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Your Treasured Chest

Your Treasured Chest


Bigger? Smaller? Implants? Uplift? Safe? Sorry? Scary? Sigh. Should we or shouldn’t we tamper
with our ta-tas? These are the February Paisley Prescriptions questions all about breast
augmentation and reduction, with our board certified plastic surgeon.

Dr. Diane Bowen, Golden Isles Center for Plastic Surgery

Explain the different options of augmentation:
Essential to comprehensive cosmetic breast surgery is a thorough assessment as to goals for a woman’s breast size and shape. Some women like what they have to be repositioned, which would involve a breast lift only. Other women wish to be larger than they are, which would be a breast augmentation. Augmentation can occur by either breast implants, or newer techniques, which allows us to do fat grafting from another part of the body to enhance the size. Many women wish to have breast surgery after pregnancy, or significant weight loss, to restore the volume and shape of their breasts.



Should I have implants or a lift?

The right surgical procedure for you depends upon your breast shape and your desired results. Someone who has smaller breasts may just need implants to achieve their goals. Someone who has larger but sagging breasts may just need a lift. Someone who has both—small breasts that are sagging—may need both an implant and lift, which can be accomplished in the same surgical procedure.

Can implants help change breast shape from its original natural shape?
Breast implants certainly will enhance the size of a deflated breast, especially after pregnancy. Women who have tubular breast deformity will also benefit from the shape changing effect of a breast augmentation.

When does insurance cover these procedures?

If you have had breast cancer and part or all your breast is missing, or you are unbalanced after radiation, then insurance will cover your breast surgery to balance shape and size. Breast reconstruction surgery using implants can also be performed after a mastectomy or injury. In some instances, insurance will cover breast reduction surgery. Yes, insurance companies require you to have symptoms of rashes, neck pain, back pain and that you are willing to be at least a half a liter smaller in size. There are certain criteria that must be met, and each insurance company is different.

Is there a minimum or maximum age for augmentation or reduction?

Typically, you want to be past puberty and not in the middle of any dramatic hormonal changes. You would want to wait at least six weeks after delivery and at least six months after stopping breast-feeding prior to doing any surgery. Also, after a pregnancy it would be important to get to your pre-baby body weight before making a major decision about your breasts. Your body will go through changes at different stages of your life, and as such, your breasts will change, as well.

Should there be routine checkups if I already have implants?

Yes, follow the suggestions of your primary care doctor or OBGYN as far as getting your scheduled mammograms done. You should also be conducting your own self checks. If anything feels out of the ordinary, or if you had a trauma to your breasts, you should bring it to the attention of your doctor. In most instances the implant company provides a lifetime warranty on the implants in case of failure. In the event something happens to the implant during the first 10 years, the manufacturer also covers the cost to replace the implant.

What are the risks/side effects associated with augmentation and reduction?

The effects of a any breast surgery last a lifetime as long as you understand that time and gravity will still be affecting you. Once augmented, your breasts will be larger than they otherwise would’ve been. Also after a breast reduction, your breasts remain smaller than they would’ve been, and once lifted, your breasts well remain perkier than they would’ve been. Time and gravity assure your breasts will never be perkier than the first few weeks after your initial surgery. It is essential you do monthly breast exams and maintain a schedule of annual mammograms after the age of 40. As with any surgery, immediate risks are bleeding and infection. The most common regret for a woman is that she is not as perky as she hoped to be. The most common reason for additional surgery is a woman’s goals for her body shape have changed and that she either wants to be bigger, smaller or more perky. Less common reasons for revision surgery is re-positioning an implant, fixing the implant pocket, or scar revision. There is a no increased risk of breast cancer following augmentation. Nipple sensation may be affected by any of the surgeries but is reduced when the incisions are placed along the crease between your breasts and your body. Many women have successfully breast-fed after augmentation, lift and breast reduction. Nipple sensation seems to remain similar although it can improve after a breast reduction. Any surgery involving the breast may change sensation.

Diane G. Bowen, MD, is owner of Golden Isles Center for Plastic Surgery, PC —1015 Arthur J. Moore Dr., SSI., with a full medical spa and plastic surgery services—for personal beauty inside and out. Call 912.634.1993. Dr. Bowen is founder and director of newly formed business, Centered on Wellness, at the same location.