Dr. Sarfati’s FAQs

01 – Does breast surgery increase the risk of breast cancer?

Breast surgery never increases the risk of breast cancer. However, it is essential to perform breast imaging (mammography, ultrasound, etc.) before any aesthetic or plastic breast surgery. This provides a reference image for any future checks.

02 – Will I be able to breastfeed after breast surgery?

This depends on the technique used. Some breast surgeries cut the milk ducts, making it difficult to predict whether the patient will be able to breastfeed afterward. Other breast surgery techniques leave the milk ducts intact, allowing for breastfeeding.

03 – Are scars visible after breast aesthetic surgery?

During breast surgery, the surgeon aims to conceal the scars within natural folds to make them as discreet as possible. The quality of the scar depends on the surgeon and, to a large extent, the patient’s healing abilities.

04 – How can I find out the cost of breast surgery? Can I send an email with photos?

It is impossible to provide an exact cost for breast surgery without first examining the patient. A consultation at your aesthetic surgeon’s office is necessary to establish a precise quote.

05 – I don’t like my breasts, how do I know what type of breast surgery I need?

During the consultation with your aesthetic surgeon, it will be determined which breast surgery technique is best suited to meet your needs.

01 – Is swelling significant after breast augmentation?

Swelling after breast augmentation varies depending on the patient and the technique used. Most of the time, it is moderate. Wearing a compression bra for a month after the procedure helps reduce swelling.

02 – I want a breast augmentation to achieve a C cup. How do I choose the ideal implant?

During your consultation with your plastic surgeon, you can try on external implants of different sizes to precisely determine the ideal size for a natural-looking breast augmentation. For example, you can choose an implant that will increase your cup size from a C to a D.

03 – My friend had a breast augmentation with 350cc implants. If I get the same implants, will I have the same results?

It is impossible to achieve identical results in two different patients, even if the same 350cc implants are used. The outcome of breast augmentation depends not only on the implants but also on the shape of the chest, the shape of the breast, and the amount of remaining breast tissue.

04 – I had breast augmentation with 400cc implants, and I want to reduce the volume. Will my breasts sag?

It depends on how much you want to reduce the implant size. If you go from 400cc to 350cc, there will be little difference in breast shape. However, if you wish to halve the size of the breast implants, the breasts may sag, and additional glandular reshaping may be necessary to correct this ptosis.

05 – Why do breast augmentation prices vary so much between surgeons?

You can find almost any price range for breast augmentation on the internet. The cost varies based on clinic fees, fees charged by the plastic surgeon, the type of breast implants used, and the post-operative care provided. Some surgeons, like Dr. Benjamin Sarfati, do not charge extra fees for revisions in the operating room.

06 – I want a natural-looking breast augmentation. What is the best technique to use?

To achieve a natural-looking breast augmentation, it is best to consider augmentation without implants, using fat grafting (lipofilling). If the desired augmentation exceeds one cup size (or if there is insufficient fat reserves), a composite breast augmentation (implant + fat grafting) should be considered. This technique allows for a natural-looking breast augmentation. Additionally, choosing a moderate-sized breast implant will also contribute to a more natural result.

07 – For breast augmentation, what is the most discreet scar?

There is no ideal scar for breast augmentation. It depends on each patient’s individual healing process. During a discussion with your plastic surgeon, you will be informed about the advantages and disadvantages of each scar location based on your breast anatomy.

08 – Where are breast implants placed?

In breast augmentation with implants, they are inserted through a discreet incision. Scars for breast augmentation can be placed under the arm, under the breast, or around the areola. Breast implants can be positioned in front or behind the pectoral muscle depending on the amount of glandular tissue. Augmentation can also be done in a dual-plane technique, where the upper half of the implant is placed under the muscle for a discreet appearance, and the lower half under the gland to enhance breast projection. The goal of implant placement in front or behind the muscle is to achieve a natural-looking result in breast augmentation.

09 – What are the most common side effects after breast augmentation with implants?

Mild swelling can be observed after breast augmentation with implants. This swelling typically subsides within a few days, and the result of breast augmentation becomes natural-looking within a few weeks. Pain is usually minimal and well managed with pain relievers. A few days of rest from work should be planned after breast augmentation with implants.

10 – How do I know if I am a good candidate for breast augmentation?

There is no bad candidate for breast augmentation; the goal is to determine the ideal technique and the perfect implant size relative to your anatomy. If you desire breast augmentation through fat injection (lipofilling), it should be noted that the augmentation will only be up to one cup size larger. The result of this breast augmentation is very natural and permanent. However, you must have enough fat reserves to harvest and reinject the fat into the breast. If you wish to have breast augmentation with implants, your plastic surgeon will examine you and take measurements to determine with you the ideal breast implant.

11 – What factors determine the cup size?

Breast augmentation to increase from a C cup to a D cup, for example, does not pose particular problems. It becomes more complicated if the patient wishes to increase their breast size by more than two cup sizes. The size of the implant can be limited by the existing breast volume and the width of the patient’s chest. Therefore, it is essential to be reasonable and not request extravagant sizes, as the aesthetic result would not be satisfactory.

12 – What is the lifespan of breast implants?

Breast implants do not have an expiration date. In the case of breast augmentation with implants, they will wear out over time, potentially leading to a rupture. In any case, this is not an emergency, and you can live with a ruptured breast implant for several weeks or even months. It is necessary to consult your plastic surgeon or gynecologist once a year to check the integrity of the breast implants. If needed, an ultrasound or MRI may be prescribed. The question of a possible replacement usually arises starting from 10 years after the first cosmetic surgery.

13 – Is there a risk of breast cancer after breast augmentation with implants?

No, there is no risk that a breast implant increases the likelihood of developing breast cancer. Moreover, breast implants do not hinder the detection of potential breast cancer through palpation or imaging (mammography, ultrasound, or MRI). We now have sufficient experience to say that breast augmentation with implants does not pose any risk concerning breast cancer.

14 – How to choose the right size of breast implant?

Choosing the size of the breast implant is crucial to achieving a good aesthetic result. Your plastic surgeon should also guide you in this choice, as there is the size “that you want” and the size “that you can have.” A breast augmentation of 350cc or 400cc will give very different results. There are breast implants of very different volumes, with various widths, heights, or projections.

01 – Are the scars visible after a breast reduction?

Depending on your skin quality and healing ability, the scars become very discreet over time. Your surgeon will prescribe healing creams to improve the aesthetic appearance.

02 – I want a breast reduction; how can I know the price and if it will be covered by health insurance?

During your consultation with your plastic surgeon, the clinical examination of your breast hypertrophy and the final volume you desire will determine if a reimbursement is possible. The cost of the breast reduction will vary depending on whether you are covered or not.

03 – Is the pain significant after a breast reduction?

No, the pain after a breast reduction is usually very moderate and well controlled with standard painkillers. Wearing a compression bra for the first month after the surgery also helps reduce this pain.

01 – Is it possible to have breast ptosis surgery or a breast lift without scars?

What is currently referred to as scarless breast ptosis surgery or breast lift is the correction of ptosis solely by placing an implant, which is suitable for moderate breast ptosis. However, a small incision is still necessary to insert the implant.

02 – I want a breast lift; how do I know if I need an implant or not?

During your consultation with your plastic surgeon, they will assess the remaining breast volume and determine whether a mastopexy with an implant is necessary to fill out the cleavage.

03 – I want a breast lift; what will my scars look like?

Depending on the degree of breast ptosis, the scars from a breast lift can vary:

• Around the areola
• Around the areola and vertically
• Around the areola and in an inverted T shape (anchor-shaped)

04 – Is the cost of correcting breast ptosis different if I have a mastopexy with or without an implant?

Yes, if a breast lift with an implant is necessary, the cost of the implant will be added to the overall price of the procedure.

05 – I have breast ptosis and want a breast lift only with an implant; is it possible?

Yes, it is possible to correct breast ptosis solely by placing a breast implant.

06 – How long after a breast lift can I plan for pregnancy or breastfeeding my baby?

A breast lift corrects sagging breasts (ptosis correction or mastopexy). The procedure raises the level of the areolas and nipples, giving the breasts a more youthful appearance. It is recommended to wait approximately 6 months to a year before planning a pregnancy. Generally, breastfeeding is possible. However, in some cases, any breast surgery can potentially interfere with breastfeeding.

07 – Can a breast augmentation be performed at the same time as a breast ptosis correction?

Breast augmentation with implants is a very common cosmetic surgery. It can be combined with or without a breast ptosis correction. This means that during the same operation, both breast volume is increased and any sagging breasts are corrected (breast lift or mastopexy). This approach achieves a harmonious and natural aesthetic result. Various techniques and types of scars depend on the degree of breast ptosis. You can find more details about the different techniques and scars for ptosis correction (breast lift) in the corresponding section.

08 – What is the round block technique?

There are different techniques for correcting breast ptosis (breast lift or mastopexy). The round block is one of these techniques. It lifts the breast with only a scar around the areola, avoiding vertical or inverted T scars. This technique is suitable for slightly sagging breasts. In cases of more severe ptosis, a vertical or inverted T scar may be added to the one around the areola. The round block technique can be combined with a breast augmentation using either implants or fat injection (lipofilling).

9 – What scars are necessary after a breast ptosis correction?

Depending on the degree of breast ptosis, there are different types of mastopexy (breast lift). In cases of very slight ptosis, inserting an implant alone can correct it. For moderate ptosis, a scar around the areola, known as the round block, is necessary. In more pronounced ptosis, a vertical or inverted T scar is required. These different scars not only lift the breast but also reshape it for a more aesthetic form. A scarless breast lift is therefore impossible.

10 – Is the result of breast ptosis correction long-lasting?

Breast lift surgery with or without implants (ptosis correction or mastopexy) provides long-lasting results, although a slight sagging may occur a few weeks after the procedure. The scars from a breast lift fade over time and become increasingly discreet. In the case of a breast lift with implants, consider replacing the implants about 10 years after the initial surgery.

11 – What is the treatment for capsular contracture around a breast implant?

When an implant is placed in a living body, an envelope forms around it as a normal and natural reaction. However, in rare cases, this envelope hardens, making the breast feel firmer and sometimes deformed and painful, known as capsular contracture. Once established, it is difficult to eliminate capsular contracture without surgery. Massages can be suggested to try to soften the breast. The preferred treatment is surgical, involving replacing the implant and removing the contracture in the same operation. It is important to distinguish between postoperative swelling, which appears the day after surgery and subsides in a few days, and capsular contracture, which typically develops several months to years after breast augmentation.

12 – Under what conditions can breast lipofilling be performed?

Breast lipofilling (fat injection to the breasts) involves harvesting fat via liposuction from a patient and reinjecting it into the breasts. Breast lipofilling can be used: alone for breast augmentation with fat injection, or combined with breast augmentation using implants, known as composite breast augmentation. In this case, fat is used to be injected around the breast implant and into the cleavage to conceal the implant and achieve a very natural result.

13 – Is breast augmentation with implants painless postoperatively?

Breast augmentation with implants can cause some pain after the procedure. Pain medications provided post-surgery effectively control this pain. Breast augmentation can be more painful if the implant is placed behind the muscle. Generally, the pain lasts only a few days after surgery, and the prescribed pain relievers are very effective. There may be pain around the scars or the implant site.

14 – Is there a risk of breast implant rupture? What should be done if this occurs?

There is indeed a risk of implant rupture. It is important to know that in the event of a ruptured breast implant, whether filled with silicone or saline, it is never an emergency, and surgery is not required immediately. Signs of implant rupture include breast deformity or a breast becoming softer. In case of suspicion, consult your plastic surgeon for an examination. If necessary, they will prescribe an ultrasound or MRI to confirm the diagnosis. If a rupture is confirmed, surgery will be needed to replace the implants.

15 – Does breast augmentation with implants guarantee symmetry?

If there is pre-existing asymmetry before breast augmentation surgery, a slight asymmetry may remain after the procedure. The plastic surgeon can choose implants of different sizes to restore symmetry. Postoperative swelling from breast augmentation with implants can cause temporary asymmetry (one breast appearing larger than the other), which should subside in the following days. These guidelines also apply after breast augmentation with fat injection (breast lipofilling).

16 – At what age can breast augmentation be performed?

For cosmetic breast augmentation, the procedure can be performed from the age of 18, when reaching civil majority. For breast augmentation covered by social security (in cases of breast agenesis, meaning a lack of breast gland development, A cup or smaller), it is necessary to wait until puberty has ended, and breast development is complete. The procedure can then be performed from the age of 16-17.

17 – Can folds appear after placing breast implants?

Over time, folds can appear around breast implants. The causes can be multiple: implant wear, even rupture, weight loss resulting in a reduction in breast volume, making the implant more visible. This risk is reduced if the implants are placed behind the muscle. There are three solutions to eliminate these folds: changing the breast implant, changing the implant’s position from in front of the muscle to behind the muscle, or injecting fat (lipofilling) around the folds to conceal the implant. These techniques can be combined during the same procedure to optimize the result.

18 – Are certain sports prohibited after breast augmentation with implants?

It is important to know that no sport is contraindicated after breast augmentation with implants. Patients can resume a completely normal life. Sports are contraindicated during the first month following cosmetic surgery. Gradual resumption of physical activities is possible from the second month after the procedure. All sports can be practiced without any restrictions.

19 – Is pregnancy and breastfeeding safe after getting breast implants?

There is no risk of getting pregnant after breast augmentation with implants, so pregnancy is not contraindicated. However, pregnancy can alter the result of breast augmentation with implants; the breasts may sag slightly, potentially causing breast ptosis, which can later be corrected with additional cosmetic surgery. In most cases, breastfeeding is possible after breast augmentation with implants.

01 – I have one breast larger than the other. How do I know if I should reduce one or increase the volume of the other?

In the case of one breast being larger than the other, the corrective procedure depends on your breast anatomy. Sometimes, only one breast needs surgery, while other times, both may require intervention.

02 – There is asymmetry after my breast augmentation with implants. What can I do?

Asymmetry following breast augmentation can stem from various factors such as implant malposition (too high or too low), or implant rotation (in the case of anatomical implants). It is important to wait at least one year to assess the final outcome of breast augmentation with implants before addressing any asymmetry.

03 – One of my breasts is lower than the other. Is it possible to operate on both breasts simultaneously to lift them?

Yes, it is entirely possible to correct breast ptosis (sagging) in both breasts in the case of breast asymmetry. This allows for achieving a harmonious and symmetrical breast appearance.

01 – Is it possible to keep breast implants for life?

No, breast implants wear out over time. They need to be replaced in case of issues, but not systematically.

02 – How do I choose between round or anatomical breast implants?

During your consultation with your plastic surgeon, depending on your wishes and the desired breast shape, a round or anatomical prosthesis will be chosen.

03 – I had breast augmentation with round implants placed in front of the muscle 20 years ago. Now, I want to remove my breast implants. What will my breasts look like afterward?

It is difficult to predict the final result after removing round implants placed in front of the muscle. If the breast tissue is excessively stretched, skin and glandular reshaping may be necessary.

04 – I had breast augmentation surgery with implants 15 years ago. Now, I feel like my breast implant has shifted. What should I do?

If in doubt, it is important to schedule an appointment with your plastic surgeon for an examination and possibly undergo a breast ultrasound to rule out implant rupture or displacement. If there is implant rupture or displacement, a new surgery will be necessary.

01 – A friend had breast reconstruction using the latissimus dorsi flap and says the pain was very significant. Will I experience the same?

Breast reconstruction using the latissimus dorsi flap has evolved in recent years, with new techniques for harvesting the flap reducing the after-effects of this procedure. Today, this method allows for natural-looking breast reconstruction with a quick return to daily activities.

02 – I want breast reconstruction solely with fat injection. I’ve heard about the Brava method for breast reconstruction. What are the benefits?

Breast reconstruction using the Brava method helps reduce the number of fat injection sessions required. However, breast reconstruction with fat injection can also be performed without the Brava method.

03 – Is breast reconstruction covered by health insurance regardless of the number of interventions?

Yes, health insurance covers breast reconstruction surgery from start to finish, regardless of the number of necessary interventions.

01 – Is corrective surgery for breast malformations covered by health insurance?

Yes, in most cases, corrective surgery for breast malformations is reimbursed by health insurance. Sometimes, prior approval (entente préalable) from the health insurance may be necessary.

02 – I suspect I have tuberous breasts. How can I be sure?

It is important to consult your plastic surgeon to confirm the presence of tuberous breasts. In such cases, corrective surgery is covered by health insurance.

03 – I have an extra breast (supernumerary breast). Can it be removed?

Yes, it is common to find supernumerary breasts or nipples in some patients. The extra nipple is usually located on the chest. There can also be what are called accessory breast glands in the armpits. Surgery to remove them is relatively simple and provides very good aesthetic results.

01 – What is breastfeeding like after surgery for inverted nipples?

It is important to note that breastfeeding is impossible after surgery for inverted nipples because the milk ducts are cut during the procedure.

02 – From what age can surgery for inverted nipples be performed?

It is advisable to wait until 18 years old to undergo surgery for inverted nipples, as it is important to wait until breast gland growth is complete.

03 – Is there a decrease in sensitivity after surgery for inverted nipples?

A decrease in nipple sensitivity may be observed in the days following the surgery, but sensitivity typically returns to normal in the following weeks.

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02 – For an otoplasty, is the scar visible?

No, in a typical otoplasty procedure, the scar is located behind the ear, often concealed by hair.

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01 – Do all skin cancers require additional treatments such as chemotherapy?

No, in some cases, the cancer is strictly localized to the skin, so additional treatments are not necessary.

02 – Is surgical treatment the only option for basal cell carcinoma?

Yes, in the vast majority of cases, basal cell carcinoma is treated solely through surgery.