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Breast Surgery FAQs with Dr. Lee Corbett


I am commonly asked by my patients if they can tan after surgery. The answer is “Yes”, it’s ok to tan as far as the implants are concerned.


The UV rays that tan beds emit are not like an X-ray. They do not go through your skin, so the light only affects your skin surface.  The underlying breast tissue and implants are safe. Now, if you tan immediately after surgery, you do run the risk of the skin along your incision darkening more than the skin around it. The pigment producing cells along the incision line are in a kind of an “excited” state as a result of the surgery. They are prone to producing extra pigment as is so if you tan this can amplify the problem and leave you with a very tan incision line. This is called hyperpigmentation.


I will refrain from jumping on my tan bed soap box but suffice to say that tan beds are not great for your skin on several levels.


Breast implants, silicone or saline, do change temperature. In the summer months they will warm up and in winter they cool down.


The reason is that the implants sit under your skin and breast tissue but outside of your chest cavity. Most women who have implants don’t have a lot of breast tissue or they wouldn’t have implants to begin with. So the implants adjust a few degrees to the outside temperature. That’s why they feel cold. The temperature change won’t hurt the implants but some women do complain that their breasts get a bit tender when this happens.


Inverted Nipples are a fairly common problem women experience, particularly after childbirth and breast feeding. The correction is easily done as an  office procedure. Often times inverted nipples are corrected in conjunction with Breast Augmentation or Breast Reduction.


Inverted nipples can result from breast cancer so a mammogram and breast exam are an essential part of the work up before correction is undertaken.


The procedure is done under local anesthesia. Small incisions are made at the base of the nipple and the milk ducts that tether the nipple are released. Small sutures are then placed to keep the nipple in its’ new released position.



The process usually takes at least 2 if not 3 steps to complete over a 6 to 12 month time period. At the first surgery, which usually takes place at the time of the mastectomy, a tissue expander is placed. An expander is a special implant type that has a built in fill port that allows for filling with a needle and a syringe. After surgery, usually starting at about a month out, we access the expander and add saline to it. We do this each week until the volume in the affected breast is similar to the unaffected side. When we reach this point it is time for an exchange.


At the exchange operation we remove the expander, make necessary adjustments to the implant pocket, and place a permanent implant. At this point, if you choose, we can quit. Often times though a third surgery is chosen so we can adjust the unaffected breast for better symmetry and to re-create a nipple on the affected side.



Perhaps one of the biggest challenges I face when operating on paired structures, usually breasts, is making both sides perfectly even. Why? Well, because if you divide the body into right and left sides, we are all uneven. It’s just the way we are made. So, creating identical breasts, via implants, a lift or reduction isn’t really possible. Think fraternal twins, not identical. Of course my goal is perfection every time, but some degree of asymmetry is always going to remain.



Great question with an easy answer…absolutely nothing.


When we place breast implants, the normal method is to place the implant behind the muscle. So what is done is that the breast and muscle are simply lifted forward and the implant slots in behind. So, in the event of a pregnancy or breast feeding the breast acts exactly as it would with or without an implant in place. And after the pregnancy and/or breast feeding, the breast tissue will change as it would with or without an implant.


The implants themselves are inert, man made devices, they do not change in response to the changes in the overlying breast when pregnancy occurs. So, they are unaffected.


What can change is the perkiness of the breasts. If the breasts get extremely large and the skin stretches it can lead to a drooping problem. But again, this is a breast problem, not an implant problem. Also, there is absolutely no evidence that having a breast implant in place, saline or silicone filled, affects the breast milk either.



Other than implant type, size of implant is of utmost importance as you consider augmentation.


So, an obvious question most patients have is how do we figure out what size to use. The answer is we try them on. It’s pretty simple, we have a lot of silicone gel implants here in the office for sizing. We will put a bra size on you that you are aiming for and then stuff your bra with the sample implants. Then we will have you pull on a snug T-shirt and we put you in front of the mirror. We will stuff the bra with different sizes until you find what you like. I will then chime is as to whether the size you have chosen makes sense based on your starting point.


This isn’t a perfect sizing system, in that a given implant usually looks a little smaller once it is behind the breast than it does when you are trying them on. But knowing this, I will push you to the top of your size ‘comfort zone’.



Yesterday I performed a Breast Reduction using Liposuction only. To my surprise, the OR nursing staff was unaware this was possible. So I figured if they were unaware it was possible, most people probably are. So lets talk about it.


Why it works: Well, breasts are normally made up of glandular milk producing breast tissue AND fat. In fact, for many women, the breast is a preferred fat storage site. So, we are able to use liposuction to remove the fatty component of the breast. This can be done with one or two very small incisions instead of the typical larger more noticeable breast incisions.


Limitations: There are limitations to the procedure being done this way. First, you cannot get as much skin tightening this way and you cannot lift the breast as well as with a traditional reduction. Secondly, you cannot suction out the glandular breast tissue component, only the fat component. So gauging final breast size is more challenging.


In the end, it is a very effective technique that replaces the significant scaring of a traditional reduction with almost no scars yet still effectively can reduce the breast.