351 Hospital Road, Suite 617
Newport Beach, CA 92663
(949) 650-6710
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351 Hospital Road, Suite 617 |
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Breast Enlargement (Augmentation)Breast augmentation is the enlargement of the breast by placing an implant (also called a prosthesis), either directly behind the tissue of the breast gland or underneath the pectoral muscles as well as the breast (figure 4).
Saline implants are available for all patients, and silicone gel implants have just been re-released for use in most patients (you must be 22 years old to receive silicone gel implants for cosmetic reasons). The breast implant is inserted through either an incision around the lower border of the nipple (at the edge of the areola or pigmented area), an incision in the skin fold below the breast or an incision in the armpit. Choice of incision and breast size is largely a matter of preference of the patient and plastic surgeon. Who is it for?You are a good candidate for this procedure if your breasts are significantly smaller than you would like them to be and not unduly droopy. If the breast is also quite droopy, you can still have a breast augmentation but you may also need a mastopexy (breast lift) to be done at the same time. What to expect.If the implants are to be inserted beneath the muscle, a general anesthetic is usually used. Breast augmentation can also be performed under local anesthesia (injections to freeze the tissues) and sedation, but I rarely do this as the procedure may still be uncomfortable. Breast augmentation is an outpatient procedure. After surgery you will have some discomfort. If the implant has been put beneath the muscles the pain is more severe and pain may occur upon moving the arms. Typically there is not a great deal of bruising or swelling. You should be able to return to work in two or three days. However, you must avoid strenuous activity for two to six weeks. I usually place On-Q™ catheters on each side, as well. These are very small tubes, about the size of an I.V. catheter, but longer, that pass a steady flow of local anesthetic into the area of surgery for the first three or four days. They significantly reduce the pain, and the amount of painkillers that you will need. When any foreign material is placed in the body, scar tissue forms a capsule around it. Usually this normal reaction is not a problem. Sometimes, for reasons that are not entirely clear, this capsule becomes thicker. It contracts around the implant, forcing the implant into a hard round ball. This spoils the shape and consistency of the breast. A tight capsule can also cause discomfort. Usually the breast must be re-opened and the capsule surgically released, to make the breast soft again. The majority of patients who have capsule problems are still happy that they had a breast augmentation. Rarely does anyone want the implants removed. The risk of developing a tight capsule is probably lower with a saline filled implant, or with a textured implant. Saline filled implants leak more easily than silicone gel, and if so the breast will rapidly return to its preoperative size. (The saline is harmlessly absorbed by the body.). Textured implants were more recently introduced, so there is less long term experience with them. They are becoming increasingly popular because of the lower risk of a tight capsule. Over two million women have undergone breast augmentation with silicone implants over the last twenty-five years and they are one of the safest surgically implanted devices in use. Breast feeding is rarely affected. There is also no good evidence of any increased risk of breast cancer or auto-immune disease. Except in rare circumstances, breast augmentation will not delay a detection of a breast cancer. There is a slight loss of accuracy of screening mammograms. Be sure that the mammographer is used to imaging augmented breasts, as extra views are needed. Of course the improvement in your figure following breast augmentation is most noticeable in swimwear or a low-cut dress. Many patients are also happier with the way their other clothes fit and look afterwards. Today's fashions often rely on a bustline for their effect. If you have this procedure to satisfy your own wishes (and not those of a husband or lover), you are likely to be very happy with the result.
Before-and-After PicturesClick on a thumbnail for a larger image.
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Many designs of implant are used. They all consist of a silicone bag containing
a fluid. The outside of the silicone bag or envelope is sometimes textured.
The first fluid used to fill implants was silicone gel, followed by saline
(salt water). Newer implants filled with soybean oil and a starch derivative
are unlikely to gain F.D.A. acceptance. (Soybean oil implants were recently
withdrawn in Britain because of concerns about their long term safety.)
