Breast augmentation surgery is performed 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 317
A medical professional in her early 30’s who is bothered by the small size of her breasts. She describes herself as a 34 A cup and would like to be fuller but still natural in appearance. She is 5’9” and 157 lbs and is shown before and again, 6 weeks after bilateral partial subpectoral breast augmentation with 350 cc Sientra Opus 600 series round smooth cohesive high strength silicone gel implants placed through an inframammary incision.
Discussion: She likes fullness in the upper breast and does not mind a slight implant look if needed. Her nipple to Inframammary fold distance is just 8 cm on her left ( the smaller of her two breasts) with a base width of 12.2 cm. The Sientra 350 High Profile implant is 12 cm at the base, which will just be accommodated by the n-IMF on stretch of 8 cm and bhte base width at 12 cm is must slightly less than the existing base of her breast so it should not have an “implant look” that can happen with the implant is wider than the breast. A larger implant would be difficult to do without worrying about her Inframmamary fold giving way and causing “bottoming out” or a “double bubble”. To decrease this risk I have reinforced her fold at the time of surgery with Long lasting but dissolvable sutures.
A mother of 3 in her early 50’s who is bothered by a deflated appearance of her breasts after pregnancy. She was a 34 B cup before pregnancy and wanted to be a full C with some fullness of the upper breast if possible but still natural in appearance. She is 5’ 6/12” and 132 lbs. She is shown before and again, nearly 8 months after bilateral partial subpectoral ( below the muscle) placement of Sientra 440 cc textured round High profile cohesive implants placed through an inframammary incision.
Discussion: The base width of her breast is 12.6 cm and the inframammary fold to nipple distance is 7.5 but increases to 10 cm on stretch. More than 9 cm on stretch is sometimes an indication for a breast lift, but her sternal notch to nipple distance is 18.5 cm on the right and 19.5 cm on her left ( “normal” is 21cm) So she is a risk for increased stretching of the lower pole skin of the breast which would allow the implant to drop and give the appearance of “bottoming out”.
A microtextured implant is less likely to drop and shift and “bottom out” balancing the potential slight increased risk of BIA-ALCL with textured implants which is much lower with the Mentor and Sientra “microtextured” implants vs the higher risk of bottoming out in a patient who is prone to this.
This Sientra implant is 12.8 cm at the base- This matches the current width of her breast which is 12.6 cm . I we went much wider than her breast width it could begin to give an overly round or “implant look” which she did not want.
A long term followup on a mother of 2 in her early 50’s who presented in her mid 30’s with deflated breasts after pregnancy. She is 5’ 4” and 116 lbs.
She elected for a smooth round saline implant placed through a vertical mastopexy position in a subglandular space. When the breasts are a little droopy the subglandular placement allows the implants to settle with the breasts and avoid a “waterfall “ effect of the implants falling off of a mound which can happen with a subpectoral placement. We were conservative with the size of the implants which have prevented excessive stretching and still fit her frame. Her breasts have changed remarkably little in the 15 years since her surgery.
She asked about whether she should change her implants now that they are 15 years old- the answer is no- she is doing great, and it will be easy to tell if and when her implants eventually leak because the saline implants will visibly deflate. But even though 8% of saline implants may have leaked by 10 years, the rest have not and she will hopefully get many more years out of her implants.
followup on a mother of 2 in her early 50’s who presented in her mid 30’s with deflated breasts after pregnancy. She is 5’ 4” and 116 lbs.
She elected for a smooth round saline implant placed through a vertical mastopexy position in a subglandular space. When the breasts are a little droopy the subglandular placement allows the implants to settle with the breasts and avoid a “waterfall “ effect of the implants falling off of a mound which can happen with a subpectoral placement. We were conservative with the size of the implants which have prevented excessive stretching and still fit her frame. Her breasts have changed remarkably little in the 15 years since her surgery.
She asked about whether she should change her implants now that they are 15 years old- the answer is no- she is doing great, and it will be easy to tell if and when her implants eventually leak because the saline implants will visibly deflate. But even though 8% of saline implants may have leaked by 10 years, the rest have not and she will hopefully get many more years out of her implants.
An Asian woman in her early 20’s who wished to have fuller breasts. She described herself as a 32-34 A cup and wanted to be a C cup is possible but still natural in appearance.
She is shown before and again 1 year after breast augmentation with 5 th generation smooth round cohesive silicone gel implants placed below the pectoralis muscle through an infra mammary ( at the breast fold) incision. Implants used were Sientra Opus 255 ml moderate profile cohesive silicone gel implants. She is petite at 5’3” and 116 lbs. This was the largest implant that would fit the dimensions of her breast and still maintain a natural appearance, without an overly round “implant” look. Her inframammary fold was reinforced at the time of her surgery by anchoring it to the rib periosteum with long lasting but dissolving sutures to prevent “bottoming out” and dropping of the breast fold.
A Boston professional woman in her mid 20’s who wished to be able to wear a bathing suit or dress and look like her padded bra but without needing the padding. She wanted to have a natural , proportional appearance after surgery. She did not want an “implant” look. She was a 32 A cup before surgery and at 5’6” and 122 lbs was relatively thin. Her chest is narrow. Based on her current breast width and tissue characteristics she selected a 300 cc smooth round moderate profile plus silicone gel implant. She is shown before and again, 6 weeks after surgery. The implant is placed below the pectoral muscle, through an infra mammary (at the breast fold)
incision. As is typical with most women, she has a difference of the positioning and size of her breasts before surgery which is still seen after surgery. A breast implant merely increases the volume of the existing breast. She is thrilled with her natural appearance after breast augmentation, and now feels comfortable in her clothes and bathing suit.
Update: Our patient is now seen 7 years later, how in her early 30’s and after 2 pregnancies. Her breast augmentation has held up well despite the changes from having children. . Her weight is back to 125 lbs. The breasts remain soft and proportional to her frame.
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
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 pectoral 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:
At our office we also offer the IDEAL implant. The IDEAL implant structured breast implant is a new type of implant designed by a plastic surgeon. It combines the safety of a saline implant with the realistic look and natural feel of silicone gel implants. The IDEAL implant offers next-generation technology that offers you the benefits of each type of implant, so you can feel both beautiful and secure.
Learn more about the IDEAL implant in Dr. Hall’s video blog below:
How is breast augmentation performed?
During breast augmentation surgery using implants, Dr. Hall creates an incision, forms a pocket in the breast area, and then places the implant inside. The incisions are then closed in a manner that will reduce scarring and remain subtle. The number and placement of incisions will depend on which breast augmentation technique that you and Dr. Hall decide is best suited for your goals and unique anatomy. 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 don’t need narcotics after 24 hours. They can typically return to office work after 5-7 days but should “rest the breasts” and avoid excessive activity for 6 weeks to allow adequate healing. Pain medication can be prescribed to help with a comfortable recovery. Patients are 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. Hall’s video blog, the Thoughtful Patient’s 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 usually 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, and gradual breakdown of collagen and elastin in the skin
Drastic changes in weight, like gaining or losing
Gravity and the weight of an implant/breast on the skin
Year after year, the breast augmentation is the number one plastic surgery procedure performed throughout the nation. Many women seek to add volume and create a new breast profile, while some women seek to balance out uneven breasts. Augmentation techniques can also be combined with other breast procedures. Whatever your reason for choosing a breast augmentation, expect excellent results from board certified plastic surgeon, Dr. Jonathan Hall.
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.
“I saw 3 surgeons before meeting with Dr. Hall and by far
he and his staff was the most compassionate, thorough,
professional and helpful. Can’t say how pleased and
comfortable he and his staff made me feel.”
At our office we also offer the IDEAL implant. The IDEAL implant structured breast implant is a new type of implant designed by a plastic surgeon. It combines the safety of a saline implant with the realistic look and natural feel of silicone gel implants. The IDEAL implant offers next-generation technology that offers you the benefits of each type of implant, so you can feel both beautiful and secure.
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- Jonathan D. Hall, MD, FACSmembers of my own family."
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