Breast augmentation surgery is done to enlarge or restore the size of breasts using implants. Being one of the most popular cosmetic procedures performed, breast augmentation is a safe and effective solution to enhance, regain, and restore balance to a woman’s figure. Breast augmentation can be achieved using many different techniques to meet the needs of each individual patient.
Am I a good candidate for breast augmentation?
Candidates for breast augmentation surgery are those who are unhappy with their small breast size, have smaller or deflated-appearing breasts due to pregnancy or weight loss, have asymmetry of the breasts, or are self-conscious with their body due to their breasts. Ideal candidates are in good health and have realistic expectations of breast augmentation surgery.
It is important that patients understand all facets of breast augmentation surgery before making a decision. Augmentation is a long-term solution for achieving a desired figure, and will help you to look and feel better in clothing and swimwear. However, breast implants require monitoring and do not last forever. Implants commonly last for 10 years or longer before they need to be replaced. During a consultation with Dr. Hall, all of the pros and cons of this surgery will be discussed so that an educated and well-informed decision can be made.
Breast Augmentation – Patient 273
An medical professional and mother of 1 who describes herself a s a 32 A cub. She was a C cup with her pregnancy and wanted to be a C cup again if possible. She did mind a slight implant look if needed to achieve her goals as long as she did not look overly unnatural. She has a mild pectus excavatum ( a depression of the sternum) She is shown before and again, 6 weeks after bilateral partial subpectoral breast augmentation with the placement of 350 cc high profile textured silicone gel implants using the milder texture.
Surgical planning: The width of her breast were 12.1cm on the right and 12.6 cm on her left. The nipple to inframammary fold distance on stretch is 8cm on her right and 7cm on her left. There is a mild laxity of her tissues from her previous pregnancy. The 350 cc high profile implant has a base width of 11.7 cm and this was the largest implant that would “fit” without requiring us to lower her inframammary fold and risk a double bubble or collapse of the fold and bottoming out. Texture was chosen to prevent medial migration of her implants over time into her pectus excavatum. Texture can be controversial because of it’s association with the rare condition of BIA-ALCL but seems to be less of a problem with the milder textures. It also is felt to be related to biofilm formation and we used the typical measures during surgery to avoid this: nipple shields/insertion sleeves ( “Keller funnel” ) as well as antibiotic irrigation. I also recommend that my breast implant patients take oral antibiotics just before dental cleaning or procedures to decrease the risk of bacteria from the mouth going through the blood stream and settling on the implant after surgery. In her case, after discussion she felt that the possible tradeoffs of texture were worth the benefits of better stability of the implants over time.
A woman in her early 30’s who wished to have fuller breasts. She described herself as wearing a padded B cup bra and wished to be a C cup without the padding. She had initially seen us two years previously and was not comfortable with the implant choices available at the time. She chose the Ideal breast implant once it was available, because it has a more natural feel than the traditional saline implant but without the risk of a “silent” rupture. It appealed to her to be able to follow her implants after surgery by simple observation rather than with ultrasound or MRI which is needed to detect the failure of a silicone gel implant.
She is 5’5” and 131 lbs and selected a 270 cc implant in the office. She is shown before and again, 6 weeks after partial subpectoral placement of 270 cc Ideal structured saline implants through an inframammary ( at the breast fold) incision. She is thrilled with her fuller but still natural appearance. The Ideal implants have two lumens and can be filled to give either a moderate or a full profile look. In this case the 270 is similar to a moderate profile standard saline implant in projection. It could also be filled to 305cc to give the equivalent of a high profile.
A woman in her mid 40’s who has lost 80 lbs and is bothered by a deflated appearance of her breasts. She has always wanted breast implants but was concerned about the possibility of a silent rupture with a silicone implant, but did not like the potential problems with rippling and wrinkling that can be seen with traditional saline implants. She wanted to be fuller but still natural in appearance, and wanted some volume back in the upper portion of her breasts. She was excited that the Ideal structured saline implants are now available and after careful sizing in the office based on her nipple to fold distance on stretch and the base width of her breasts we selected a 415 cc total volume Ideal breast implant. When it is filled to the full capacity it has the profile of a “high profile” silicone implant which is good for restoring some fullness to the upper breast. She is 5’5” and 134 lbs and is shown before and again, 6 weeks after bilateral “dual plane” placement of the Ideal breast implants through an inframammary incision
A mother of 3 who is bothered by a deflated appearance of her breasts and would like to have fuller breasts. She is 5’ 5” and 128 lbs. She is shown before and again, nearly 4 years after bilateral partial sub-pectoral placement of smooth round 350 cc moderate profile plus silicone gel implants through an infra mammary incision.
A mother of 3 who is now in early 50’s. She was bothered by a deflated look of her breasts after pregnancy and wished to be fuller but still natural in appearance. She is 5’6” and 167 lbs and is now 11 years after bilateral partial sub-pectoral breast augmentation with smooth round moderate profile 375 cc saline implants, She stopped by the office for a quick check and to see if she needed to “do anything” now that her implants are 11 years old. This is a question that comes up frequently. Breast implants in general have about an 8 % rupture rate in 10 years- that means that in 10 years, 8 patients out of 100 will have developed a leak. If she had silicone gel implants it would be reasonable to send her for an ultrasound or an MRI to see if the implants are intact- a “silent” rupture can occur with silicone implants and it may not be possible to tell if the implant is intact without one of these tests. With saline implants its much easier. If the implants are still there when you look in the mirror, then they are intact! So this is the big advantage of saline implants. If the implant leaks, the saline gets absorbed by the body and the implant shell goes flat. The breast “deflates” and it’s obvious. Not a panic situation but time to consider a replacement. But she is doing great, her breasts remain soft, and she can wait until she has a deflation. This could be 20 or more years. I have personally seen patients who are 30 years out from saline implants (before I started my practice) who still have intact implants. I generally recommend that my patients with Silicone gel implants get an ultrasound at 9 years after their surgery-a silent rupture doesn’t cause any immediate problems- there may be some slow thickening of the capsule of scar tissue around the implant over the years, but if it is failed it is better to know before the warranty has expired at 10 years.
This case also illustrates the importance of choosing the proper sized implant. An overly large implant is heavier and may cause more stretching of the tissues with time.
There are many different options when it comes to breast augmentation techniques, as well as implant choices. The different techniques available often have to do with differences in incision placement, and include the inframammary incision, which is located underneath the breast, the periareolar incision, which is located along the border of the areola, and the axillary incision, which is located in the armpit. Other techniques also include the transabdominal breast augmentation (TABA), in which breast implants are inserted through an incision in the abdomen, and the transumbilical breast augmentation (TUBA), in which implants are placed through an incision in the naval. Furthermore, patients have the option of having their implants placed on top of or underneath the muscle.
There are also many breast implant options available for each patient’s unique needs. The two most common types of breast implants used today are saline and silicone implants. Saline implants are filled with a saline solution, while silicone implants are filled with a silicone-gel. If a saline implant were to rupture, the breast would simply deflate and the solution would be absorbed into the body. If a silicone implant were to rupture the silicone is typically still contained within the layer of scar tissue that forms around the implant, as the body cannot absorb the silicone gel. Below is more information about breast implants:
How is breast augmentation performed?
During breast augmentation surgery using implants, Dr. Hall will create an incision, create a pocket in the breast area and then place the implant inside. The number and placement of incisions created will depend on which breast augmentation technique Dr. Hall and you decide is best suited for your goals. The type of implant used and whether the implant is placed underneath or on top of the muscle is also a decision that you will make with Dr. Hall during your consultation.
What should I expect during recovery?
After breast augmentation surgery, patients typically are not needing narcotics after 24 hours. They can typically return to office type work after 5-7 days but should “rest the breasts” and avoid excessive activity for 6 weeks to allow adequate healing. Pain medication will be prescribed to help with a comfortable recovery. Patients will be given a surgical bra to wear after surgery for support, and they should wear a comfortable bra throughout their recovery to ensure optimal results. Any sutures that are placed are typically self -absorbing and do not need to be removed.. Dr. Hall will provide you with specific recovery instructions , which are imperative to follow for a quick and safe recovery. Learn more about proven methods to improve your recovery following a breast augmentation in Dr. Halls video blog, the Thoughtful Patients’ Guide!
How Long Will My Breast Augmentation Last?
With the proper preparation and aftercare, breast augmentation results are typically long-lasting. In the event that the breast implants become damaged, they will need to be removed and replaced. For best results, scheduling a routine follow-up appointment with Dr. Hall is recommended to make sure the implants are healing properly. There are a few physical changes that can affect the integrity of breast augmentation results, which include:
Pregnancy, childbirth, and nursing
The natural aging process, gradual breakdown of collagen and elastin in the skin
Drastic changes in weight, gaining or losing
Gravity; the weight of an implant/breast on the skin
If you are located in the Boston, MA area and are interested in learning more about breast augmentation, contact our office today. We would be happy to schedule a consultation for you, as well as answer any questions you may have about the procedure.
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