Board Certified
Plastic Surgeon
Since 1989

Is Breast Augmentation Right for You?

Considering breast augmentation? Before diving in, it’s important to know the facts and what to expect.

Read on below to hear from plastic surgeon Dr. Shlomo Widder on everything you need to know about breast augmentation.

breast augmentation

Q&A with Dr. Shlomo Widder

breast augmentation

Read the Q&A with plastic surgeon Shlomo Widder as he answers questions about breast augmentation and how to decide if it’s right for you.

Q: What is breast augmentation?

A: Breast augmentation is a cosmetic surgery for women who want to increase the size of their breasts. Also known as “augmentation mammaplasty,” breast augmentation enhances both the size and shape of the breasts.

Q: What are the top reasons for breast augmentation?

A: Breast augmentation is one of the best investments a woman can make for herself. It increases self-esteem, confidence, their sense of femininity, and more.

It’s a symbol that is being being portrayed in the media all over, so women without sizeable breasts often feel deficient. At the end of the day, you deserve to feel good about yourself and your body – not for others, but for you.


You deserve to feel good about yourself and your body – not for others; for you.


I had one patient who was in high school. She didn’t participate in gym, never took off her shirt, and never went to the beach – because she was, in her words, “almost flat” and felt self-conscious.

She was very young – only 15 years old – but the negative psychological impact on her was so significant that her pediatrician and parents supported her without any hesitation.

So I did the surgery for her. I didn’t make them too big, just a full B, which is a moderate size. She was extremely happy after that. In fact, a few years later when she finished college, she came to my office out of the blue and thanked me for the positive change in her life. It was a wonderful feeling to know I had helped her.

Q: How often do you do breast augmentation?

A: I do it on a weekly basis. Breast augmentation is actually the most popular procedure in the United States. Millions of women have it done – millions.

I do maybe 2 or 3 breast augmentation surgeries per week for patients.

breast augmentation

Q: Who is your typical patient?

A: While typically our average patients are young women in good health, all sorts of people get breast augmentation done. We’ve helped breast cancer patients, women with different size breasts, transgender and transitioning patients, and women of all ages.

We absolutely do breast augmentation on transgender patients. It’s not a huge percentage of our surgeries, but I’ve done quite a few of them.

I had one patient – she had a very small breast on the right side, and the left side was large and droopy. So I did breast augmentation on the right side and a lift on the left side. So again, you have to deal with whatever comes to you, whatever the patient requires.

In plastic surgery, we say that breasts are sisters, not twins. That means they’re not identical. And most of the time, it’s a small discrepancy (25-50 CCs), but sometimes it’s larger and that’s when you have to use different implant sizes.


In plastic surgery, we say that breasts are sisters, not twins.


A few weeks ago, I worked on a patient who didn’t want to be too big on one side – she just wanted to be a full B size. I was surprised, as she was American, and typically my American patients have asked for C cups or larger.

She was a nurse and she told me she would feel uncomfortable going any bigger than a B. She was asymmetrical, so one one side I used 200 CCs. On the other breast, I used 275 CCs, so there was a 75CC difference. Now she’s almost perfectly symmetrical!

Again, it all depends on the clinical judgment of the surgeon, your chest size, and your desires.

breast augmentation

Q: What are the different types of breast implants?

A: There are three main types of breast implants:

  1. Saline – My preferred implant.
  2. Silicone Gel
  3. Gummy Bear – A base of silicone. It’s not gel, but it’s very soft.

There is also a new type of saline implant out there, which is highly sophisticated and has all kinds of compartments in it. As it is quite recent, I have not yet used it, but I know the technology is out there.

Q: Why do you prefer to use saline implants?

A: The reason I use the saline implant is that it costs less. Plus, you can use the subareolar incision instead of making an incision in the crease of the breast.

An incision in the crease is not the best in my opinion because the skin is thick and it can produce a thick scar, whereas most of the time, skin under the areola is very thin and heals very nicely. It’s barely visible because it’s along the line of the areola, which is also dark – darker than the skin.

The technique of using the subareaola is much better than the technique of using the crease because it allows for easier and better exposure of the cleavage area. If you look at results of doctors who use the crease incision, you can see that many of their patients end up with wide cleavage. The reason for it is that there are big blood vessels in the cleavage area that are going to the pectoral muscle, and it’s very difficult to control bleeding from the crease incision if you hit the blood vessel. When you use the subareolar incision, it’s very easy to control it because you see it. From the crease, it’s very difficult, it’s very far away, and overall technically difficult.

breast augmentation

Women’s main concern with breast augmentation is the cleavage area. They want volume and shape, but they also want nice cleavage. If you can’t deliver them nice cleavage, they’re disappointed. So the saline gives you a huge advantage by being able to use the subareolar incision as opposed to the crease incision to create better cleavage for the patient.

Another advantage with saline implants is that you have less capsular contracture with saline implants than with silicone implants.

Also, if you have a saline implant leak, you can exchange the implant with local anesthesia. You don’t need to go to sleep. With silicone implants, the patient must go to sleep because these leaks are difficult to clean under local anesthesia. It’s very uncomfortable for the patient as you scrape the silicone from the tissue.

So in my opinion, there are more advantages to the saline implant, and it costs less!

Did you know?

It is a myth that silicone implants are more natural. I have replaced lots of silicone implants with saline implants, to the delight of my patients.


Saline implants cost less than silicone implants.


Finally, silicone implants are still under investigation; the study wasn’t finished, so you don’t know what the final outcome is. With saline, we know it’s salt water and it doesn’t impose any risk to patients, whereas with the silicone you never know.

In addition, they just discovered that textured breast implants are associated with breast lymphoma (ALCL), which is a kind of cancer, though not breast cancer. This cancer is not associated with smooth implants such as saline. I use only smooth, so I don’t worry about that issue, but it just tells you to be careful – sometimes risks are discovered later on.

In my opinion, why use the silicone gel, which can theoretically cause a serious problem in the future instead of saline, which we know has no risks?

I don’t want to take any risks with my patients, and I want to give them great results, so the gel implant makes no sense to me. Saline is much better.


Q: How do you choose your new breast size?

A: Size preferences vary upon different people and even different cultures. In my experience, my Asian patients typically prefer small to medium-sized breasts. My American patients have typically requested larger breasts, especially those from Texas.

And there’s nothing wrong with either choice! It’s all up to the patient.

As plastic surgeons, we’re in the business of pleasing people. That’s what we’re supposed to do: please people. We’re not doing these surgeries for ourselves; we’re doing them for the patient.


Plastic surgeons are in the business of pleasing people.


You know, somebody recently defined plastic surgeons as psychiatrists with a knife. Because that’s what we do, right? We help build our patients’ confidence and self esteem.

So we try to deliver to the patient whatever they want, within reason, obviously. The way I select the size depends on the chest size, anatomy, and the desires of the patient.

The anatomy dictates the size of the implant as well, because the bigger the chest, the more volume you need to increase the breast size by cup size. For example, if you are a 32A, you need 125 CCs per cup increase. If you’re a 34A, you need 150 CCs per cup size. If you are a 36A, you need 175, and so on. So the chest determines the amount of volume you need to put in the implant to reach the goal.

A patient who’s an A cup and wants to be a D cup – that’s a 3 size increase- so you multiply it by the volume and the chest size. If you’re a 34, each cup size is 150 CCs, so the implants will be 450 CC.


150 * 3 = 450


That’s how I determine the size of the implant that the patient needs.

Not all doctors use that formula. Many of them use sizes, which means that during surgery they take different sizes, put them in, and then figure out which one looks the best and which one piques the patient’s desire. But that’s not as precise as my technique. My technique is more precise and more predictable.

It’s very rare that I have to replace implants because of not delivering the size the patient requested. It’s extremely rare that I’m incorrect.


Q: Who is a good candidate for breast augmentation?

A: In order to qualify for augmentation, you must have small breasts and be healthy. Most women are young, healthy women and there are no issues.

You cannot be on blood thinners. Some patients may have heart disease that requires treatment with blood thinners. Obviously, you cannot operate on those people as they can bleed.

Every patient with any medical problems, like diabetes, must be cleared by their physician for breast augmentation.

After the age of 45, all my patients have to get a physical and get approval from their family doctor on whether it’s safe for them or if they are low risk for the surgery.

Finally, the patient must have reasonable expectations and no serious psychological issues. If any of my patients takes anti-psychotic medication, I always send them to the psychiatrist to get clearance. Their psychiatrist will make sure they can get through the surgery safely.

Every surgery is stressful, so if they cannot tolerate the stress of surgery due to psychological reasons, they’re not a good candidate for breast augmentation surgery.

That’s why I send them to the psychiatrist to make sure they understand that if the result is not perfect, they’re not going to have a seriously negative reaction, such as suicide out of frustration. So that’s why it’s very important to get the psychological evaluation and clearance for surgery.


Q: Do most people need breast lift with augmentation?

A: Now, when you’re young you typically only get breast augmentation. However, sometimes you can have some droopiness when you’re young. That droopiness needs some kind of breast lift.

Typically you’ll need either a mini lift or a donut lift, with an incision around the areola. There’s no incision below the areola or under the breast, in the crease. But that’s usually for what we call level 1 or level 2 droopiness.

If you’re at level 2 or 3, for example, you’ll need to have a full lift, also called a keyhole lift. This usually only happens later in life, though I have seen this on young people if they’ve lost a lot of weight. After losing a tremendous amount of weight, the breasts may droop and hang, so they need the full lift.

Usually patients with significant weight loss also need the implants because the breast is not only droopy, but also volume was lost. The breast implants will add that necessary volume to their breasts.


Q: Do you have patients come in asking for you to fix breast implants other doctors did badly?

A: Many, many people come in asking for this. I have done hundreds of re-dos after another doctor botched the breast implants, or patients had complications.

Schedule a Breast Augmentation Consultation with Dr. Widder

Interested in breast augmentation? Then call the best plastic surgeon practice in Vienna, VA: Widder Cosmetic & Plastic Surgery Center. Simply call us at 703-506-0300 or click the button below to schedule your initial consultation.

breast augmentation

Is Breast Augmentation Right for You? | Widder Cosmetic and Plastic Surgery Center – Vienna, VA

2019 is “The New You Year”

What are the top New Year’s Resolutions?

Is it any surprise that the most common New Year’s resolution has to do with getting in shape?  Men and women both want tighter, firmer skin, a flatter, more toned stomach and more confidence within  our own skin.

The second most popular New Year’s Resolution is “Losing Weight.”  The effects of getting in shape can lead to weight loss, both minimal and significant.

If you’re one of the few that stick to their New Year’s resolutions to lose weight, get in better shape in order to build self-confidence and find that you still don’t feel good about yourself; Dr. Shlomo Widder is here to help.  He understands that no matter how hard you try, diet and exercise may not be enough to improve specific trouble areas on your body.

Dr. Widder has helped many patients with getting their confidence back with cosmetic surgeries such as; breast augmentation, butt lift and butt implants, liposuction, tummy tucks and more.  Call today to schedule your consultation with Dr. Widder.  Schedule before 2/28/19 and receive $300 credit towards your surgical procedure.

Happy Holidays

Wishing all of our patients and their family a Safe and Fun Holiday season. We are so thankful that you entrusted us with your cosmetic plastic surgery in 2018.  We also want to take a moment to thank all of our armed service men and women, police and firefighters that will not be able to celebrate with their families due to their commitment to protect and serve us. We thank you for your service and dedication.

We hope to see you again in 2019, even if it’s to stop in and say hi!

Breast Augmentation: Questions Answered

When women are having a “boob job” or breast augmentation, a major concern that is discussed frequently is in regards to the shape of the nipple and how the areola will change. Specifically, does having breast implants affect the size and shape of the areola?

When discussing “nipples,” what some women are really referring to is the areolas.  The center projection column is the nipple (where milk comes out when breast feeding).  The areola is the darkly pigmented skin of the center of the breast. Sometimes areola have some small bumps called Areolar glands or Glands of Montgomery.  Most women contemplating breast surgery have some concerns regarding the size and shape of the areola, not so much the nipple itself.

Do breast implants change the size of the areola?

The nipple areolar complex (the entire areola and nipple) will either be unchanged, may look a bit fuller, or get larger and have shape change.

Board certified plastic surgeon, Dr. Shlomo Widder, can perform mini lift or areola reduction procedure where some of the areolar skin is removed and a purse-string suture is used to cinch up the skin around the areola to achieve a narrower diameter to the nipple areolar complex.

What can be done if the nipples themselves are retracted?

The reason for the retraction is that there are ducts attached to the nipple from the underlying breast tissue which invert the nipple.  During the procedure by itself, or with breast augmentation, these ducts can be divided to allow a normal or non-retracted appearance to the nipple.   If the nipple is long or large, nipple shortening or reduction can be performed.

If you’re considering a breast lift, breast implants or breast augmentation within the Washington DC and Northern Virginia area, contact top rated, Dr. Widder of Widder Cosmetic & Plastic Surgery.  His private surgical suite is conveniently located in Vienna, VA for patients in DC, Arlington, Alexandria, Fairfax and Loudoun counties.

If you are thinking about have a cosmetic surgery procedure, time is running out to receive 5% discount on your procedure.  Must schedule your consultation with Dr. Widder by December 31, 2018 to qualify for the 5% discount.  Call 703-506-0300 today to schedule your consultation.

Cosmetic Procedures – Not just for women!

In today’s society, your appearance means a lot.   People form first impressions of you based solely on your looks.  Physically attractive people are more likely to be seen as dateable, reliable, marketable, worthy of a promotion, etc. Now more than ever, men over age 40 are undergoing cosmetic treatments to maintain an attractive, youthful appearance as the years pass. So what procedures are men seeking?  Widder Cosmetic & Plastic Surgery based in Vienna, VA has been assisting men within our area for many years with non-surgical and surgical procedures.

FACIAL INJECTABLES

Women aren’t the only victims of facial wrinkles, sagging skin, and volume loss due to aging. To help you look younger so that you can keep up with all the younger generations competing with you for promotions, facial injectable treatments for men is a great option. Injectables such as Botox, can treat moderate to severe frown lines, smile lines, sagging skin; and injectable fillers such as Restylane help with volume loss, giving a lift and tightening the skin. Injectables can even add definition to the chin to create a stronger-looking jawline.

CALF IMPLANTS

Men decide to have calf implant surgery for varying reasons. The obvious reason is unhappiness with the size and shape of their lower legs – specifically – the leg calf.  Once men have realized that no amount of exercise will significantly enlarge the calf muscles, they choose calf implant surgery. Calf implants are also used to correct deformities resulting from injury or nerve diseases that result in muscle deterioration.

LIPOSUCTION

Most men aren’t able to put in a lot of time in the gym due to career, family, and life.  They may be in their prime professionally, but they may not feel as on top of their game physically once they hit middle age. This is where liposuction becomes a possibility. Liposuction removes fat from the abdomen, revealing the muscles that are already present.

RHINOPLASTY

According to Dr. Widder, beyond liposuction, rhinoplasty is a very sought after surgical procedure by men.   Noses don’t particularly age like other parts of the face and body, but men that haven’t “liked” their nose through the younger years, are now in a position financially to be address their concerns.

GYNECOMASTIA

Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity or the use of certain drugs. Gynecomastia can cause embarrassment, causing men to avoid certain physical activities and intimacy simply to hide their condition.  Liposuction and removal of breast tissue are required to provide optimal results.  Men that have had this cosmetic surgery regain confidence, self-esteem and sense of masculinity.

If you or the man in your life is wanting a more youthful appearance, contact Widder Cosmetic & Plastic Surgery to discuss options; both non-surgical and surgical.   Dr. Widder will listen to your concerns and overall goals and provide a plan that will help reach those goals.  Call to schedule your consultation and book before December 31, 2018 to receive 5% off surgical procedure.

Does a Breast Lift Without Implants Achieve Good Results?

For many women seeking to enhance the appearance of their breasts via breast lift surgery, deciding whether or not to also receive implants can be a tough choice to make. A breast lift without implants works well in patients who are satisfied with their breast size but not satisfied with sagging and excessive overhang of their breasts and a low nipple position.  Usually, patients with breast size under a B cup request implants.

A breast lift will reshape the breast, raising the nipple to a better position and reducing the overhang of the breast.  The breast will not be smaller than it was before, just more youthful and with tighter skin.  There will be better fullness of the breast behind the nipple as the tissue is pushed upward and held in a tighter “skin envelope”.  Undergoing breast lift surgery without the placement of implants will typically leave patients with a little less upper pole fullness in the breasts, but will provide an easier recovery.

However, there is no way of creating more fullness in the upper pole of the breast without using an implant in small breasted women.  Restoring volume in a truly deflated breast is only achievable with an implant.

To have implants or not?  If a patient is undecided on what to do, Dr. Widder could recommend receiving a breast lift without implants.  Why?  Implants can usually be placed easily at a later date, giving the patient time to be absolutely certain about whether or not they want breast implants in addition to their lift.  It’s extremely important to discuss your overall aesthetic goals with Dr. Widder during your consultation to determine the most effective surgery plan for you as there are 3 types of breast lifts, and options for implants.

Dr. Shlomo Widder is a highly rated plastic surgeon serving the Washington DC and Northern Virginia area.  His office and private surgical suite is conveniently located in Vienna, close to Tyson’s Corner Mall.  Call 703-506-0300 to schedule your free consultation with Dr. Widder.  If you book your procedure before December 31, 2018, you will receive 5% discount on your surgical cosmetic procedure.

Take Advantage of Holiday Promotion

Have you been thinking about a New You for the New Year?  Wanting to have a little incentive to finally make that call to schedule your consultation?  Dr. Widder’s Holiday Promotion is just the boost you need as this promotion is only for a short time.

Save 5% off ANY surgical cosmetic procedure(s) to include; Tummy Tucks, Breast Augmentations, Liposuction, Butt or Calf Implants, Facial Procedures, etc.

Call to schedule your consultation 703-506-0300.  Procedures must be booked by December 31, 2018 to qualify for the 5% discount.

Widder Cosmetic & Plastic Surgery is conveniently located in Vienna for all patients in Northern Virginia, Washington DC and those traveling from other areas.

Preparation For Breast Augmentation Surgery

Q: Planning to have breast augmentation soon and had one consultation. The clinic did not need any mammograms or cardiogram. Is this normal?

Congratulation on your upcoming breast augmentation surgery, which is one of the best investment that you can make for yourself. It will increase your confidence, your self-esteem, your sense of femininity and will make shopping fun…

As far as tests before surgery, in my practice, if you are under the age of 45, healthy with no bleeding issues, no tests are required for breasts augmentation surgery. The only preparation that is required, is to comply with diet, supplements and medication sheet, to avoid bleeding and compromise of anesthesia.

You have to realize that not all results are the same, because experience, technical skills, and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely, to avoid bad result and need for corrective surgery.

Always, consult with experienced board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.

Breast Asymmetry

Q: I have slightly asymmetrical breasts. When I originally told my plastic surgeon, he said the asymmetry was minor, and that he did not recommend using two different sized implants. At my pre-op appointment, he said that we could use 304 and 339 natural style 15 implants to try to even them out. I am worried about having implants with different dimensions. I want to call him and ask him if we can just do the same size implants on both breasts. What do you think?

Thanks for posting your picture. From observing your picture, you appear to have size asymmetry (right breast bigger) and submammary crease asymmetry (right crease lower, bottoming out).

For symmetry purposes, I would recommend a larger implant on the left side (25cc more), and raise the right submammary crease. Not raising the crease will worsen the bottoming-out after surgery.

I have been in practice for over 30 years, and my preferred implants are smooth, round, moderate profile saline implants. One of the many advantages of these implants is the easy flexibility of size asymmetry correction.

Another important note: your cleavage is wide with irregularity. The most predictable way to achieve nice and symmetrical cleavage is by sub-areola incision, which allows easy dissection under direct vision and feel. A submammary incision is simply too far to reach to your upper cleavage.

Always consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and a natural look.

Breast Implants Size

Q: How come every doctor uses Mentor and Allergan but not Motiva Plus?

When you decide to have breast augmentation surgery, you should not choose the type of implants or the tools for surgery; but rather, choose a quality surgeon to avoid bad results and risking the need for corrective surgery.

Always consult with experienced, board-certified plastic surgeons, who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, and make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and a natural look.

The goal of surgery is to increase your confidence, your self-esteem, and your sense of femininity. The type of implants are irrelevant for those goals. You should select the surgeon that achieves the most attractive results to your liking.

Recurrent problems with breast augmentation

Q: In June 2016, I replaced my original implants from 1999. One was leaking. Everything went well. In October 2016, I had a folded implant and got it replaced with surgery #2. Today, Dec 2017, I have yet another leakage and am at a loss for what to do—fearing this is a pattern. Over the muscle, saline, 300cc. Do I change doctors? Now I have more costs to pay, due to no fault of my own! So frustrated.

Three strikes and you are out! If all 3 problems occurred with the same surgeon, then it might be smart to try another surgeon with a different technique or handling of the implants.

Another caveat is that it might be worth considering converting the subglandular pocket into the submuscular pocket for better coverage of the implants and more natural feel.

I have been in practice for over 30 years, and almost exclusively use saline implants under the muscles. Many of my patients are mothers and daughters, and it is in inconceivable that a mother would refer her daughter to me if she was happy with the outcome!

The good news with your situation is that you are a little over a year from your last surgery. In your case, the manufacturer will replace the implant for free and cover anesthesia and operating room costs. Unfortunately, the surgeon’s cost will not be covered and will be your responsibility (unless the surgeon agrees to wave it), since it is not the surgeon’s fault.

Always consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and natural looks.

Breast Implants Size Selection

Q: How many CCs should I go to get my desired look? I just went in for my pre-op appointment and loved the look of 300s using the sports bra method. But my doctor said I should order 385–415s to get the look I desire. I am currently a 34A, but DO NOT want to be a D cup. I desire to be a 34C, or large 34B. I am scared the 385–415s are too big! Help!

Front and side view pictures would have been very helpful. Breasts implants size selection depends on the patient’s desire, as well as chest and breasts circumference measurement.

So, if you are indeed a 34A cup size currently, you need 300cc implants to become 34C cup size. However, in my experience, many patients who wear A cup size bra are toward the smaller end of an A cup size.

If that is your situation, you might need 375–425cc, depending on your measurement.  Your surgeon has to take a direct measurement of your chest and breasts circumference in order to make the correct recommendation for your implants’ size.

Not all results are the same! Experience, skills, and aesthetic eye are critical for a good outcome. Do your due diligence carefully, and choose your surgeon wisely to avoid bad results and the need for corrective surgery.

Always consult with experienced, board-certified plastic surgeons from an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery and make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and are natural-looking.

Breast Asymmetry

Q: I had a revision surgery one year after the initial augmentation. I am now almost four weeks post op and am completely asymmetrical in size. The swelling has not gotten worse, but has not gotten better by any means. Is this normal? Should I be concerned?

Posting of front and side view pictures would have been very helpful.

It is difficult to opine without seeing your pictures or examining you. However, “I am completely asymmetrical in size” one month after surgery reflects something wrong with your recovery. If you have saline implants, one might have deflated; if you have silicone implants, you might have a hematoma.

In any event: yes, you should be concerned! Contact your surgeon as soon as possible for assessment, as it may be possible to take appropriate action (if determined by your surgeon).

 

Male-to-Female Breasts Augmentation

Q: I’m a male that wants to have more female looking breasts. How hard would this be to do?

Thanks for posting your pictures. From observing your pictures, you appear to be small A cup size with level 2 ptosis. Whatever cup size you elect to have, you should request a mini lift (donut, Benelli) at the same time, in order to get beautiful, perky, and youthful looking breasts.

Another strong recommendation would be to get saline implants, because they can be inserted through the sub areola incision, which allows for easy dissection of the muscles in the midline, under direct vision and feel that creates predictable, nice cleavage. Large silicone implants require long incision in the submammary crease, which is too far from the cleavage area and too close to the crease.

As far as implants’ size selection, you did not provide your chest circumference measurement in inches, which is critical for the correct implants’ size selection according to your desire. If you are currently 40 small A cup size, to become 40 C cup size, you will need implants with volume of 500 cc.

You have to realize that not all results are the same; because experience, technical skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely.

Always, consult with experienced, board-certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, and make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and look natural.

Replace Saline Implants With Silicone Implants

Q: I’m switching from Mentor saline implant under muscle to Allergan Natrelle Inspira under muscle. My existing saline implant is 375, overfilled to 425. I’m looking for the same (or maybe slightly bigger) size, with natrelle Inspira gel implant under the muscle. What size do I need? Is it true that when switching from saline to silicone, you need to go a little larger?

It would have been very helpful to see your front and side view pictures. I am curious to know why you want to change your saline implants to silicone implants, since, in my opinion, saline implants are superior to silicone implants.

I have been in practice for over 30 years, and performed breasts augmentation surgery on thousands of patients, using almost exclusively smooth, round, moderate profile saline implants made by Mentor. Many of these patients were mothers and daughters, and it is inconceivable that a mother would refer her daughter to me if she was unhappy with the saline implants.

One of the many disadvantages of silicone implants is that you will get long incision in the submammary crease, which is not scar friendly. Saline implants require only a small scar along the inferior sub areola line, which is very scar friendly.

If you insist on silicone implants, you do not have to change the size of the implants if you are happy with your current breasts cup size. Implants’ size is the same for silicone and saline implants.

Always, consult with experienced, board-certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of “redo” breast augmentation in the photo gallery; make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and look natural.

Redo Breast Augmentation

Q: My breast augmentation was just 15 months ago. The right breast never seemed to fully “drop”, however, and I’ve been told I need revision. The original doctor said he would go in and cut/release the muscle to let implant drop. A 2nd opinion said it is contracture and should score the tissue instead. Are these two ways to get same result? Are these diagnoses very different? I cannot tell and don’t know what to do.

Thanks for posting your pictures. From observing your pictures, you have significant problems on both sides:

  1. Left side: medial capsule contracture creating wide cleavage and lateral displacement of the implant. The corrective procedures are medial capsulotomy (scar release) and lateral capsulorrhaphy (internal bra).

  2. Right side: severe capsule contracture and smaller breast. If the breast is very hard, you will need capsulectomy (scar excision) and replacement of implant due to ‘biofilm’. If it is not very hard, just capsulotomy will suffice. The implant should be replaced anyhow, for size symmetry.

The procedures on both breasts should be done through sub areola incisions, which make the maneuvers and the dissections easier and more predictable, since they are done under direct vision and feel. Submammary or axillary approach is too far for comfort and consistency.

As you can see from your own experience, not all results are the same. Experience, technical skills, and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely.

Always, consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and natural looks.

Gummy Bear Breast Implants – Just Say Wait

The new Natrelle 410 cohesive gel implants have been conditionally approved by the FDA, but Dr. Widder explains why his practice is taking a wait and see approach. The natural look and feel of silicone and saline implants are an important consideration for those seeking cosmetic improvements.

gummy bear implants

Q: What do you think of the new breast implants, commonly known as the “Gummy Bear” implants?

They have been gaining a lot of interest lately, but for the most part, I really recommend people stick with the softer silicone or saline implants for a natural look and feel.

Q: What exactly are the “Gummy Bear” implants?  How do they differ from the implants you prefer?

The “Gummy Bear” type of implants are made of what is called cohesive gel.  Their official name is the Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Gel Filled Breast Implant.  They are considered form-stable, which means the gel substance makes them firmer than can either silicone or saline.  They are being manufactured by the healthcare company Allergan, Inc.  What they claim is that the implants will provide a natural “tear-drop” shape and that there will be less leakage in the case of rupture.  These claims are not yet proven.

Q: Do the “Gummy Bear” implants have official approval for use?

The Food and Drug Administration (FDA) gave them conditional approval in February of this year, which sparked the current buzz about them.  What people don’t realize is that the FDA’s conditional approval is not an endorsement.  Jeffrey Shuren, M.D., who is the director of the FDA’s Center for Devices and Radiological Health said, “We will be looking at the results from post-approval studies that will focus on their long-term safety and effectiveness.”  So Allergan, Inc. will be conducting a study that will follow 2,000 women and will take ten years.  Basically, the “Gummy Bear” implants are just entering a major trial stage.

Q: Do you have a sense of what the popularity or importance of these new implants might be in the future?

I believe they may show some promise for reconstructive surgery.  I don’t prefer them for the cosmetic surgery I do.  They are firmer and because of that, a larger incision is needed.  They can’t be inserted through a subareolar incision, which is the method I prefer to use.

I’m not the only surgeon who is wary of taking up the “Gummy Bear” fad.  Many doctors want to take their time to learn about them and to be sure they are making the right decision for each patient.  Dr. Oren Lerman of Lenox Hill Hospital in New York City commented on this to CBS in February.  He said, “These new form-stable implants are not necessarily a better product or a better choice for all women.”

I agree with that statement.  I still believe that for augmentation, saline implants are the best.  There is less scarring and they have the feel of a natural breast.  My patients love the results they get from saline implants.

Dr. Shlomo Widder, the “D.C. Butt Doctor,” offers premium services to fit every cosmetic surgery need in Northern Virginia, the Washington, D.C. metropolitan area, and beyond. To find out more about the Widder Cosmetic & Plastic Surgery Center, stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com.

 

*Individual results are not guaranteed and may vary from person to person. Images may contain models.