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Breast Augmentation

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As the number one cosmetic surgery performed in the U.S., breast augmentation is an individualized procedure which is designed to satisfy your expectations regarding the size and appearance of your breasts. Women choose to have breast augmentation surgery for a number of reasons. Apart from enlarging the breasts, the procedure can help improve appearance by making the breasts more proportionate to the rest of the body, even out breasts which differ in size or shape, and can return breasts to their previous size and shape after losing volume from weight loss, pregnancy or aging. Some women decide to pursue breast augmentation to correct a congenital breast deformity or for reconstructive purposes after undergoing a mastectomy.

Breast augmentation does not improve the appearance of drooping breasts, but that can be corrected through a breast lift. Some women choose to have a breast augmentation and lift in the same procedure, to lift and add volume to sagging breasts.

Your consultation

During the initial meeting with your surgeon, many aspects of breast surgery will be discussed. Your expectations regarding size, shape, and implant type will be considered, and all of your questions regarding implant types, incision locations and implant placement will be addressed. You will have the opportunity to discuss your concerns about how your breasts will look in addition to the pros and cons of having breast augmentation.

A consultation also includes a physical examination to assess the size and shape of your breasts, as well as the skin’s thickness and elasticity. Your surgeon will evaluate the position of the breasts, your nipple placement, and the distance between your breasts. All of these variables help the surgeon determine if you are a good candidate for breast augmentation and help you determine which type of implant type is best suited to you.

You will have the opportunity to try on some sample breast implants inside your bra to evaluate how different sizes look. Choosing the appropriate implant size is crucial to achieving the results you want, because the number one reason women opt to have revision breast augmentation is because they wish they had opted for a larger size the first time. Your surgeon will make recommendations regarding which size is appropriate for your body according to your height and body type, but the ultimate decision about size will be up to you. The surgeon will take a detailed medical history to ensure you are a good candidate for the procedure. Your doctor will ask you about any medical conditions or drug allergies you have, in addition to your current medication use, previous surgeries and history of breast cancer in your family. If you have serious medical conditions, you surgeon may ask your primary care physician for clearance to perform breast augmentation.

Good candidates for breast augmentation are physically healthy and have reasonable expectations for what the procedure can and cannot achieve. Women who choose to have the procedure are often bothered by the size or shape of the breasts, and sometimes the overall proportion of the breasts to the body.

Incision options

Many women are concerned about incisions to insert breast implants, and where they will be made to minimize visible scarring. No one breast augmentation incision is best, and it is one of the many decisions you will have to make before undergoing surgery. Incision patterns depend on many variables, and your plastic surgeon will take into account your chosen implant type, size, your anatomy, your lifestyle and your preferences.

Breast augmentation incision length depends on many factors, including the surface, type and size of your implant. Some incisions are small and do not leave much visible scarring, such as those made through the belly button. In general, though, incisions are anywhere from one to four inches long, and the larger the implant, the larger the incision. Your chosen implant type (silicone or saline) will affect the incision you choose, because prefilled silicone implants require larger incisions than saline implants, which are filled after they are inserted.

Incision options vary depending on your desired outcome, and include:
  • Inframammary (crease incision): in the crease below each breast.
  • Periareolar incision (nipple incision)
  • Transaxillary (armpit incision)
  • Transumbilical (belly button incision)

Saline or Silicone?

Saline implants are filled with a sterile saltwater solution. They are implanted while they are empty and then filled with a syringe to the desired level. Silicone implants are prefilled and contain an elastic gel, which feels and moves very much like a natural breast. Both saline and silicone breast implants have pros and cons, and your ultimate choice will be made with the help of your plastic surgeon. Your choice will depend on your goals, preferences and anatomy.

Saline and silicone implants are both made of a silicone shell, but saline implants are filled with a saltwater solution and silicone implants contain silicone-based gel. Another thing to consider is that you have more options for incision site with saline implants, because saline implants are filled after being placed, whereas silicone implants are already filled. Saline implants are also adjustable by adding more liquid or taking it out through a syringe, but prefilled silicone implants are not adjustable.

A disadvantage of saline implants is how they feel, which is similar to a water balloon under the skin. The feel of a saline implant may be made more natural by placing it behind the chest muscle, but overall, the feeling of a silicone implant is more natural. Saline implants may also show ripples and wrinkles, whereas silicone implants are less likely to have these problems.

Silicone implants have pros and cons, too. For instance, it is less obvious if a silicone implants ruptures. If a saline implant leaks, the rupture is obvious because the breast will have a deflated appearance immediately. Women who opt for silicone implants must undergo MRI scans every few years to determine if their implant has ruptured. If an implant ruptures, whether it is saline or silicone, it must be removed and replaced.

Your surgeon will discuss the benefits and risks of each implant type with you during your consultation and prior to surgery.

Size Matters

Choosing the right implant size can be the most difficult decision you’ll make once you decide to go through with breast augmentation surgery. Although some women think “the bigger the better,” it may not be the case. Your ultimate choice on size will depend on a number of factors, including your preferences, body frame, and what look you want. Your plastic surgeon, who has extensive experience in breast augmentation, coupled with your realistic expectations, can ensure you will get the look you want.

Your surgeon will help provide some guidance on how large you might want to go by evaluating your anatomy, taking precise measurements of the chest and breasts, and help determine what will look best on your frame. When you’ve made a choice, your surgeon will discuss it with you and provide feedback. Sometimes the surgeon will tell you that your size goal is not going to look as good as it can because of your body frame, and may suggest going smaller or larger.

When deciding on a size, you may be surprised to learn that your surgeon doesn’t think in terms of A, B, or C, but “cc,” or cubic centimeters. Cubic centimeters are a metric unit of volume which defines the capacity of a breast implant, and the sizes range from 120cc to 850cc for both silicone and saline implants. Your natural breast size will obviously influence your choice of how many cc’s you would like, and two women of different natural sizes will request a different amount of cc’s if they both want to be a full C cup.

Remember to choose whatever size makes you happy, and don’t choose a size to please a significant other, family member or friend. You will be the one who will have to live with the decision in the end, so be sure to make yourself happy.

Risks

All surgery carries inherent risks, and breast augmentation has specific risks as well, including:
  • Anesthesia risks
  • Infection
  • Scarring
  • Bleeding
  • Loss of sensation, either temporarily or permanently
  • Collection of fluid under the skin
  • Asymmetry
  • Poor cosmetic results
  • Wrinkled, ruptured, shifted or deflated implants
  • Breast stiffness

Another important consideration is that breast implants are not meant or guaranteed to last a lifetime. Future surgery is usually required every 10 years to replace one or both implants. The size and shape of your breasts may change over the years, as well, from a number of conditions, such as pregnancy, weight loss and menopause.

The Procedure

Breast augmentation surgery is performed on an outpatient basis and takes between one to three hours to complete. The surgery has many variables which are determined before the surgery even begins, and your specific procedure will be individualized based on the choices you and your surgeon make on incision location, placement and size.

Your surgeon will make incisions in a pre-determined area: the armpit, crease below the breast, around the nipple, or through the belly button. Once the incision is made, your surgeon will make a space or pocket where the implant is to be inserted. The placement of the implant will be determined before surgery, and may be beneath or above the chest muscle. If you have chosen a saline implant, then a silicone shell is inserted in the area where the implant is to be placed. The surgeon will then fill the shell with the predetermined amount of saline. Once both breasts are filled with the implants, the incisions are closed with stitches. Your breasts will be wrapped with gauze or bandages, and drainage tubes may be placed at the incision site to avoid fluid accumulation. You will then be taken to the recovery room where you will gradually wake up from anesthesia, be monitored, and then you can go home after a relatively short period of time to rest and heal.

Recovery

Once you wake up from anesthesia, you are likely to feel sore, tired and stiff, which can persist for several days. You can expect to feel a degree of discomfort and pain because the procedure stretches the breast tissues. Your surgeon will prescribe pain medication to alleviate your discomfort and suggest that you avoid strenuous activity for up to a week so you can heal properly.

Within a week or sometimes even the day after your procedure, you will return to the plastic surgeon’s office to have the bandages removed, as well as your drains (if they were used), and to assess your results. Many patients will be required to wear a support bra to help position and protect the breasts as you continue to heal. Stitches are removed about a week after your surgery.

You may feel tightness as your skin adjusts to the new breast size, and the breasts may seem hard and bigger than you expected during the first week. Swelling is common, but will begin to diminish after a few weeks. Your breasts will soften in time and with gentle massaging exercises. Recovery time varies for each patient and for each technique. Most patients are able to return to work or school a few days after their procedure.

Pros and Cons

If you’ve been thinking about getting breast augmentation surgery, you probably have a lot of questions about what it can and cannot do for you. Some of the information you’ve been given may lead you to ask whether you should go through with it because of the pros and cons associated with the procedure.

Here are some of the pros and cons of breast augmentation to consider before committing to going through with the surgery.

PROS

  • Breast augmentation not only increases the size of your breasts, it also can improve your self-esteem by giving you the look you have wanted since puberty. For women who are dissatisfied with the size of their breasts, breast augmentation surgery may be a good choice if you are bothered by their small size.
  • Breast augmentation surgery can have a number of benefits for women who decide to have it done. Common reasons to get breast implants include:
    • Increasing your self-esteem by improving your appearance.
    • Fitting better into clothing and filling out tops and dresses properly.
    • Reshaping and restoring the size and shape of breasts after pregnancy.
    • Increasing breast size after substantial weight loss.
    • Looking more youthful.
  • You have many options regarding size, implant type and incision placement. Your doctor will help you make the choice which should make you the most satisfied with your results, but the final decision is up to you.
  • Breast augmentation is a relatively safe surgery, although like any surgery, there are risks. The procedure is extremely popular, and the most commonly performed plastic surgery in the United States, with low rates of complications.
  • Women of childbearing age can expect to be able to breastfeed after having breast augmentation.

CONS

All surgery has inherent risks, and you will learn all of the potential risks and complications associated with breast augmentation surgery during your consultations. You will be required to sign consent forms to ensure you fully understand what can potentially happen as a result of your breast augmentation. Risks include but are not limited to the following:

  • Infection
  • Scarring
  • Bleeding
  • Loss of sensation in the nipples or breasts, either temporarily or permanently
  • Collection of fluid under the skin
  • Asymmetry
  • Poor cosmetic results
  • Wrinkled, ruptured, shifted or deflated implants
  • Breast stiffness
  • Cost. Breast augmentations can be quite expensive. The total cost for breast augmentation in Los Angeles, including the fees for the plastic surgeon, anesthesiologist, and facility fee, ranges between $5,500 and $15,000. In the majority of cases, health insurance does not pay for the cost of breast augmentation, because it is an elective procedure. Exceptions to this include breast reconstruction after a mastectomy. Financing options are available for patients who wish to make monthly payments.
  • Breast implants are not meant to last a lifetime, nor is there a guarantee for permanent results. Just like natural breasts, you may experience changes in the appearance of augmented breasts over the course of your lifetime. Common causes for changes include pregnancy, weight loss, menopause and aging.
  • Breast implants require some maintenance, such as necessary MRI scans to check for ruptures, if you choose silicone-gel implants. While ruptures are not necessarily dangerous, it does indicate the need to remove and replace the implants. MRI scans are not necessary for saline-filled implants, because a rupture will be immediately obvious as the gel leaks out.

If you're ready to have a successful breast augmentation, West Medical is here to help. We're happy to asses your individual case, and offer the best suited procedure for you. We work with you for the results you want. Interested in a breast augmentation in Los Angeles? Please call us at (855) 690-0565 to schedule your initial consultation; we’re looking forward to meeting you!

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