Breast Augmentation

Although all surgical procedures come with some degree of risk, breast augmentation is generally considered very safe—especially when performed under the care of a board-certified plastic surgeon like Dr. Holzman. In order to promote optimal healing and results, it is important to carefully follow all of Dr. Holzman’s post-operative instructions and to attend your follow-up appointments as directed.

We also understand that many patients may be concerned about the apparent links between breast implants and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). BIA-ALCL is a very rare form of immune system cancer that has been associated with certain types of breast implants—predominantly specific kinds of textured breast implants—and tissue expanders. It should be noted that the risk of developing BIA-ALCL is very low, and the condition can typically be treated quite effectively when discovered early. That said, all of us here at Become Plastic Surgery take your comfort and safety very seriously, and we want our patients to feel confident and empowered throughout their breast augmentation journey. In response to concerns surrounding BIA-ALCL, Dr. Holzman will not be utilizing textured breast implants or tissue expanders at this time.  

The following is a direct quote from the American Society of Plastic Surgeons regarding BIA-ALCL:

“Women with saline and silicone gel breast implants may have a very small and possibly increased risk of developing anaplastic large cell lymphoma (ALCL) in the scar capsule adjacent to the implant. This is a very rare disease and is currently being investigated as to its relationship to breast implants, and whether this is even a cancer or a Lymphoproliferative Disorder. ALCL is an extremely rare cancer of the immune system which can occur anywhere in the body. The National Cancer Institute estimated 1 in 500,000 women per year in the U.S. are diagnosed with ALCL. ALCL in the breast is even rarer with approximately 3 in 100 million women in U.S diagnosed per year. The relationship between breast implants and ALCL is unclear and is currently under investigation. In most cases, women observed changes in the look or feel of the area surrounding the implant after their initial surgical sites were fully healed. Patients with breast implants should be followed by a surgeon over time and seek professional care for implant-related symptoms such as pain, lumps, swelling, or asymmetry. Patients should monitor their breast implants with routine breast self exams and follow standard medical recommendations for imaging (e.g. Mammography, Ultrasound, MRI). Abnormal screening results or implant-related symptoms may result in additional costs and expenses for tests and/or procedures to properly diagnose and treat your condition. Tests and procedures could include but may not be limited to: obtaining breast fluid or tissue for pathology and laboratory evaluation and surgery to remove the scar capsule around the breast implant, implant removal or implant replacement.” 

During your consultation, we are happy to answer any further questions you may have about breast implant safety and BIA-ALCL risks. 

The longevity of your breast implants will vary based on a number of factors, including the type of implants placed (silicone vs. saline), your existing body type and breast tissue, and your lifestyle habits. That said, modern implants are designed to be quite durable, and many patients find that their implants can last for decades without replacement. 

The need for a breast implant revision, exchange, or removal can arise for a number of reasons, including personal aesthetic choices or complications such as capsular contracture and/or implant rupture. It is important to be vigilant about the state of your implants, and if you notice any changes in shape or volume, feel a tightening or hardening of the breast tissue, or experience any discomfort, you should contact your doctor. It can also be helpful to have the state of your implants assessed by a board-certified plastic surgeon every 5-10 years to ensure they are still in good condition. 

The best type of bra to wear after breast augmentation will depend on the stage of healing you are in. Immediately after surgery, patients should wear a special compression bra without underwires. These garments are designed to help support the breasts, keep any dressings in place, and restrict excess movement in order to promote faster healing. A compression bra will typically need to be worn both day and night for a few weeks after surgery, at which point you can transition to a sports bra. When picking out your sports bras, it is best to find highly-supportive garments without underwires. Underwires can irritate your incisions and interfere with healing. Choosing a front-clasping bra can also help limit the amount of effort needed to remove it, which can be helpful while you heal.  

Healing times vary from patient to patient, and it is important to consult with Dr. Holzman before transitioning to any bras that have underwires. Dr. Holzman also recommends investing in quality bras that will provide your new implants with proper elevation and support. A supportive bra can help extend the longevity of your implants and keep them in good condition for years to come. 

Implants should not negatively impact your ability to breastfeed in most cases. However, you should talk to Dr. Holzman about any future childbearing or breastfeeding plans you may have during your consultation. This will allow him to approach surgery and implant placement in such a way as to yield optimal aesthetic and functional results.

Mammograms are an important screening tool when it comes to detecting breast cancer, and Dr. Holzman encourages all women of the appropriate age to schedule regular tests. When you go in for a mammogram, you should be sure to inform the technician that you have breast implants, which will allow them to adjust the screening process accordingly. This often entails taking extra images from different angles in order to visualize the entirety of the breast around the implant. If you are at a particularly high risk for breast cancer or if you simply wish to ensure your mammograms go as smoothly as possible, Dr. Holzman can also discuss submuscular implant placement with you. Submuscular placement positions the implant under the pectoral muscles, rather than on top of them (as in the case of subglandular implants). This allows for less interference during mammograms.

Dr. Holzman recommends that patients sleep on their backs in an elevated position for the first few days to weeks after breast augmentation surgery. This keeps the implants in a more ideal position while the protective tissue capsules form, optimizing your aesthetic results. Sleeping in an elevated position can also minimize swelling and improve circulation for more efficient healing.

Dr. Holzman will provide you with detailed pre-operative instructions in advance of your breast augmentation procedure, which you should follow carefully. Some generalized tips for optimizing your recovery period include:

-Arrange to have someone drive you to and from the hospital on the day of your procedure
-Do as many household chores as you can in advance of surgery so that you won’t have to worry about them during your recovery
-Pre-make nutritious, easy to digest meals that are simple to heat up or that can be eaten cold
-Schedule time off from work and make childcare arrangements, as needed
-Prepare loose, comfortable clothing—preferably items that button or zip in the front so you won’t need to raise your arms above your head while changing
-Consider having a caregiver either present or on-call for at least the first few days after surgery
-Get a good night’s sleep the night before your procedure

Dr. Holzman generally recommends that patients wait at least six weeks after breast augmentation surgery prior to resuming their usual workout routine. This ensures that protective tissue capsules have time to form around your new implants, keeping them in the desired position. If exercise is resumed too early, it can disturb the breast pocket and disrupt capsule formation, leading to a range of side effects, including implant dislocation, breast asymmetry, and even implant rupture. Exercising too soon after surgery can also irritate or even reopen your incisions, increasing the risk of infection and delaying healing.

During your post-operative appointments, Dr. Holzman can offer personalized guidance regarding how and when to resume specific physical activities.