Curves Ahead


Dr. Attkiss
Dr. Attkiss

You’re going to the gym and you’re watching your diet (you are, you swear it), but there are still changes in your body that you don’t want to think about everyday. And, yet, there they are, every time you look in the mirror or see a photo of yourself out on the social scene. Enough’s enough—and why not? These days, plastic surgeons offer many options in body contouring, such as tummy tucks, liposuction, Botox, fillers…even thigh and arm lifts. Here we focus  on breast augmentation and getting the curves you want.

How do you know you’ll be happy with the results? You can try computer simulations and review before-and-after photographs. For enhancements you might wear padded bras. But, ultimately, securing satisfaction includes an open, one-on-one discussion with your plastic surgeon. Dr. Keith Attkiss, a Greenwich Board certified plastic surgeon who graduated cum laude from Harvard College and received his medical degree from Columbia College of Physicians and Surgeons, says during an initial visit his patients should expect to consider size, shape, skin elasticity and more.

“The most common question I get regarding breast augmentation is about size,” he begins. “Most women who come to see me ask to be fuller, but to look natural and proportionate. Not too big. Not too small. Not too obvious, but not too subtle, either. I find photographs to be the best way to communicate, so we spend as much time as necessary reviewing likes and dislikes.”

While women tend focus on size, Dr. Atkiss advises his patients to also consider implant shape and fill. “Implants obviously come in different sizes, but just as importantly, they come in different shapes ranging from flatter ‘low profile’ to rounder ‘high profile’ implants. The key to getting a beautiful, natural, blended result is carefully considering the existing anatomy and properly placing the correct implant.”

Most implants are filled with saline or silicone gel, have a textured or smooth shell, and are round or tear-drop shaped. Be sure to discuss each of these options with your surgeon. “The most popular implant is round, smooth-surfaced, and filled with silicone gel because it feels closest to breast tissue,” says Dr. Attkiss. “The smooth surface allows the implant to move naturally within the pocket that the body forms around the implant and makes it easier to insert through a small incision. More recently, form-stable, or gummy bear, implants were approved by the FDA for use in the U.S. These implants are tear-drop shaped and have a textured surface to prevent them from rotating. They are a little firmer and require a longer incision for placement, but they are useful in certain circumstances, depending on one’s anatomy. Gummy bear implants also may have a somewhat lower risk of leakage or capsular contracture.”

For reductions—perhaps to ease discomfort in your back, neck or shoulders—the method of surgery is particular to each individual. Dr. Attkiss explains why he has a preference for certain technique, saying, “Obtaining a beautiful shape during a breast reduction is a matter of technique. Each surgeon has his or her own tendencies, but my preferred method is to use a technique called a superomedial pedicle, which has been popular in Europe for many decades. This technique allows efficient reduction of unwanted breast excess in the outer and lower breasts, while preserving ‘good volume’ at the upper breast and cleavage area. The resulting shape is long-lasting and does not drop with time as with other techniques.” Surprisingly, the standard breast reduction method practiced for decades in the U.S. does just the opposite.

Recovery time for enhance or reduction procedures varies person to person, but patients should expect to restrict their activities for two to three weeks.

The bottom line for enhancements  or reduction is: The more you talk, the more your expectations are in line with what the surgeon can do, and the happier you’ll be in the long run.

If you’re considering this procedure, step one is to have a consultation with a Plastic Surgeon who is board-certified by the American Board of Plastic Surgery. Search by zip code at Dr. Attkiss can be reached at 2 ½ Dearfield Drive, Greenwich, 203-862-2700;



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