long Do I Need to Wear a Compression Garment After Breast Augmentation? How Tight Should It Be?

Our patients typically wake up following their surgery wearing a soft cotton surgical support bra. It is comfortable, breathes well, and does not have any zippers or clips which can potentially harm the skin.

This cotton surgical bra is worn for approximately 3-4 weeks. After that, patients are encouraged to wear any bra that is comfortable provided that it has no underwire. Underwire bras may be worn 6-8 weeks after surgery, once the incisions have healed sufficiently.

We do not use any sort of compression garments following breast augmentation surgery as they are too tight and can potentially cause skin breakdown or blisters. No postoperative bra should be too tight because it can not only be uncomfortable as the breasts swell, but it can lead to skin ischemia (lack of oxygen) and blistering.

To schedule a consultation with one of our board-certified plastic surgeons, call our office at (480) 423-1973 or request a consultation. Click to learn more about Dr. Sigalove and to see his before and after gallery.

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