For New York plastic surgeon Daniel Y. Maman, MD performing breast augmentation surgery is “both an art and a science.” From what size is right to that age-old question of how long until you need to replace them, these are the biggest myths about the storied surgery the top doctor wants to set straight.
What do you think is the biggest myth surrounding breast augmentation?
“It is a common myth that breast implants need to be replaced every 10 years. This is not true. Spontaneous implant failure does increase by about 1 percent per year, after ten years. How long implants will last is unknown and varies from person to person. The expected range is between 10 and 25 years. If your breast aesthetic has changed because of aging, breastfeeding, pregnancy or change in personal desires, then it may be a good idea to perform revisional surgery and use the opportunity to replace the implants. In the absence of any issues, I will advise recommendations for implant exchange including any urgency and optimal timing. Each of the three FDA approved implant manufacturers offers some degree of warranty against implant rupture.”
During the past year, have you seen a shift in what women are looking for when it comes to breast-augmentation procedures?
“Most patients in my practice seek a return to pre-pregnancy baseline rather than a noticeable increase in breast size. A large portion of my practice is centered on revising breast augmentations previously performed elsewhere, downsizing to a more appropriate, natural-sized implant.”
Are there any “trends” in breast augmentation that you see at your practice that are region-specific any that you think are New York–specific?
“The trend is smaller, discreet breast implants. I take detailed measurements of the breast to ensure that the breast implant fits your chest perfectly. Once I determine the correct dimensions of an implant, I will provide a range of three sizes that will give you a result in the natural range. I will then place sizers in and sit you up during the surgery and see which fits and looks the best. If two sizes fit well, I will choose the one based on the guidance you provided me prior to surgery. Patients will often say, ‘please put the largest implant that fits well and looks natural.’ If a patient specifies that she wants the smallest implant, I will choose an implant that adequately spans the chest wall, respects appropriate breast borders, but has the lowest volume.
Implants are custom ordered for each patient, not only based on size, but on implant projection, gel cohesiveness/viscosity, implant fill pressure, implant shape, texture, and manufacturer. Each of these variables plays a critical part in my ability to provide you with the most natural-looking breast augmentation.
I will not agree to insert implants that are too big are very unnatural looking. Patients who want large, unnatural-appearing breast augmentations will be referred to another surgeon.”
What is your number-one piece of advice you’d give to a prospective patient considering a breast augmentation?
“Since breast implant surgery is very common, almost every plastic surgeon does it. The key to finding the right surgeon is reviewing the surgeon’ credentials, looking at their before and after gallery, making sure they do a high volume of breast augmentations, and, very importantly, make sure you like the aesthetic of their results. Not every surgeon/artist is the same. The more pictures you look at, the better sense you will have as to the surgeon’s preference for nipple positioning, nipple size, breast shape, breast size relative to body proportions, etc.”
