Breast Blog

The Breast Augmentation Patient Cluster Phenomenon

Posted by on Nov 7, 2017 in Blog | 0 comments

Redheads come in clusters, according to Austrian biologist Paul Kammerer, who studied coincidences when he wasn’t studying salamanders. In the early 1900s, he spent hours on the streets of Vienna recording the height, hair color and type of hat worn by passersby. He observed that men with red hair tended to pass by in clusters – often in threes – proof of his “law of series.”

The Redhead Cluster Phenomenon makes sense to me because over the last 10 years, I’ve made a similar observation, which I call the “Breast Augmentation Patient Cluster Phenomenon”!

When I review the charts in the operating room before I begin surgery, I notice similarities: “Everyone’s Asian today, ” or “Everyone has a tattoo or piercing,” or “All of the patients are named Jamie – and so is one of the nurses!”

Is it a cosmic biorhythm or an unexplainable phenomenon? What are the odds?

According to the “law of truly large numbers,’ credited to mathematicians Persi Diaconis and Frederick Mosteller, “with a large enough sample, any outrageous thing is likely to happen.” I’ve performed a truly large number of breast augmentations and breast lifts – more than 7,000 – so perhaps I have a large enough sample.

I don’t know if these patient groupings are statistically inevitable or proof of Kammerer’s law, but I do know that my staff does not arrange the surgical schedule this way. Women choose their surgery date according to their convenience; we don’t choose it for them.

Some of the coincidences can be related to the seasons. We see large numbers of teachers and students who have the same school breaks. But most groupings are not seasonally related.

Even though my patients range in age from 18 to 67, on some days everyone is in their early 20s; on another day they’re in their 30s, on another in their 50s.

One day everybody might have children; on another day nobody has kids. One day all the women live close to my Philadelphia office, while on another day everyone comes from out of town. Some days all the women come in to the hospital with a bunch of family members; other days they are just dropped off.

I’ve also had days where all the patients were Hispanic, and others where they were all Italian, Indian or Russian.

I’ve had days where everybody was a nurse and others where all were a stay-at-home mom. And yes, I do have groupings of redheads, brunettes and blondes.

Sometimes, the women’s choice of breast implant size is the common denominator: Everyone seems to be choosing bigger implants one day, while others are “smaller size day” and “average size day.” This might correlate with the stature of the patients, which is another common denominator. They might all be tall and have big frames or all may be more petite.

I’ve also had days where all the patients were perkier and other days where all were droopier. And even though breasts are sisters, not twins, some days all the women are fairly symmetrical and on another day they are more noticeably uneven and are getting breast implants of different sizes.

Do other people notice this phenomenon? Does this phenomenon occur in other settings? Does a hairstylist notice that one day all her clients are redheads and on another day everyone says, “Just cut it a little bit”? At Dunkin’ Donuts, is one day all about glazed jelly donuts? Do the chocolate frosted donuts sell out on another day?

Maybe I’m observing these similarities because I’m solely performing cosmetic breast surgery, and that’s making the coincidences more statistically possible. But on a recent surgery day, when I was chatting with the OR staff and I asked them their favorite ice cream flavor, they all said mint chocolate chip.

There might just be something to cluster phenomena after all!

 

Breast Augmentation: Lessons Learned From 56,000 Breasts

Posted by on Sep 26, 2017 in Blog | 0 comments

I’ve examined a lot of breasts – at least 56,000 – during my career as a plastic surgeon. How’d I get to that number? About 7,000 women have come to me for breast augmentation surgery. On average, I see each woman about four times – once before her surgery and three times afterward for post-op visits.

So, 7,000 women x 2 breasts x 4 visits = 56,000. That’s not a problem that would have been on your sixth-grade math homework.

Through the years, I’ve observed every variation in breast size and shape, in breast perkiness and nipple size, and in women’s thoughts about their figure and their surgical goals.

If I could sum up what I’ve discovered in one sentence, it would be this: You shouldn’t make assumptions about who gets breast augmentation – and why.

Don’t assume that . . . 

. . . many of my patients are exotic dancers. Only about 1 percent of my patients are exotic dancers. The other 99 percent include teachers, nurses, hairstylists, construction workers, doctors, ballroom dancers, stay-at-home moms, company executives, waitresses, fitness trainers, bartenders, cheerleaders, policewomen who want to know how soon they can put their bulletproof vests back on, and women in all branches of the military who email us from Iraq and Afghanistan to set up appointments for when they are back in the United States. This is not a complete list.

. . . breast implants are just for younger women. True, the large number of breast augmentation patients are in their 20s, women who come in because they want to feel more feminine and self-confident. “It’s pretty bad when your 13-year-old sister can already wear your bra,” one woman told me.

The second largest demographic is in their 30s. Many women in this age range come in because they liked the fullness of their breasts during pregnancy and want to recapture that look. Others have lost weight and with it their breast volume.

Women 40 and older – and even in their 60s – come in for breast augmentation surgery, too. They want to look as good on the outside as they feel on the inside. They tell me they’ve been taking care of everyone else for years and now they’re ready to do something for themselves. Many have been thinking about breast augmentation for years.

. . . women get breast implants to attract attention. “Do you want to be proportional, turn heads or stop traffic?” That’s what one of my colleagues asks a prospective breast augmentation patient to see what she has in mind. I’ve tried it. Most women tell me they want their figure to be more proportional, and they want to fit better in their sweaters, bikinis and tank tops. Some comment that they wouldn’t mind turning heads now and then. Not many want to stop traffic. Ironically, some of my patients are policewomen who literally stop traffic – but they would rather not do it with their breasts.

. . . women get breast implants to make men happy. Only two women out of 6,000 have ever told me that their partner wants them to get implants. Instead, women have consistently told me that their partners love them exactly the way they are, and they are having surgery to make themselves look and feel better. So, sorry guys. Women don’t get implants to please you. That might be an outcome, but it’s not the motivation.

. . . a woman’s breasts are the same on the right and left side. Breasts are sisters, not twins. Few women have identical breasts; the difference might be slight or more obvious. Nipple position, chest diameter, the amount of breast tissue, the location of the breast on the chest wall, and how high or low a breast hangs all contribute to the appearance. With all these variables, it is no surprise that no one has identical twins.

. . . women need much guidance from me. Women know what they want. During medical training, we are taught that we should know the answers, that we are the authority. But I have discovered that women know best. My job is to listen carefully and to determine if there is a match between their goals and what I can accomplish. I believe I am an expert at figuring that out.

Here are the top 5 countries for breast augmentation, lift & reduction surgery. 

Can you make me a full C cup?

Posted by on Jun 29, 2017 in Blog, Videos | 0 comments

When women come in for their breast augmentation consultation, most tell me that they want to be a “full C cup.” They want to look proportional, and they think this means they will wear a C cup bra after surgery.

Problem #1: There is no standard bra cup-sizing system.
“C cup” can mean one thing if it’s made by Victoria’s Secret and another if it’s made by Vanity Fair. You might need a B cup in a full-coverage bra and a C cup in a demi bra, even if the same company makes both styles. Your cup size is also affected by how tight you make the band. If you wear it tighter, it will push your breasts deeper into the cup and you’ll need a bigger cup size.

Problem #2: What looks proportional varies from person to person.
Think of “proportional” as a “C look” rather than a “C cup.” To achieve the C look, a 5-foot woman with a small frame might only need a B cup while a 5-foot-8-inch woman with a large frame might need a D cup.

During each breast augmentation consultation, I show prospective patients before-and-after photographs of women who started out similar to them in height, weight, frame size and breast volume. Each photo notes the size of the implants that I used. Women look at the pictures and tell me, “too big,” “too small” or “just right.” It’s almost like looking through a magic mirror into the future. A woman is almost always consistent with the number of cubic centimeters (ccs) she likes, so I know what size saline or silicone breast implants to order to give her the look she wants on her body.

When we are finished, women almost always ask, “What cup size will I be?” This is where they can get into trouble. The letter doesn’t matter. They chose a look, and it looked right to them.

Here’s an example of that trouble: A 5’ 9” tall woman with a large frame wanted to be a full C. She liked eight different pictures; all had the same size implants and would give her a C look on her body. When I told her she’d probably wear a D cup, she said, “I don’t want to be a D.” She was stuck on the cup size. She decided to go smaller and was disappointed after surgery.

A woman with a small frame also wanted to be a full C. After voting on the pictures, she asked for her final cup size. I told her she’d probably wear a B. “Can you show me something bigger?” she asked. She had looked at larger implants, but didn’t like the pictures that were even a tiny bit bigger. She decided to stick with the size she liked in the pictures and was happy with her decision.

After my breast augmentation, do I have to sleep on my back?

Posted by on Jun 15, 2017 in Blog | 0 comments

There’s a myth that after breast augmentation surgery, you’ll need to sleep on your back for a week or longer. Many of my patients believe it, and they are worried that they won’t be able to get to sleep, because they normally lie on their side or their stomach.

They are not alone. According to the Better Sleep Council, fewer than 15 percent of people prefer to sleep on their back.

Let’s bust this myth: You don’t have to sleep on your back after breast augmentation surgery. You don’t have to stay up all night to make sure you don’t doze off and turn over onto your stomach. You can sleep any way you want.

Saline and silicone breast implants won’t pop if you sleep on them; they are extremely durable and can withstand a lot of weight. In fact, Allergan, an implant manufacturer, tests its implants by exerting 55 pounds of force on them repeatedly, up to 6.5 million times. (That would be equivalent to sleeping on your stomach for the next 17,808 years.)

Just as your contact lens can’t slip behind your eye, your breast implants can’t disappear into your body. They are carefully positioned in a space (a pocket) behind the pectoral muscle. Just like contact lenses, the implants can’t go anywhere because they bounded by muscle and strong tissues. The normal movement in the pocket won’t disrupt your healing.

The only factor limiting your sleep position is comfort. Most women tell me that they are fully comfortable sleeping on their stomach in about three weeks on average. They are comfortable sleeping on their side much sooner.

Sweet dreams.

The information above  is what I tell my patients to do and to expect after breast augmentation surgery: Each doctor has his or her specific postoperative protocol, and it might vary greatly from what you read here. It’s imperative that you follow your doctor’s instructions.

Breast Augmentation: It’s Easier the Second Time Around

Posted by on Jun 1, 2017 in Blog | 0 comments

Times change. And so may your breast size – especially if you’ve been pregnant or had a significant change in your weight.

During pregnancy, breasts enlarge from hormonal changes and milk production. Afterward, they could return to their original size or get smaller or bigger. Because breasts are made up mostly of fatty tissue, they will get bigger or smaller as you gain or lose weight. In fact, they are often the first indicators.

Although your breasts may change, your breast implants will remain the same. They don’t need to be replaced every 10 years. I recently changed a woman’s implants after 23 years – she had a child, got smaller and wanted to go bigger – and the implants looked the same as they did the day I put them in.

About 10 percent of my breast augmentation patients come in for a consultation to get information about making a change. The average time elapsed is about 10 years, though it varies greatly.

They tell me, “I’ve gained a lot of weight, and I’m much bigger than I want to be. I’d like to go a little smaller.”

Or, “After my two children, my breasts got smaller. I just want to get my pre-pregnancy size back – and maybe a little extra.”

Others say, “I went for the gusto 15 years ago. I’ve enjoyed them and they served their purpose, but now that I’m 50something, I just want them a little smaller.”

Like the first time, we look at before and after photographs of women who started out similar to them in height, weight, frame size and breast volume. They tell me, “too big,” too small” or “just right” so I know what size implants to order.

Breast augmentation surgery is easier the second time around. Here’s what’s involved in upsizing or downsizing:

Less discomfort: To change each implant, I go through the same incision that I made initially in the crease beneath the breast. I don’t have to make a pocket beneath the chest muscle for the implant, so there is less manipulation of breast tissue and therefore less discomfort post-op. All you’ll feel is the incision. Consequently, you’ll likely need less medication after surgery for discomfort.

Shorter procedure time: This second surgery takes less time than your initial breast augmentation surgery, which means less anesthesia and a lower possibility of post-operative nausea and vomiting.

Shorter recovery time: You should still take it easy for a week, but you could probably get back to work on the third day because there is much less chance of bleeding. So if your surgery is on a Friday, you could return to work on Monday. First-timers are generally back to work in an office setting in 5 days. And you don’t have to wait until the sixth week to do upper body weights. You can start up again after three weeks.

Quicker results: Because your skin and chest muscles have already stretched to accommodate your implants, the implants won’t start off high like they did the first time. You’ll pretty much see the final result when you get home. After surgery, I’ll have you wear something supportive like a sports bra for three weeks to protect your incision. At that time, you’ll be able to wear and do anything and everything you want. No waiting eight weeks this time to go shopping for new bras and bathing suits.