San Diego Breast Augmentation
“With the weather and lifestyle in San Diego, breast augmentation is one of my most frequently performed surgeries, and the one with some of the happiest patients.” – Dr. Marin
Breast augmentation surgery with either saline or silicone implants is the most commonly performed cosmetic operation in the United States. This surgery is designed to enhance both the size and shape of your breasts with the insertion of implants either beneath the breast tissue or the underlying chest (pectoralis) muscle. During your consultation, both you and San Diego plastic surgeon Vince Marin will discuss the breast augmentation procedure in detail, and make several decisions based upon your specific needs, aesthetic goals, and anatomy. These can be broken down into four easy steps.
WHAT TO EXPECT FOR YOUR
What To Expect
General or local with sedation
Temporary swelling, mild bruising, and some pain
Pain, bleeding, infection, asymmetry, implant failure, scarring around the implant (capsular contracture)
Back to work: 3 days to 1 week
More strenuous activity: 2 – 3 weeks
6 – 8 weeks for implants to completely descend into the final position
Duration of Results:
Breast implants are warrantied for life. If there are no problems with the implant, there is no need to replace the device. However, when an implant is replaced, this is easily accomplished through a relatively minor procedure.
1. Type of Implant
Breast implants are made with an identical silicone shell but filled with either saline or silicone. As the implant becomes larger in volume, it also becomes wider and projects out further from the chest. This fact is missed by many of our San Diego breast augmentation patients and must be taken into consideration to get the best results.
There are pros and cons to each implant. The saline breast implant comes empty and is filled with saline (salt water) during the surgical procedure. This allows for the incision to be slightly smaller (about 1 inch), and the implant is inserted empty. The implant has a more dramatic appearance and can produce a bit more “showy” of a result. There is a higher risk of the edge of the implant being visible and postoperative “rippling” with saline implants.
Silicone breast implants are pre-filled with a silicone gel and are manufactured in standard size increments. The silicone implant requires a slightly larger incision (1/2 an inch larger) as it must be put in its proper location completely full. However, these implants tend to feel more natural and behave more like a natural breast. These implants are almost undetectable and have a very low incidence of postoperative visibility or “rippling”. Any patient considering a more “natural” result should consider a silicone implant as it achieves this goal much more consistently than its saline counterpart.
The breast implants can be inserted through several different approaches. The most commonly requested incisions are through the breast crease or around the areola (the pigmented part of the nipple). The advantages to the breast crease incision is that the incision is hidden beneath the breast and not usually visible from the front. Areolar incisions are hidden in the color change where the breast skin meets the more pigmented areola and, once healed, are almost invisible. Less frequently women elect to proceed with an axillary (arm pit) approach to prevent any visible scarring near the breast. However, in sleeveless tops or tanks, there is the possibility of visible scarring.
3. Above or Below the Muscle
The role of the chest muscle in breast augmentation surgery is to help camouflage the saline or silicone breast implant. Most of our San Diego breast augmentation patients are missing enough breast tissue to effectively “hide” the implant from being obvious. We commonly use the chest muscle (pectoralis major) to help soften the look of the implant to make it appear more natural. If, however, you have at least a large B to C cup breast, there is enough of your own breast tissue to effectively hide the implant without using the chest muscle. The advantages of this approach are that the recovery is better tolerated, and there is no risk of movement of the implant with the contraction of the muscle – again adding to a natural postoperative appearance. However, most women who are looking to have a breast augmentation do not have enough breast tissue and must have the implant placed under the muscle.
4. Implant Size
This is often the most challenging decision of the entire process. The key to choosing the “right” implant is communication between both of us. During the consultation, I will perform a full exam taking note of the size of your breasts, symmetry, breast tissue, skin elasticity and specifics about your chest. Additionally, I will take a number of measurements of your both your chest and breasts. This helps me determine which implants will be appropriate for your specific anatomy. The key measurement is how wide your breasts are as our goal is to augment the entire breast – not choosing an implant that is too wide nor too small. We need to find a specific implant that fits both your anatomy as well as your aesthetic goals.
At the conclusion of the consult, you will have an opportunity to “size” or actually try on the implants to get a sense of how you are going to look in clothes after the surgery. Most patients find this to be very helpful in picking the ideal implant. Once we have finished this process, I will attempt to assimilate all of the information to help you choose the “perfect” implant.
Breast implant manufacturers make both saline and silicone implants in three specific “profiles”: in essence a low profile, moderate profile and high profile implant. To better understand this, for every specific volume, each implant will contain the same amount of fluid, but the low profile will be wider and less projecting out from the chest, the moderate is a bit narrower and projects further out, and the high profile is the narrowest with the most dramatic projection. Each of these is designed to help different women with different chest and breast shapes achieve their aesthetic breast augmentation goals. Allergan has recently developed a Style 45 implant which is an even higher projecting implant, giving the most projection of any silicone implant on the market today.
Silicone Breast Implant Profiles
Implant Shape and Texture
Saline and silicone breast implants come with both a smooth and textured surface, as well as a round and anatomic or “teardrop” shape. I have found that to achieve the best results, the most effective combination for both saline and silicone implants is a smooth, round implant that is by far the most common approach in the US.
Smooth round silicone implants (above), textured anatomic silicone implants below
Breast Augmentation Surgery and Recovery
Breast augmentation with either saline or silicone implants is almost always performed as outpatient surgery. My recommended approach is with a general anesthetic and always in a fully accredited (AAAASF) operating room under the supervision of a Board Certified anesthesiologist. The surgery usually takes a little under an hour to complete and most patients are on their way home less than an hour after the completion of surgery.
Your recovery should be relatively uneventful, and postoperative pain is well controlled with prescription pain medication. You will remain in a surgical bra for 23 hours a day, removing this to shower only. We normally recommend that you limit your upper body activities for the first several days. All sutures are dissolvable and there is no need for suture removal. Patients wear a postoperative surgical bra or sports bra for several weeks after surgery as your new implants begin to settle into position. Most women will begin to see their “final” result after three to six months. The biggest complaint we see is women asking why they didn’t decide to do this sooner.
San Diego Breast Augmentation Consultations
Contact us for a complimentary consultation with Dr. Marin at our San Diego office if you are considering a breast augmentation.
Read More: Discussing Breast Augmentation with Dr. Marin
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