FREQUENTLY ASKED QUESTIONS
ABOUT SUBFASCIAL BREAST AUGMENTATION
1. I have breast augmentation done under the muscle. Can I convert this to subfascial?
Yes, in most instances, you can. The surgery takes more time and is a little more technical, but the results are truly rewarding. Check out the photo gallery. I perform a lot of revision surgery converting submuscular to subfascial.
2. Is there a lot of pain with subfascial breast augmentation? What are the risks compared with under the muscle?
No, the patients are surprised after surgery. Immediately post op, they usually WALK DOWN TO THE RIDE HOME, and by the second day, most don't even need pain meds. Frequently we scold them for being too active, because they feel fine. Subfascial breast augmentation has less risk than submuscular, because it is less traumatic and technically more precise. Complications are rare, and in my practice I have not observed any increase in capsular contracture. (maybe even better than submuscular)
3. Where is the incision? Does it scar?
The incision is at the lower half of the edge of the areola. My opinion is that this approach is the most accurate, and heals the best, compared with axillary or inframammary. I do perform axillary incisions if the areola is too small.
4. What's better, gel or saline implants?
Almost all our patients select cohesive gel implants. However, if the patient has thick breast tissue, sometimes it can be very difficult to tell the diference between gel and saline. In thinner tissue women, gel is superior, but, both gel and saline implants can have rippling in very skinny women, under or over the muscle.
ABOUT FAT TRANSFER TO THE FACE
1. Is the fat permanent? How long does it last?
Yes, fat transplantation is considered permanent if done optimally. The survival rate may vary, but on average, I give patients a 50% take rate, meaning 50% of the transplanted fat should be permanent.
2. What about "fillers" like hyaluronic acid ( Juvederm, Restylane) and calcium hydroxyapatite (Radiesse) ?
These fillers are not permanent, and actually per cc are much more expensive. Fat transplantation is natural and can be obtained in large amounts, for filling in the entire face if desired. You couldn't do that with fillers. Moreover, even for small areas like the nasolabial fold, I can't say honestly that I believe fillers work well.
3. Does fat transplantation leave lumps and bumps? Does it look natural?
Successful fat transplantation is like planting corn. You can't throw all the seeds in one hole, they have to be planted in nice, even rows. Immediately after fat transfer, there is swelling, and a little "firmness" which subsides in a month and becomes soft, smooth and natural. Because of this, fat is useful in correcting contour defects in the face or body.
