Breast Augmentation (Enlargement)

The goal in breast augmentation is to achieve breasts that are not only fuller in appearance but also retain a natural look and feel. For some women this will mean restoring their breasts to the appearance they had when they were younger or before having children. For other women this will mean giving them a fullness that they have never enjoyed. The augmentation is achieved through the use of implants. Saline implants are currently the most commonly used; however, some women do qualify for silicone implants and their use will increase in the future. Most implants are placed beneath the pectoralis muscle which lies underneath the breast. Incisions that can be utilized to achieve the enlargement include one just below the nipple, one along the lower aspect of the breast, and one in the armpit. During a consultation with the surgeon, the patient will be able to find out which implant, incision, and placement is most appropriate for her to achieve her goal.

The operation is performed in a hospital or outpatient surgery center with the patient returning home the same day. The implant will achieve the goal of giving the breast more fullness as well as raising the nipple to a more youthful position. For some women who have greater degrees of ptosis, or drooping of the breasts, an additional lifting (or mastopexy) procedure might be required at the same time. Women will experience the most discomfort in the first four to five days following the procedure. Most are able to return to work at approximately one week. The most natural results will not be evident for approximately six weeks to three months depending on the implant and its position. This procedure should have little, if any, effect on nipple sensation and the future ability to breastfeed.

During the consultation, you will be carefully examined and your breast dimensions will be measured. Following this you will be able to view photographs of women who have previously had this procedure. Women will be selected with similar dimensions to you so that you may get an idea of the results you may achieve with different sized implants. In addition the patient care coordinator will discuss with you the costs and financing options available.

Fully Customized Breast Enhancement 

We know that every woman is unique in both her desires and her body shape. With that in mind, we take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type and implant placement is best. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind. 

Complementary Procedures  

Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. 

Saline and Silicone Gel Breast Implants 

Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. We will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle. 

After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants. 

Breast Augmentation Surgery - Incision Techniques 

The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located:

• In the armpit (transaxillary),

• In the crease on the underside of the breast (inframammary), or

• Around the areola, the dark skin around the nipple (periareolar).

The breast is then lifted, creating a pocket into which the implant is inserted. 

Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach. 

Breast Augmentation Surgery - Placement Options 

Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery. We will discuss which option may be best for you. 

In the TUBA procedure, implants cannot be placed beneath the chest wall. 

After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed, then taped and bandaged. In a few days, these bandages may be replaced with a surgical bra. 

Recovery 

Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. 

Stitches are removed in a week to 10 days after breast augmentation. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. 

Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. 

Complications 

Complications following breast augmentation surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast. 

If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. If a silicone implant leaks, you will need to see a doctor immediately. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health.

To view our photo gallery of before and after examples, please click here.

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