During your consultation and examination Dr. Restifo will assess the dimensions of your chest, the amount of soft tissue coverage, and the consistency of your own breast tissue. He will listen to your goals, expectations and preferences. After discussing and considering these factors, it is likely that you and Dr. Restifo will be able to agree on an implant and surgical technique that will give you the best possible result.

Not always. For example, a very petite or slender woman may not have enough room on her chest for a very large implant. Also, there is considerable variation in cup sizes among different bra manufacturers, and even among different styles of the same manufacturer. In general, it is more useful to pose the question "what size implant will give me a result that looks right to me?" The best way to approach this question is to "try on" a particular implant size by wearing a pair of implants in your bra and underneath your clothing for a period of time. We have a large stock of "trial" implants that will be available to you. If you're having trouble deciding between two sizes, it is generally advisable to choose the larger of the two.

Yes. The FDA has recently given approval to unrestricted use of silicone implants.

There are specific advantages to each type. The silicone gel implants tend to look and feel more natural, especially in thin women. However, saline implants can give excellent results if soft tissue coverage (fat or glandular tissue) is abundant. Furthermore, saline implants can be inserted through the shortest incisions possible. Of note, the cost (from the manufacturer) of the silicone implants is substantially higher than that of the saline implants. The choice of silicone versus saline implants will likely depend upon a woman's individual situation, and after your consultation these issues should be clearer.

There is no good information on the longevity of the current implants. In general, a healthy young woman should expect to replace the implants at some point in her lifetime.

When a saline implant deteriorates it is usually obvious; the implant size will decrease as the saline is harmlessly absorbed into the body. With a silicone implant the deterioration is usually harder to detect and may require a specific radiological study (MRI) to confirm a problem. There is no evidence that a broken or leaking implant presents any harm, although replacement will usually be desired.

Pregnancy, weight loss, and aging can result in a situation where there is an excess of skin for the available breast tissue. This usually presents as the nipple or breast tissue descending below the breast fold ("ptosis"). In mild cases this can be treated by an implant alone, which will fill out the loose skin and improve breast shape. More significant ptosis will require skin excision to elevate the nipple and the areola and create a desirable breast shape.

Yes. The optimal technique depends upon several factors, such as the position of the nipple in relation to the fold, and the amount of excess skin. Some techniques will confine the incision to the areolar area and others may involve extension of the incision downwards and into the fold. The goal is to limit the amount of incision as much as possible, but at the same time recognizing that the most desirable breast shape is of paramount importance.

In some circumstances this may be desirable. In small-breasted women or women with substantial amounts of excess skin, adding an implant may lead to the nicest result.

Liposuction is intended to treat localized areas of fat. Some commonly treated areas are the abdomen, flanks, trochanters (" saddle bags"), thighs, upper arms and back. The most important factor in a good outcome is the quality of the skin overlying the localized area of fat. Smooth, taut and youthful skin will respond well to liposuction. If the skin is loose, flabby or has many stretch marks, then liposuction may not give the best result. For example, the abdominal skin after multiple pregnancies is more often treated better by abdominoplasty.

In general, liposuction is not used on heavy patients. Liposuction is a body contouring procedure, not a method of weight reduction. Even after extensive liposuction a patient will only lose a few pounds. The best scenario is a patient that, through diet and exercise, has reached his or her ideal weight, but still has localized, stubborn areas of fat that are resistant to diet and exercise. A patient that is a little overweight can still be a candidate for liposuction, but the significantly overweight person is not.

If a patient gains a significant amount of weight after the procedure the new fat will be distributed throughout the body, including the areas of liposuction. However, if a healthy diet and exercise regimen is maintained and body weight remains constant, then the results of liposuction are usually long-lasting.

The best choice of operation depends upon the skin in the abdominal area. If the skin is taut and smooth, liposuction may be all that is necessary. If skin is loose or flabby, one of the variants of a tummy tuck will be required. If the loose skin is all below the belly button, then a "mini" tummy tuck is the best option. It the excess or flabby skin extends higher than the belly button then a standard tummy tuck will be required. In either type of tummy tuck, sometimes liposuction is performed around the sides or the pubic area to give the nicest contour.

In most cases patients will go home the same day following a "mini" abdominoplasty. Many patients will go home the same day following a "full" abdominoplasty as well. There are, however, some situations in which an overnight stay is advisable. If the abdominoplasty is combined with another procedure (such as breast reduction), or if a very large amount of skin and fat is removed during the abdominoplasty, or if significant tightening of the abdominal wall fascia (the surface of the muscle) is required, then it may be desirable to spend the night in the facility.

Probably not. Although an abdominoplasty will not interfere with your ability to have more children, the stretching and weight gain of the pregnancy will likely "undo" much of the benefit of the abdominoplasty. It is best to wait until you are fairly sure that you are finished having children.