9 Breast Augmentation Questions Patients Never Ask (But They Should)

Important Questions to Ask during Breast Augmentation Consultation

Breast augmentation is one of the most popular cosmetic surgery procedures worldwide, with many women opting to alter their breast size and shape. It is important for patients to be well-informed about the procedure, its potential risks, and the long-term implications. Many patients focus solely on the aesthetic benefits of breast augmentation and may overlook or feel hesitant to ask important questions that can significantly impact their overall well-being and satisfaction with the results.

In this blog post, Sydney Specialist Plastic Surgeon Dr Bish Soliman will address 9 essential questions that patients rarely ask about breast augmentation. These questions go beyond the basics and get into the more complex aspects of the procedure, including pain management during recovery, long-term effects on skin elasticity and overall health, the impact of weight fluctuations, and the potential need for revision surgery. By exploring these topics, Dr Soliman aims to provide patients with a more complex understanding of breast augmentation surgery.

Download Dr Bish Soliman’s Guide to Cosmetic Breast Surgery

Ultimate Guide To Cosmetic Breast Surgery

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1.     How can I manage pain and discomfort during recovery without becoming dependent on pain medication?

As you consider breast augmentation surgery, it’s important to think about pain management during your recovery. You might feel hesitant to bring up this topic with your surgeon, worrying that you’ll appear weak or prone to addiction. However, having an open discussion about your options can help you create a safe and effective plan to manage discomfort while minimising the risk of becoming dependent on pain medication.

It’s important to understand that some degree of pain and discomfort is normal and expected after breast augmentation. The level and length of pain you experience may vary based on factors like the extent of your procedure, your individual pain tolerance, and how closely you follow post-operative care instructions. By asking your surgeon about pain management options, you can work together to develop a personalised plan that suits your specific needs and preferences.

One of the main concerns you might have about pain management after breast augmentation is the potential for developing a dependence on opioid pain medications. While these medications can effectively manage acute pain, they also come with the risk of addiction when used for extended periods. Be sure to ask your surgeon about alternative pain management techniques, such as non-opioid medications, cold compresses, and gentle stretching exercises, which can help ease discomfort without the risk of dependence.

2.     What are the potential effects of breast augmentation on skin elasticity and the natural ageing process of the breasts?

As you consider breast augmentation, it’s important to understand how the procedure may affect your skin elasticity and the natural ageing process of your breasts. Over time, factors such as gravity, weight fluctuations, and hormonal changes can cause the skin to stretch and lose elasticity, leading to sagging or drooping breasts. Asking your surgeon about the long-term effects of breast implants on skin elasticity can help you make an informed decision and set realistic expectations for your results.

Your surgeon should explain that while breast implants can alter the size and shape of your breasts, they do not stop the natural ageing process. As you age, your skin will continue to lose elasticity, and your breasts may begin to sag, regardless of whether you have implants or not. However, the added weight of the implants may accelerate this process, especially if you opt for larger implants or have thin skin with poor elasticity.

To minimise the impact of breast augmentation on skin elasticity, your surgeon may recommend techniques such as placing the implants underneath the chest muscle (submuscular placement) or using smaller implants that are proportional to your body frame. They may also advise you on ways to maintain the health and elasticity of your skin, such as staying hydrated, protecting your skin from sun damage, and maintaining a stable weight.

It’s also essential to ask about the potential need for future revision surgery, such as a breast lift, to address any sagging or drooping that may occur over time.

3.     How will weight fluctuations impact the appearance of my augmented breasts?

Weight fluctuations are a common concern among women considering breast augmentation. Your surgeon should explain that while breast implants do not directly respond to weight fluctuations, the surrounding breast tissue can change in size and shape as you gain or lose weight. If you experience significant weight gain after breast augmentation, your breasts may increase in size, potentially causing the skin to stretch and the implants to appear more pronounced. Conversely, if you lose a substantial amount of weight, your breasts may decrease in size, leading to a more deflated appearance and potential rippling or visibility of the implants.

To minimise the impact of weight fluctuations on your augmented breasts, your surgeon may recommend maintaining a stable, healthy weight through a balanced diet and regular exercise. They may also advise you to choose an implant size that is proportional to your body frame and to have realistic expectations about the potential changes in appearance that may occur with weight fluctuations.

4.     How will breast augmentation affect nipple sensitivity and sexual sensation?

Nipple sensitivity and sexual sensation are important factors to consider when deciding on breast augmentation. Many women may feel hesitant to ask about these intimate topics, but it’s essential to have an open and honest discussion with your surgeon. Your surgeon should explain that changes in nipple sensitivity and sexual sensation after breast augmentation are possible, but the extent and duration of these changes can vary from person to person. Some women may experience temporary numbness, tingling, or hypersensitivity in the nipples and surrounding skin after surgery, as the nerves that supply sensation to these areas may be stretched or damaged during the procedure. In most cases, these changes are temporary and will resolve as the nerves heal and regenerate, which can take several months.

However, in rare cases, some women may experience permanent changes in nipple sensitivity or sexual sensation. The risk of permanent changes is higher with certain surgical techniques, such as the periareolar incision (around the nipple), or if there are complications during the procedure.

It’s important to ask your surgeon about their experience with preserving nipple sensitivity and sexual sensation during breast augmentation, as well as the techniques they use to minimise the risk of nerve damage. They should also provide guidance on how to manage any changes in sensitivity during the recovery process, such as avoiding direct stimulation or wearing soft, comfortable clothing.

5.     Are there any specific exercises or physical activities I should avoid permanently after breast augmentation to prevent complications or implant displacement?

As you plan for your breast augmentation surgery, it’s important to consider how the procedure may impact your lifestyle and physical activities in the long term. Asking your surgeon about any specific exercises or activities that you should avoid permanently can help you make necessary adjustments and prevent potential complications or implant displacement.

Your surgeon should provide guidance on the types of exercises and activities that are safe to resume after you have fully recovered from surgery, as well as any that you should avoid or modify permanently. In general, most women can return to their regular exercise routines after breast augmentation, but there may be some exceptions depending on the individual case and the type of implants used.

For example, if you have subglandular implants (placed above the chest muscle), your surgeon may advise you to avoid high-impact exercises that involve a lot of bouncing or jumping, such as running or aerobics, as these activities can cause the implants to shift or displace over time. Instead, they may recommend low-impact alternatives like cycling, swimming, or yoga.

If you have submuscular implants (placed beneath the chest muscle), you may have fewer restrictions on high-impact activities, as the muscle provides additional support and stability for the implants. However, your surgeon may still advise you to avoid certain chest exercises, such as push-ups or chest flies, as these can cause the implants to shift or contribute to the development of capsular contracture (scar tissue formation around the implant).

Additionally, your surgeon should emphasise the importance of wearing a supportive, well-fitting sports bra during all physical activities to minimise bouncing and protect your implants from displacement. They may also recommend specific brands or styles of sports bras that are designed for women with breast implants.

6.     What happens if I’m not satisfied with the results of my breast augmentation? What are my options for revision surgery?

While most women are satisfied with the results of their breast augmentation, it’s important to understand that there is always a possibility that you may not be entirely happy with the outcome. Asking your surgeon about your options for revision surgery in case of dissatisfaction can help you feel more prepared and confident in your decision to undergo the procedure.

Your surgeon should explain that dissatisfaction with breast augmentation results can arise from various factors, such as implant size, shape, or placement, asymmetry between the breasts, or changes in your personal preferences over time. In some cases, dissatisfaction may also result from surgical complications, such as capsular contracture or implant rupture.

If you are not satisfied with your results, the first step is to communicate your concerns with your surgeon. They should listen to your feedback and work with you to identify the specific aspects of your results that you are unhappy with. In some cases, your surgeon may recommend waiting for several months after the initial surgery to allow your breasts to fully heal and settle before considering revision surgery.

Your options for revision surgery will depend on the specific nature of your dissatisfaction and your individual case. Some common revision procedures include:

• Implant exchange: Replacing your current implants with a different size, shape, or type to achieve your desired results.
• Pocket revision: Adjusting the pocket (space) around the implant to correct issues such as implant displacement or asymmetry.
• Capsulectomy: Removing the scar tissue capsule that forms around the implant to correct complications such as capsular contracture.
• Breast lift: Combining implant revision with a breast lift to address sagging or drooping that may occur over time.

Additionally, you should inquire about the costs associated with revision surgery, as these procedures may not be covered by your initial surgical fee or health insurance.

7.     How do you handle complications, and what is your complication rate for breast augmentation?

It’s essential to understand that all surgical procedures carry some level of risk and potential for complications. Your surgeon should be transparent about the potential complications associated with breast augmentation, which can include:

• Infection
• Bleeding or haematoma
• Seroma (fluid accumulation)
• Capsular contracture
• Implant rupture or leakage
• Changes in nipple or breast sensation
• Unsatisfactory aesthetic results

They should also explain their specific protocols for preventing, detecting, and managing these complications, such as using sterile techniques during surgery, providing detailed post-operative care instructions, and scheduling regular follow-up appointments to monitor your healing and results.

It’s important to ask your surgeon about their complication rate for breast augmentation, which refers to the percentage of their patients who experience complications after the procedure. A low complication rate can be an indicator of a surgeon’s skill, experience, and commitment to patient safety. However, it’s essential to keep in mind that even the most experienced surgeons may encounter complications in some cases, as individual patient factors can also contribute to the risk of complications.

Your surgeon should also discuss their approach to handling complications if they do occur. This may involve additional procedures, such as draining a hematoma or seroma, treating an infection with antibiotics, or performing revision surgery to correct capsular contracture or implant displacement. They should also provide information on the potential costs associated with treating complications, as these may not be covered by your initial surgical fee or health insurance.

8.     How do you ensure symmetry between the breasts, and what can be done if asymmetry occurs after the procedure?

Achieving symmetry between the breasts is one of the primary goals of breast augmentation, as it contributes to a natural-looking result. However, it’s important to understand that perfect symmetry may not always be possible, as most women have some degree of natural asymmetry between their breasts.

Your surgeon should explain that they take several steps to promote symmetry during the breast augmentation procedure, such as:

• Performing precise measurements and markings on the breasts to ensure accurate implant placement
• Using sizers or temporary implants to assess symmetry and make adjustments before placing the final implants
• Carefully positioning the implants within the breast pockets to achieve a balanced and proportional result
• Assessing symmetry from multiple angles and in different positions (sitting, standing, etc.) during the procedure

They should also discuss the potential factors that can contribute to asymmetry after breast augmentation, such as:

• Pre-existing asymmetry in breast size, shape, or position
• Differences in chest wall anatomy or rib cage structure
• Uneven healing or scar tissue formation (capsular contracture) around the implants
• Implant displacement or shifting over time

If asymmetry occurs after the procedure, your surgeon should work with you to determine the best course of action to address the issue. In some cases, minor asymmetry may be addressed through non-surgical methods, such as using padded bras or custom-fitted clothing to create a more balanced appearance.

However, if the asymmetry is significant or bothersome, your surgeon may recommend revision surgery to correct the issue. This may involve:

• Replacing one or both implants with a different size or shape to achieve better symmetry
• Adjusting the position of the implants within the breast pockets
• Performing a capsulectomy to remove scar tissue that may be causing implant distortion or displacement
• Combining implant revision with a breast lift to address any sagging or drooping that may be contributing to asymmetry

9.     What are the long-term implications of breast implants on overall health, such as the potential risk of autoimmune disorders or connective tissue diseases?

One important aspect to discuss with your surgeon is the potential impact of breast implants on your overall health, particularly in relation to the risk of developing autoimmune disorders or connective tissue diseases.

Your surgeon should explain that while the majority of women with breast implants do not experience significant health issues, there have been some concerns raised about the potential link between breast implants and certain systemic diseases. These concerns have primarily focused on silicone gel-filled implants, which were temporarily removed from the market in the United States in the 1990s due to reports of possible connective tissue diseases and autoimmune disorders in some women with these implants.

However, it’s important to note that after extensive research and studies, no clear causal relationship has been established between silicone gel-filled implants and these health conditions. In 2006, the FDA re-approved the use of silicone gel-filled implants after determining that they were safe and effective for breast augmentation and reconstruction.

Despite this, your surgeon should discuss the current state of research on the potential health risks associated with breast implants, including:

• Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): A rare type of non-Hodgkin’s lymphoma that has been linked to textured breast implants. While the risk is low, it’s important to be aware of the symptoms and to follow up regularly with your surgeon.
• Breast Implant Illness (BII): A term used to describe a range of systemic symptoms that some women with breast implants have reported, such as fatigue, joint pain, memory loss, and skin problems. While the cause of these symptoms is not well understood, some women have reported improvement after having their implants removed.
• Autoimmune disorders and connective tissue diseases: Some studies have suggested a possible association between breast implants and conditions such as rheumatoid arthritis, lupus, and scleroderma. However, the evidence is limited, and more research is needed to fully understand any potential link.

Your surgeon should emphasise the importance of regular follow-up care and monitoring after breast augmentation to detect any potential health issues early on. They should also provide information on the signs and symptoms to watch for and when to seek medical attention.

If you are considering breast augmentation, schedule a consultation with Specialist Plastic Surgeon Dr Bish Soliman now to discuss the details of the procedure.

Further Reading about Breast Augmentation with Sydney Specialist Plastic Surgeon Dr Bish Soliman

• Read Dr Soliman’s Blog about Consultation for Breast Augmentation
• Read Dr Soliman’s Blog about 10 Questions You Must Ask Your Surgeon before a Breast Augmentation
• Read Dr Soliman’s Blog about Minimising Breast Augmentation Scars
• Read Dr Soliman’s Blog about What Is Dropping and Fluffing after Breast Augmentation?
• Read Dr Soliman’s Blog about How to Choose the Best Bra after Breast Augmentation

Medical References about Breast Augmentation Surgery

• Prospective Study of Clinical Outcomes From a Breast Implant Assessment Service
• Risk Factor Analysis for Capsular Contracture
• Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type
• Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy?
• Management of Capsular Contracture in Cases of Silicone Gel Breast Implant Rupture with Use of Pulse Lavage and Open Capsulotomy