NOTICE: 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.

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• Good day! If you already have breast implants is there a way to tell if you can go bigger by looking at them for yourself? Is there a way you can tell the ons you have now are the limit by looking at your own anatomy? Any clues?

  Answer:  it really would take a surgeon to do the measurements I am afraid, sorry. JG 1.27.12

• Good day Doctor! I was wondering if one was going to replace there implant size for a different size and the pockets are already made, is there Less bleeding occurring during a swamp in size then the original surgery?

  Answer:  Yes, unless you are going much bigger as the pocket needs to be made larger, but still likely less than the first time. JG 1.26.12

• Dr Garcia, I had a breast augmentation on March 9 2011. My doctor put in Mentor High Profile 375 cc. One week out of surgery my left breast was way high and my arm started hurting. I have been back at least 7 times complaining of the pain and the look. He had me wear a strap for 10 months and kept assuring me it would drop and if not he could cut the muscle but there would be no guarantee it would drop. I finally put my foot down and said I wanted it fixed. I cannot wear a swimsuit and my tops pull to the left side. His office would not call me back for 3 weeks and then said it would cost me 1900.00. I live in Alabama and want to know if I have any rights and is this normal? I am desperate and so unhappy.

  Answer:  not normal and it is up to the surgeon to determine what is the cost, in my experience, most surgeons will try to make the patient happy if it is something that might be easily fixed. In your case, it seems the problem started right away and although I do agree with trying to war the bandeau, it appears at this time that you will need more surgery for it to get better. Sorry to hear about all of it. JG 1.22.12

• I am scheduled for surgery with you February 7th. In the event of a complication and/or emergency hospital admittance is required, how is that handled. Does your office have hospital admitting privileges ?

  Answer:  yes, all true plastic surgeons that perform procedures in a surgicenter have admitting privileges at a local hospital, as I do. JG 1.15.12

• Good Day Doctor! I need your opinion. I am a fitness girl and had my implants for more than 4 years, under the muscle. Genetically my breasts are low on my chest and I am big into intense weight training. I have not ever trained my chest since 2007 because when I had my first implants put in threw the armpit under the muscle my chest muscles, due to training were so tight on my rib cage the doctor had the worst time getting the implants under, but eventually did and it was a bad recovery....any ways years passed and I have been training and decided to try training just the UPPER part of my chest, the muscle from the shoulders across the upper chest NOT touching the pecs. I notice I DO NOT FEEL ANY movement of the implants which is good...BUT I DO NOTICE that when I lift I can feel the left implants unnoticeable but the right implants more stiff when I perform the exercise? Can this be Capsule on the right implant causing it to be stiffer? Also, should I NOT EVE N train my chest just in case I want to replace my implants? I don`t want to have the doctor have a hard time putting them in again if my chest muscle are well built! Thank you and I wish you the best 2012 EVER!! =D

  Answer:  it is most likely a slight degree of capsule on the right that makes it feel tighter and does not allow it to move as much. I think since the pocket has already been made for the implants below the muscle, any further surgery on your breasts would be much easier if the same pocket is used. All the best. JG 12.30.11

• Hope you had a wonderful Holiday!!! i have a question. My left breast implant feels looser than the right. I hate when I sleep and sleep on its side I feel it tug a little so I sleep on my right where this stays in place. Iam 5 years post op and they are under the muscle...probably not anymore but I wonder why this is? It also looks more natural than the right.... Thanks Doc..=)

  Answer:  you might have some degree of capsular contracture that is causing one of the pockets to be smaller and not allow the implant to move as freely. A surgical removal of the scar tissue can be performed if desired. All the best and Happy New Year to you. JG 12.27.11

• dear Doc, I`m an older woman getting breast lift and Mentor cohesive implants (I live outside the US). I`m 5.2, 107 pounds, and a 32A, chest measurement 27.5 inches below and 30 inches above. I want to have nice full perky breasts but not obviously big ones! My PS recommends 300 cc`s but do you think that`s too big for my size and height? I feel I may have a distorted sense of normal after being flat chested for so long.

  Answer:  I think that should not make you look too big, going down a little but to say 270 will likely not make a big difference. I think you will be a small C cup with that. I wish you the best. JG 12.14.11

• Dr. Garcia, This forum is the best. Thank you for your help. I have had my Silicone Breast Implants for almost 5 years. I noticed as time goes on they get more looser and lower on my chest then the first year. Is this possible or am I just used to them. They also seem more loose than tire and softer then they ever were 4 years post OP. Also, I kind of want to change my size but want to wait longer just because I dot want to be stupid and selfish if there aren`t anything wrong with the ones I have. What are the ODDS of replacing them and something bad happening? Your the best!

  Answer:  It is common for the skin to stretch over time and the implants to move down and sag. The risks for something bad happening the second time are the same as the first. Going bigger might make you sag faster though due to more weight. All the best. JG 12.12.11

• Can the butt implant and breast implant surgeries be combined and done at the same time. Is it safe to do so? How safe are the solid silicone implants used for the butt augmentation? Compared to the cohesive silicone gel?

  Answer:  Buttocks and breast implant can be performed at the same time. The buttocks implants are placed below or within the muscle and the solid nature of them is not as soft as a breast implant but it is not hard, it is quite similar to the cohesive gel implants that are still not released for use in the US. I think solid implants are as safe if not safer than gel implants as they cannot leak. JG 12.2.11

• Dear Dr.Garcia, I had silicone breast implants 35 years ago. I am seeing on TV that these are leaking and having to be removed or replaced. It is now scaring me. To the best of my knowledge I have had no problems. How would I know if they are leaking? I of course have a mamogram every year. thanks for your thoughts.

  Answer:  The most accurate test to see if silicone implants are leaking is an MRI. JG 11.8.11

• I had a latismus muscle done to my left breast several months ago which left me with a much wider and bigger looking breast than the other side. Also there was some dents in it afterwards. Now, two weeks ago, PS cut the nerve to the latismus muscle and put in a smaller diameter implant. It looks much better, but is still wider than the other one in spite of cutting the nerve and smaller diameter implant. Will that improve in time as the muscle atrophies now that the nerve is cut, or is the result that I see now the end result. If it will improve, how long are we thanks in advance.

  Answer:  The muscke should weaken now that the nerve has been cut and will likely allow the implant to look more round in time. JG 11.6.11

• Hi, Dr. Garcia. It has been a long time since I have seen you. My name is Lynette Ball. You did my breast augmentation a long time ago. We put Misty Gold in. One of my breasts broke in flight to Hawaii many years ago. I had Barry Markman fix it. I wish I had`nt. My right breast is gorgeous. My left breast is hard and the nipple looks off to the left. I can hardly stand the sight of it. I have the money right now for more surgery. I hate the thought and the expense. I take that bake. I welcome the thought and the expense. If you think you can help. Please! I look forward to looking forward again. lynekey@aol.com 702-450-4285

  Answer:  give out office a call and we lsee you as soon as you are able to come in. JG 10.9.11

• I just asked the question about the latismus muscle and more width to the breast. If surgeon cuts the nerve, will the muscle atrophy and lose the wide look and return more to previous look it had before the latismus? Also, can a portion of the muscle be cut so that it is not so binding and flattening? Thanks again

  Answer:  the muscle will atrophy in time on its own without the nerve being cut, but cutting the nerve will allow it to happen faster. If the deformity you have now is due to the muscle being tight and causing the flattening, then relaxing the muscle will help achieve a more projected appearance. JG 9.23.11

• I have natrelle implants style #20 475cc on both sides. These are smooth high profile silicone. I had infection which ended up with need for latismus muscle on one side. Since them the new implant on that side is flattened and has more width look than the other side. Also, some dents in bottom part of implant. Surgeon will fill out the dents with fat, but suggested changing the implant for a style 45 which is even higher profile and less width. Will I look uneven if the implants are not the same on both sides?In other words, because the diameter is l.2cm. less on the higher profile and projection 4mm. more, will the fullness look different from one side than the other.He will cut the nerve whicj he says will help alleviate the flatness a little bit..but, am confused as to whether I should agree to a different dimension on that side...Help..confused...

  Answer:  well, they are uneven now and moving to that implant will certainly look different from the present state but might make you look closer to the other side. I think the differences in tissues from one side to the other along with the latissimus muscle has caused some differences that might benefit from asymmetric implant choices.Cutting the nerve might speed things along too. I wish you the best. JG 9.23.11

• hello dr. garcia, i asked the previous question on breast implants during heart surgery. i meant is it safe to , do you know, to do full sternotomy on aortic valve with a patient who already has breast implants, and do you know or have you heard if the implants can be ruptured during the actual heart surgery?

  Answer:  Sorry the sternotomy should not affect the implants, all the best. JG 7.4.11

• Hi Dr G I would really like your professional opinion on Polyurethane implants,I`m aware that these were withdrawn from the Market in the US ,also the EU and Australia but have been reintroduced in Europe and the rest of the EU and Oz after there being extensive testing and them being given the all clear of the carcinogenic link. A number of surgeons past and present swear these give great longterm results with the added bonus of limiting CC to a tiny amount,also displacement Is virtually eradicated . Two things I have had trouble with. I`m very much drawn to these implants but do wonder why in the US they are still banned, do you know something we don`t,lol. I have done a fair amount of research on these and can`t find any patient testimonies to problems with them,only positives and I know that over in the US scilicone was removed from the Market also but we now know that these pose no significant link to breast cancer. would love to know your opinion or any info or experience you have with these implants.

  Answer:  well, the issue with the polyurethane in the US years ago was that the polyurethane sheared off of the silicone bag, it caused a chronic inflammatory state and if that happened it would reduce the chance of mature scar tissue forming, which reduced the chances of capsular contracture. The issues with that were the polyurethane made it to the liver in rats and caused cancer, but just as bad was that the chronic inflamamtion was never know whether or not it would cause cancer in the capsular tissue. Chronic inflammation is never good as it is well known in humans that chronic inflammation will lead to cancers. I know of no implant makers that are trying to get it passed in the US, the cost would be prohibitive and long. I am unsure as to how expensive the clearance process is or expensive it is around the world, but it is likely less on both counts. I personally would not use them here until the long term safety issues are worked out. All the best. JG 7.3.11

• Need clarification on more comment, please: The higher the profile of the implant, the more displacement will be caused by the muscle. What do you mean by displacement? Sag/drop/ball in sock effect? Thank you!

  Answer:  That the muscle will try to push it out from below the muscle and it moves down and to the side. Not ball in sock. JG 5.22.11

• As to the fullness and roundness you desire, if your implants stay soft, that might not last more then a few years. Not sure what you meant here...what would happen in a few years? And, Do you mean remain soft as in no capsular contracture? Thank you kindly.

  Answer:  You will sag and lose the upper pole fullness . Staying soft, yes, as in no capsular contraction. JG 5.22.11

• (I meant double bubble as in the snoopy effect where actual breast tissue drops below implant) thx...

  Answer:  Thought so. JG 5.22.11

• Thanks so much for the quick reply. Thinking ahead and just curious... Which revision surgery causes more visible scarring....double bubble fix or bottom out fix?

  Answer:  About the same and both likely with new scars. JG 5.22.11

• DR G, Totally submuscular vs. partial sub-muscular vs. dual plane.....Pros and cons in your experience/opinion? 5`8; 128 lbs; medium frame. 34 full B, very slight ptosis, no kids before, no kids in future. Wanting to be full D or DD. I also want some side boob and round upper pole fullness (even though it looks less natural.) I want round fullness all over! My biggest concern is sagging or bottom out with partial or dual plane, And double bubble or snoopy effect with total submuscular placement. in S Fla, so many skilled surgeons to choose from, but funny thing is many have different ideas as to what`s best. I was thinking Mentor HP or MP 400-500 CCs. (This fits within the measurements the plastic surgeons took.) what do you think re complete submuscular vs. partial vs dual plane? And will HP give me more upper pole fullness than Mod Plus? Thoughts? Please help. :)

  Answer:  totally submuscular is almost impossible, unless a very small implant is be used though, the partial submuscular is the old name for the dual plane, they are the same. Might be hard to keep an implant that big under the muscle long term, it might slip out with muscle action and the sagginess will be less corrected cosmetically if placed under the muscle. As to the fullness and roundness you desire, if your implants stay soft, that might not last more then a few years. I see no way that a implant of the size and shape you want will give you the look if it is placed under the muscle. If you have it placed above the muscle, it might, but then you will sag faster in the future. In short, some parts of what you want are likely impossible to achieve, especially long term. The higher the profile of the implant, the more displacement will be caused by the muscle. The HP will likely give you more of a rounded upper pole, but might look more artificial as breast typically are not that narrow in base dimension. All the best. JG 5.22.11

• Hi again. I asked a question before about cutting the latismus muscle under the arm.. You said the tendon could be cut, and my PS yesterday said the nerve could be cut. Which of the three is it.. the muscle, the tendon or the nerve, or are we basically all saying the same thing. Thanks again for your prompt answers.

  Answer:  either one can be cut, might be hard to identify the nerve in many cases, but if the flap has healed in place for a few months, releasing the tendon will have no significant negative effect, and likely easier to perform. Either one can be performed. JG 5.13.11

• Is my first time consulting for a breast augmentation? Do you change for the first visit, I would like to it as soon as possible but would like to consult various doctors before committing.

  Answer:  we do charge for the consultation, it is booked with a credit card, if you end up having the surgery that fee is applied towards the surgical fee, and if you cancel the appointment within less than 48 hours of the appointment, the payment is kept as a credit on your account. If cancel more than 48 hours before, the fee would be refunded. JG 5.5.11

• Thank you for answering my question previously. Now, my next question is. How hard is it to close the capsule under the arm since it seems that when I hold it with my hand like it was closed a little, the symetry improves a lot. It seems that even tho a high profile implant is in there, it is being held down by the latismus muscle ans squishing it and making it look larger. Would releasing {cutting} the muscle under the arm also help? But I also think the pocket is more open allowing it to relax more..Thanks again

  Answer:  I think releasing the tendon in the armpit area could certainly weaken the muscle and allow a bit more roundness, less flattening. The pocket can be attempted to be reduced, but it is hard to close an area that has been previously larger if the implant wants to move into that space. JG 5.4.11

• I had an infection last year at which time the implant was removed.This was the result of a breast reconstruction.My PS felt that I needed a muscle sparing latismus muscle done at the time of the expansion due to skin integrity because of the infection and thin skin. Now that I have had the exchange from the expander to the permanent implant, the breast appears flatter and wider than the other breast which has the same high profile implant. The muscle is only on the third bottom part of the breast, and not covering the whole thing.Why is the breast flatter and wider when the same size implant was used? And can anything be done to fix that? The fullness is all on the outer part of the implant under my arm.

  Answer:  the difference in appearance is due to scar tissue and different tissues covering the similar implant. I cannot comment on what would be needed to achieve better symmetry without seeing you in person, but there is likely at least some things that can help. Perfect symmetry, never, but a closer approximation is likely. Sounds like at least a revision of the capsule is in order to attempt to push the implant towards the breast bone. All the best. JG 5.3.11

• Hi Dr G:: I can`t find my question. Anyway I was wanting to reduce my implant size. I want to be a full B. My under bust measurement is 31 and my bust measurement is 36. I currently have 300cc (for two years). I feel they are too wide, like melons. what cc do you think I would need to drop to get a better result?

  Answer:  I think 200-225 at most, all the best. JG 4.11.11

• Answer: 

• Hi Dr. Garcia, I had over the muscle breast implant and lift done to go smaller. I had a lot of my own tissue but it was pushed to the sides, i went from a 275 to 150 and now they are too small. The dr. did take away alot of my own tissue from the sides. So my question is will going from 150 cc to 220 make a difference? I was a very large C with 275cc, now at 150 I am a small B. I want to be a C cup a little full. I just had these done 2 mos ago, how long should I wait to swap to the bigger ones.

  Answer:  I think you will need more than 70 cc to go from a B to a C cup, need to make up for the tissue that was removed. I think if the size implant is not the correct size, it can be switched out at any time. Best of luck. JG 3.14.11

• Hello Dr. Garcia! I have a question. I have had implants for 4 years very active in fitness and running and am a perfection to body proportion especially when I compete in figure competitions. I`m not happy with my implants for my body structure. They maybe too narrow or big or something is not right with my pockets. My surgeon isn`t really good at fitting implants to ones body and wanted a second opinion. Is there a way I can email you photos for your advice on what they look like and if u think there wrong for my body as well as pocket issues?

  Answer:  certainly, please send them to drgarcia@lvcosmeticsurgery.com and take straight on, full sides, 3/4 views and one with your arms at your sides but flex your pecs too. JG 3.7.11

• My shape from breast implants is not as round as used to be. Why is this? I know the breat implants drop after 6 months to a year so they are not sticking up. But the shape was rounder after they dropped than the shape years later.

  Answer:  might be from loss of your own breast tissue and also the weight of the breast stretching the skin out allowing a more tear drop shape to be visible. JG 10.18.10

• Dr. Garcia, I want to get breast implants, and stopped breast feeding about 2 months ago, but not completely. I was still nursing baby once a day (about every 24 hrs), for the last two months. How long do I need to wait before getting breast implants?? thank you!!

  Answer:  my preference is to have no milk coming out of the breast for three months to decrease infection rates. JG 10.11.10

• hi Dr. Garcia, I would appreciate if you can let me know if Retinol is good for butt and breast augmentation. I`m in the process of getting this done but wanted to know if this is safe for the body. thank you for your answer.

  Answer:  Retinol is a vitamin A derivative used for fine lines and pigment issues, never heard of it being used for augmenting anything, sorry.JG 9.22.10

• Hi Dr. Garcia, About 3 years ago I had breast augmentation using Inamed/Allergan (?) 286 cc midrange style 15 profile implants. After, I had rippling in the cleavage area and a lot of muscle movement/distortion. I also felt that the implants were too big for me. A year later, I had those removed and replaced with 210 cc moderate (lower) profile (style 10) implants. The size is much better and the doctor released the muscle and the muscle movement is much improved. The rippling, however, is not. I figure it must be due to the scar capsule since it is in exactly the same place as it was with the original implants. It really only bothers me on my left side as I can see and feel the ripples (feels like something is bunched up in there). My doctor is suggesting that I do micro fat injections to cover the one or two ripples that are higher up in the cleavage area and very obvious even in tops that are not that low-cut. Have you had any experience with this? I am concerned about what negatives there may associated with fat injections. Might it turn out looking bumpy/lumpy where the fat is injected and, therefore, more noticeable than now? Is there a chance the implant can be punctured? Any other complications/concerns you know of? Or, is this a good option instead of doing another surgery to remove the capsule (which I hear may cause problems also) and start over. Thanks for your help!

  Answer:  there are not alot of options for the ripples, silicone ripples less than saline, but both can ripple. I think the long term survival of the fat injections is fair at best, but with yoru case, it might be worth a try. Otherwise a piece of Alloderm can be placed below the skin to try to thicken it up and make the ripples, that are due to the shell of the implant and not the capsule, less visible. Injury to the implants and lumps are likely low risk. Best of luck. JG 9.18.10

• thanks doc, ok are the risks of granulomas with breast implant types and macrolane the same? or similar?

  Answer:  the percentage of granulomas with Macrolane is unknown at the present time, but capsular contracture rate of implants ia 20%. JG 8.24.10

• doc garcia You know how you said macrolane has granulomas risk for breast is the chances getting this on facial implants the same like with fillers for cheeks and all? are the risks the same or similar?

  Answer:  the more concentrated the HA is the, I feel greater the likelyhood of granulomas and Macrolane is the thickest. JG 8.22.10

• dr garcia I want to ask bout macrolane fillers for breast aug. I know it will cost more then implants however is it safer then breast implants in terms of capsular problems and other ..thnx

  Answer:  they have not been used for long enough to say that there are no scarring issues, but there is supposedly no material left long term so that is probably a good thing and no chance of capsular contracture in the classic sense since there is no implant to contract around, but the inejctionw might cause granulomas that are lumps that might make diagnosing a breast mass or cancer more difficult. Not sure if that will ever be released for use in the USA because of those issues. JG 8.22.10

• I am the same person that asked the other night about an expander that looks too wide. I saw my PS yesterday, and he admitted that the expander is right in the mid line, in other words, if I had two expanders in, they would be touching each other.What does that mean when I get fills?Will they get even closer together, and can the adjustment be made at the exchange to put a little more space between, or should we put a smaller expander in now before expanding. Thanks again.

  Answer:  as the expander stretches it will lift out and not push the expander to the center, it will pull it out to the side if anything. Minor adjustments are always part of the final exchange of the expander for the permanent prosthesis.Best of luck. JG 8.19.10

• I had expander put in on Friday August 13th.It is the second one on this side since I had an infection after Christmas and had to get the implant removed.The right side is complete with high profile implant and looks great. But, now with this expander, it looks much wider than the implant side. Is it because it is still flat with 120cc of saline in it, or did he use something too wide. It seems to cross over the middle line in the cleavage area. Will that get taken care of at the exchange, or will he have to close the pocket in the middle? Before the surgery, he said that the pocket is already there, since I had an implant already and he will not open anything that isn`t already open.If that is the case, why does it look so much wider than the other side?Thanks for your input..

  Answer:  correct, it is just because of the stage the expander is at presently. As the expander fills the dimensions will change, all the best. JG 8.16.10

• I had silicone breast implants in April. They have bottomed out. My surgeon informs me that due the exceptionally strong pectoral muscles (even though I am thin) he will redo the surgery above the muscles rather than below the muscle. The surgery should take about 2 1/2 hours since he has to close the other pocket. Do you see any problem with this? he is a very reputable Plastic Surgeon. Thank you for your response

  Answer:  it can happen for a variety of reasons and I think that is the best way to improve the problem, all the best. JG 8.15.10

• I want to have breast enlargement but I am affraid of the complications...:(( really affraiiiiddd... How often will capsule contractions occur? and when it does will it need surgery? or are there other ways to treat them like pills or something.. coz i read you stated if surgery is performed then after that for it to occur is more likely... so it will just be surgery after surgery and it will just gradually get worse... that will be awful for a female... am I over worrying? Capsule contraction (a l

  Answer:  on top of the muscle, after 5 years the risk is about 20-24%, under the muscle it is about 8%. Not all patients with capsular contracture need more surgery, all depends on how firm the capsule is and the patient`s desires. Once someone has a capsular contracture rate, the chances of recurrance at some time on the same breast is about 50%. I tell patients when they have a breast augmentation that there is a 20-24% chance that they will need a second surgery at some point in time. JG 8.6.10

• Is it necessary to replace implants every 10 years? I have had mine since 1995, and have had no problems. Also, I have saline implants, are they still about the same or better today?

  Answer:  saline implants have not changed to any significnat degree in that time and if it is not broken, don`t fix it, leave them alone until somethiing has to be done is my motto. JG 8.2.10

• I am a 36b with moderate droop breastfed 2 kids and I am getting 440cc silicone textured implants under the muscle. I noticed you said you don`t put textured under the muscle and now you have me wondering why. My PS said to go with texture so they would stay in place better because of the droop. I don`t have a clue so please fill me in. Kinda nervous. Also what size do you think that will that make me? Thanks :)

  Answer:  well firstly, your own breast tissue above the muscle will stil droop with time regardless of the implant, and if the texturing does in fact attach to the muscle, which it does not always do, it will not move as a natural implant would and also the leak rate is higher due to the folding in a repetitive fashion of the shell of the implant that is textured. I cannot comment on your eventual size as I cannot examine your own tissue and the shape of your ribcage, sorry. Best of luck. JG 8.1.10

• I had a breast biopsy one week ago today. I had no discharge till monday, and wensday the steri strips came off, taking my skin with it. I had a huge spot without any skin covering and the discharge has been horrible. Lastnight finally stopped discharge and started to heal over the incision, but the skin covering incision is really black, and there is a big indent where biopsy was taken?

  Answer:  might have developed a hematoma where the biospy was done, I suggest you see your surgeon as soon as you can. JG 7.29.10

• (2/2) I previously posted a question (Fleur de Lys patient in Kirkland, WA) and forgot to add one thing...I forgot to mention that I had the procedure(s) done in October of 2009. So they have had plenty of time to heal.

  Answer:  I think the only thing at this time that can be done involves more surgery, sorry. JG 7.17.10

• Hello Dr. Garcia, I had a breast lift procedure and breast implant done along with a Mercator tummy tuck (Fleur de Lys style) done by a Dr. in Kirkland, WA. I am very satisfied with the results of the surgery other than a small difference in sizes between the two breasts. I had 430 cc implants put in (saline), but the right breast seems a little smaller, soft and more natural than the left. Could it be that the doctor left more tissue on the left side than the right when performing the breast lift? Or is there any possible way that he could have filled up one breast with saline solution more than the other? Thank you for your time..

  Answer:  do not think there was an unequal fill so more likely is a difference in the breast tissue as you mentioned. JG 7.17.10

• Dr. Garcia, If there is some bottoming out after breast augmentation is another surgery always necessary. Since this is not a health hazard, is it ok not to do anything. Thank you for your response.

  Answer:  OK to leave it alone, but it can usually only be repaired with more surgery unless treated with suspension very very soon after surgery. JG 7.13.10

• Thank you for your prompt response. It is is a case of bottoming out and new sutures have to be placed is that a big surgery? Also, it the bottoming out does not go below the suture line can it be left the way it is without surgery?

  Answer:  yes, it is big surgery with significant downtime after the surgery and the results are fair, and many times it has to be done more than once. If you can live with it, it does not cause any health problems. JG 7.13.10

• Dr.Garcia, Just had consultation with my PL and was told that one implant was possibly bottoming out. He suggested I wear a bra and if it stayed in this position it would be alright. I have thin breast tissue. Options are to put additional sutures in affected implant or if I so desire go to a smaller implant. I decided to take a wait and see attitude - what would you recommend?

  Answer:  well, if the surgery was just a week or so ago, the bra, being worn all of the time, might cause enough scar tissue to form to hold it in place. If it is much longer than that, I am afraid it likely will not work and more surgery will be required, such as you described of placing sutures to elevate the capsule into a better position. All the best. JG 7.12.10

• Doctor do you take monthly payments cz im gettin a second job so i can get some things done

  Answer:  no, but we do offer financing through an outside company. JG 7.8.10

• I underwent a breast mascectomy on 8-27-09. I was informed by my breast surgeon that I can got ahead for reconstructive surgery. Is this something you do? Are you a provider of UHC and Tricare? What are you outcomes? I would like the breast to look like the other breast as much as possible? Can I see you pictures of work done?

  Answer:  I was a provider for UHC until the end of this month, unfortunately that was the only insurance we accepted and as of now, we are only doing it on a cash basis. sorry. JG 5.24.10

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