Enhance Your Curves with Breast Augmentation
Breast augmentation is the most popular plastic surgery procedure in the United States, with over 300,000 women enjoying it yearly. This procedure is designed to enhance the size and shape of a woman’s breast through the placement of implants, namely silicone, saline (salt water), or gummy bear. These can be placed beneath the breast tissue (sub-glandular) or beneath the chest muscle (sub-muscular). In most cases, Dr. Marin places the implant through an incision around the areola or at the breast crease. The type, size, profile, and placement of the implants are largely based on a patient’s anatomy and her ultimate cosmetic desire.
WHAT TO EXPECT FOR YOUR
Pain, bleeding, infection, asymmetry, implant failure, capsular contracture
6-8 weeks for implants to completely descend into the final position
General or local with sedation
Back to work: 3 days Strenuous activities: 2-3 weeks
DURATION OF RESULTS
Breast implants are warrantied for life. Replacement only entails a minor procedure.
Temporary swelling, bruising, mild pain
Breast implants were invented in 1962 by Dr. Frank Gerow and Dr. Thomas Cronin at the Baylor College of Medicine – the same institution where Dr. Marin trained in plastic surgery. The implants initially were much less structurally sound, but very soft and almost undetectable. Since that time, the implants have been under intense scrutiny by both physicians as well as the FDA. They are now significantly improved, and have been demonstrated to be safe in hundreds of peer reviewed journals; many of which have been published in one of the premiere plastic surgery journals – Plastic and Reconstructive Surgery. Older models of the breast implant were often wide and made with a very thin silicone shell, failing to help “re-shape” a woman’s breast. When placed upright, the implants would collapse and not hold their form, making the breast less full in the upper aspect. The newer “4th generation” silicone models are much more effective at producing a more attractive shape. You can learn more about the evolution of breast implants here.
Things To Consider For Your Breast Augmentation
1. Type of Implant
All breast implants are made with a nearly identical silicone “elastomer” shell no matter what the content – saline or silicone. This shell has either a smooth or textured surface depending on the specific design of the implant. The implants that are shaped or anatomic have to be textured so that they do not rotate in the body, whereas the round implants are usually smooth as there is not a problem with the round implants moving inside the breast pocket. However, we use every combination of implant and surface depending upon the need and goals of our patients.
Saline breast implants are shipped empty and then routinely filled to a specified volume range (CCs) with the equivalent to IV fluid. This allows the implant to be placed through a slightly smaller incision (roughly 1 inch) as the implant is inserted empty and then filled once it is placed in the body through a small fill tube. Having a “fill range” for each implant allows for the greatest degree of flexibility in controlling the volume of each implant; this is particularly helpful in cases with pre-existing asymmetry. This implant produces a more dramatic result and tends to push against the tissues more aggressively than the silicone counterpart. However, the implant tends to be more “firm” to the touch and has the reputation of having the highest incidence of postoperative rippling of any of the available implant choices.
Silicone breast implants are now available in two different forms – traditional silicone and the “gummy-bear” variety. Both of these implants are “pre-filled” from the manufacturer and arrive in sterile containers. Thus, no adjustments can be made in the operating room to “fine tune” the result. There are options to use different sized implants, but the volume options are fixed from the manufacturers. Traditional silicone implants are softer, more natural, behave more like a natural breast and have less rippling than the saline counterpart. Silicone breast implants are what 90 percent of our patients choose.
“Gummy bear” breast implants are more cohesive – meaning that they hold their form even when cut in half. These implants come in a round and anatomic or “teardrop” shape. Round implants can be textured or smooth, but ALL gummy bear implants have to be textured as they are not designed to rotate within the body. These implants are a bit more firm than the traditional implants, which have more of a “marshmallow” feel. As a result, these implants hold their shape better than any other implant, but can be firmer to the touch. They also require a slightly larger incision to be able to deliver the implant into the breast pocket. See Dr. Marin’s Fox 5 news segment on the topic for more information.
2. Type of Incision
Incisions are a big concern for almost every woman undergoing breast augmentation. But women may not need to worry since nearly all incisions heal extremely well after a procedure. We traditionally insert the implant through either the breast crease (inframammary incision) or the areola (the pigmented part of the nipple). There are advantages and disadvantages to both incisions. Most women can choose between either.
The breast crease incision keeps the incision off the breast and hidden at the breast crease. However, a smaller bikini can possibly reveal this incision location. The areolar incision keeps the incision well concealed at the color change at the border of the areola and the breast skin. But this is not hidden in an anatomic crease.
Fewer women elect to go with an axillary approach. This is when the incision is made near the armpit to prevent visible scarring around the breast. Scarring may be seen when your arms are raised while wearing sleeveless tops, bikinis, and tank tops.
3. Implant Placement
Both silicone and saline breast implants can be placed above or below the chest muscle. The decision to use the muscle is largely dependent upon how much pre-existing breast tissue the patient has before surgery. The chest muscle serves as a camouflage to the upper aspect of the breast, which is the area most visible in a low cut top or bikini. For thin women, the implant edges could be potentially visible and placement of the implant beneath the muscle can help to significantly improve this. We commonly use the chest muscle (pectoralis major) to help soften the look of the implant and to make it appear more natural. There is a phenomenon called “animation deformity” where the implant can be moved by the chest muscle, which only occurs with implants placed beneath the muscle. However, there are several significant benefits to this approach:
- The appearance is more natural
- The incidence of long-term complications is less
- It is better for mammographic evaluation of the breast than over the muscle.
Despite these options, 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
Choosing the “perfect implant” is often the most challenging aspect of breast augmentation surgery for patients. The success of this process is largely dependent on the communication between you and Dr. Marin. During your consultation, Dr. Marin will measure your breasts to determine the anatomic requirements to help better choose the appropriate implant. Simultaneously, he will take note of any breast asymmetry, chest wall shape and appearance and your skin elasticity.
The key measurement is the width of each of your breasts as our goal is to augment the entire breast – choosing an implant that is not too wide or too small. We need to find a specific implant that fits both your anatomy as well as achieving your desired look. Since a traditional cup size can be quite variable, bringing in photographs of specific “looks” that you are trying to achieve can be very helpful in communicating accurately regarding the ultimate outcome you desire. Areas to consider when choosing the photographs are the overall shape or “roundness” of the breast, the fullness at the upper aspect of the breast and the degree of cleavage – just to name a few. We also offer patients the opportunity to “try on” their implants by sizing specific 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.
All breast implant manufacturers (Allergan, Mentor and Sientra) make both saline and silicone implants in three to four specific profiles: in essence a low profile, moderate profile, high profile and ultra 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 even more narrow with a more dramatic projection, and finally the ultra high profile being the most narrow with the most dramatic projection. Each of these implant designs is designed to help different women with different chest and breast shapes achieve their desired aesthetic breast augmentation goals.
Implant Shape and Texture
Saline and silicone breast implants come with both a smooth and textured surface, as well as a round and “teardrop” or anatomic shape. The most common combination in the United States for both saline and silicone implants is a smooth. However, with the advent of both a textured surface in combination with a shaped appearance, we are finding more and more women are electing to use this combination of implant shape and texture.
Undergoing Breast Augmentation Surgery
A typical breast augmentation procedure 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. It is performed using either local anesthesia with sedation or general anesthesia. Our recommended approach is with a general anesthetic and always in a fully accredited (AAAASF) operating room under the supervision of a Board Certified anesthesiologist.
After Your Breast Augmentation
After your surgery, you may feel drowsy and sore for the next 2 days. It will be best if someone would accompany you within this time frame. Dr. Marin will also provide a surgical bra which you should wear for 23 hours a day, removing only when you shower. Patients are required to wear the bra for 6-8 weeks after surgery depending on how well they are healing.
You may notice your breasts will feel tender and sensitive right after your surgery. Your implants may also seem too big and hard, but this is only temporary and will subside as the swelling goes down.
Recovery and Scarring
Recovery from breast augmentation is relatively shorter than other plastic surgery procedures. It may only take 4-6 weeks of proper rest for you to get back to your usual activities. Patients who chose the beneath-the-muscle placement may experience a longer recovery time. All sutures are dissolvable so there is no need for suture removal. Postoperative pain is also well controlled with prescription pain medication. Typically, patients may return to work after 3-4 days.
Still, it is crucial for you not to rush the recovery because this may only cause adverse effects. Let your body recuperate. If your need to take some time from work, do not hesitate to do so. Here are some important tips to recover well from breast augmentation:
- Keep your incisions dry to reduce the risk of infections.
- Do not apply creams or lotions on the incisions or anywhere near the area. This may cause inflammation.
- Avoid strenuous activities like lifting heavy things and exercise for at least three to four weeks after your surgery.
- Do not take pain relievers unless your doctor approves. This may cause excessive bleeding.
- If you feel well enough, walk around your home or neighborhood to reduce blood clotting and to relieve the swelling of your chest.
Like any other surgery, scarring is inevitable after breast augmentation. The position of your scar depends on the type of incision you chose and how the implants were inserted. Your scars will look pinkish for the next few weeks, but it will fade considerably over time if you carefully follow your doctor’s orders regarding your healing process.
Your New Look After Breast Augmentation
In your healing process, your body will gradually accommodate the addition of your implants. As you go through your recovery, your breasts will improve in appearance – gearing towards a more natural and softer look. Most women will begin to see their “final” result after three to six months.
Breast augmentation is highly personal, and enjoying the benefits depends on the perspective of the patient. Nonetheless, it is positive that breast augmentation may improve the confidence and self-image of a woman who’s looking for a great way to improve her appearance.
Request Your Consultation
To learn more, you can schedule an appointment online or you can call 858-638-9800