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Breast Augmentation

Breast augmentation is a cosmetic procedure that enlarges and shapes a woman's breasts through the placement of implants. You may be a candidate for breast augmentation if you want to enlarge naturally small breasts, restore breast volume lost following pregnancy or weight loss, or improve symmetry.

Breast Implant Placement

Four different incisions have been described for breast enlargement:

Around the Areola - The incision is made around the lower part of the areola (darker area around the nipple). These scars typically heal very nicely and are difficult to see. However, if the areola is small it may be difficult to perform the procedure through this area.

Base of the Breast (Inframammary) - The incision is made under the breast just above the natural crease and provides technically easier route for implant placement. The scar however, because of its location, has a greater risk of being wider or thicker. In patients who have large breasts to start with, the scar may be well hidden.

Armpit - The incision is made within the armpit (axilla). The scars in this area typically heal well and are hidden and at the end look like fold in the arm pit. Implant placement via the armpit is performed with the help of an endoscopic camera for appropriate placement of the implants.

Belly Button - The incision is made at the upper portion of the belly button and placement of implants is done by feel. The results of this method certainly depend on the experience of the surgeon but this is a blind method and Dr. Yousif does not believe this is a desirable method.

There are several factors to consider when choosing the location of the incision such as the type of implant to be used, degree of enlargement, patient anatomy, and patient and surgeon preference.

Breast Implant Placement

Subglandular - The breast implants are placed directly behind your breast tissue. If there is adequate breast tissue to cover an implant, subglandular placement can be done. However, if there is limited breast tissue, it may be better to hide the implant beneath the muscle layer.

Advantages of Subglandular Placement:

• Probably less pain after surgery
• It may allow for more central placement of the implants, giving more cleavage
• Implant moves less with muscle contraction
• When there is some sagging of the of the breast, subglandular placement may help to push the nipple upward slightly

Disadvantages of Subglandular Placement:

• Implants may be more visible and ripples may be more prominent
• Mammograms may be harder to perform because of the proximity of breast tissue to the implant
• Breast hardening (capsule contracture) may be more frequent

Submuscular - The breast implants are placed beneath the chest muscle.

Advantages of Submuscular Placement:

• Implants less visible especially when there is limited breast tissue
• Breast hardening (capsule contracture) may be less frequent
• Mammograms are easier to perform
• Looks natural
• Results remain longer

Disadvantages to Submuscular Placement:

• More painful after surgery
• There may be movement of implants with muscle contraction
• Not helpful in breasts with slight sagging to lift the nipple

Anesthesia and Surgery Facility

Breast augmentation is most comfortably performed under general anesthesia in a surgery center or hospital setting.

Operative time for breast augmentation is 1.5 hours.

Considerations

When considering Breast Augmentation three key components need to be decided – type of implant: silicone or saline, size of the implant and where the incision will be made for placement.  We at ARSA spend the time it takes to help answer all of those questions so you receive the best possible outcome from your Breast Augmentation Surgery.

Natural Looking Designed To You.

Although each person's results will differ, before and after photos are good examples of potential changes. They should be used not only as a comparison of techniques and surgeons, but are good starting points for evaluation, comparison and discussion with your surgeon. Please note that these are post surgical photos that are not suitable for all audiences. Viewers should be 18 or older to view the gallery images.

See More Before and After Photos >

Types of Breast Implants

Saline - Implant is filled with a salt-water solution. This type of breast implant is filled to the desired volume by the surgeon in the operating room. Saline is a natural solution, therefore if the implant does rupture the body will safely absorb the fluid. Beneath the pectoralis muscle they are rarely visible and ripples are rarely seen. Capsule contracture or hardness is less frequent with saline implants. The incisions can be very small and the implants can be adjusted at for final fill volume at the end of the procedure. This may be important if there are any variations or differences between breasts before surgery.

Silicone - Implant is pre-filled by the manufacturer with a silicone gel. Silicone was the first substance used to fill breast implants because of its natural feel. In 1992, following allegations that silicone gel may cause autoimmune diseases, the FDA restricted the placement of silicone implants to breast reconstruction patients and other patients who meet certain criteria. Since that time, numerous independent medical studies have failed to find a link between silicone gel implants and autoimmune diseases. Recently the FDA has deemed the implants safe for general use again. They are now available for anyone who desires these implants. Silicone implants may be slightly softer and have fewer ripples. They have, however, some continued problems. Dr Yousif recommends that if you desire silicone implants that you review one of the two company sites that make silicone implants in the US and the risks and complications that relate to silicone implants. Those include www.mentorcorp.com and www.allergan.com. Finally it is important to remember that with silicone implants although they may be slightly softer in feel, the incisions are larger, it may not be apparent if they rupture, and capsule contracture may be slightly higher.

Side Effects

It is common to experience temporary discomfort, some swelling, bruising and a possible change in nipple sensation. The breast may be sensitive to stimulation for a few weeks.

Risks

Risks include post-operative bleeding, mal-position, the formation of scar tissue around the implant (capsular contracture) which may cause the breasts to feel tight or hard, deflation, or infection. An increase or decrease in sensitivity of nipples or the breast skin may occasionally be permanent. Most complications are infrequent and can typically be corrected. Future mammography will require a special technique be performed for accuracy. The implants have a permanent warranty by the company and the companies cover some surgical costs related to deflation within the first 7-10 years. The treatment of complications may involve further costs. Those typically relate only to the facility and anesthesia costs.

Recovery

Depending upon the type of work, most women return after 1 week. Aerobic-type exercise, heavy lifting and physical contact with the breasts should be avoided for approximately 3-4 weeks. The fading of scars may take several months to a year. You will be instructed on post-operative care and massage as you progress.

Duration of Results

This may be variable as implants may require replacement over a woman's life span, most implants last for many years without problems.

Again Dr. Yousif recommends that you review the different types of Implants by visiting their web sites. Be sure to review their stated policies and risks and complications.

http://www.allergan.com
http://www.mentorcorp.com