Breast Augmentation

Over the past few years, breast augmentation procedures have gained enormous popularity throughout the world. Next to liposuction, breast augmentation is the second most commonly performed cosmetic surgical procedure in the United States, according to the America Society for Aesthetic Plastic surgery. Common reasons to consider the breast augmentation procedure include:

• Enlarging the breasts to make the body more proportional.
• Reshaping and enlarging breasts that have lost their shape due to breast-feeding.
• Balancing breasts that differ in size or shape.

Breast augmentation is performed in our outpatient facility under general anesthesia. A small incision is made under the breast or around the areola and the implant is inserted under the breast tissue and the underlying muscle. The patient is bandaged to hold the breasts in the correct position. Patients come back for a post op visit 7-10 days after surgery for stitch removal.

Before

After

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Choosing an Implant

Silicone: Since the reintroduction of silicone breast implants for cosmetic use in 2006, breast augmentation patients have increased choices to make. Together we will determine which implant is most appropriate. In general several advantages of silicone include:

• Implants made with silicone have a more natural-looking and natural-feeling quality
• They can provide a shapelier contour for women with naturally small breasts.
• Silicone implants are very good for women who do not have a lot of soft tissue coverage as they will feel more natural and will have less visible rippling.

Saline: Saline implants are a popular choice with patients. For years they have been the only choice available for cosmetic breast enhancement in the United States. They are popular today for several reasons. Some include:

• No need for post surgical follow up imaging with MRI (a recommendation from implant manufacturers to detect any rupture to the implant).
• Saline implants are less expensive than Silicone.
• The implants can be placed via a smaller incision since they are filled in the body.

Incision Techniques

In my practice, I use three different types of incisions:

1. Inframammary – an incision made at the crease on the underside of the breast.
2. Periareolar – an incision is made around the areola, the dark pigmented skin around the nipple.
3. Through the lower abdomen during a concomitant tummy tuck. The implant is inserted through the tummy tuck incision-leaving no breast scars.

These incisions are used to minimize scar visibility. Scars will diminish over several months. Once the incision is made, I lift the breast tissue, create a pocket in the chest/breast area, and place an envelope containing a soft, implant material underneath either chest muscle.

After Surgery

After undergoing a breast augmentation, you will need someone to drive you home and to assist you for the first few days after surgery. You will be wrapped with gauze bandages and placed in a surgical bra. You will need to wear a non-underwire support or sports bra continuously for several weeks. Your breasts will appear firm but swollen and will sit high on your chest at first. The implants will drop into a more natural position and shape as the swelling dissipates.