BREAST AUGMENTATION

Breast Augmentation, also known as Breast Implant Surgery or augmentation mammoplasty, is an outpatient plastic surgery procedure in which breast implants are inserted to change the appearance of the breasts by increasing volume and enhancing shape. Breast augmentation can correct asymmetry for breasts that are different sizes, restore a youthful look, and create a more feminine silhouette. For women who are unhappy with the size or shape of their breasts, breast augmentation can do more than just fill out their figure – it can improve self-esteem, self-confidence, and allow them to feel confident in their bodies.

REASONS FOR BREAST AUGMENTATION

Restore loss of breast volume after breastfeeding or weight loss
Create symmetry for breasts that are different sizes from each other
Balance a pear-shaped body with a larger lower half
Correct congenital defects, such as tubular or hypoplastic breasts
Breast Reconstruction after breast cancer
Resolve feelings of self-consciousness or lack of femininity in their bodies.

IS BREAST AUGMENTATION SAFE?

Breast Augmentation presents the common risks of any surgery. Breast implants were FDA-approved in 2006 and breast augmentation surgery carries a low risk of complications. Many clinical studies have been administered to evaluate the safety of breast augmentation, including an extensive study of breast implants conducted by the federal Department of Health and Human Services, focusing on potential causes of disease, cancer detection, effects on pregnancy and children, and much more. Results are conclusive that there is no link between implants and any systemic diseases or autoimmune disorders.

Although some women who have implants may develop diseases throughout their lives, the studies imply that the primary cause would be a pre-existing condition rather than a result of breast implants. Recent reports from the FDA do report the possibility of a link between breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and certain types of textured breast implants. BIA-ALCL has been associated almost exclusively with one particular type of breast implant that has a textured outer shell and has was recalled in July of 2018.

BEFORE YOUR BREAST AUGMENTATION SURGERY

Once you have had your initial consultation with Dr. Sever and you have scheduled your surgery you will receive specific pre-surgery instructions. It is critically important that you follow all instructions and contact us immediately if you have any questions. You will have an appointment for any necessary pre-surgical tests and paperwork scheduled for two weeks before surgery. You will be given complete instructions, but some general guidelines include:

Avoid strenuous activity the day before surgery
Do not eat or drink anything, including water, after midnight before surgery
Shower the evening before surgery and abstain from any lotions, fragrances or deodorant the day of surgery
Have a plan in place for a friend or family member to transport you to and from surgery and stay with you during the first 24 hours of recovery.

CHOOSING BREAST IMPLANT SIZE, TYPE AND Placement

Before your breast augmentation surgery, Dr. C.Sever will discuss all of your options with you to determine your surgical plan. It is important that you communicate your breast enhancement goals, so that he understands the breast volume and shape you’re seeking and can help you achieve your goals. The goal of every breast augmentation procedure is to create natural-looking breasts with good shape and symmetry.

Should You Choose Saline or Silicone Breast Implants?

Saline Breast Implants

Saline is sterile salt water and saline breast implants are contained within a silicone shell. Saline implant shells are inserted empty and then filled by the surgeon once in place.

Silicone Breast Implants

Silicone is a synthetic material that is hypoallergenic, and to date has not been known to cause any negative reactions in the human body. Silicone is thicker than saline and more closely mimics the natural look of breast tissue. The FDA regulates that women must be 22 years of age or older to receive silicone implants.

Gummy Bear Cohesive Gel Breast Implants

The key difference between gummy bear implants and traditional implants is that gummy bear implants are filled with a highly cohesive silicone gel that is form stable, allowing the implant to maintain a natural breast shape at all times. This creates a natural breast appearance and feel. Gummy bear implants also may be less likely to rupture in the case of injury due to the stronger nature of the shell of the implant and the cohesivity of the silicone gel filling.

BREAST IMPLANT PLACEMENT

Subglandular Implant Placement

With this technique, the breast implant is placed between the pectoralis muscle and the glandular and soft breast tissue. This placement may reduce surgery and recovery time and may be less painful. It may improve the appearance of sagging breasts (ptotic breasts) in the short term, but also has a higher rate of capsular contracture and may lead to sagging breasts in the long term.

Partial Submuscular (Dual Plane) Breast Implant Placement

This is the preferred implant placement option. In this method, the implant is placed below the chest muscle (pectoralis major muscle) or partially under the muscle in its superior portion and under the breast tissue in its inferior pole (also known as a “dual plane” method).

This placement offers better coverage of the implants, reduces the palpability and visibility of the implants, and reduces the risk of developing capsular contracture. Another benefit of this approach is the increased amount of breast tissue that is visible on mammographic imaging of the breast. This placement can cause animation of the breast implants with muscle contracture and has a downward and outward movement of the implants over time.

BREAST IMPLANT INCISION SITES

Periareolar Incision

This incision is made at the border of the areola and the lighter breast skin. It is typically the most concealed option out of the four incision types and offers a good amount of control when it comes to creating the pocket and positioning the implant.

Inframammary Incision

This commonly used incision is made at the breast fold. It may be slightly  less concealed than the periareolar incision but gives a faster approach for creating the breast pocket for the implant. Some recent studies have shown a lower capsular contracture (hardening of the breast) rate with the inframammary approach. Since this incision does not affect the breast ducts it reduces the possibilities of inability, or reduced ability to breastfeed.

Transaxillary Incision

An incision is made in the axilla (underarm). An endoscope (lighted camera) is used to assist in creating the breast pocket for the implant. The incision is less concealed than the periareolar approach as if someone raises their arms while wearing a bathing suit the scars may be visible. In addition when a second procedure is needed in the future, scar tissue in the region may make this approach less attractive. This option also has a tendency to result in higher-riding implants and capsular contracture.

Transumbilical Incision

During this method, an incision is made in the belly button and a tunnel created to the breast. This approach is only applicable for saline implants. It carries a higher risk of chest trauma, since it is a blind approach. This incision site is typically not recommended.

BREAST AUGMENTATION COMBINED WITH OTHER PROCEDURES

Depending on your goals, Dr. C.Sever may be able to combine additional procedures with your breast augmentation. For mothers who have concerns about other parts of their bodies, and are finished with childbirth, a mommy makeover procedure can be customized to address multiple areas of the body.

HOW LONG DOES BREAST AUGMENTATION SURGERY TAKE?

Procedure time will vary, generally between 40 to 90 minutes, depending on the complexity of technique required and any additional procedures.

WHAT TYPE OF INCISIONS ARE USED FOR BREAST AUGMENTATION?

The location and size of your breast implant incisions will depend on your current breast size, the planned increase to your breast size, and which type of implant you will be receiving. Dr. Sever typically places the incisions for implant insertion at the inframammary fold or as a periareolar incision (semi-circular incision in the lower portion of the areola). Because the goal of breast augmentation is to create more aesthetically pleasing breasts.

BREAST AUGMENTATION RECOVERY AND RESULTS – WHAT TO EXPECT

You will be given complete post-operative instructions. Please follow all instructions carefully, as they are designed to help you have the best possible results from your surgery and minimize the risks of infection and scarring. If you have any questions regarding your post-op instructions, please don’t hesitate to call our office. You will experience some discomfort and pain for a few days after surgery, which you will be prescribed pain medication to help alleviate. You can expect some swelling after your surgery, and initially it may obscure your true results, although the increase in breast size will be immediately evident. It is not uncommon for one breast to swell more than the other. For most patients, significant reduction of swelling begins by about the sixth week and continues to subside over a period of six months to a year.

Keeping in mind that it is very important to follow all specific post-operative instructions, here are a few general guidelines:

Plan for a minimum of 5 days rest, with complete bed rest the day of surgery
Light activity may be approved the third week after surgery, with return to normal activities  at approximately six weeks after surgery.
Keep all scheduled post-operative appointments, starting with one to be scheduled 3 days after surgery
Wear a bra only if instructed to do so
Avoid sun exposure for a minimum of six weeks and ideally for a six-month period.

CAN I BREASTFEED WITH BREAST IMPLANTS?

Breast implants should have a minimal to no effect on your ability to breastfeed according to recent studies of women who had undergone breast augmentation surgery. If you were able to breastfeed before breast augmentation then you should be able to do so after your Can breast implants rupture? Although breast implants can rupture, it is extremely rare – especially with new FDA-approved implants. Breast implant rupture in modern implants generally only occurs in traumatic situations such as a car accident. If rupture or leakage does occur, it should be treated, but it does not pose any immediate health risk. MRI’s scheduled at 3 years after the surgery and every other year therefore are recommended to evaluate the integrity of your breast implants. It is also recommended to change the implants overtime according to the manufacturer’s recommendations.

CAN I HAVE MAMMOGRAM WITH BREAST IMPLANTS?

There are millions of women with breast implants, so mammographers are very experienced in examining breasts with implants.

DO I NEED TO CHANGE MY BREAST IMPLANTS EVERY 10 YEARS?

No. There is no standard time period where you have to change your implants. If you are happy with your implants and the size, and there is no evidence of leaking or rupture, you can keep your implants in forever. Keep in mind, that the risk of implant leaking will increase as the implants get older, so some women prefer to change them after about 10 years just to be safe.

Also, the technology changes over time, so the implants that are available in 10 years may be better than the implants you get now, and you may want to change them. If you get breast implants, you should at least be aware that you will likely want to have another breast surgery in your lifetime.

WHAT ARE THE SYMPTOMS OF LEAKING BREAST İMPLANTS?

Implant rupture is not common. With saline implants, you’ll notice right away as the salt water leaks out and is absorbed by the body.

With silicone implant ruptures, while you may notice a very subtle change in shape, you may not notice any change at all. To detect a silicone gel implant rupture, you would need an MRI.

IS THE RECOVERY FROM BREAST SURGERY PAINFUL?

Patients recuperating from any medical procedure generally experience some discomfort, and breast implant surgery is no different. The location of the incisions and the breast tissue affected during the surgery may cause some inflammation and pain for the first one to five days postoperatively, but Dr. Sever helps to control discomfort by using drainage tubes at the surgical site to keep swelling and fluid accumulation to a minimum. He also provides a post-surgical bra or special bandages for the patient to wear to support the new breasts. In addition to this, the doctor recommends icing the area and taking prescription pain medication to ensure comfortable healing, and sitting and lying in an elevated position to lessen swelling. Most residual soreness will not last beyond a few weeks following the surgery.

DO BREAST IMPLANTS FEEL SYNTHETIC TO THE TOUCH ONCE THEY ARE INSIDE THE BODY?

Many patients are pleasantly surprised with the natural feel of their breast implants, especially when the silicone models are chosen and placed under the breast muscle. The silicone gel provides a natural breast feel, and the patient’s own breast tissue will be positioned overtop of the implants.

HOW CAN BREAST AUGMENTATION PATIENTS AVOID COMPLICATIONS?

By following the doctor’s instructions on avoiding strenuous activities, massaging the breasts, maintaining good hygiene, and taking medications as prescribed, patients can help to prevent most complications from occurring. In certain cases, there are unavoidable complications, like implant rejection that even the most diligent patients can experience.

HOW LONG AFTER BREAST AUGMENTATION CAN REGULAR OR STRENUOUS ACTIVITIES CAN BE RESUMED?

Typically, those who have undergone the implant procedure can return to their normal activities at about the two-week mark. It may be around six weeks before patients are cleared for activities like exercise, sexual activity, or any other actions that may cause strain to the body or interfere with the healing of the breasts. Dr. Sever customizes each treatment plan, so directions may vary from one patient to the next.