Frequently Asked Questions:
Breast Procedures

3 weeks after surgery: You can go tanning and swimming!

You will be able to go swimming because the incision will be healed three weeks after surgery.

If you chose to tan 3 weeks after, make sure to protect the incision with sunscreen that is SPF 15 of higher so the scar won’t become dark.

 

8 weeks after surgery: Swelling will go down and you will have an accurate idea about your new breast size!

That means 8 weeks after surgery it is time to go shopping and buy new bras, swimsuits, and other clothes!  It is essential that any decisions that take into account your breast size, such as a wedding dress, should not be decided until 8 weeks after surgery.

 

Factors to consider before having a breast augmentation:

1. Pregnancy

A breast augmentation will NOT affect your pregnancy.  You will still be able to breast feed.  Pregnancy, however, does affect one’s breasts.  After being pregnant some women’s breasts get smaller, others bigger, and others droopier.  That means if you get a breast augmentation and soon after get pregnant your breasts may change and you could need a revision surgery to get them back to how they were before you were pregnant.  So if you plan on getting pregnant take that into consideration while thinking about your breast augmentation surgery.  You can even wait until having your child or children and add a tummy tuck and get what we call a mommy makeover!

2. Weight loss

Weight loss can cause one’s breasts to decrease in size or can result in droopy breast due to there being more skin than there is fatty tissue in the breast.  That means if you are planning on losing weight you should ideally do so before your breast augmentation.  The reason for this is so that the excess skin can be factored into the surgery and taken care of so you do not finally have the breasts you want only to lose weight and then have your breast droop.  However, if you end up losing weight then you should also check out Dr. Makhlouf for a tummy tuck in addition to your breast augmentation!

During consultation for breast augmentation there are essentially three decisions that the doctor and the patient have to make:

1. The type of implant: saline or silicone

2. The size of the implant

3. And whether to place the implant above the muscle or below the muscle

The decision process can be made starting with any of those issues. But it is important to understand that any decision we make will affect one or both remaining issues.  A decision in one affects the choices in the other; therefore, they cannot be made independently of one another.

For example, starting with decision one: saline or a silicone implant. 

We know from a previous blog that a silicone implant before it is inserted in a patient is softer than a saline implant.  The saline implant has more projection per volume than a silicone implant (which is why the companies are coming up with firmer types of silicone implants to increase the projection similar to a saline implant).

Let us assume you decided to use a saline implant, the next question will be: Is there adequate cover for the implant? Adequate coverage is defined by having enough breast tissue to avoid the result from being an unnatural round ball on the chest, and hiding any rippling of the implant.  If coverage is deemed insufficient particularly in this superior pole of the breast then one will have to resort to a sub muscular placement. Here, a decision in issue number one has affected issue number three.

On the other hand, if a silicone implant is chosen and you want projection, then a larger implant needs to be selected.   

Here we see that the type of implant is impacting on the size of the implant.

Let us take another example: Looking at the implant size, the goal of using a large implant is to enhance projection.  However when a large implant is chosen, your doctor needs to assess whether there is enough tissue to provide adequate coverage for the implant.  If that is not possible then one might recommend a saline implant to obtain a better projection with a smaller volume (issue number1). So in this example the size of the implant has an impact on the type of implant

Now if we insist on a larger On the other hand, if you insist on a large implant and the type is saline implant, it will have to be placed in a sub-muscular position to improve coverage. (issue number 3).

Again here making choices in one and two has affected the choice we have in issue three.

Because of the complexities of the decisions, it is important to have an experienced surgeon and one who takes the time in the consultation to make the right choice for you. It should not be relegated to a staff member other than your surgeon. In Dr Makhlouf’s office the decision is shared between the doctor and the patient and the thought process explained.

Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

When to consider Breast Augmentation

      • If you want a better proportioned or more appealing figure
      • If you wish your clothes fit better
      • When pregnancy, weight loss or aging has affected the size and shape of your breasts
      • To restore symmetry if one of your breasts is smaller than the other

 

Is Breast Augmentation safe?

It is important for women with breast implants to keep in mind that while breast implants are intended to last your lifetime, replacement may become necessary. After breast implant surgery, you should have periodic examination by a board-certified plastic surgeon to monitor your implants.

Silicone gel?filled breast implants have been under scrutiny for years, but after gathering detailed and meticulous research and data, the FDA has approved them for use in cosmetic breast enhancement surgery, finding no link between silicone gel breast implants and connective tissue disease, breast cancer or reproductive problems. In addition, the FDA has approved three companies to develop and market breast implants and continue to collect data on their long-term safety and efficacy. For more information, please see the FDA breast implant information provided on their site.

Surgical techniques for breast augmentation and all breast implants are continually being refined, increasing the safety and reliability of the procedure. Ask your Dr. Makhlouf to provide you with the information you need to make an informed decision.

How do I prepare for a breast augmentation procedure

Dr. Makhlouf will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.

 

To help detect and track any changes in your breast tissue, your plastic surgeon may recommend:

  • A baseline mammogram before surgery
  • Another mammogram a few month after surgery

In advance of your procedure, Dr. Makhlouf will ask you to:

  • Stop smoking at least 6 weeks before undergoing surgery to better promote healing.
  • Avoid taking aspirin and other certain anti-inflammatory drugs that can increase bleeding.
  • Hydrate, regardless of the type of surgery, hydration is very important before and after surgery for safe recovery.

For breast augmentation using autologous fat transfer, you may be instructed to wear a special bra to expand the skin and tissue around the breasts to prepare them for fat injection.

Breast augmentation is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

 

Maintain a relationship with your aesthetic plastic surgeon

For safety, as well as the most beautiful and healthy outcome, it’s important to return to see Dr. Makhlouf’s office for follow-up evaluation at prescribed times and whenever you notice any changes in your breasts. Do not hesitate to contact us at 847-297-8001 when you have any questions or concerns.

Studies show that body confidence can radiate outwards affecting all areas of a person’s life!  Looking your best means feeling your best and now more than ever before women can feel better about their shape.  Breast Augmentation is a procedure done to increase the size and improve the shape of a woman’s breasts with a silicone or saline implant.  Patients in Chicago may choose to undergo Breast Augmentation Surgery for a variety of reasons: the desire to make the body more proportional, restoring volume and firmness to breasts that have lost their shape due to age or breast feeding, and creating symmetry for breasts that differ in size or shape.

Breast augmentation implant surgery requires careful consideration, so partner with an experienced surgeon like Dr. Makhlouf for trusted results.  

For many years, fat transfer from one part of the body to the other was thought to only be a temporary correction.  However, over the last few years a large body of evidence, both scientific and photographic have shown that if the fat is transferred properly, it can result in a permanent solution.

Early on there was a lot of fear that fat placed in the breasts would melt away, possibly create cysts, and more importantly create calcifications that would hide a present cancer by decreasing the efficacy of mammographic detection. There have been multiple reports in the literature which indicated that a radiologist is in fact able to distinguish between malignant calcification and benign calcification that could have resulted from fat placement in the breasts.

Studies have also shown some amazing results which support that fat grafting has improved the quality of the skin under which it was grafted. The safety of the procedure along with its incredible results have brought fat grafting to the breasts into the cutting edge of cosmetic surgery.

On a trial basis Dr. Makhlouf has injected breasts with fat obtained through liposuction and has monitored the results. He was performing this trial of fat grafting to the breasts while doing another main procedure on the patient. He has been able to document survival of the fat and the patients have been quite happy.

It is worth mentioning that it is impossible to place large amounts of fat in the breasts in volumes similar to the sizes of breast implants. Many patients who desire breast augmentation want breast implants of 300 to 400cc in volume. Fat grafting to the breasts cannot be expected to add to more than 200 cc in volume, therefore, a repeat procedure would be needed if one wants the augmentation done with fat alone.

Breast Enhancement with Implants

Learn about the various breast procedures in Chicago.

Patients interested in breast enhancement are frequently confused about the choices and options available to them regarding the type and size of implant, location of implant placement ( under or over the muscle) and the type of incision.  There are many reasons for the confusion, one of which is because questions cannot be answered independently of one another and therefore various decisions need to be made simultaneously.  The other reason for confusion is that much information is biased and opinionated and does not allow for a rational decision.

I am going to start with the most difficult issues regarding the type of implant to use, saline versus silicone and its placement, above or below the muscle.

Let’s provide some factual information:

1. Saline implants require a smaller incision.

2. Saline implants provide flexibility in scar location.

3. For a given final volume, the envelope in a saline implant is smaller than that of a silicone implant resulting in a firmer implant as it lies outside the body.

4. Saline implants placed under the muscle tend to feel softer than above the muscle.

5. The firmness of the breasts is directly related to the scar tissue formed around the implant, inversely proportionate to the amount of breast and muscle tissue in front of the implant and the inherent firmness of the implant.

6. When an implant is placed underneath the muscle only the upper inner part of the implant is covered with muscle. The outer and lower part of the implant is covered by whatever breast tissue, fat, or skin is available.

7. Silicone implants are much more amenable to placement above the muscle.

8. Silicone implants are more expensive than saline implants.

9.  Silicone implants are felt to be longer lasting than saline implants, but the present type of implants have been on the market only since 2006 and have been implanted in trial since 1992.

10. Implants placed subpectorally have three drawbacks:

  • They are more painful in the immediate postoperative period.
  • They can occasionally result in distortion of the breasts with muscle contracture.
  • If the patient has some breast tissue and the breasts themselves are soft or become softer over time, the breast will tend to drop down while the implant stays in its initial higher position under the muscle. However, an implant placed underneath the breast tissue will tend to migrate down with the breast tissue, maintaining the aesthetic result longer.


11. Cleavage issues: the implant must be centered underneath the nipple; therefore, the cleavage is directly related to the distance between the sternum in the midline and the nipple itself, and the size of the implant to be placed in that space.  As the implant gets larger its radius becomes larger and if the center of the circle is at the nipple, then the larger radius will allow for more fullness medially and, therefore, more cleavage.

12. In order to have a satisfactory result with implant placement above the muscle, 2 cm of breast tissue in the upper pole are needed. With silicone implants, we are not as strictly restricted as with saline implant by this law.

13. Mammography: The sensitivity of a mammography decreases with any type of implant in any position. Generally, radiologists prefer implants placed subpectorally.

MRIs are very valuable if implants are present and are required for patients who have silicone implants.


14. Incision site: there are four types of incisions available.

The inframammary incision is the most common incision and is felt to be the safest.  The next common incision is a periareolar incision. The way I perform the enhancement, is by making the incision in the lower part of the areola elevating the skin off the lower part of the breast and then going down underneath the breasts with a similar dissection as an inframammary incision. The axillary incision is performed less commonly. Its drawback is the inability to always properly dissect the lateral pocket to provide a natural result. If bleeding were to occur, it will occur farthest away from the entry site and may require a separate inframammary incision for control. Sometimes curvature of the chest prevents the surgeon from visualizing well the medial and inferior aspects of the pocket. Therefore, I personally reserve it to a situation where small implants are going to be placed.  The last incision is from the umbilicus.  This does not allow for silicone implant placement and voids the warranty that the manufacturer provides. I do not offer it to my patients.

Implant size: the way we manage size is a combination of the patient’s desires, the result of sizers tried in the office at least two times and the measurements we obtained during the examination. All that combined with my surgical experience dating back to 1987 is used to help the patient chose an implant they are happy with.

If you’ve been considering breast augmentation for a while, but not sure how to proceed, then this is a great chance to get informed.  Breast augmentation surgery can either restore breast size, or increase it altogether.  It’s a very popular surgical procedure that is frequently performed with a successful track record.  Additionally, it has a tremendous impact on a woman’s confidence and body image.

You may want to consider breast augmentation (aka – “mammaplasty”) if:

– your breasts are asymmetrical and one is slightly smaller than the other

– you feel that your breasts are too small or would like a fuller breast size

– you’re physically fit and healthy

– you’ve lost volume or shape due to pregnancy, aging, menopause, or otherwise

– you’d like your clothes to fit you better

– you’re not pregnant or breastfeeding

 

Safety Concerns of Breast Augmentation

As in all surgeries, breast augmentation surgery is not without its risks.  There may be a need for revision of the surgery, changes in the nipple sensation or even the breast sensation.

Breast implants are not guaranteed to last a lifetime.  As such, it is highly recommended to have them periodically examined by a board certified plastic surgeon.  At some point, replacement may be necessary.

As per the American Society of Plastic Surgeons (ASPS), independent groups such as the Institute of Medicine have found no link between breast implants and autoimmune or other systemic diseases.

 

Silicone or Saline

Silicone breast implants are approved by the FDA, for use in cosmetic breast enhancement surgery.  Saline implants are also quite viable in this application.  There is a great ASPS article to help you in determining which option is better for you – saline or silicone.  Additionally, Dr. Makhlouf, a board certified plastic surgeon, is also a superb resource for helping you make this decision.  You can see in this article, why it’s important to use a board certified plastic surgeon.

 

Preparing for Breast Augmentation Surgery

During your consultation with Dr. Makhlouf, he will answer any and all questions you may have and advise as to how to proceed.  You’ll be required to provide a medical history and get an updated medical exam to determine if you are fit for surgery.  If you’re 40+ years of age, Dr. Makhlouf will require a baseline mammogram.

Prior to surgery, Dr. Makhlouf will require:

– You stop smoking, at least 6 weeks prior to surgery – to promote better healing.

– You stop taking aspiring 7-10 days before surgery.

Additionally, you’ll be advised on any medications that are blood thinning, affect the hormones, or any steroids.  Hydrating prior to surgery is also important.

2 weeks Before Surgery:

– During your pre-op visit with Dr. Makhlouf, you’ll finalize the choice of implant

– Review your medical history, issue prescriptions and give you detailed instructions

– Be sure to come with your list of questions as the Dr. will be glad to answer them.

A Few Days Before Surgery:

– Figure out who’s going to take you home, after surgery.

– Figure out who’s going to stay home with you that first night, if it’s not the same as the person driving you home.

– If you have children or pets, you may want to have someone else help you with care for them.

– Fill prescriptions.

– Make sure you have food and other essentials as you stay home to rest, for a few days.

The Night Before Surgery:

– Use antibacterial soap to shower the night before and the morning of the procedure.

– Take any medications prescribed to you: i.e. – anxiety reduction, etc.

– Avoid makeup, lotion, perfume and remove all jewelry prior to surgery.

After Surgery:

After your breast augmentation surgery, you’ll be provided with a support bra that is front-opening.  Then you’ll be closely monitored in a recovery room where you will awaken.  You’ll be sent home to rest when you are ready.

Initially, you may have some moderate swelling and bruising.  This is typical for the initial recovery phase.  If you have some discomfort, you can take the prescribed medication – as necessary.  You will need to rest for a few days.  Gradually, you can return to normal activities adding more strenuous activities day by day.

3 Weeks after Breast Augmentation Surgery:

You can go tanning and swimming, but not without some sunscreen coverage.  Choose an SPF of 15 or greater so the scar doesn’t darken.

8 Weeks after Breast Augmentation Surgery:

Swelling is at its minimum, at this point.  This will most likely be your new breast size.  Now is the time to go shopping for a new bra and swimsuit.  However, at 4 months your breasts will drop into place and that will be their final positioning.

If you were considering making any significant clothing investments prior to this time (ie – wedding dress), you should hold off until 8 weeks post-op.

 

Additional Factors to Consider

Pregnancy:

A breast augmentation surgery will not affect your pregnancy; breastfeeding is still viable.  Pregnancy does affect one’s breasts, however.  So, if you’re considering breast augmentation surgery, you may want to wait until after pregnancy.

Weight Loss:

One’s breasts tend to decrease, and may even droop with weight loss.  As such, if you’re planning on losing weight, you should hold off on the breast augmentation surgery until after your weight loss.

 

In Conclusion

Breast augmentation surgery is a relatively common procedure and can quickly enhance a woman’s body and self-confidence.  It is an out-patient procedure and results are visible relatively soon.

If you have some unanswered questions or a situation that’s unique to you, please make an appointment: (847) 297-8001  We’d love to see you for a consultation.  Here are some previously augmented breasts.

For men who are coping with gynecomastia, swelling or increased size around the nipple and breast, male breast reduction surgery may be the answer. In the Chicago area, Dr. Makhlouf is known for his discretion and professional staff.

Compassionate and skilled, Dr. Makhlouf employs various forms of liposuction as well as state of the art surgical skills in order to correct the enlarged region and give you the toned look you want.  The procedure, which usually takes about an hour to perform, can usually be done on an outpatient basis. Dramatic results on a person’s appearance and self esteem are a common result.

Want to look your best for this Valentine’s Day?

ThermiTight is a minimally invasive procedure that is used to tighten loose skin.  It’s quite effective in areas that are prone to looser skin (skin laxity), as we age:

  • Loose skin on the neck
  • Loose skin on the arms
  • Wrinkles on the knees


Thermi is done in the office with little to no down-time.

There are a multitude of approaches to skin tightening. On the one end of the spectrum are creams, lotions, and potions, and the other end of the spectrum is a facelift procedure (rhytidectomy). There are inherent and significant limitations to lotions and potions, and there are significant hurdles to signing up for a facelift. For a number of years, there has been interest in intermediate modalities.

Types of Skin Tightening

Laser skin tightening has been used since the mid 90’s to minimize deep wrinkles. Although effective, the multitude of laser frequencies and modalities speak to the fact that it has not yet been perfected. Ultrasound is another modality and is used for skin tightening. By penetrating the skin and heating the deep skin layers, it encourages collagen production.

There are inherent limitations to laser and ultrasound technologies in the fact that both have to go through the skin to deliver the energy needed to remodel the deep tissues. Hence pain and the possibility of permanent skin damage in terms of scarring, hyper- and hypopigmentation limit their impact on the rejuvenation.

There is now a long established technology that is being used in novel way: Radiofrequency; now used in a minimally invasive way. This refers to the use of a fine probe that penetrates the skin. Its insulated tip delivers a controlled quantity of energy to the deeper layer of the skin. The radius of impact is small, and a series of spots under the skin are needed. There is both external and internal monitoring of the temperature, a unique feature of this technology. Because it is done under local anesthesia, it is an office procedure and requires 24 to 48 hours of down time.

If you are interested in exploring minimally invasive skin tightening, Dr. Makhlouf is on the advisory board of this technology and would be happy to discuss it further.

Cellulite is a term that originated in France in the early part of the 1900’s. It refers to dimpling of the skin that overlies fat deposits.

Especially in lower regions of the body, fat deposits develop between muscles and skin. Skin is attached to the muscles beneath by fibrous bands, and cellulite occurs as a result of one or more of the following reasons:

  • The fibrous bands are tight and inelastic, pulling the skin toward the muscles
  • Excess fat bulges through to skin that is not tightly tethered to muscles beneath
  • Skin is thin and loose, allowing fat pockets to push outward and make dimples


Treatment addresses one or more of these mechanisms:

  • Releasing the tight fibrous bands that cause dimpling
  • Decreasing the volume of fat through liposuction and/or weight loss
  • Skin tightening treatment that enables skin to hold in fat more effectively
  • Which treatment might be the right one for you? Would you benefit by trying more than one approach?

Ready for a Consultation?

Ready to Enhance Your Form? Give us a call: 847-297-8001. or fill out the form and one of our patient coordinators will be with you. Thanks!

Everything you need to feel healthy and beautiful

    Copyright ©Enhanced Form 2022. All rights reserved.