Breast Augmentation

The Breast Augmentation Surgery Procedure:
Augmentation Mammoplasty, as the name states, is the procedure to make the breast larger. This is the only way a woman can make her breasts larger and fuller that's approved by the American Society of Plastic and Reconstructive Surgery. For most woman this procedure is a phenominum. Most of the women who have had this surgery done are extremely satisfied and would not remove their implants unless they wanted to increase the size. The augmentation can be done through the following four approaches:

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1. Breast Surgery Axillary Approach - an incision is made underneath the armpit. An endoscope may or may not be used with this approach.

2. Breast Surgery Periareolar Approach - an incision is made next to the nipple areolar complex.

3. Breast Surgery Inframammary Approach - an incision is made at the crease of the breast.

4. Breast Surgery Umbilical Approach - using an endoscope, entry is made through the belly button area. Through either one of these four incisions, a space is created for the implant underneath the breast. In the case of the first three incisions, that space can be created in front or behind the pectoral muscle. In the case of the fourth, via the umbilicus, using an endoscope the implant is generally placed in front of the pectorals muscle. After this space is created in either location, an implant is placed and the breast enlarged.

The Best Breast Surgery Approach
When deciding where to have your incision you should take into consideration the scarring that may occur at each incision. Some are more noticeable than others. Your surgeon should be experienced in all four techniques. If a doctor tells you that he only performs one type of entry because he feels it's the best, more than likely it is because he is inept in the others. Every patient is different and what might be the right approach for one is not necessarily the best for another.

The operation generally takes from 1-2 hours depending upon the approach. You will spend another 2-4 hours in recovery before your allowed to go home. I tailor the procedure to fit the patient based on what each individuals needs are.

Breast Surgery Implants:
What are they made of and what's available? The fill material in implants presently being used is saline and silicone. Saline is the only fill material allowed on first time cosmetic patients. Silicone implants can be used on patients who are replacing existing silicone implants and patients undergoing breast reconstruction, and those requiring a significant breast lift. The data on silicone implants and potential concerns is available through the FDA and The American Society of Plastic and Reconstructive Surgery. Your doctor can also answer any questions. At any rate, perhaps the safest fill material is saline because saline is nothing but physiologic salt water, which is totally harmless. One needs to understand that should a saline implant rupture for any reason the implant will deflate and that the saline will be absorbed into the body causing no harm. The implant however will have to be replaced. Incidents of rupture are uncommon but can occur.

Selecting your Breast Implant size:
The most frequently asked question is "How big should I be". The most common mistake is a patient who is small busted settling for an implant only a size bigger. They're so excited to think they are going to have something to fill out their bra that they settle for less. From my experience when a patient does not take the advice of the doctor or his staff regarding size the patient ends up coming back for more. I have available different sizes for you to try on with a surgical bra so you can get a rough idea what you will look like in your clothes. Listen to the doctor's advice because not only is he going to advise you cosmetically but he takes your body structure into account as well as the shape of your breasts.

Breast Surgery Recovery:
How long and what should I expect? This is something that varies from patient to patient. In general the first three days are the hardest. You will be sore from the incision and implant insertion as well as your body getting used to the addition. Within a week your stitches come out and you've pretty much resumed your normal life style except for strenuous activity. Allow 4-6 weeks for that. You'll continue to feel some sharp pains at times but most of the swelling is gone. Usually most of my patients by the fourth day are out shopping for new lingerie and clothing and are eager to show off their new figures.

Breast Surgery Complications:
What are they? How often do they occur? As with any surgery you're at risk for bleeding, infection and scar formation. Bleeding, should it occur, generally occurs within the first week of surgery and most likely within the first few days.One knows about it because generally one breast will become larger, more painful, and more black and blue than the other. Should this occur to any significant extent, the patient would be taken back into surgery, the incisions opened, the blood evacuated, the bleeding stopped and the implants placed back. Should infection occur, they are usually associated with increasing pain, increasing tenderness, redness, and fever. If the infection can not be treated orally the doctor may have to take the patient back into surgery and remove the implant until the infection can be cleared up. Finally, there is scarring. How a patient heals is very individual. Some patients will heal with almost invisible scars where others won't. The most common concern for patients is the way your body will respond to a foreign object such as the implant being placed inside you. Capsular contracture can occur if your body responds by pushing scar tissue down under the implant.If that happens, there are things that can be done to help correct it such as changing the type of implants or the location of the implants and in most patients that is enough. However, there are always some patients that no matter what you do they develop capsular contracture and these patients need to decide either to do away with the implants or live with a firmer breast. Some patients also experience an increase and/or decrease in sensation, either around the breast in general or the nipple areolar complex. Usually this increase and/or decrease in sensation disappears with time. These complications are very rare but can occur. That is why I mentioned that an informed patient who is knowledgeable about the procedure can avoid and or deal with a problem.

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