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Return To The Procedures | Before and After Photos Breast Augmentation Breast augmentation is a surgical procedure to increase the size of the breasts. It is usually performed to enlarge small, underdeveloped breasts that have decreased in size after pregnancy. It can also be performed in cases of breast deformity, or where one breast has not developed in proper symmetry with the other. When a breast is lost due to breast cancer, breast reconstruction may also be possible. There are several types of incision techniques that can be considered for breast augmentation. The incision type used generally depends on the surgeon's technique. Once the incision is made, the surgeon will lift breast tissue up and down to create a pocket. This pocket will either be under the tissue or underneath the chest wall muscle. Once the pocket is created, the Beverly Hills breast augmentation surgeon will place a breast implant inside. Traditionally, this procedure has been accomplished by using a flexible plastic envelope containing a silicone gel. However, there have recently been concerns raised about the safety of silicone implants. While further research is being done, new patients desiring breast augmentation are restricted to saline-filled implants. Breast augmentation surgery can usually be done in one-day surgery as an outpatient procedure. Most women are able to return to work in four days. Risks: Costs: About Breast Reconstruction Each year, thousands of women lose their breasts to cancer. To compensate for the loss, some choose to have their breasts reconstructed. Breast reconstruction can be done during, or following a mastectomy. Breast reconstruction can be performed on even those women whose skin has been damaged by radiation, or those who have had a radial mastectomy. (Where the pectoral muscles have also been removed.) Breast Reconstruction Procedure If done during a mastectomy, after the breast has been removed, an implant is inserted, the incision is then closed and drainage tubes inserted. This type of reconstruction has several advantages: It avoids a second operation, an additional scar, and increased expense. Many people who undergo reconstruction during mastectomy surgery, rather than after, do not experience the same sense of loss. If breast reconstruction surgery is done following mastectomy, there are a couple of options. The most typical method of reconstruction involves gradually stretching the skin and muscle so that an implant can be inserted. During the initial surgery, a balloon-type expander is placed under the tissue of the chest wall. Over the course of several weeks, the balloon is filled with increasing amounts of salt water solution. When the skin and muscle are stretched enough, the expander is removed, and replaced with a permanent implant. On occasion, there is enough loose skin to allow for the placement of an implant without going through the step of expansion. This method uses the patient's own tissue from either the abdomen or back. The skin, fat and muscle are repositioned on the chest wall creating a natural breast contour with, or without the use of an implant. Most women who undergo breast reconstruction also have nipple reconstruction surgery. The final step utilizes tattooing pigment, to help the reconstructed breast look as natural as possible. Incisions in Breast Enlargements Saline implants for breast enlargement can be placed through several types of incisions. Usually the type of incision used depends on the surgeon's technique. There are several types of incisions that are used for breast enlargement. One of the most commonly used incision techniques is an inframammary (in-fra-mam'-a-ree) incision. This incision is made slightly above where the lower part of the breast touches the chest. Another common technique is the periareolar (pear-e-are-ee-o-lar) incision. This incision is made around the lower border of the areola (are-ee-o-la) which is the dark pink skin that surrounds the nipple. Another technique, which is used less frequently, is an incision in the armpit. Incisions are generally very small, one-inch incisions which are then filled with a saline-filled implant. Once the implant is complete, the incisions are then closed by a few sutures. The sutures will be removed within a week of the surgery and every effort is made to keep scars as inconspicuous as possible. Technical Information Regarding Breast Augmentation Breast augmentation requires incisions to insert an implant. This incision is usually no longer than an inch. It can be placed (following the surgeon's preference or the patient's specific needs) in the fold below the breast, below the areola or in the armpit region. Rarely, the umbilical road will be chosen. Implants can be placed under the gland (subglandular) or under the pectoral muscle and gland (submuscular). Submuscular placement is the most common for saline-filled implants since it reduces the risk of ripple, implant visibility, and hardening of the breast. Sometimes scarring can occur around the breast implant, producing a tightening of the implant (encapsulation). This process occurs in a few cases, producing breasts that are two firm. This condition can be remedied, but will probably require an additional procedure. A breast lift is the placement of an implant to correct the sagging of the breast. After an evaluation, the surgeon should tell you if placement of the implant is sufficient to correct breast or nipple sagging or if an additional procedure is needed. This second surgery can be done simultaneously with breast augmentation, but will require more incisions than a simple enlargement. As in any surgical procedure, there is a chance of infection or bleeding. Loss of nipple sensitivity is also a risk, but fortunately is quite rare. And remember the long-term effect of a breast implant should be discussed with an experienced plastic surgeon at the time of the original evaluation. Placement in breast enlargement A woman can choose to enlarge her breasts through a process called augmentation (awg-men-tay-shun). This surgical procedure involves the placement of an implant under the breast in order to increase its size. There are two types of placement options for implants. A breast implant can be placed either over or under the pectoralis chest muscle. There are advantages to each approach depending on a patient's age, degree of breast sagging, and requirements for mammography. In general, the sagging breast requires an implant to be placed above the muscle in order to provide the most aesthetically contoured breast. However, an implant placed below the muscle makes mammography a little easier. These factors as well as others should be carefully considered to determine which placement option is most appropriate for you. Consultation with an experienced board certified plastic surgeon familiar with both approaches is advisable. Saline Implants In nineteen ninety-two (1992), the Food and Drug Administration outlawed the silicone gel breast implant for most breast surgery. Saline implants have since replaced the silicone gel implant for breast augmentation and reconstruction. These implants contain a natural salt water solution surrounded by a textured silicone rubber shell. Implants may be placed between the breast and the muscle behind it, or between the muscle and the ribs. Your surgeon will discuss with you the pros and the cons of each placement option. The Food and Drug Administration is also currently scrutinizing the use of saline implants in breast augmentation. A detailed review of the safety data and the FDA position on saline implants can be provided by an experienced, board certified plastic surgeon. |