Ask the Experts

18 June 2010

This column of "Ask the Experts" is answered by Dr. Mark A. Eberbach from Hudson, FL. Dr. Eberbach is a highly skilled and experienced, board-certified plastic surgeon and an active member of the American Society of Plastic Surgeons (ASPS).

Q: What kind of scars will I have from a breast enlargement?
- Kelly, 34 - Columbus, Ohio

A: The scars that occur from having a breast augmentation (enlargement) can vary. There are 3 common incisions used to perform this procedure, the most common incision is under the breast at the crease using a 2.5 to 3cm (about an inch) incision for saline implants and about a 4cm for gel implants. The second most common incision used is the peri-areolar (nipple) incision. The (nipple) incision works well if there is a well defined color change between the areola and skin to camouflage the scar, which can be nearly invisible. The last incision used is the axillary (arm pit) incision. This scar is located away from the breast, but is most visible to the public in sleeveless clothes. The choice depends on your preference, your anatomy, and the final implant size. I use a device called the Keller Funnel with my gel implants, which requires a much smaller incision site. No matter what you choose, scars are rarely a problem.
- Dr. Mark A. Eberbach from Hudson, FL.

Q: Do breast implants need to be replaced after a number of years?
- Jess - Croton on Hudson, New York

A: There is no absolute time when a breast implant needs to be replaced. Implants could last a lifetime. Implants are replaced when there is a need such as deflation or "failure," or a desire to change the shape or size of your breast, such as after having children. There are minor differences in failure rates between manufacturers and type (gel or saline) and there is little clinical distinction. Trust your board certified plastic surgeon to help you with this choice.
- Dr. Mark A. Eberbach from Hudson, FL.

Q: How will my breast augmentation affect my future mammograms?
- Miranda, 28 - West Jordan, Utah

A: Breast implants do affect a screening mammogram's ability to see all the breast tissue, but this in not significant when breast cancer survival outcomes are considered.  A screening mammogram is sometimes suggested prior to elective breast surgery in women over 30, or if you have a positive family history. Magnetic resonance imaging or "MRI" is becoming more common in breast evaluation and even for breast screening. It is used to evaluate gel breast implants over time.
- Dr. Mark A. Eberbach from Hudson, FL.

Q: If I get a breast reduction and lift, will I be able to breast feed my future children?
- Heidi - Seattle, Washington

A: A breast lift and a breast reduction are different procedures. A breast lift rejuvenates a droopy breast and reverses the effects of weight loss, pregnancy, or unfortunate developmental shape. A lift makes you "perky." Often an implant is added with breast lifting to restore lost volume as well. A breast reduction makes a smaller and perky breast in women whose breast is too large and uncomfortable. There are different "styles" for these procedures. They each have different effects on breast feeding and on the final shape of your breast. Most breast lift patients will be able to breast feed but most breast reduction patients will not.
- Dr. Mark A. Eberbach from Hudson, FL.

Q: What's the difference between Botox and Dysport?
- Ashley, 39 - Miami, FL

A: Botox Cosmetic® and Dysport® both work by the same mechanism. They paralyze the muscles that are injected. In my staff's experience, the results from Dysport® have a quicker onset, but the injections hurt a little more than Botox Cosmetic® . They both work well and have a low incidence of complications. Neurolytic agents such as Botox cosmetic® and Dysport® are the most popular minimally invasive procedures performed by plastic surgeons because they work so well.
- Dr. Mark A. Eberbach from Hudson, FL.

"I hope you all have a great result from your surgery."
- Mark A. Eberbach, MD

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*Originally published on January 12, 2010