In our society, there is a strong emphasis on breasts and breast size. From magazines, television, movies and even advertisements, there is a preponderance of voluptuous well-endowed women that are seen as the ideal. Their presence seemingly everywhere can be quite stressful for the adolescent girl experiencing considerable hormonal and emotional fluctuations and physical changes along with a fragile body image.

When an adolescent girl realizes that her breasts are not and will never be the size that she would like them to be, what is the youngest age that it would be reasonable for her to pursue breast augmentation surgery? Taking physical, emotional, and intellectual issues and maturation into consideration, my recommendation is for her to wait until at least 18 years of age before undergoing a breast enlargement.

As with many things, there are some exceptions. If a girl has breasts of such significantly different sizes that is difficult to hide with normal clothing or if there is either severe underdevelopment or absence of one breast (which is often congenital in nature), proceeding with surgery at an earlier age may be more prudent. Surgery in these situations may even be considered to be reconstructive.

If you would like additional information on breast augmentation, breast implants or other cosmetic procedures, you can contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

You must be thinking that there has to be a typo here. If anything, from all the news media palaver in the past, it is the opposite that must be true. Actually, this is the right question and it does have an unexpected answer.
Silicone breast implants have been subjected to more scrutiny and studies over the years than any other medical device. Several of these looked at any possible association of the long term presence of silicone breast implants with the development of breast cancer by evaluating large numbers of women over many years. The results were shocking but consistent: there is a statistically lower risk of developing breast cancer in women who have had these implants long term. This finding has been reconfirmed by many studies in diverse locations around the world.

The most recent research published in January 2009 in the International Journal of Cancer revealed the results of a epidemiological study of over 6200 Swedish and Danish women who had a mean duration of implantation of over 16.5 years with thirteen percent having them in excess of twenty five years. The findings identified a statistically significant reduction of risk of developing breast cancer of 27%. Previous studies conducted in the United States have shown decreased risks as high as 37 to 53%.

Why women with silicone breast implants have a lowered risk of developing breast cancer is unclear and has been the subject of much conjecture. However, this is fantastic news both for women who are considering a breast augmentation and those who already have silicone implants. When discussing breast enlargement with my patients, I try to put this all in perspective. I do not tell them that if they elect to have silicone breast implants, their risk for breast cancer may be decreased. Instead, I let them know that at a minimum there is no evidence that having silicone breast implants will increase their chances for developing breast cancer.

Steven H. Turkeltaub, M.D P.C.
Scottsdale and Phoenix, Arizona

If you have breast implants, don’t you wish that they would last forever? Although this would be wonderful, they are not lifetime devices and will probably need to be replaced sometime in the future. Many of my patients here in the Scottsdale, Glendale and the Phoenix area are under the impression that breast implants need to be replaced every ten years. Fortunately, this is not the case. The silicone gel implants manufactured today are much better than previous generations. There have been many technological and manufacturing improvements including a thicker and more durable outer shell that is virtually impermeable to any silicone migration.

They also are filled with a much more cohesive silicone gel. As a consequence, it is possible for many silicone gel breast implants to last 20 to 30 years or more. In an ongoing prospective scientific study overseen by one of the silicone implant manufacturers, Allergan, it was noted that there is a rupture rate of 2.7% at 4 years after breast enlargement surgery.

Saline breast implants deflate, on average, much earlier and at a significantly higher rate as compared to silicone implants. This has been borne out by my personal experience of over twenty years at the Arizona Center for Aesthetic Plastic Surgery. Textured saline implants do not fare nearly as well as the smooth surfaced ones.

There are many other factors that can influence the lifespan of the implants aside from whether they are silicone or saline. Some of these include the presence or absence of surface texturing, size of the implant, manufacturer of the implant, size and location of the incision for insertion, surgical technique, mammograms and trauma. Each one of these issues can be discussed in more detail during your consultation.

Breast enlargement is extremely rewarding for the vast majority of women who have had the procedure. Just realize that although the breast implants are generally quite durable, they typically will not last forever.

For much more information or to schedule a thorough consultation for a breast augmentation, breast lift with implants or other cosmetic procedures, you can contact Dr. Turkeltaub at 480-451-3000.

Smooth(left) and textured(right) silicone implants

The number one issue facing women when electing to undergo a breast augmentation is selecting the proper sized breast implant. This is a truly a much more complex problem than one would think. You know that you want to be larger but how large? Do you want to be a “C”? A “small D”? A “full C”? Do you want to be proportionate, a little larger than proportionate or very large?

Unfortunately, these are all very subjective, personal and not standardized. What may be proportionate for one person would be way too small for another. A large “C” for one woman may be another’s “D”. Overly large breasts to one woman may be considered balanced to another. Further compounding the confusion is that there is no standardization of cup sizes among bra manufacturers. One company’s “C” bra may be identical in fit with another company’s “D” sized bra.

In my experience, I have found some useful approaches to assist my patients in better determining the size that they are seeking. Trying on a variety of implants in the office can provide some facsimile of a three dimensional result although the true shape and size will be different. Judging their responses to various elements then allows me to better ascertain what they desire. They are also shown photographs of a diversity of patients with varying cup sizes. Many patients bring in pictures of breast shapes and sizes that they like from the internet or magazines which can further help. However, there are limitations due to clothing, air-brushing, perspective and the two dimensionality of the pictures.

Combining all this information and input along with some intuition, I can determine reasonably well what my patient is looking for. During surgery, all this information assists me in making the final decision on the most desirable implant size. If there is any question about the size, I will elect to go larger rather than smaller. This approach is usually makes everyone happy.

These a a few different sizes of Silicone implants