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 291
A woman in her later 30’s who wishes to have fuller breasts. She has not had children or significant weight loss but does work out 2 hours a day at the gym and finds that her breasts have deflated in appearance. She is 5’6” and 133 lbs and describes herself as a 34 A to small B cup. Based on her tissue dimensions she was sized in the office and felt that a 400 cc implant was too large but liked the 350-375 cc size in clothing, using the Mentor sizing system.
After discussions she elected for a Mentor 375 cc high profile micro-textured implant placed through an inframammary incision in a partial sub-pectoral position. She is shown before and again, 5 months after surgery. She is thrilled with the fuller but still natural appearance of her breasts after surgery.
Discussion: A high profile was chosen to try and add some fullness to the deflated upper breast. Breast implants tend to shift to the side and to drop with time. This is more of a problem in “looser” breasts after weight loss or pregnancy. Texture can decrease the risk of this shifting. But texture can also increase the risk of Breast-implant associated ALCL, a kind of lymphoma that can start in a late fluid collection (seroma) around an implant and is felt to be related to Biofilm around an implant. Although rare, it has only been reported after the use of textured implants. It is more common in aggressively textured implants. When we chose to use texture I prefer the micro-textured implants such as the Mentor, which gives us the benefits without as many risks. In our patient’s case, after discussing the tradeoffs, she felt that the greater stability of the implant was worth the small increased risk of BIA-ALCL that is seen with texture.
A woman in her mid 40’s who has lost 70 lb with diet and exercise and would like her breast to be fuller. She described herself as a 34B cup and wanted to be a C to full C cup. She was fearful of silicone and silent rupture and wanted saline implants. She is 5’6” and 134 lbs. Sizing was performed in the office based on her tissue dimensions and using the Mentor sizing shell system. She liked an implant size around 400 in clothing and felt that 450 was too big.
She is shown before and again, 9 months after bilateral partial subpectoral (below the muscle) placement of Ideal Structured Saline 370-415 cc implant filled to 415 ( the equivalent of a high profile implant) placed through an inframammary incision ( at the breast fold). She is thrilled by the fuller but still natural appearance of her breasts.
Tattoos have been blurred for her privacy. The photos are otherwise untouched.
A woman in her early 20’s who wants fuller breasts but still natural in appearance. She is concerned about silent rupture and has elected for the Ideal structured saline implants.
She is petite at 5’3” and 109 lbs and wore a 32 A to B cup before surgery. She is shown before and again, 4 ½ months after bilateral partial sub-pectoral breast augmentation with the placement of the 300cc Ideal structure Saline implant filled to the 300cc total volume. The empty implant is 37 cc, and the back/inner lumen is filled to 188 cc and the front/outer lumen is filled to 75 cc to give the total volume of 300 cc.
A woman in her early 20’s who describes herself as a 32 a-b cup and would like to be fuller but still relatively natural in appearance. She wanted the Ideal structured saline implant because she did not want to worry about silent rupture but wanted a more natural look and feel than the traditional saline implants. She is shown before and again, 3 months after bilateral partial sub=pectoral placement of the 300 cc Ideal implant filled to 300c, placed through an inframammary incision.
Discussion: She is very petite. When sized for a bra we are taught to measure around the chest just under the breast and add 3 inches- she measures 28” so a 31” bra would be her actual band size if they were made. The base width of her left breast is 11.2 cm. With the Ideal implant the edges are a little firmer and it is best to use an implant base width that is less than the actual breast base width. In a silicone gel implant it is possible to go slightly wider.
In addition, she has a mild pectus excavatum, a hollow in the sternal area that limits the medial placement of the implant. The base width of the 300cc ideal implant is 10.9, so it just fits within the base of her breast. The next larger size is 5 mm wider and would tend to stretch the breast more and appear unnatural. So, as is our usual practice, we want to use the largest implant that we can use that still looks relatively natural and won’t cause problems by overly stretching the breast.
A woman in her early 20’s who is bothered by breast asymmetry and would also like to have fuller breasts. She describes herself as a 34 B and is 5’3” and 150 lbs. She is shown before and again, 5 ½ months after bilateral partial subpectoral breast augmentation through an inframammary incision with a 300 cc smooth round moderate profile plus silicone gel implant on her right and a 200 cc smooth round moderate profile plus silicone gel implant on her left.
Discussion: The difference in her nipple position is not enough to justify the typical scar of a mastopexy (breast lift). Her right breast is the smaller and tighter of the two breasts and limits the size of the implant that can be used. So we choose the largest implant that will fit in her right breast based on her breast dimensions and that she also finds acceptable in clothing, and then work backwards with a smaller implant on her left breast to match as closely as possible. A larger implant on her right breast would have more fullness in the upper breast because it would be even more implant to breast proportionally and therefore not match the shape of her left breast as closely. She is thrilled with her result.
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:
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.
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professional and helpful. Can’t say how pleased and
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Cosmetic & Plastic Surgery Specialist
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- Jonathan D. Hall, MD, FACSmembers of my own family."
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