Moneer Jaibaji, M.D.
Board Certified Plastic Surgeon
Breast Augmentation A-Z
Breast Implant Safety
The Consultation
Your breast augmentation plastic surgery consultation at Dr. Jaibaji office is an opportunity to meet Dr. Jaibaji and his staff as well. Our aim to make you feel comfortable with how you are treated and the way the office "feels."
The discussion with Dr. Jaibaji:
Dr. Jaibaji expects and welcomes any and all questions. In addition to asking your questions, Dr. Jaibaji will show you recent before and after patient photos. Most likely you will be shown photos of patients have similar shape to yours.
Dr. Jaibaji will address the following issues about the surgery itself:
- The risks and complications associated with breast implants.
- The number of operations you can expect over a lifetime.
- The shape your breasts will look if I choose to have the implants removed without replacement.
- The shape, size, surface texturing, incision site and placement site recommended.
- The long term shape of the breast.
- The ability to breast feed in the future.
- The changes to the implanted breasts after pregnancy or after breast feeding.
- The alternate procedures or products are available if I choose not to have breast implants.
- The manufacturer of your breast implant.
- The manufacturer product warranty.
- The voluntary patient registry.
Are you a candidate for breast augmentation?
A candidate:
If you are healthy women 18 years of age for saline implants and 22 years old for silicone gel implants.
Not a candidate:
If you are pregnant, breast-feeding, have an active infection anywhere in the body, have an existing, malignant or pre-malignant breast cancer for which you have not yet received adequate treatment, or are under the age of 18.
Other factors that can affect your decision to proceed with surgery:
Discuss these in detail during your consultation with Dr. Jaibaji
- Your health in general
- If you have healing problems, which can be affected by smoking, alcohol and certain medications
- Prior breast surgeries
- Infections
- Bleeding tendencies
- The tendency to develop a hardened capsule around the implant
Before Breast Augmentation Surgery
Before having your breast implant surgery, you will be given specific instruction to read these pre-surgery tips will help you prepare for this important and exciting day. Dr. Jaibaji will review these breast implant surgery tips with you.
- Stop smoking before your procedure and for some time afterward.
- Make sure Dr. Jaibaji is aware of any medications, supplements and herbs you are currently taking. Certain medications such as aspirin or ibuprofen can cause bleeding problems during the surgery and after. Therefore, do not take these medications for a few weeks before your procedure.
- Eat a healthy diet and avoid drinking alcohol a few days prior to your procedure.
- Exercise is generally good for your overall health; however, refrain from extremely vigorous exercise the day prior to your breast implant procedure.
- Do not eat or drink anything, including water, eight hours prior to surgery. Usually after midnight the night before your breast surgery.
- Remove nail polish from at least one fingernail and toenail to help the anesthesia person monitor your blood circulation during your procedure.
- The morning of your breast implant surgery you may brush your teeth, but do not swallow more than a sip of water. If you need to take any prescribed medication, swallow it with a small amount of water.
- Wear loose-fitting clothes that open in the front and comfortable flat shoes that slip on.
Making Personal Arrangements
Step 1: Make arrangements for someone to drive you to and from the surgery center as well as a friend or relative to stay with you for the first 24 hours after your breast surgery.
Step 2:, You may want to make arrangements for your children and their care as well. Prepare extra food ahead of time and have plenty of fluids and crackers available. Clear your responsibilities at home so that you can have a safe, worry-free, relaxing time to recover.
Step 3: Make sure your prescription medications have been filled and are in a convenient location. Dr. Jaibaji will tell you when you can resume driving a car, having sex and exercising.
Step 4: The list of things you will need to bring with you on the day of your surgery is short. Generally, patients should have their identification and a small bag to carry medications and paperwork. Dr. Jaibaji office will give you more detailed information when you schedule your surgery.
Breast Augmentation Procedure
Dr. Jaibaji will make an incision in the lower part of the areola to create a "pocket," or space under the muscle, for the breast implant. The breast implant will be placed in the pocket and positioned. Then the incision will be closed, usually with dissolvable stitches, and the wound is covered with adhesive tape. A sports bra will be applied after surgery and a band will also be applied to the upper part of the breast.
Where is the breast surgery performed?
Breast augmentation is most frequently performed on an outpatient basis in surgery center. Usually the surgery is performed at Grossmont Plaza Surgery Center or at Coronado hospital.
How long does the breast implant procedure take?
On average, the surgery lasts one to two hours.
What anesthesia will be used?
General anesthesia is used. A local anesthetic will placed into the pocket during surgery to reduce the after surgery pain. Anesthesia is provided by a board certified anesthesiologist.
What are the differences between incision site options?
With incision sites, the goal is always to choose the option that will result in the least obvious scar. There are three common incision sites used for breast augmentation: around the nipple (periareolar). This incision is the most concealed, or within the breast fold (inframammary) and under the arm (transaxillary). If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a pocket for the breast implant. (Umbilical/endoscopic: This incision site has not been studied and is not recommended.)
Types of implant pocket?
Here again, you have options. Breast implants may be placed sub-glandular, which is between the chest muscle and the breast tissue, or sub-muscular, which is below the chest muscle.
Sub-glandular (over the muscle) Breast Implant Placement
Over the muscle placement may make your surgery and recovery time shorter and it may be less painful. This placement also may make it easier to see and feel your implants through your skin after your surgery. Capsular contracture is more likely with sub-glandular placement, and imaging of the breast with mammography may be more difficult. In addition, for women with thin breast tissue, rippling of the skin may become an issue.
Sub-muscular (under the muscle) Breast Implant Placement
The sub-muscular placement may make surgery last longer, may make recovery longer and may be more painful. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography. The the risk of visible rippling is much lower.
The recovery from breast implant surgery
How will I feel the first few days after surgery?
You will probably feel tired and sore for several days, and your breasts may remain swollen and sensitive to physical contact for a month or longer. Therefore, rest is essential in the first few days after surgery.
How will the skin on my breasts feel?
You may also experience a feeling of tightness in the breast area as your skin adjusts to your new breast size and your breast implants.
Will I have to wear a special bra?
You may need to wear a sports bra, compression bandage, or jog bra for extra support and positioning while you heal. Usually for two months.
When can I resume my normal life?
Most patients are able to return to work within a few days. It’s best to avoid any strenuous activities that could raise your pulse and blood pressure for four to six weeks.
What else do I need to know about recovery?
An important note: If you experience fever, or noticeable swelling and/or redness in your implanted breast(s), you should contact Dr. Jaibaji office immediately.
Common Questions:
Breast Augmentation & Breast Implants
What gives the normal breast its shape?
The breast is an organ that is influenced by hormones, and gravity. The breast tissue consists of ducts and glands, encased by fatty tissue that provides its shape and feel. Beneath the breast is the pectoralis major muscle or chest muscle. Factors which may combine to stretch the skin and cause the breast to droop or sag include pregnancy (when milk glands are temporarily enlarged), rapid weight loss, and the effects of gravity as you age.
What type of silicone in breast implant?
Silicone is made of a semi-metallic that combines with oxygen to form silicon dioxide, or silica. Beach sand, crystals, and quartz are silica, which is the most common substance on earth. Heating silica with carbon at a high temperature can produce silicon. Further processing can convert the silicon into a long chemical chain called silicone - which can be a liquid, a gel, or a rubbery substance. Silicone can be found in many common household items, such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings, and chewing gum.
Is it safe to have silicone implant?
The Institute of Medicine concluded that: “There is no evidence that silicone implants are responsible for any major diseases of the whole body. Women are exposed to silicone constantly in their daily lives.
How long before I need to change the breast implants?
When deciding to undergo augmentation, be aware that breast implantation is likely to not be a one-time surgery. Breast implants are not considered lifetime devices. You will likely need additional surgery with or without replacement over the course of your life. You are likely to need additional surgery.
Many of the changes to your breast following implantation are not reversible. Problems such as deflation, capsular contracture, infection, and shifting can require removal of the implants. Many women decide to have the implants replaced, but some women do not. If you later choose to have your implant(s) removed and/or replaced, you may experience unacceptable dimpling, puckering, wrinkling, or other cosmetic changes of the breast.
Changes on mammograms after breast augmentation and can be mistaken for possible cancer, resulting in additional surgery to biopsy and/or removal of the implant to distinguish them from cancer.
What are the different shapes of breast implants?
The implants are available with textured or smooth surface shells. Breast implants come in either round or contoured shapes.
There are two main implants types: saline implants (saline is a sterile salt water solution, and is put into the implant by your physician at the time of your surgery) or silicone implants.
Am I eligible for saline breast implants?
Breast Augmentation - this procedure is done to increase the size and proportion of a woman's breasts. You must be healthy and at least 18 years old for breast augmentation.
Am I eligible for silicone breast implants?
Gel-Filled Breast Implants are indicated for females for the following uses (procedures):
- Breast augmentation for women at least 22 years old.
Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of a primary breast augmentation surgery. - Breast reconstruction.
Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the result of a primary breast reconstruction surgery. (A separate patient brochure is available for and should be read for breast reconstruction.)
Contraindications
Breast implant surgery is avoided in:
- Women with active infection anywhere in their body.
- Women with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions.
- Women who are currently pregnant or nursing.
Health & Pregnancy
Is there an increased risk of breast cancer with implants?
While the majority of studies do not show that there is concern for humans regarding implants and cancer, some studies do talk about the possibility.
Do breast implants interfere with mammogram?
Women with breast implants undergo mammography and other imaging techniques just as do women without implants. Dr. Jaibaji may ask you to have a preoperative mammogram and another one 6 months to 1 year after implantation to establish a baseline. With breast implants, routine screening mammography will be more difficult, and you will need to have additional views, which means more time and radiation. . Breast implants may complicate the interpretation of mammographic images by obscuring underlying breast tissue and/or by compressing overlying tissue. Accredited mammography centers and use of displacement techniques are needed to adequately visualize breast tissue in the implanted breast. You must inform mammography technologists about your implants so that the technologist can use special techniques to minimize the possibility of rupture and to get the best possible views of the breast tissue. Because the breast is squeezed during mammography, it is possible for an implant to rupture during the procedure.
Deposits of calcium can be seen on mammograms and can be mistaken for possible cancer, resulting in additional surgery to biopsy and/or removal of the implant to distinguish them from cancer.
What are the effects of radiation therapy on breast implants?
The literature suggests that radiation therapy may increase the likelihood of capsular contracture, necrosis, and extrusion.
Can I become allergic to silicone?
Silicone allergies are very rare. We are all exposed to silicone in our environment every day. Silicone is found in many household items, such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings, and chewing gum.
Am I a candidate for breast augmentation if I am over 50 years?
Yes; general good health is important, not age.
Will the breast shape change with weight fluctuations?
Yes, you should be close to your ideal weight. A significant loss of weight after receiving breast implants could alter the results in a manner that is not satisfactory to you. There may be some drooping (ptosis) and a reduction in size. A significant gain in weight would cause a breast size increase.
Will breast implant surgery affect nipple sensation?
Feeling in the nipple and breast can increase or decrease after implant surgery. The range of changes varies from intense sensitivity to no feeling in the nipple or breast following surgery. Changes in feeling can be temporary or permanent and may affect sexual response or the ability to nurse a baby. In general, about 60% of women will not see a change in nipple sensation.
Will my breast be soft and move like normal breast?
This depends upon multiple factors, such as the type and size of implant you receive, the way your body holds the implant and whether or not there is any degree of capsular contracture. It is possible for many women to have breast implants that are soft and move nicely, while other women have results that are firmer with an implant more fixed in position.
Do breast implants cause stretch marks on breasts?
Insertion of implants can cause stretch marks but rarely does. If you are concerned, you can go for a smaller size implant to minimize the stretching of the skin, or choose an adjustable implant to slowly stretch the skin over time.
Should I stop smoking before surgery?
Yes. Smoking causes the blood vessels to constrict, reducing the blood supply and the oxygen carried by the blood to the surgical area. The tissues need this blood supply and the oxygen that the blood carries in order to heal. When the blood supply is reduced, the tissue takes longer to heal. It is better to stop smoking completely before surgery.
When can I go back to work and resume exercise?
It is based on your job and the activities that you normally do. Dr. Jaibaji will address this issue during the consultation. Recovery periods vary from person to person. Generally the first few days are the most uncomfortable. The average time to return to full activities is four to six weeks.
Going into a Jacuzzi or bath after a month is usually ok. During the early time, one to two weeks following surgery, you don’t want to soak the incision.
When can I sunbath or tanning if I have breast implants?
Tanning at salons or sun bathing will not hurt the implant but may make the scars worse. You should avoid getting sun or tanning rays on the incisions for at least one year after surgery as tanning rays will turn the incisions dark permanently. The implant may feel warm and may take longer to cool down than your body. You may want to consider spray tan after surgery.
When can I fly after breast implant?
There may be slight expansion and contraction of the shell with changes in pressure. This may result in a small amount of air bubbles in the saline implant. With saline filled breast implants, you may feel or hear fluid sounds (gurgling). This should correct itself within 24-48 hours.
How long after breast implant surgery I can wear underwire bra?
Women wait 2 - 3 months before wearing under wire bras after implant surgery. Your body will be forming scar tissue around the implant for 3 months. During this time the pressure of the wires could cause the scar tissue to form in such a way that an indentation from the wires could become permanent. After this initial healing time under wire bras should be worn intermittently to avoid permanent indentation. In the first 2 – 3 months you are advised to wear sports bra.
Will pregnancy affect my breast implant or breast shape?
Yes, every woman is an individual and therefore has different results whether before a pregnancy or after. As part of the hormonal change with pregnancy, your breasts will enlarge and will go through all the usual changes associated with pregnancy. The amount of enlargement will vary from woman to woman and the size of the implants will factor into this as well.
Will I be able to breast feed after breast augmentation?
Breast implants may interfere with your ability to successfully breast-feed. With respect to the ability to successfully breast-feed after breast implantation, one study reported up to 64% of women with implants who were unable to breast feed compared to 7% without implants. The periareolar incision site may significantly reduce the ability to successfully breast-feed. Also correction of an inverted nipple will interfere with the ability to breast feed.
Is there a risk to fetus from silicone breast implants?
A review of the published literature suggests that the information is insufficient to show definitive conclusions.
Considerations & Potential Complications
What is capsular contracture or implant hardening?
It is a natural reaction to any device placed in the body to form scar tissue around the breast implant surface creating a capsule.
The scar tissue or capsule that normally forms around the implant may tighten and put pressure on the implant and is called capsular contracture. Infection, hematoma, and seroma predispose to capsular contracture. It is also more common with over the muscle placement. Symptoms range from firmness and mild discomfort, to pain, distortion, palpability of the implant, and/or displacement of the implant. In cases where pain and/or firmness is severe additional surgery is needed . This surgery ranges from removal of the implant capsule tissue to removal and possibly replacement of the implant itself. Capsular contracture may happen again after these additional surgeries.
How do I know if an implant is ruptured?
Saline breast implants deflate when the saline solution leaks either through an unsealed or damaged valve, or through a break in the implant shell. Implant deflation can occur immediately or progressively over a period of days and is noticed by loss of size and shape of the implant. Causes of deflation include damage during surgery, overfilling or under-filling of the implant with saline solution, capsular contracture, stresses such as trauma or intense physical manipulation, excessive compression during mammographic imaging, umbilical incision placement, and unknown/unexplained reasons. Deflated implants will require additional surgery to remove and to possibly replace the implant.
What are the risks of silicone breast implant?
Concern over the association of breast implants to the development of autoimmune or connective tissue diseases, such as lupus, scleroderma, or rheumatoid arthritis, was raised because of cases reported in the literature with small numbers of women with implants. After review of several large epidemiological studies of women with and without implants, the results indicate that these diseases are no more common in women with implants than those women without implants.
In addition, published studies indicated that breast cancer is no more common in women with implants that those without implants.
San Diego Area Cosmetic Breast Surgery - Coronado, California
Breast Surgery to Enhance Your Natural Beauty - Dr. Moneer Jaibaji
Many women feel unsatisfied with the size, shape, or firmness of their breasts. Breasts that do not meet a woman's own expectations may cause her to feel self-conscious or even embarrassed about her body. Some very large breasts may also present physical problems such as pain and difficulty with circulation and breathing. For women in San Diego and throughout the country who would like to change some aspect of their breasts, Dr. Moneer Jaibaji offers a variety of breast procedures that employ the latest techniques and technology to create natural-looking results with minimal visible scarring. Please view our before-and-after gallery to see outstanding examples of different breast surgery procedures that Dr. Jaibaji has performed.
Dr. Jaibaji is a Top Contributor on Breast Enhancement Q&A on Realself.
Our San Diego practice offers a wide range of plastic surgery procedures using the latest techniques to help patients make their cosmetic dreams a reality. Dr. Moneer Jaibaji is a highly skilled surgeon who believes that patient care and satisfaction should be the top priority.
Moneer Jaibaji, M.D. |1001 B Avenue, Suite 108 | Coronado, CA 92118 | Ph: (619) 522-0821
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