Information and answers to your questions about breast surgery
Breast Augmentation is the surgical procedure to enlarge the size of the breasts by placement of saline or silicone implants under the breast skin or breast muscle . There are a number of different techniques and philosophies regarding the surgery and I will explain these differences for you below. For more information on these and other cosmetic plastic surgery procedures please visit my web site at www.Tavmd.com or call 703-876-9400 for a consultation.Silicone or Saline Implants? The first breast implants developed in the 1960s were saline implants. Silicone implants became the standard soon thereafter with their almost exclusive use till 1990 when they were withdrawn from the market because of concerns with auto-immune diseases. Saline implants were hence improved upon and became the only choice for cosmetic breast augmentation in this country. After extensive research the silicone implants were re-introduced and are currently available though with some restrictions. Both saline and silicone implants are offered by the manufacturers with warranties as to their performance.So which implants do I use? For over 90% of my patients I still prefer to use saline implants for the following reasons;1. The silicone implants are filled with a given volume of silicone and cannot be adjusted to allow for the natural differences that you and every woman have between your breast sizes. A saline implant can be filled to match the size of the other breast.2. The silicone implant is pre-filled and requires a larger incision, usually two inches or more for placement of the implant. Saline implants can be placed through incisions as small as one inch. 3. Since I prefer to place my implants under the muscle of the chest, so the implant is just pushing what breast tissue you have forward, the advantage of the silicone implants in feeling more "squishy", is lost. Both saline and silicone implants push your own muscle and breast tissue forward and the implant is not really felt. Placing implants under the muscle not only gives a more natural look and feel for the breast, but also provides for a lower rate of breast scar formation and also for a better longterm cosmetic result. 4. The cost of the silicone implants is double that of the saline implants. 5. If you have silicone implants must get an MRI scan of the chest every two years. This gives you both extra radiation and a significant extra cost. Which incision is best? Breast implants can be placed under the muscle or breast tissue using a number of different incisions. To a great extent the choice of the incision, which is only 1-2 inches, depends on you; but there are important differences that you need to be aware of. With time all scars improve in appearance; the important decision you must make is whether you want to breast feed a child or not. If you want to breast feed children later; 1. Under the Breast- "infra-mammary" is by far the most common incision. Its advantage is that it provides direct access to the area under the muscle for placement of the implant without disturbing the breast tissue itself; so you can breast feed children later in life. The incision is not seen when you are standing up, and only visible when you lie down. 2. Under the arm-pit "axillary" incisions are usually longer than other incisions and associated with the highest complication rates. Since the procedure is essentially a blind procedure, where the surgeon does not really see what he is doing, but is operating by feel, there is a tendency not to dissect as much as is required for a natural shape to the breast, and a higher rate of bleeding and nerve damage. The perceived hidden scar is also more likely to be noticed on a day by day basis when you are wearing a bra,bikini,or sun dress. It's not my favorite but I do use this techniques for patients who really want it. 3. Belly Button "trans umbilcal" incisons are seen only on TV. Another of the "blind" techniques, this has a high complication rate and leaves breast implant in a tight unnatural pocket. Most implants are placed on top of the muscle. despite the fact that this technique has been around for over twenty years very few plastic surgeons use it for good reason! if you don't want to breast feed children; 4. Under the nipple- "infra-teton" is my own particular favorite. This incision is within the areola, right under the nipple. When healed it is very difficult to see. sensation is not affected any more or less than with other techniques, but you will probably not be able to breast feed a child with this incision. 5. Around the areola "peri areolar" incisions are associated with the worst of all worlds in my opinion. First you will not be able to breast feed since the breast ducts are cut, second there is a good chance you will have decreased sensation of the nipple and areola, and third the scar is sometimes thick and visible with no way to hide it. Use the infra-teton incison above! Can You do breast augmentation and breast lift at the same time? Both these procedures can be performed at the same surgery. Many women need to have a breast lift and augmentation after breast feeding children. Other surgeries such as abdominoplasty (tummy tuck) can also be performed at the same time as part of a "Mommy Makeover". Do you need High Profile implants? Breast implants come in different' profiles". For the same diameter implant, high profile implants come out more- they are more cone shaped. These implants are best for patients you have very small hips and on whom a moderate profile implant, which would have a greater fullness on the sides, would appear too big. They would look top heavy with a moderate profile implant. However, most patients need moderate profile implants since they have larger hips than chests. The art of breast enlargement surgery is to make your body appear more proportionate. The Surgery takes about one hour and is performed in a surgery center under general anesthesia. Using the post operative regimen I have designed, you will probably be back to your normal life activities within three days. No exercise is allowed for two weeks other than walking. You will not be wearing an under-wire bra till your breast implants, which are initially high on your chest, have had a chance to fall down to a normal position; something that happens between two weeks to four months after the surgery. You will be taught how to massage your breasts after the surgery to bring the implants down to their position. For more information on breast enlargement or augmentation using saline and silicone implants, breast lift surgery with or without augmentation, and other cosmetic surgery procedures please visit my website at www.Tavmd.com or call 703-876-9400 for a consultation. | What are the risks? As with any surgery there are risks to breast enlargement surgery. There is a 2% risk of infection or bleeding which may require the implant to be removed and replaced at a later surgery. Specific to the breast implants there is a 10% risk of developing hardness of the scar tissue around the implant, a condition known as "capsular contracture", which leaved the patient with a hard breast. Though there are some medicines that can help this poorly understood condition, 1% of all patients may require a second surgery to remove the scar tissue and replace the implant. Do you need to change your implants after ten years? Almost every patient asks me this question, and it arises from misunderstanding of the facts. Breast implants do not need to be exchanged. 50% of patient who have breast augmentation surgery never have another cosmetic procedure on their breast. Of the other 50% who will end up having a second breast procedure, 93% have the second procedure because they want to. After say 10-15 years the shape of the breast may have become more droopy, or you decide that you want larger or smaller breast implants etc. So, there is only a small group needing to have another surgery; this may be necessary because of implants rupturing (happens to both saline or silicone implants), moving out of place (implant mal-position), infection, bleeding, scar formation or pain. Overall 98% of women who have had breast enlargement surgery would undergo the surgery again! |