Let’s (NOT) Talk Bra Cup Sizes

When considering breast enhancement surgery, it is natural to think in cup sizes. For instance, you might wear a B cup now, and want to go to a C cup. While that is useful information to share with your surgeon at your consultation, it’s important to realize that it is just a guideline and that implants don’t come in cup sizes. Breast implants are sized according to their volume in cubic centimeters (cc).

One of the first things to consider is that all “C”s are not created equal. A 32C is significantly smaller in volume than a 38C. Then there is variation in cup size by the manufacturer—a Bali 32C may be bigger or smaller than a Victoria’s Secret 32C. There is even variation in cup size with different type bras by the same manufacturer.

A 32C demi bra by Victoria’s Secret may fit, while a 32C pushup may not. So, while it’s useful to have an idea of the cup size you want, remember that there is no standardization of cup sizes.

Below is a photo of four C cup bras by the same manufacturer:

A group of bras

Now take a look at this chart designed to help you figure out your proper bra size:

Bra size chart

First, you measure around your chest, then measure around the breasts where they project the most. The difference gives you the cup size. It seems a bit confusing, right?

Now take a look at this chart:

Bra size chart

This chart gives an idea of what volume in ccs each cup size represents. The hard part comes when the patient is thinking in B, C, D, and the surgeon is thinking in ccs.

What has worked in my practice is to first talk to the patient and listen to what they want, look at pictures of what they might want to look like, and then actually try on some implants. An implant is placed into each cup of the bra, then with a tee shirt on, we get an idea if we’re in the right ballpark. We go up or down in size as needed. Often, the patient will turn to me at this point and say, “So, this is a C?” In response, I tell them if they like the way it looks in the mirror, that’s the one we use, and then find out what cup size it is when they go bra shopping after surgery.

We are usually fairly accurate in getting the size right in terms of patient satisfaction, and having done this for 20 years, I have a very good idea of what volume will make a patient a desired cup size. In the end, as long as the patient is happy with the result, and the size; then the letter, or cup size, really doesn’t matter. It’s just a guideline.

If you’re considering breast augmentation surgery, take the first step by scheduling your consultation today.

Time to Start Thinking About Summer

It’s hard to start thinking about summer and bathing suits already, but if you want to be ready, now is the time to start planning and doing.If you’re considering finally taking that leap and getting that mommy makeover or breast implants, then you have to consider how long the plastic surgery process will take from consultation to surgery, recovery, and time until the final results are evident. Assuming you want to be ready for the summer, here is a sort of timeline of procedures to get you bikini ready.

Liposuction

A woman in a bathing suit and sunglasses at the beach

Liposuction is one of the most popular cosmetic procedures. There is little downtime, little risk, and lots of reward, but the results are not instantaneous. When liposuction is performed, the tissues are infused with a lot of fluid. This helps with bruising, blood loss, and general contour. However, the tissues swell from the fluid and from the procedure itself. A day or two after liposuction you may look great; then you will probably swell. It’s usually not so much that you look larger than you did before but rather hard to tell that you had anything done. At six weeks you may start to notice your clothes fitting differently and start noticing changes in your appearance. It generally takes at least three months before you see the final results. So, liposuction should be done at least three to four months from the time you need to be recovered.

Tummy Tuck

Abdominoplasty, or a tummy tuck, is another procedure that has a rather short initial recovery but rather long period until you see the final results. Usually, patients are out of work (desk jobs) for two weeks. There is a period of two to three months where the abdominal tissue will swell a bit at the end of the day. Spanx or other compression garments can conceal this, but who wants to wear Spanx at the beach? The other consideration is the recovery from the muscle repair; with most tummy tucks this is six to eight weeks with no heavy core activity. So, water skiing, jet skiing, etc., might be difficult even if you look fabulous. Summer timeline for tummy tucks: March to May.

Breast Augmentation

Breast augmentation is the most flexible plastic surgery procedures on the summer timeline. Usually, a weekend recovery, or at most one to two weeks, is all that’s required. So, this can be done a week or two before vacation. If traveling a long distance, its always good to leave adequate time for recovery and healing. Other breast procedures, such as lifts and reductions, are also rather short in recovery time, and results are seen fairly soon after surgery, although the scars will take a full year to fully fade/mature. Breast procedures are year round on the summer timeline, as recovery and results can be very quick.

No matter your aesthetic goals for this summer or beyond, the first step is always a consultation at my office. Get in contact today to start this process, and together we can create a personalized timeline to fit your goals.

Understanding Your Implant Options, Part One: Saline vs. Silicone

People have very strong opinions on this topic and, unfortunately, most of the information on this topic is not based on facts. Understanding the history of the different types of implants may help shed some light on the topic.

The History of Silicone & Saline Implants

Woman preparing for breast augmentation surgery

The first silicone implant for breast augmentation was made in 1961, and the first saline implant in 1964. The silicone implant went through various changes for the next several decades in attempts to improve the longevity, feel, appearance, and texture. Saline implants were not used frequently, as the feel and look of the silicone was far superior. In 1992, the FDA placed a moratorium on the use of silicone implants, stating there was insufficient data proving their safety. Basically, the FDA was saying not to use these until we have a lot more research showing they are safe. At this time, saline implants were used in almost every case except for patients undergoing reconstruction or those involved in the clinical trials.

Concerns With Saline Options

Saline implants worked fine, but there were problems. Saline implants tend to show more ripples, so placement was almost always under the muscle. This requires slightly longer recovery, and over time the implants, in some patients, tend to shift down and out. This is perhaps due to the action of the muscle in combination with the viscosity of the saline. At any rate, pocket revisions for implants sliding off to the side of the chest were not uncommon. Because the muscle only covers a portion of the implant, ripples could be seen on the lateral or outer portion of the breast. The biggest downfall of saline implants is the rupture rate of 3-6 percent at three years, and 7-10 percent at 10 years. Saline implants can rupture without any cause, and it usually happens a week before a scheduled vacation. Joking, but its never convenient to wake up and discover your breast has gone flat. The rupture rate of silicone, by comparison, is less than 1 percent at 6 years.

Rise of Silicone Implants

In 2006, the FDA allowed the manufacture and use of silicone implants once again. The studies proving their safety were to continue for an additional 10 years. During this time, there were no studies that showed a correlation between silicone implants and any disease process or syndrome (chronic fatigue, fibromyalgia, lupus, etc.). The silicone implants used today are vastly superior to the ones used back in the ’60s. The outer shell of the implant is pliable but very resistant to tearing or leakage. The biggest improvement is in the quality of the gel. All silicone implants made now have some form of cohesiveness. That is, the silicone gel isn’t a liquid that will leak out if the outer shell is damaged. There are gummy bear, memory gel, and cohesive gel implants that all have slightly different qualities, but basically, if the implant is damaged, the gel will stay within the shell. If pressure is applied to a damaged implant, the gel will come out of the implant and then return to the inside of the shell once the pressure is removed.

Silicone implants can be placed in front of the muscle or behind the muscle, depending on the amount of available breast tissue. If a patient has adequate tissue to cover the implant, then in front of the muscle is an excellent option. The recovery for this surgery is two to three days. In very thin patients with little breast tissue, the implant is placed behind the muscle.

The bottom line? Both saline and silicone implants will augment the breast. Silicone implants, in my opinion, are vastly superior to saline in terms of natural feel, appearance, and longevity.

For more answers to common questions about breast augmentation, visit our FAQ page. Or, to speak directly to Dr. Kinsley about your questions and concerns, schedule a consultation today.

Male Cosmetic Procedures

Man in a white t-shirtAlthough my practice is made predominantly of female patients, many men also seek cosmetic enhancements. Popular male cosmetic procedures range from injectables, like Botox and fillers, to non-invasive therapies, like Coolsculpting and Ultherapy, to more intensive surgical procedures.

Botox

For men, a little Botox in the glabellar (the area between the eyebrows) and the crows feet is all that’s needed. Younger men frequently request Botox in the forehead lines, as well. When using Botox or other similar agents (Xeomin, Dysport, etc.), more is not always better. No one wants to see a guy with a Nicole Kidman frozen face, so a subtle approach is often used.

Fillers

Like women, men tend to lose volume in their faces as they age. This can be replaced using a number of fillers, such as Juvederm, Voluma, and Radiesse. Fillers for men are most commonly used to restore volume in the cheeks and to lessen nasolabial folds. Another great use for fillers, in both men and women, is in the tear trough. As we age, the cheeks sag a bit, and the lower eyelid becomes more distinct from the cheek. Fillers can be used along the lower margin of the lower cheek to camouflage under eye bags and deep tear troughs for a more youthful look.

Coolsculpting

Coolsculpting has become our go-to technology for guys who have a few problem areas of stubborn fat, such as love handles. The treatments are fast, noninvasive, comfortable, and offer results similar to traditional liposuction in one treatment. The ideal patient is someone close to his ideal body weight with small problems areas.

Ultherapy

Ultherapy is known as the nonsurgical facelift. This in-office procedure is used to tighten loose skin, typically in the lower face and neck. The brow area is also popular for male cosmetic procedures, as tightening in this area tends to open the eyes a bit, without an “operated” look (think Burt Reynolds). There are also a wide variety of laser treatments for any number of skin conditions.

Surgery

Finally, there are numerous options for surgical procedures. The most common is liposuction, as it offers a quick and easy recovery. Abdominoplasty, as well as thigh, arm, and breast lifts, are common after massive weight loss for both men and women. Facial procedures such as facelifts and eyelid surgeries are also available. Some implants are also unique to male cosmetic procedures, such as pectoral, rectus (abs), and calf implants.

Almost all of these male cosmetic procedures are done on an outpatient basis, allowing men to return to regular activity within a few days to a week.

What You Should Know About Breastfeeding With Breast Implants

If you are considering breast implants, one of the concerns you may have is how the implants will affect your ability to breastfeed. In a nutshell, the answer is not very much.

The Procedure

If you consider how this type of breast augmentation is done, it is easy to understand that the implants shouldn’t affect the actual function of the breast at all. A pocket, which is a space not naturally present, is made either behind the breast, behind the muscle, or some combination of both. This means the natural configuration of the nipple ducts gland is completely intact. Therefore the breasts’ ability to produce milk should be unchanged. Think of it this way, in either the submuscular or subglandular position, the implant is merely pushing or filling the breast out. The implant is behind the breast. It doesn’t sever any connections between nipple and gland and only comes into contact with the back of the breast. The implant simply pushes the breast outward and upward.

The Speculations

The only wrinkle here is that some approaches may be more invasive than others. A periareolar incision may actually necessitate disrupting some breast tissue, and there is the chance that milk production could be decreased. However, this is speculative as there is no real scientific data to support this claim.

Image of Breast Implant - Elizabeth A. Kinsley, MD

Lastly, some patients worry if it is safe to breastfeed with implants in place after breast augmentation. The answer is absolutely, yes. As the above image shows, modern implants are very sturdy and your body makes a natural capsule of scar tissue around the implant. There is no communication between your implant and your breast, and ultimately your milk production goes on unchanged.

The Husband’s Guide to Plastic Surgery

red carpet prom dressesHere’s the deal. If a man fathers 20 children or more, his body will look absolutely no different after than it did before children, except for normal aging (str8 h8). Women, on the other hand, see their bodies undergo permanent changes during maternity that can affect their self-confidence, self-esteem, and sex drive, which is why they may decide to undergo a procedure like a mommy makeover. So, even if you think she looks beautiful, and you’re happy with her just the way she is, the important thing to remember is that she might not be satisfied with the way she is. And, most smart men want their wives to be happy.

In my years of practice, I have seen so many cringe-worthy moments as husbands sit through their spouses’ consultations for everything from breast augmentations to eyebrow lifts to mommy makeovers.​ Some do better than others to be perfectly honest, so I decided to give the guys a little help. Here are seven tips on how to survive your wife’s plastic surgery journey.

Lesson 1

This is in no way about you. Not on any level. Not even a little bit. Your wife wants to look better in her clothes, feel better about her body, feel better about how she looks in a bathing suit, or any number of other personal goals. At some point, you will be able to enjoy your wife’s new self-confidence and self-esteem, but you are not the reason she is having a mommy makeover or any other procedure.

Lesson 2

Be supportive. If you’re too enthusiastic about your wife altering her appearance, you will look like a jerk. If you aren’t excited at all, you will look like a jerk. The best bet is just to be supportive of her decisions. If she looks at you and asks what you think, say “whatever you think, honey,” or something to that effect.

Lesson 3

At the consultation for a mommy makeover or other procedure, speak only when spoken to. I have had husbands actually pipe in and tell me, “Doctor, I don’t know if this is important, but I’ve known her since college, and she’s never been petite.” Yikes! It’s best to remember that you don’t really factor into this, and you’re only there for moral support.

Lesson 4
Do not feel like it’s necessary to tell the doctor that you think your wife looks great just as she is (see lesson 1). So many husbands feel like they have to get this in, and they blurt it out at the start of the consultation as if they need to get it off their chests. The doctor knows this. She has heard it a million times.

Lesson 5
Your wife will not die, widow you, or orphan her children in her attempt to improve her appearance. Secretly, women have this fear, too, and I often bring it up in the consultation. Most women seeking mommy makeovers, tummy tucks, or breast augmentations are relatively young and at a very low risk for complications from surgery or anesthesia. The important things to do are make sure you are seeing a board-certified plastic surgeon, and make sure the surgery is done at an accredited surgical facility. This will optimize the chances of a good outcome, minimize complications, and make you both feel less anxious about having elective surgery.

Lesson 6 (Optional)
Take her on a shopping spree, give her a spa day, or do something extra special when she is recuperating. Cosmetic surgery can make a person feel vain, petty, or selfish, and a lot of moms feel super guilty about spending money on themselves, whether for a full mommy makeover or less invasive cellulite treatment. Most cosmetic patients go through a period after surgery where they question why they did it and whether it was the right thing to do. This is usually when they are hurting, bruised, and swollen. This is the time to step in, be supportive, and reaffirm her decisions.

Lesson 7
When all else fails, refer back to lesson 1. Good Luck!

Breast Implants 101: How to Choose the Perfect Implant for You

Ok, so you’ve decided to have a breast augmentation. You’ve done hours of research on the internet and talked with friends who’ve had it done. You’ve asked questions on Image of breast implant - Elizabeth A. Kinsley, MDrealself.com and gotten a ton of good advice. So now it comes down to choosing the perfect implant for you. How do you do that? Trick question, lol, as there is no such thing as the perfect implant for you.

Many of my patients stress sooooo much over making this decision that I often point out that there is no one single correct answer, no one implant that will work if they research enough to find it. The truth is, for most patients, any number of implants will work nicely.

Not too many years ago, the only choices were saline or silicone, smooth or textured. There were moderate and high profiles (profile is how much the implant sticks out from your chest). Today there is an incredible array of implants available to use in a breast augmentation. We still have smooth or textured, saline or silicone, but the choices now include an incredible variety of shaped implants with varying profiles:
Photo Of Breast Augmentation Implants Of Varying Profile Size - Elizabeth A. Kinsley, MD

This picture demonstrates the different profiles available in a classic round, textured, gel implant.

Now throw shaped implants into the mix:
idress tulle prom dresses

Keep in mind that there are 3 manufacturers in the US—Allergen, Mentor, and Sientra—and each has an extensive collection of shaped implants. Some are longer and more narrow, some shorter and wider. Some have a wide base, and some have a narrow base. So how are you ever going to pick the right one?
The answer to this trick question is don’t even try. Do your homework, find a reputable, board certified plastic surgeon, and let her help you decide which of the dozens of breast augmentation implants on the market is right for you. Then turn off your router! It’ll all be ok!

3 Simple, Overlooked Ways to Prepare for Breast Augmentation

As you anticipate your upcoming breast augmentation surgery, you likely have a good idea of the length of the recovery process and what you should expect. However, when the time approaches, it might also be helpful to have this handy list of must-do activities. Here are a few items to help you prepare for your changed body and anticipate your needs during recovery.

Set up a Self-Care Corner

Self-care should be a part of everyone’s day, but it’s an absolute necessity in the time after you receive breast implants. Create a self-care corner to encourage this impulse. Fill the corner with things that remind you to prioritize your body. Items to choose may include lotions, soaps, bottled water, healthy snacks, magazines, and other things that will help remind you to relax and take care of yourself during recovery.

Clear Your Calendar of Responsibilities

Even in the aftermath of breast augmentation surgery, absolving yourself of all responsibilities is just not going to happen. However, you need to clear your calendar as much as possible in the week following surgery. You have to be practicsatin cocktail dressesal about the fact that you need to seek alternative care for kids and pets. Don’t try to carry out responsibilities all on your own, or you will be cheating both of you of the care you deserve. The recovery is usually just a long weekend, so you won’t need too much help with the kids.

Prep Your Post-Operation Bra

As your doctor has probably suggested, you will be in a surgical bra right after the breast augmentation that will be easy to handle and very breathable. It needs to be comfortable to support your recovery, and you need to be prepared to wear it for the first several weeks after surgery. Beyond that, you’ll be able to use sports bras for exercise and supportive full coverage bras for daily wear. Between one to two months after you get implants, you can then buy regular bras, and what a joy that shopping trip will be in your new body.

Finally, keep in mind that you can reach out to your doctor with questions you may have before the breast augmentation surgery. You should always go into this surgical procedure feeling ready and confident with your decision. This is your chance to do something special for yourself, so it’s important also to take the time to be fully prepared.

Envison Implants

Due to the clinical success of the Envision Implants Sizing System, Dr. Kinsley’s patent and the Envision Implants brand are now integrated into the Natrelle Pre-Consultation Kit offered by breast implant manufacturer Allergan.
The Envision Breast Implant Sizing System contains the tools you need to help you make the second most important decision about your breast augmentation surgery (the choice of your surgeon being the number one decision).

  • “Tester implants” in four of the most popular sizes
  • A Breast Sizing Ruler to help you find a “starting point” for which implant size might be best
  • A booklet written by Dr. Kinsley that will answer many of your questions about breast augmentation
  • An instructional DVD that shows you how to use the Envision System
  • Some “before and after” photos of women who have had breast implant surgery

An “Envision Bra” is a perfect way to use your “tester implants”.