What is Breast Augmentation?
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 softer 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 269
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.
Breast Augmentation – Patient 268
A woman in her early 20’s who would like to have breasts that are fuller and more proportional to her frame, but still natural in appearance. She is 5’4” and 154 lbs and is shown before and again, 6 weeks after bilateral partial sub-pectoral breast augmentation with 425 cc high profile smooth round implants placed through an infra-mammary ( at the breast fold) incision. She also had a retracted nipple on the left and requested treatment at the same time. A micro-incision technique was used. Her left breast is smaller than the right and it was necessary to lower her left breast fold slightly to accommodate this sized implant. I am cautious when lower a breast fold because sometimes it can “give way” and the implant can drop-this is called “bottoming out”. In order to decrease the chance of this happening her left breast fold was anchored with internal sutures to the rib periosteum on the left. She is thrilled with her fuller but still natural appearance.
Breast Augmentation – Patient 267
A challenging case in a woman with small breasts and a tight skin envelope, as well as pectus excavatum ( a hollow depression in the chest bone) who wishes to have a natural appearance. When the chest wall is sloped, the implant will tend to migrate “down the slope” towards the middle with time. Therefore we selected textured, cohesive silicone round gel implants. When the tissues are tight the implant needs to be even more precisely matched to the patient. She is 5’5” and 120 lbs and is shown before and again, 22 months after partial subpectoral placement through an inframammary incision. 305 cc Sientra implants were used. Tattoos are blurred for privacy.
Breast Augmentation- Patient 266
A woman in her early 30’s who describes herself as an A-B cup and would like to be closer to the padded C cup bra that she currently wears, but still natural in appearance. She is 5’ 2 1/2” and 112 lbs and after careful sizing in the office based on her tissue measurements and characteristics a 325 cc moderate profile plus smooth round silicone gel implant was selected. She is shown before and again, 6 weeks after partial subpectoral ( below the muscle) placement of the implants through an infra mammary ( at the breast fold) incision. She is thrilled with her fuller but still natural appearance.
Breast Augmentation – Patient 265
A mother of 1 who has gained and lost 90 lbs with her pregnancy. She does not feel feminine because of her flat chest “ like a 14 year old boy” and wants to have a fuller but natural look. She describes herself as a 32 iA but was a 36 C cup before pregnancy. She is 5’6” and 135 lbs. She is shown before and again, 18 months after Sientra, round, 385 cc High Profile silicone gel textured implants. They were placed in a dual plane position through an inframammary ( at the breast fold) incision. The High profile implant was selected to help add some fullness to the upper part of the deflated breast. The goal is to fill but not overly stretch the breast, and her breast was deflated after pregnancy and weight loss. Texture is chosen to decrease the tendency of a smooth implant to drop and/or slip to the side with time. A ”dual plane” allows the implant to be under the muscle in the upper breast and under the breast in the lower breast. This helps when the breast is starting to droop to allow the implant to settle more with the breast and decrease the tendency to a “waterfall” effect where the breast drops off the implant. At 18 months she has maintained a stable and natural looking result.
What are my options for breast augmentation?
There are many different options when it comes to breast augmentation techniques, as well as implants. 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!
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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