200 S. Orange Center Rd. | Orange CT 06477 »

FAQ’s

Below is a list of some frequently asked questions, but please feel free to call our office if you need additional information, 203.772.1444. We are always pleased to assist you.

Breast Augmentation

Q. There seems to be a wide variety of options with respect to size, type and shape of the implants, as well as pocket location and incision type. How do I know which combination is right for me?
A. 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.
Q. Is it possible to choose a specific cup size?
A. 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.
Q. Are silicone gel implants available?
A. Yes. The FDA has given approval to unrestricted use of silicone implants. Additionally, the FDA has recently approved a newer implant referred to colloquially as the “Gummy Bear” silicone implant, which has a more “cohesive” gel which is less likely to spread in the event of implant breakage. Dr. Restifo will be happy to discuss the pros and cons of each of these types of implants.
Q. Are silicone gel implants better than saline implants?
A. 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.
Q. How long do the implants last?
A. 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.
Q. How will I know if there is a problem with my implants?
A. 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.

Breast Revision

Q. What options are available for breast revision?

A.Dr. Restifo may discuss the following options with you:

  • What type and size of implant would achieve the desired results (saline or silicone)
  • Whether the implant will be placed above or below the muscle
  • Whether you would also benefit from a breast lift or reshaping of the breast
  • Whether you’d like to remove the implants without replacing them
Q. How is breast revision done?
A. Your reasons for breast revision will determine the best treatment plan. Whenever possible, Dr. Restifo will use your original incisions to remove and/or replace implants. He may need to either enlarge the size of the pocket to accommodate larger implants or surgically reduce the pocket to accommodate smaller implants. If your original implant pockets were originally placed too far apart or too close together, Dr. Restifo will use sutures to reconstruct the pocket in the desired location. Finally, if your original implants were placed above the muscle, he may recommend placing them below the muscle for better results. A breast lift may also be helpful to achieving the desired results, in which case your incisions may be different than for your initial breast augmentation.
Q. What are the considerations and limitations surrounding breast revision?

A.Issues following breast revision surgery are uncommon and usually minimal, however they may include:

  • Capsular contracture (with silicone implants)
  • Swelling and pain
  • Scarring
  • Changes in sensation
  • Milk production
  • Change to the implant as a result of injury, activity, or the normal passage of time

Implants do require monitoring and will eventually need to be replaced. If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. Regular monitoring of breast implants after breast augmentation is recommended to ensure continued breast and implant health.

Q. What should I expect at an initial breast revision consultation?

A.Prior to your consultation, you will be asked to fill out a complete medical history, which includes information about:

  • Medical conditions, both past and present
  • Current medications and supplements
  • Previous surgeries and medical treatments
  • Allergies
  • Pregnancies
  • Mammogram results from within the past year (for patients over 40)
  • Family history of breast cancer
  • Current use of alcohol, tobacco and recreational drugs
  • Weight fluctuations

During your initial consultation, Dr. Restifo will listen to your cosmetic goals, needs, and any medical concerns. He will evaluate whether you’re a good candidate for breast revision based on your anatomy and physical health, and will determine a treatment plan based on your expectations. He will also be candid about whether he can achieve the outcome you desire.

After you’ve discussed the size and shape of breasts that you desire, Dr. Restifo will work with his assistant to measure and photograph your breasts for your medical record. He will also evaluate the following:

  • Current size and shape of your breasts.
  • State of your skin’s elasticity.
  • State of existing breast tissue.
  • Type and size of current implant.
  • Current size and location of your nipples and areolas.
  • Desired breast size after surgery.

If your breasts are drooping significantly, Dr. Restifo may also recommend a breast lift (mastopexy) in conjunction with breast revision to achieve the best overall outcome. See Dr. Restifo’s video “Implant, Lift or Both?” for more information.

If you are planning to lose a significant amount of weight, be sure to mention this in the initial consultation. Also be sure to mention any plans to get pregnant, in either the near or distant future. It is ideal to stabilize your weight before undergoing surgery to get the best possible results.

Q. Is breast revision safe?
A. Dr. Restifo is committed to each patient’s safety and satisfaction, and he stays well-informed regarding breast implant options and surgical techniques for breast revision. It is important for women who have had breast augmentation to have periodic examination by a board-certified plastic surgeon to monitor their implants.
Q. What will my breast revision scars be like?
A. Whenever possible, Dr. Restifo will use your original incisions to remove and/or replace implants, however if you have a breast lift to change the position of your nipples or the shape of your breasts, additional incisions may be necessary. Scars from breast surgery incisions will begin to fade in a few months and will continue to fade for months or years. Our postoperative instructions include information about scar therapy.
Q. How long will the results of breast revision surgery last?

A.Breast revision is typically long-lasting if you maintain a healthy body weight, however lifestyle and life-stage both play a role in how long the results of your surgery will last. Your breasts can change due to a number of factors, including:

  • Pregnancy
  • Hormonal fluctuations
  • Time and gravity

In general, implants do not need to be changed until they demonstrate deflation (saline) or internal disruption (silicone).

Q. How do I prepare for breast revision surgery?

A.Prior to your surgery, Dr. Restifo will ask you to:

  • Stop smoking at least six weeks before undergoing surgery to better promote healing.
  • Contact your primary care physician to schedule a preoperative physical for the following tests required for your surgery:
    • A recent complete history and physical with medical clearance for surgery and general anesthesia
    • Labs complete with CBC, PT, PTT
    • Current EKG and report of the reading for patients over the age of 50 or those with a cardiac history
    • A mammography report completed within the last year (for patients over 40)
    • Any other exam that you or your physician feel is indicated
  • Avoid taking aspirin and certain anti-inflammatory drugs (e.g. ibuprofen, naproxen) that can increase bleeding.
  • Fill any prescriptions he provided prior to surgery (though you won’t need them until afterwards).
  • Hydrate well both before and after the surgery for safe recovery.
  • Purchase a front-closure sports bra.
  • Arrange for a ride home after surgery.
  • Plan to have someone to stay with you for at least the first 24 hours following surgery.

Full preoperative instructions can be found under Patient Resources.

Q. What Should I Expect After Breast Revision Surgery?

A.Most patients feel tired and sore after breast revision surgery for the first day or two. Some discoloration and swelling may occur, but this usually passes relatively quickly. Some patients feel an increased tightness and sensitivity in the breasts, and skin may feel warm or itchy. Dr. Restifo will prescribe specific medications that will increase your safety and comfort during healing. If you’ve had a breast lift in addition to implants, your recovery time may be a little longer.

Many patients return to work within one week, although we recommend that patients wait a minimum of two weeks before driving. Patients should walk as early as the day of surgery, but should also refrain from lifting, pulling or pushing anything greater than five pounds for one month. We also recommend avoiding high impact aerobic exercise or upper body workouts for six weeks.

Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. It may take several weeks for your breasts to fully “settle” into place.

Breast Lift (Mastopexy)

Q. What are the reasons for having a mastopexy or breast lift?
A. 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.
Q. Are there different types of mastopexies?
A. 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.
Q. Is it possible to combine mastopexy with augmentation?
A. 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.

Breast Lift with Augmentation

Q. How is a breast lift with augmentation done?

A.

  • Incisions are made according to the treatment plan.
  • A pocket is created in the breast area and an implant is placed either underneath or on top of the pectoral muscle.
  • The nipple and areola is moved higher on the breast and/or resized.
  • Breast tissue is reshaped to achieve the desired breast contour.
  • Any excess skin is trimmed to create a tighter, more defined appearance.
  • When the breast lift with augmentation is complete, the incisions are closed with sutures.

Dr. Restifo will recommend implant placement and size based on your anatomy, type of implant, and any other factors that will enhance your safety and satisfaction.

Q. What options are available for a breast lift with augmentation?

A.A course of treatment will be suggested based on your body shape, medical history, lifestyle, and beauty goals. The following options are available for augmentation:

  • Saline-filled breast implants are filled with sterile salt water. They are filled at the time of surgery to allow for a shorter incision and for minor modifications in implant size.
  • Silicone-filled breast implants are filled with soft gel and are available in a variety of shapes. All silicone breast implants are pre-filled and may require a longer incision for implant placement.
  • Cohesive gel silicone implants, also known as “gummy bear” or “form stable” implants, are filled with a cohesive silicone gel which makes them feel thicker and firmer than traditional silicone implants. This enables them to retain their shape better.
  • Shaped implants, also called “teardrop” or “anatomical” implants have less fullness in the upper part and more fullness in the lower part, mimicking the shape of a real breast. They have advantages and disadvantages compared to other implants. Watch Dr. Restifo’s video “Straight Talk about Shaped Implants” to learn more.

Here are some factors that influence what breast implant is right for you:

  • Your anatomy, including your body frame and existing breast tissue
  • Your preferences related to size
  • Your goals for breast augmentation
  • Your lifestyle
Q. What are the considerations and limitations surrounding a breast lift with implants?

A.Breast lift with augmentation surgery is a long-term way to achieve an ideal, youthful figure. Issues following this type of surgery are uncommon and usually minimal, however they may include:

  • Capsular contracture
  • Swelling and pain
  • Infection
  • Changes in nipple sensation
  • Milk production
  • Change to the implant as a result of injury, activity, or the normal passage of time

Of course, it is not possible to stop time and gravity in their tracks indefinitely. After a number of years, some women choose to have their breast lift revised. Additionally, implants do require monitoring and may eventually need to be replaced. Regular monitoring of breast implants after a breast lift with augmentation is recommended to ensure continued breast health.

Q. What should I expect at an initial breast lift/augmentation consultation?

A.Prior to your consultation, you will be asked to fill out a complete medical history, which includes information about:

  • Medical conditions, both past and present
  • Current medications and supplements
  • Previous surgeries and medical treatments
  • Allergies
  • Pregnancies
  • Mammogram results from within the past year (for patients over 40)
  • Family history of breast cancer
  • Current use of alcohol, tobacco and recreational drugs
  • Weight fluctuations

During your initial consultation, Dr. Restifo will listen to your goals, needs, and concerns. He will evaluate whether you’re a good candidate for breast lift with augmentation based on your anatomy and physical health, and will determine a treatment plan based on your expectations. He will also be candid about whether he can achieve the outcome you desire.

After you’ve discussed the size and shape of breasts that you desire, Dr. Restifo will work with his assistant to measure and photograph your breasts for your medical record. He will also evaluate the following:

  • Current size and shape of your breasts.
  • State of your skin’s elasticity.
  • Quality and quantity of existing breast tissue.
  • Current size and location of your nipples and areolas.

After the examination, you will be introduced to the Vectra 3-D Imaging device which will enable you to see how a breast lift with different types of implants will look on your body.

If you are planning to lose a significant amount of weight, be sure to mention this in the initial consultation. Also be sure to mention any plans to get pregnant, in either the near or distant future. It is ideal to stabilize your weight before undergoing surgery to get the best possible long-term results.

Q. Is a breast lift with augmentation safe?

A.Dr. Restifo is committed to each patient’s safety and satisfaction, and he stays well-informed regarding breast implant options and surgical techniques for both breast lifts and breast augmentation.

It is important for women who have had breast implants to have periodic examination by a board-certified plastic surgeon to monitor their implants. Both saline and silicone gel−filled breast implants have been approved by the FDA. More information can be found on the FDA breast implant page on their website.

Q. What will my breast lift with augmentation scars be like?

A.Dr. Restifo aims to minimize the appearance of scarring and will work with you to determine the best incision point based on your overall beauty goals, including the size, type, and placement of implants and based upon the amount of existing breast tissue that needs to be reshaped.

Incision Techniques For a Breast Lift with Augmentation Include:

  • The “periareolar” lift has an incision around the edge of the areola and is suited for women who need a modest amount of lift.
  • The “lollipop” lift has an incision around the areola and vertically down to the breast crease in a lollipop shape. This is suitable for women with a moderate degree of drooping.
  • The “anchor” incision is a lollipop shape with an additional incision along the breast crease; this is ideal for breasts with significant sagging.

Scars from breast surgery incisions will begin to fade in a few months and will continue to fade for months or years. We will work with you to minimize scarring and to obtain the best possible outcome.

Q. When will I need to replace my breast implants?

A.Breast augmentation with a lift is typically long-lasting, however lifestyle and life-stage both play a role in how long the results of your surgery will last. Your breasts can change due to a number of factors, including:

  • Pregnancy
  • Weight fluctuations
  • Hormones
  • Time and gravity

After several years, some patients undergo a breast revision to exchange implants, or another breast lift to restore a more youthful shape and contour. In general, implants do not need to be changed until they demonstrate deflation (saline) or internal disruption (silicone).

Q. When will I need to replace my breast implants?
A. If you’re planning a pregnancy in either the short-term or long-term, it’s important to tell Dr. Restifo. Pregnancy alters the breast size and shape and could affect the long-term appearance of your breast lift with augmentation.
Q. How do I prepare for breast surgery?

A.Prior to your surgery, Dr. Restifo will ask you to:

  • Stop smoking at least six weeks before undergoing surgery to better promote healing.
  • Contact your primary care physician to schedule a preoperative physical for the following tests required for your surgery:
    • A recent complete history and physical with medical clearance for surgery and general anesthesia
    • Labs complete with CBC, PT, PTT
    • Current EKG and report of the reading for patients over the age of 50 or those with a cardiac history
    • A mammography report completed within the last year (for patients over 40)
    • Any other exam that you or your physician feel is indicated
  • Avoid taking aspirin and certain anti-inflammatory drugs (e.g. ibuprofen, naproxen) that can increase bleeding.
  • Fill any prescriptions provided prior to surgery (though you won’t need them until afterwards).
  • Hydrate well both before and after the surgery for safe recovery.
  • Purchase a front-closure sports bra.
  • Arrange for a ride home after surgery.
  • Plan to have someone to stay with you for at least the first 24 hours following surgery.
  • If you have children, plan to get help for one week around the house.
  • Prepare your recovery space to minimize lifting, twisting, and stretching.

Full preoperative and postoperative instructions can be found under Patient Resources. We recommend that you read all the information related to both mastopexy and breast augmentation prior to surgery.

Q. When will I need to replace my breast implants?
A. If you’re planning a pregnancy in either the short-term or long-term, it’s important to tell Dr. Restifo. Pregnancy alters the breast size and shape and could affect the long-term appearance of your breast lift with augmentation.
Q. What Should I Expect After a Breast Lift with Augmentation?

A.Most patients feel tired and sore after having a breast lift with augmentation for the first two to five days. Some discoloration and swelling may occur, but this usually passes within the first two weeks. Some patients feel an increased tightness and sensitivity in the breasts, and skin may feel warm or itchy. Dr. Restifo will prescribe specific medications that will increase your safety and comfort during healing.

A recovery timeline usually involves:

  • Sleeping on your back in an inclined position during the initial healing period, using extra pillows for elevation if necessary.
  • A return to work within a week of breast lift with augmentation surgery.
  • No laundry or housework for at least a week.
  • No driving for a minimum of two weeks.
  • No heavy lifting > 5 pounds, pulling, or pushing for one month.
  • The option to ride a stationary bike 2-3 weeks after surgery.
  • No high-impact aerobic exercise or upper body workout for 6 weeks.

After surgery, the shape of your breasts will continue to improve as swelling subsides, settling take place, and scars fade. In approximately one month, most patients have a good sense of how the breast lift with implants achieved their desired look. It does, however, typically take several weeks or months before the breasts fully settle, sensation returns to normal, and scarring fades significantly.

Most patients who maintain realistic expectations and who thoroughly discussed their goals prior to surgery are very satisfied with the look of their more youthful, lifted breasts.

Liposuction (also called lipoplasty or liposculpture)

Q. Which areas of the body are most suitable for liposuction?
A. 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.
Q. Is liposuction useful for an overweight patient?
A. 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.
Q. I have heard that the suctioned fat can come back or spread to other areas. Does this happen?
A. 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.

Abdominoplasty (“Tummy Tuck”)

Q. How do I tell if I need liposuction or a tummy tuck?
A. 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.
Q. Do I need to stay overnight at a hospital or facility following an abdominoplasty?
A. 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.
Q. Should I have an abdominoplasty now if I am considering having more children?
A. 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.

Questions from RealSelf

RealSelf Q&A with Richard J. Restifo, MD

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Tel: 203.772.1444
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