Breast Augmentation in Miami

Dr. Hunsaker, a lot of patients message us on Instagram asking how many CCs they should get. What do you usually say? My first answer is that it's not a volume operation, it's a dimensional operation. The number of CCs is secondary, even tertiary, in our consideration. What's important is the dimensions; then we choose a profile, and however many CCs that is, is what we use. When I'm with a patient, I show them implants and how dramatically different they can be depending on the dimensions, even with the same volume. If I say you should have 600 CCs: would you want this 600 cc or this 600 cc? Held sideways, there's a tremendous difference in projection and a huge difference in diameter, but they're the same volume. The wide, low-profile implant suits someone who already has a wide chest, which is more common in taller people, a fair amount of existing breast tissue, and who wants only a modest increase. If a 5'10" patient wants the look a 5'3" patient got, she may need that width with more projection, so far more than 600 CCs. Sometimes silicone only goes to about 800 cc and the patient needs 900 or 1,100, so we use saline implants, which can be overfilled to reach a greater volume on that base width. Patients often compare themselves with a friend who got 300 CCs, but the friend may have a completely different frame and different starting breast tissue. Someone very flat needs more projection, and therefore more volume, than someone with the same build who starts with a B cup. What's the difference between a teardrop implant and a round one? The teardrop, or contoured, implant is pre-shaped. Patients often think it gives a more natural result, but when a round implant is upright in the body it also takes a teardrop shape. Teardrop implants have to be oriented exactly vertically, so they have a somewhat higher re-operation rate, and large studies show you really can't tell the difference in the cosmetic result. How many CCs for a natural look? Everybody's idea of natural is different. The smaller you go, the less fake it looks; the bigger you go, the more fake it looks. The more of your own tissue and body fat you have covering the implant, the harder it is to get a fake look. That's why I communicate through pictures: patients show me what proportion they want to see in the mirror from belly button to collarbone six months or a year after surgery. You won't decide if you're happy based on bra size or CCs; you'll look in the mirror.

Hi, I'm Dr. Hunsaker, one of the board-certified plastic surgeons here at CG Cosmetic. Patients sometimes ask why an extra-large breast augmentation costs more than a standard breast augmentation. You need to understand that an extra-large breast augmentation places a tremendous amount of stress on the overlying tissues. It requires not only better technique, but a great deal of judgment in how full to make it before you stop, how much to stress the tissues. Because of this higher complication rate and the greater degree of skill and experience necessary to achieve predictable good results, the cost is somewhat higher. If you have other questions about this procedure, please call the office and one of the coordinators will be happy to answer all your questions.

Under most circumstances, most women are going to be able to breastfeed after just a breast augmentation alone. There shouldn't be any breast tissue that's cut. There's no division of the glands or the ducts. So theoretically, it should be 100%. But there still is a percentage, I believe it's under 8%, that are just going to have difficulty breastfeeding afterwards. The only way to know would be a study: if you've already had one child and you were able to breastfeed, then you got a breast augmentation and then you're not able to. But under most circumstances, again, if you're not cutting the glandular tissue, you're not cutting the ductal tissue, you should be able to breastfeed. But there is a small percentage that are going to have trouble. It's not that they won't be able to breastfeed, it's that maybe they'll have decreased production of milk.

Doctor, when it comes to a woman's anatomy, we're all different. And some women have a larger gap in between their breasts than others. And some women want to close that. Which approach do you use to help women close that gap? In every case, the pectoralis muscle inserts into the sternum, which is the breastbone. So that kind of creates a boundary for the implant. Like how close can we get them? Well, how far apart is the area where the pectoralis major muscle inserts into the sternum? So if it's kind of far apart, maybe going under the muscle isn't going to close that gap as much as somebody wants. And so if there is a wide gap, I may suggest let's go over the muscle. And then I can make it as close as I want. So I think that's probably the best approach for that.

Dr. Hunsaker, one question that we get often is about the gap in between the breasts that some women have. How do you address the gap, and how can you close the gap, or open it in some cases when women request it? It's a common question that they ask. I want to get them closer together. Sometimes they're further apart. It's partly the anatomy but partly what we do. But once I've actually examined them, I can give them the feedback about what they can expect. Occasionally someone says they don't want them very close, and the part we can control is how far we dissect under the muscle toward the breastbone. If somebody has implants that are too close together, then we have surgery we can do, usually using some sort of mesh like GalaFLEX to recreate the middle border, to reset the position of the implant.

If you look at a genetic male breast, the nipple position is much, much closer to the inframammary fold. And so if there hasn't been really any meaningful breast development from their hormone therapy, that has to be taken into consideration. That distance does stretch a little bit over time. That nipple isn't actually sitting up in the middle of the breast mound. Now if they have reasonable breast development from their hormone therapy, that distance is already stretched, and it's less of a consideration for sure.