Breast augmentation, breast implants, or “augmentation mammaplasty,” is a popular procedure for my patients and is one of the most frequently performed cosmetic surgery procedures in the U.S.
To become a proficient at this technique I spent years performing all types of breast surgery including mastectomy, breast reconstruction, breast lift, and breast reduction. This unparalleled experience in breast surgery gives me the ability to best identify what changes can be safely made in your breast to give you the best possible outcome during your breast implant surgery.
Who Can Benefit?
When considering breast augmentation, you should first determine which breast type you are.
Naturally Small Breasts
This is the most common breast implant category. Typical patients are younger, without pregnancy changes, and have good skin quality.
Post-Pregnancy Breasts
With pregnancy, the breast respond to the hormonal changes to prepare for milk production. This involves increasing the glandular size, the skin envelope and stretching of the internal ligaments. Women with minimal “droop” or ptosis will benefit from standard breast augmentation alone. Those with significant deflation or sagging may require a breast lift, “mastopexy” in combination with a breast augmentation.
Breast Surgery Revision
Given my experience with breast surgery, I perform a significant number of breast revisions each month. The causes for the revision include capsular contracture (scar around the implant), implant rupture or failure, desire to change size, implant displacement or poor position, or to change from saline to silicone implant.
Sagging, Deflated Breasts
As with post-pregnancy breast surgery, breast deflation can benefit from volume increases. Implant size will be dependent on the amount of loose skin. There are time when the implant cannot accommodate enough of the breast and, therefore, a breast lift may be required.
What do you want to accomplish with your augmentation?
Those that know me know that I lean toward a natural look with breast augmentation. To achieve this, I consider several factors
- I generally place the implants below the muscle (subpectoral) or release the lower muscle border (dual plane). This gives the breast a natural, subtle contour. The pectoralis serves to camouflage the implant.
- Silicone implants feel more natural and have less rippling. This is especially true in my thinner patients and those without significant breast tissue (more tissue means the implant is less noticeable).
- My recommendations on size depend largely on the patient’s natural breast size and shape in combination with her anatomy (height, weight, chest measurements, etc.)
A breast lift with an augmentation is a great way to give you a more youthful breast shape.
- Breast augmentation alone only helps with deflation. I often include a breast lift to correct the sagging and is necessary to avoid a ‘snoopy’ deformity (where the implant sits higher than the sagging breast). The best breast lift comes with minimal scarring and maximum results. I typically use the circumvertical “lollipop” approach.
Breast augmentation is a great way to improve the appearance of your breasts after pregnancy.
With pregnancy, the breast skin and ligaments stretch as a results of hormones and glandular response of the pregnancy. The baby is born and the breast “letdown” occurs. This can be addressed with an implant alone to restore volume after “deflation.” Another option is to add a small implant along with a breast lift. However, if you do not desire more volume, a breast lift may be necessary
The most common regret after breast augmentation is “I didn’t go large enough.”
- My primary role as surgeon is to counsel you on the procedure and assist in finding the right size for your body. Patients play a large role in deciding the type of implant and size. We go through an extensive sizing process to determine the general range before surgery. During the breast augmentation procedure, I will place temporary sizers and sit you upright until I feel the breast are symmetric.
For women who have sagging, small, or asymmetrical breasts, a breast augmentation can be extremely rewarding.
- Cosmetic surgery cannot replace a lack on self-confidence. However, much like braces do for a smile, breast augmentation can do for a woman’s confidence level. You feel better in swimwear, in clothing and, sometimes, with intimacy.
Concerns
Full recovery from breast augmentation is roughly two weeks.
Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week.
I utilize the Rapid Recovery Method for breast augmentation. I find that the majority of our patients are free from pain medication within 2-3 days with no sacrifice in their outcome.
I placed absorbable sutures and do not use drains. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks.
Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. Most are barely noticeable and placed below the breast.
Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located:
- In the armpit (transaxillary)
- In the crease on the underside of the breast (inframammary), or
- Around the areola, the dark skin around the nipple (periareolar).
- The breast is then lifted, creating a pocket into which the implant is inserted.
Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach. However, I do not advocate this approach as the implants are typically placed above the muscle and, in his opinion, the results are much inferior to the other approaches.
Cost of breast augmentation varies depending on the type of implant used (silicone is approximately $1300 more than saline).
The average cost, including OR/anesthesia/etc., is around $4500 for saline and slightly over $5600 for silicone. I caution patients to beware of the “discount” surgeon. Find a surgeon that has extensive experience, superb credentials, and provides a responsive staff.
See the Results for Yourself
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