Las Vegas Breast - Ask Dr. Garcia Library - Page 22

NOTICE: Las Vegas Breast: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use. All responses regarding Las Vegas Breast are done personally by Julio Garcia.

• Is a 28 inch rib cage considered a narrow ribcage to the point I cant go to wide? Also, is there any dropping and fluffing degree on a second BA? Or is there not due to the fact the pocket is already there and skin is stretched?

  Answer:  yes, I feel it is narrow. As to a secondary breast aug and the post operative course, it all depends on what it is being done for, the more surgery involved the onger it will take to settle. No way for me to tell without more information on what is being done. JG 9.10.08

• Dr Garcia, I am thinking about a breast lift and possible one with implants, either one. The problem is that I don`t want to have general anestesia and I`ve hear d that some doctors will perform this surgery under local anestesia...will local anestesia be a good choice if I am giving either option of anestesia? thank you

  Answer:  I would not be willing to do a breast lift or a breast augmentation under local anesthesia and I do not recommend you try it either. JG 9.8.08

• what do you think of breast enhancement pills and the serum for the breast to also firm it? thanks

  Answer:  both a waste of time. JG 9.6.08

• Docter, I had a second BA 3 months ago. Went from Saline to Silicone. I noticed that my breast actually bounce and move about!! I never had that with my Salione they were HARD, FIRM and never moved. Just stood in place. I coulda literally run and jump with no sports bra and no movement. But with my Sili they are so real like. Why is this? Do you think my octer before didnt make my pocket big enuff when i had saline? Also how do you know if your docter made your pocket to small or larger for ones implant?

  Answer:  it is likely becasue they made the pocket larger this time and in time I am afraid the same feeling you had with the saline might be present with the silcone implants. As to how large the pocket was made can only be answered by the surgeon. JG 9.5.08

• Hi Doctor Garcia, Following my breast augmentation in thailand 4 weeks ago now. one of my breast is alot more sensitive than the other. i think that one has dropped before the other it is alot lower than the other one and softer. is this possible? and more or less is this normal?

  Answer:  all possible, not necessarily abnormal, I think you need to give it some time though and see what happens. JG 8.31.08

• Hi Dr. Garcia! I am about 2 weeks out of surgery with under the muscle silicone implants. How much more time until all my swelling is gone and how much smaller size wise will my implants ultimately become? Or is it more about my breast shape changing significantly? I do not want to lose anymore size wise or want them to change shape all that much. Should I be buying regular bra now or will I need a smaller size when swelling is over? How long till I can exercise and be in the sun? Thanks!!!

  Answer:  that is quite variable from patient to patient, should see size differences in about 6 weeks. If you are 2 weeks out you will lose some visible size I feel. I would wait on buying bras for 6 weeks. We allow our patients to exercise in 3-4 weeks and go out in the sun then. These are really questions your surgeon should have gone over with you before surgery though. JG 8.25.08

• WOULD ANY MEDICATION (EX. PROZAC) INTERACT WITH JUVERDERM OR BREAST IMPLANTS?

  Answer:  not that I am aware of. JG 8.25.08

• Docter, How come some surgeons fix assymetry or such things in BA`s and some do not. Like my surgeon is an excellent surgeon. He does not fix little things like lets say if one breast is SLIGHTLY lalrger than the oter have different fills. Also he doesnt measure ones breast tissue for sizeing. He will only say tthings as to you will look wrong if your too big for your frame or want more if you pick to small. Hoe come some docters are precise and some just arent?

  Answer:  I am asorry but I do not have an answer for that. JG 8.25.08

• Docter, What actually auses ripples in a silicone implant to show. I have a bit in my left breast. BUT itsd is also my bigger breast. So you think id not have it in that one? Also sometimes the ripples arent there, just when i wake up and then as the day g oes on they are gone? Is it or has it anything to do with water rentention threw the day?

  Answer:  due to thin tissue between the implant and the skin is what is the cause as all implants sold in the US now will ripple. If you have swelling that comes and goes that can hide the ripples at times. JG 8.25.08

• Dr. Garcia, I had breast enlargement surgery in 1990. Lately, I have had pain in the right breast and the breast has hardened. What do you recommend or what are my options to correct the situation? Thank you.

  Answer:  the only real option is to go in and have the capsule cut out, but there is likey about a 50% chnace of it coming back in time. JG 8.25.08

• do breast implants cause cancer? will the scra tissue cause cancer?

  Answer:  neither breast impalnts nor scar tissue there cause cancer. JG 8.25.08

• can anything with breast implants affect your breathing. Ive been having chest tightness they yell me is anxiety, but just want to make sure nothing with breast implants could be the problem.

  Answer:  I do not see how it could cause that. JG 8.25.08

• I had breast implants about 7 months ago (under the muscle/400 CC/smooth moderate mentor). I have lost 130 pounds in the past three years. I was 5`7 and weighed 128 at the time of surgery and breasts or should I say lack of breast were a size b. At my peak weight when pregnant my breasts were a very large double d. The dr did not cut my muscles or did not want to go bigger because he was afraid that my lack of breast tissue would not hold a bigger implant. My implants now refuse to drop. They sit up very perky and high but my nipples and saggy skin hand below the implant. the dr is telling me that i need to wait until a year post op to see if they will drop. is this common. he said he might have to go in and cut the muscle. Im afraid the implants will not fill the pocket. would larger implants work, will the cutting the muscle work or will i need a lift

  Answer:  cutting the muscle will likely allow the implant to slip out from below the muscle, and a larger implant might do the same thing. I think with your degree of weigth loss and likely loose skin and breast ptosis, you more appropriately need a breast lift to position the nipple better and remove the excess skin. JG 8.22.08

• How come after surgery about 3 weeks my breasts felt heavy n bounced around when walking to the point I was babying them. Now there light as a feather n feels like there apart of me? did my body just yet used to them

  Answer:  just swelling mostly. JG 8.21.08

• Hi Dr. Garcia, After my breast augmentation nearly 3 weeks ago I have noticed my left breast is softer than my left and more sensitive to pain. I feel a burning feeling from my armpit to my nipple which really hurts sometimes. And i noticed my right one is higher than my left. is this just the healing process? and my left is moving around alot (can i send you a picture for your opinion) when i lie down i have to wear a sports bra cause it hurts when it rolls around. Is this normal?

  Answer:  at this point all is stil healing, all that you are seeing and feeling can still be normal, I would take it easy and follow your doctor`s instructions and see him in the next week or so to make sure all is progressing well from this point on. JG 8.19.08

• what do you mean by, You feel very little muscle is covered anymore, if any by the implant due to many capsule scorrings ...Where did the muscle go? Does all the tissue get taking out or dies off?

  Answer:  as the caspules are cut, it is not uncommon for the muscle to retract superiorly and then cover less and less of the implant. The fat and breast tissue that is around the implant when a capsulotomy or capsulectomy is done can get thiner due to injury to the blood vessels and subsequent atrophy of the tissues. JG 8.19.08

• Regarding the less healthy tissue with reaccuring redos of a BA, so what tissues die off or get ruined during a BA over time? Especilly if under ones muscles

  Answer:  breast tissue and fat that provide a covering for the implant. I would venture to say that in your case that very little if any of your implant is still under the muscles after repeated capsulotomies. JG 8.19.08

• Docteer-Why do they say the more redos or breast agumenation you have the higher rate of Capsular Contraction goes way up? Why is this?

  Answer:  there is less normal healthy tissue and the less there is of that the greater the chance of recurrance of the capsules. JG 8.19.08

• Docter--Is ther a way for me to determine what diamter-width implant is best for my body or even tops? Reason being my docter says thats olkd school and YOU choose the size and ill tell you if its doable or not. WITHOUT any measuring. so basically its a guess game. I had a redo to go from a 11.2 diamter to a 13..2....NOW he said any bigger would look funny on my small frame but he never said not possible. So badically if i ever use him for gthe future i need to figure the width diamter myself. SOO any suggestions i can do for myself even tho iam implanted already?

  Answer:  you can measure the diameter of your present breast tissue is the best way. It is the distance from inside to the outer edge. JG 8.16.08

• Docter, my two breasts are different in sizes to the point one fills a cup bra better than the other` my docter doesnt fix symmettry in sizes. I had a redo to go larger n well its even more annoying` I don`t want to go for a third BA now because I feel selfish for agumentation will never be perfect! Any suggestions for the future shall I bother telling him! Or be quiet n just accept

  Answer:  I think you need to be vocal with the surgeon and tell him your desires and concerns, otherwise it will never be corrected. Some issues are impossible to correct but many can be fixed so there is no need to live with it if it can be fixed, all the best. JG 8.18.08

• i recently had breast reconstruction on my left breast. After 1 month after surgery, i noticed a yellow-clear fluid coming out of a little hole on the incision site. i had the fluid tested and there is no infection. what is this and when will the incision finally close, the incision is on the areola. what should i do...please help!!!

  Answer:  it is called serum and is the breakdown products of blood that was in the wound The incision will close once the pressure from the fluid slows, I think antibiotics are a good idea along with seeing your surgeon so they can stay on top of it. JG 8.18.08

• I had BA in Mid April... 350 Silicone unders. My PS is doing an crescent lift in his office tomorrow as my nipples are still sitting fairly low on my breast mounds. My main concern is am I going to feel pain if I use LMX4 before I go to the office and then local anestetic with valume (sp?) once i get to the office? Is this procudure done in an office setting very often? My PS said the procudure would take about 45 minues.

  Answer:  there is always a possibility of that and you might just need more local anesthetic, the LMX4 does not remove all of the pain of the injection, it just lessens the pain from the puncture but not the injection of the fluid. I very very rarely do crescent lifts, either under local or general anesthesia as I find it distorts the areola and makes it look like an inverted tear drop many times. JG 8.14.08

• on someone that is flat as a board, with almost absolutely no breast tissue get to a full c or small d size? what would 330cc filled to 360 give. about what size. this is on a 95 pound 5`3inch body.

  Answer:  maybe a C. JG 8.13.08

• Hi Doctor Garcia, i had a breast augmentation in thailand two weeks ago. My scar under my armpit has healed but i noticed a small bump i thought it might have been an ingrown hair so i tried to exract it. I removed a bit of hard skin to find a clear/ white stitch underneath. i think my skin grew over the stitches. is this bad? isnt the stitch supposed to fall out? also my right breast doesnt look as smooth and round as the left one. its a bit lumpy underneath. is this normal? is it normal for the my breasts to feel itchy on the inside? HELP! Should i go to a GP?

  Answer:  no, those stitches were likely meant to dissolve and just had not done so yet, not a problem. Hard to say what the lumpyness can be, could be swelling and could be the edge of the implant too. I think a GP will not be able to help, I think a plastic surgeon is what you need but it might be difficult to get one to see you if they did not do your surgery. JG 8.13.08

• In a previous question I asked about the gortex sutures that were used around the areola for a breast lift. I don`t like the way they feel - I can feel a ridge around the areola. You mentioned that you don`t use that type of suture. What do you use and does it feel more natural or also feel like a ridge? Is this something that I could have redone?

  Answer:  I use absorbable sutures in that area to avoid feeling the ridge, some doctors prefer the permanent sutures like Gortex to try to keep the scar from stretching but it does not always work as the tissues can tear awayfrom the suture material. The Gortex suture can be removed but it is possible, due to the technique they used for your surgery that the areola might widen along with the scar. JG 8.13.08