There are usually two issues with breasts that look like they have aged – skin excess (which manifests itself as breast droop) and a loss of fullness in the upper breasts.  Both need to be considered for optimal breast aesthetics.

In order to regain fullness of the upper breast, an implant will be necessary.  Implants will serve to increase the volume of the breast and also create more of a perky look.  That may well be the only procedure needed, provided there is minimal droopiness to the breast.

However, if there is sagging, without correcting the droop (i.e. the position of the nipple and areola); breasts can still look old even with their newfound volume.  A lift procedure can correct the droop by positioning the breast higher on the chest, which will help to increase the full appearance.

In a consultation I can immediately determine whether or not a lift is needed and just how much of a lift is necessary.  I can also determine what incisions would be needed.

All things considered, when the nipples have dropped to a level close to the fold, you should count on a lift being a very strong possibility in order to achieve the best results.  Book a consult with a reputable surgeon experienced in breast augmentation and then go from there.

Implants themselves do not increase the risk of cancer.  However placing implants above the muscle can slightly decrease the accuracy of mammography.  It’s important when getting them you inform the person doing the mammogram that you have implants, as they will take an additional xray of each breast in order to be able to view almost all of the breast tissue surrounding the implant.

Breast implants should not inhibit self-exams, and if there are any questionable problems that crop up with a mammogram, there are other methods of detection that can be implemented if needed, such as an MRI which is unaffected by implants.

For patients with an increased risk of breast cancer, I’d recommend a preoperative mammogram just to be sure there isn’t anything that should be investigated before surgery.  It also may be prudent find an imaging center that is comfortable imaging around implants.  Discuss this with your surgeon as it’s likely they will have a referral they can send you to.

In order to find the right implant size, I highly recommend consulting with a surgeon who allows you to try on implants at the time of your consultation.  This will give you the opportunity to try on actual implants so that you can see if a certain size gives you the result you are looking for.

Size is usually based on breast characteristics such as your personal goals and what you have pictured in your mind’s eye, as well as physical characteristics such as breast tissue elasticity, nipple location, current amount of breast tissue available, and the width of your breast.

You’d also want to keep in mind variables such as where you want your incisions, and whether or not the implant’s placement is well hidden beneath the breast.  As every body type is different, your unique anatomy would also play a role in size selection and choosing an option that ‘fits’ your body well.  I’d schedule a consultation and thoroughly discuss all possible options with your board certified plastic surgeon, before making any concrete decisions.

Congratulations on celebrating such a wonderful milestone!  By no means is being 50 a disqualifier for breast augmentation.  Good candidacy is left to your overall health, genetics, the health and condition of your skin and breast tissue, as well as your expectations.  I’d also recommend getting medical clearance from your primary care doctor beforehand.

You may have different goals for the breast augmentation surgery than a 20 year old would.  For that reason, I suggest that you be very open in what you are looking for and what your goals are with your surgeon.  I also recommend asking if they have experience doing breast augmentation with women in your age range.  Last, if you have any concerns regarding skin laxity, I’d also consider discussing the possible necessity of a breast lift  to compliment your augmentation.

This is one of the most frequently asked questions in my practice.  Breast augmentation prior to pregnancy is perfectly safe & while there is a very small chance of trouble with breastfeeding in some women, ultimately it should not affect the ability to breast feed.  This is especially true if you opt to have the implants placed beneath the muscle.

That said, if you’re actively trying to get pregnant right now, I’d recommend waiting until after the pregnancy to have your surgery anyway, as it is true pregnancy can often change the shape of the breasts, and even the size.  That may then require a possible additional surgery, in the form of a breast lift.

There’s no ‘yes’ or ‘no’ answer to this question. The most correct reply is that gummy bear implants may be ideal for one patient and not at all suitable for another, depending on body characteristics, age, skin type, size, and personal goals.

“Gummy bear’ implants, due to their form-stable shape, require a longer incision than standard round or tear shaped silicone implants and cannot be inserted into tiny incisions in an non-inflated form as can saline filled implants. They also require very precise positioning in the spaces created for them either under or over the chest muscles.  For this reason they are often not suitable to replace previous larger implants.

If you decide that ‘gummy bear’ implants are right for you be sure to chose a skilled plastic surgeon with expertise and experience using the new cohesive gel implants.

With the US FDA approval of silicone breast implants in November 2006, US plastic surgeons are again able to offer their patients a choice of silicone implants in addition to the commonly used saline filled implants. Throughout their 14-year ban silicone implants continued to be used in Europe and South America, and were also used under approved conditions such as reconstruction following mastectomy and in research within the US.

Advances have been made in the shape and consistency of silicone implants, one of them being the ‘gummy bear’ implant, so named because the consistency of the gel inside the implant resembles the popular chewy treat.

The ‘gummy bear’ has been on the market in France, Germany, Spain, and Japan for the past ten years. It is composed of exactly the same ingredients as the standard silicone gel implants; the difference lies in its form-stable shape due to more cross linking causing the silicone molecules to bond more to one another. Such cohesive gel implants can be sliced, punctured, or damaged and nothing will leak out.

If you’ve made the decision to have breast augmentation surgery and you’ve chosen a board-certified plastic surgeon, you now face the important step of selecting the breast implant that will suit your goals.

Here are three ways to ensure that you make the right decision:

• A full medical appraisal to match your age, weight, skin and body type and general health to an implant that best suits you from a medical standpoint.Some implants may not be suitable at all so you might as well eliminate those at the outset.
• Define your body image goals.Be sure you are clear about what size and shape you feel is ideal and discuss candidly with your plastic surgeon what you hope to achieve. This will help you to determine realistic goals and avoid disappointment later.
• Try them on for size.  Your plastic surgeon will let you touch and handle – and try on – any of the various implant sizes, shapes, and textures.He will also let you view ‘before and after’ photos to help you visualize results.

By the time your surgery date rolls around if you feel confident that you have made the right choice and are in possession of the full information you can look forward to successfully realizing your realistic goals.