Breast Augmentation

What is Breast Augmentation?

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/Ideal Implants – Patient 301
A mother of 1 in her early 30’s who is bothered by a deflated appearance of her breasts after pregnancy and breast feeding. She describes herself as a 36 B and would like to be a full C. She is 5’4” and 158 lbs and is shown before and again, 6 weeks after bilateral subglandular placement of Ideal Structured Saline implants 370 filled to “100%” fill of 410 cc. Discussion: Our patient wanted a natural but fuller appearance and wanted to restore some volume to her upper breasts. Her breast width is 13.97 on her right and 14.3 on her her left. Her nipple to breast fold distance on stretch is 9 cm. The diameter of the Ideal Implant she selected and filled to 410 is 11.7 I usually add 3 mm to the base width of the Ideal because is it designed to sit on a curved surface. So 12 cm is less than her breast width, so it will not “look like an implant”. Her nipple to breast fold on stretch is 9cm. Any more and she may be a candidate for a lift. If her implants were placed below the muscle the implant would move separately from the breast and the breast which is slightly lax would have a tendency to drop off of the implant- this is sometimes called the “waterfall effect”. In a case like hers where the breast is lax, a subglandular placement allows the implant to move with the breast and settle with the breast, giving a more natural look. The tradeoff for a subglandular placement is a slightly higher risk of capsular contracture. The 370 implant has an empty implant volume of 56 cc. The inner lumen is always filled to 214 cc. The outer lumen is filled to 145 cc, giving her a total implant volume of 410 cc. This gives a higher profile, which helps to add some volume back to her deflated upper breast.
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Breast Augmentation/Ideal Implants – Patient 300
A 39 year old woman who described herself as a 34B but wished to be a full C to D but still relatively natural in appearance. She was concerned about capsular contracture because of a friend who has breast augmentation elsewhere and wished to do everything to avoid this. She wanted to have some superior pole fullness as long as it would look relatively natural. After discussing the different implant choices she elected for an Ideal Structured Saline implant because she did not want to have to worry about a silent rupture. She is 5’5” and 137 lbs and elected for a 455 cc implant placed through an inframammary fold incision and below the pectoralis muscle. She is shown before and again, 10 months after her surgery. Details: We used the 405 cc Ideal Structured saline implant with the empty implant volume of 60 c. The inner lumen was filled to 235 cc and the outer lumen was filled to the maximum recommended volume of 160 cc to give a total volume of 455cc. ( “100% fill “) Because of the relatively large size of the implant that she selected, I reinforced her inframammary folds by anchoring her inframammary fold ligament to the rib periosteum at the time of surgery with a strong dissolvable suture to decrease the risk of “bottoming out”. This can be an issue with a larger implant when additional force is placed on the fold, causing it to “give way” and allow the implant to drop excessively. She is thrilled with her very full but still natural appearance, and her inframammary folds have been stable.
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Breast Augmentation – Patient 299
A more than 17 year follow-up on a woman who is now in her 40’s but had a breast augmentation with us at the age of 24 with saline implants. She had per-areolar incisions with partial sub-pectoral placement of 300-325 filled to 305 on her left and 325 on her right. She continues to do well and just stopped in for an implant check in our office. Her case illustrates 3 important concepts of breast augmentation. First, pick the right size but don’t use an overly large implant. She is 5’2” and 117 lbs and has not had issues with too much stretching of her tissues because we did use too large of an implant for her tissues. 17 years later she still looks good. Second: Don’t keep the nipple piercing in after surgery ( or a tongue or vaginal piercing) because they may increase the risk of capsular contracture by allowing bacteria that lives in the nipple ducts/ mouth or vagina to get into the blood stream and travel to the implant, leading to biofilm and a capsular contracture. Her breasts remain soft after 17 years. Third: One huge benefit of saline implants is not having to worry about a silent rupture- the implant will go flat when it eventually leaks. So it is nice to be able to tell her that her implants are fine without getting an MRI or an ultrasound as would be need at this point to check on the integrity of a silicone gel implant.
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Breast Augmentation/Ideal Implants – Patient 296
A mother of 2 in her late 30’s who has 2 children and breast fed. She describes herself as a 34 B cup but would like to be a C cup. She is 5’2” and 127 lbs and is shown before and again, 6 weeks after bilateral partial subpectoral placement of Ideal Structured saline implants. She had the 270 cc implant with the inner lumen filled to 165 cc, the outer lumen filled to 70 cc to give, along with the empty implant volume of 35 cc a total volume of 270 cc. This is considered the “ High” volume. The outer volume could also have been filled to a total of 200 cc to give the “100%” fill of 305 cc for this particular implant. She is thrilled with her fuller but still natural appearance.
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Breast Augmentation – Patient 298
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What are my options for breast augmentation?

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:

IDEAL IMPLANTAt 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.”

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