Breast Procedure FAQs

Dr. Kirn and Dr. Al Bayati are Plastic Surgeons devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body.

Augmentation / Lift

Frequently Asked Questions

Will implants lift my breasts?

Implants fill out the breast, but they do not lift it. If the breast appears droopy just due to lack of volume, simply placing an implant will correct it. If the nipple is sitting below the fold at the bottom of the breast, then a lift operation will be needed either with or without simultaneous implant placement. This determination is a key component of the consultation.

Will using an implant decrease my incisions for a breast lift?

Under some circumstances, adding an implant may decrease the number or size of incisions needed for a breast lift. These options are discussed with the patient at the time of the consultation.

Breast Reduction

Frequently Asked Questions

Will a breast reduction help my back, shoulder, and neck pain?

Although breast reduction is not a direct treatment for back pain, shoulder pain, or neck pain, these symptoms are almost always improved by having a breast reduction. Some patients have other reasons for these symptoms in addition to large breasts, such as arthritis. In those cases, the breast reduction will likely lead to an improvement, but not a resolution of the problem.

Will insurance pay for breast reduction?

Insurance coverage for breast reduction surgery varies by company. Many require patients to complete "conservative management," such as physical therapy, non-steroidal anti-inflammatory medications, and an evaluation by an independent physician, before considering coverage. Insurers may also use breast size relative to body weight to assess eligibility.

It's recommended that patients contact their insurance provider to understand specific requirements. Please note, our practice is considered "out of network" with most insurance companies, meaning patients are typically responsible for the surgeon's fee upfront, and reimbursement may vary depending on your plan’s out-of-network benefits.

Will I lose nipple sensation if I have a breast reduction?

Nipple sensation can be increased, decreased, or remain unchanged after a breast reduction, but most commonly, it remains unchanged. It is rare to lose nipple sensation altogether due to the procedure.

Breast Lift

Frequently Asked Questions

Can I have my breasts lifted without any scarring?

All breast lift procedures require incisions, which means some scarring is inevitable. However, our approach is to minimize scarring as much as possible and strategically place incisions to keep them as inconspicuous as possible. The extent of scarring largely depends on the degree of lift required. For minimal sagging, a scar may only be around the areola. More significant drooping may necessitate an anchor-shaped incision pattern, which includes around the areola, vertically down from the areola to the breast crease, and along the underside of the breast.

Will I lose nipple sensation with a breast lift?

It is relatively uncommon to lose nipple sensation following a breast lift. However, the risk can increase with the degree of droopiness of the breasts, as correcting more significant sagging involves moving more tissue, which can potentially disturb nerve pathways. Our surgical techniques aim to minimize this risk as much as possible, preserving sensation while enhancing breast shape.

Will the breasts droop again after breast lift?

After a breast lift, the breasts will continue to age naturally. Therefore, some degree of recurrent drooping over time is to be expected. However, the longevity of the lift results can be significantly extended if substantial weight fluctuations or pregnancy are avoided after the procedure. Patients who maintain a stable weight and do not become pregnant typically enjoy their lift results for many years.

What should I put on my incisions after breast lift surgery?

After your breast lift, we will provide detailed instructions on how to care for your incisions. While there are numerous products marketed for scar treatment, we have not observed significant benefits from these when an incision is healing normally. It’s important to follow our specific post-operative care recommendations to ensure optimal healing.

Will my breast size be smaller after a lift operation?

Breast lift procedures primarily involve repositioning existing breast tissue and removing excess skin to create a tighter, more elevated appearance. Typically, no breast tissue is removed unless specifically requested, so the actual volume of the breasts remains the same. While the breasts might appear slightly smaller due to the tightening of the skin, they often look the same size or even larger because the tissue is reshaped and repositioned more favorably.

Will my breast sit higher on my chest after a breast lift?

The anatomical position of the breasts on the chest wall is fixed, but a breast lift aims to elevate the breast mound to its natural center and reposition the nipple-areola complex accordingly. The inframammary fold (the fold at the bottom of the breast) remains in its original position, though minor adjustments can be made to correct congenital asymmetry. The overall effect of the lift is to enhance the breast shape and position, giving the appearance of higher, more youthful breasts.

Breast Implant Revision

Frequently Asked Questions

When should I have my breast implants replaced?

There is no mandatory timeline for replacing breast implants. However, you should consider replacement if you experience any problems, or if you wish to change the size or shape of your implants. In such cases, breast revision surgery may be a desirable option. If a leak is diagnosed, the leaking implant(s) should be replaced.

The FDA recommends monitoring gel breast implants starting at 5-6 years after surgery and every 2-3 years thereafter with ultrasound or MRI to detect silent leaks. Our practice offers ultrasound monitoring as a complimentary service to our patients. If a leak is detected, the implant(s) should be replaced.

I have old silicone implants which have ruptured, how are they removed/replaced?

The same incision used for your initial implant placement is typically used for the exchange procedure. When dealing with ruptured old gel implants, Dr. Kirn and Dr. Al Bayati aim to remove both the leaking implant and the surrounding scar capsule. However, if the implants and scar tissue are too fragile, some free silicone gel may escape into the breast tissue or may have already escaped prior to surgery.

During the operation, every effort is made to remove all the silicone gel, but it is usually impossible to remove every drop. Leaving a small amount of old gel in the breast typically causes minimal, if any, issues. The primary goal is to create as clean a pocket as possible for the new implant, if one is being placed.

How do I determine if my breast implants are leaking?

If saline implants leak, they usually deflate over a relatively short period of time—within hours or a few days—making it quite apparent. In contrast, leaks in silicone gel implants are more difficult to diagnose and cannot typically be detected through a physical exam.

Dr. Kirn and Dr. Al Bayati perform ultrasound evaluations in our office during your consultation, which is usually a reliable method to determine if an implant has ruptured. In some cases, MRI studies may be necessary to confirm the diagnosis. We offer complimentary ultrasound monitoring for all patients on whom we place breast implants.

Is it possible to place new breast implants after removal of old ruptured gel implants?

Yes, it is common to remove ruptured gel implants and place new ones during the same operation. This approach allows for immediate replacement, minimizing downtime and ensuring continuity in your breast appearance.

What will my breasts look like if I remove my implants and do not replace them?

The appearance of your breasts after implant removal (explantation) can vary significantly from patient to patient. In many cases, Dr. Kirn and Dr. Al Bayati recommend combining a lift operation with the removal of implants to improve breast shape if the implants are not being replaced. Alternatively, it may be best to simply remove the old implants, clean out the scar tissue, and allow the breasts to shrink down naturally before considering any additional procedures.

After implants are removed and not replaced, the breast tissue will contract, and this process usually takes six months to a year to complete.

Should I change my current saline implants out for gel implants?

There are no mandatory requirements for implant replacement if you are not experiencing any problems. However, many patients with long-term saline implants choose to replace them preemptively. Gel implants are often preferred for their natural feel compared to saline implants. Other reasons for considering surgery include a desire for a size change, shape change, or improvement in symmetry.

Breast Augmentation

Frequently Asked Questions

How much weight will I gain from breast implants?

The weight added by breast implants depends on the size you choose. On average, you can expect to gain about one pound, although this may vary slightly based on the specific implants selected.

What size implant will give me a C cup bra?

Determining the bra cup size after breast augmentation involves several factors including your initial breast tissue amount, chest width, and the implant size you choose. Additionally, different bra manufacturers may have varying sizing standards. During your consultation, we will guide you through a detailed sizing process to help set realistic expectations for your final cup size. However, it’s important to note that predicting the cup size is not an exact science, due to these variables.

Will I lose sensation if I have a breast augmentation?

Temporary numbness in the nipple or breast area is not uncommon shortly after surgery. However, the vast majority of patients regain normal sensation once fully recovered. While the nipple incision is sometimes associated with a higher risk of decreased sensation, our experience shows that this is quite rare. Thus, the risk of permanently reduced nipple sensation from breast augmentation, regardless of the incision type, is very low.

Which breast augmentation incision is best?

The choice of incision location for breast augmentation is a decision made collaboratively between you and your surgeon. Dr. Kirn and Dr. Al Bayati consider scientific data, particularly concerning incisions around the areola, to guide this choice. Each patient's unique anatomy and specific needs are paramount in this decision-making process. If one incision type offers advantages for your situation, this will be discussed during your consultation, ensuring you are well-informed and actively involved in the decision-making process.

Does one breast augmentation incision hurt more than the others?

Most of the discomfort experienced after breast augmentation is generally related to the stretching of the muscle and breast tissue to accommodate the implant, rather than the incision itself. As such, there is no significant difference in pain between the various incision types.

What happens if I get pregnant after breast augmentation?

During pregnancy, your breasts will undergo the typical changes expected as the glandular tissue enlarges, regardless of whether you have implants. The implants themselves generally do not impact your ability to breastfeed, though their effect can vary based on several factors:

Implants placed below the chest muscles are less likely to interfere with breastfeeding capabilities. The incision location for inserting the implants can influence breastfeeding. Periareolar incisions (around the areola) may disrupt milk ducts and nerves, possibly affecting milk supply. Inframammary (under the breast) or transaxillary (through the armpit) incisions are less likely to cause such issues.

The surgeon’s technique and the timing of the surgery relative to when you plan to become pregnant can also play significant roles. Having surgery well before pregnancy can help minimize potential breastfeeding problems.

After pregnancy and nursing, the breast tissue typically reduces to its pre-pregnancy size, but the implant remains unaffected. However, the stretching of the breast skin and tissue during this time may lead to shape changes. If these changes are significant and troubling, a breast lift may be considered to restore the desired breast contour.

What happens if there is a leak / deflation of the breast implant?

If a saline implant leaks, it will deflate, causing a noticeable decrease in breast size. This can occur rapidly, within a few hours, or more gradually over several days. Slow leaks over months are rare. The saline solution used inside these implants is the same as intravenous fluid, which the body can safely absorb without causing harm.

Detecting a leak in silicone gel implants is less straightforward, as they may not show obvious signs of deflation. Diagnostic imaging such as an ultrasound, mammogram, or MRI is often required to determine if there is a leak. The current FDA recommendation for patients with gel implants is an ultrasound or MRI 5-6 years after implant placement and every 2-3 years thereafter. Our practice has ultrasound technology to allow us to monitor gel implants as needed and according to the FDA recommendations. If a leak is confirmed, the implant should be replaced. We provide the recommended screening for the implants we place at no cost to our patients at our clinic.

For both types of implants, it is recommended to replace a leaking implant to maintain aesthetic results and ensure safety. Prompt consultation with your surgeon is advised if you suspect an implant leak.

Are breast implants safe?

Breast implants are among the most thoroughly tested medical devices in history, having been safely used in millions of women since the 1960s. There is no increased risk of breast cancer with the use of breast implants. However, like any medical procedure, they can come with some risks. These include potential complications such as implant leakage and capsular contracture (scar tissue that forms around the implant).

It's important to note that a very rare type of cancer known as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) has been linked to the use of textured breast implants. However, our practice does not use textured implants, significantly reducing the risk of this condition. For more comprehensive information, we encourage consulting the American Society of Plastic Surgeons’ resources.

Do I need to replace my breast implants?

There is no set requirement for replacing breast implants at any specific interval. Replacement is generally only necessary if you experience a complication or wish to alter the size or type of your implants for personal reasons. Both saline and silicone gel breast implants are designed to be long-lasting, and there is no mandatory replacement timeline for them.

Should I use a gel or a saline breast implant?

Dr. Kirn and Dr. Al Bayati offer both saline and gel implants, and the choice largely depends on your personal preferences and specific needs. During your consultation, we will discuss your aesthetic goals and conduct a thorough examination. There are occasions where one type of implant may be more suitable for you based on specific anatomical or personal factors. In such cases, we will provide detailed information to help you make an informed decision. Our priority is to ensure that you are fully satisfied with your choice and that the results meet your long-term expectations.

Can I break a breast implant?

Breast implants are designed to be very durable and can withstand a substantial amount of force. Incidents such as car accidents and falls, even from a height like off a horse, have occurred without resulting in broken implants. Normal activities, including vigorous exercise, generally do not impact the integrity of breast implants. Therefore, having breast implants does not necessitate restricting yourself from any activities. You can continue to lead an active lifestyle without undue concern about damaging the implants.

Do breast implants wrinkle?

Both saline and silicone gel breast implants can exhibit visible wrinkling, though this tends to be more noticeable with saline implants, particularly in slender individuals. The likelihood of seeing visible wrinkling increases if you have less body fat and breast tissue. Additionally, larger implants can also have a higher risk of wrinkling.

Placing implants under the muscle can help reduce the appearance of wrinkling compared to placement above the muscle, especially in individuals with minimal natural breast tissue.

Will I have cleavage after breast augmentation?

The amount of cleavage you can achieve through breast augmentation depends largely on your natural breast anatomy as well as the size of the implants chosen. If your breasts are naturally spaced wider apart on your chest, achieving pronounced cleavage may be more challenging. However, patients whose breasts are more centrally positioned, with nipples roughly midway between the center and the outer edge of the chest, are more likely to achieve desirable cleavage, even with modest-sized implants.

Will I look like natural after breast augmentation?

The natural appearance of breast augmentation largely depends on the choices made during the planning process. Generally, the larger the implant, the less natural the breasts may appear. For women with smaller breasts prior to surgery, placing implants under the muscle tends to offer a more natural look compared to placement above the muscle. Additionally, having more natural breast tissue can help in achieving a more natural outcome, as the tissue will drape over the implant and blend its shape with your body’s contours.

Which type of breast implant weighs more - saline or gel?

The weight difference between saline and gel breast implants is negligible when comparing implants of the same size. Both types weigh similarly, ensuring that the choice between them can be based on other factors such as feel and desired outcome rather than weight.

Meet Dr. David Kirn

Dr. David Kirn is an American Board of Plastic Surgery Certified Plastic Surgeon who is devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body. In private practice since 1998, he is located in a state-of-the-art facility which includes a full service skin care center. The practice is focused on personalized patient care and attention to detail. Where possible, Dr. Kirn utilizes minimally invasive procedures.

Meet Dr. Ahmed Al Bayati

Having completed his training in plastic surgery and serving as Chief Resident at the University of Kentucky, Dr. Al Bayati brings a wealth of expertise and dedication to his practice. His commitment to advancing patient care and achieving exceptional outcomes reflects his unwavering passion for plastic surgery.

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