Breast Augmentation

Breast augmentation is a surgical procedure typically performed under general anesthesia. All procedures are performed in an accredited outpatient surgical facility. Breast augmentation is always completed using sterile technique. The incision location is pre-determined and carefully placed incision(s)are made in order to place the implants in the pre-determined site (subglandular vs. subpectoral). Once the breast implants are aesthetically and anatomically well placed, the incisions are carefully closed and a compression bra is secured. You will recover from the anesthesia for approximately one hour prior to being discharged to home.

A few careful decisions are made prior to the breast augmentation procedure. Your choices assisted by your doctors guidance include the type of implant (saline vs. silicone), size of the implant and incision location.Dr. Mitchell will personally counsel you regarding these important choices.

Once you have decided that you want your breasts augmented options to consider and choose are type or implant, size of implant fill and incision location.

The first choice you need to make is whether you want saline filled implants or silicone filled implants.This is a very personal choice and a well-informed decision is necessary.

The second choice to make is the location of your incision.There are four locations on or around the breast where incisions are made in order to place the implant.These choices are Transaxillary, Periaerolar, Inframammary and Transumbilical.There are pros and cons to each incision type.These will be discussed during your consultation.The bottom line is that they all work well.However, with that said there are distinct advantages and disadvantages to each technique.

Breast enhancement surgery has become very socially acceptable in our society.It is one of the most commonly performed cosmetic procedures.Breast enhancement is performed to increase the size and shape of the breasts.Some women start with subjectively beautiful, natural breasts but they desire to be larger.Other women present with deflated breasts secondary to post-partum involution (loss of breast volume after one or more pregnancies).Further, some women present with very little native breast tissue and they may feel unfeminine.Despite the reason for seeking breast augmentation, all of these women are seeking fuller breast appearance.

A woman  at least 18 years or older with reasonable expectations and acceptable initial appearance of the breasts are necessary to undergo a breast augmentation procedure.

Breast augmentation surgery may not a suitable procedure for those with bleeding disorders, serious health conditions, or unreasonable expectations.

Breast Augmentation takes approximately one hour to complete. It is necessary to arrive at the surgery center at least one hour prior to your procedure. You will recover from the anesthesia for another hour after the procedure. In total you will be at the surgery center for three to four hours.

Breast augmentation is performed in an accredited surgery center on an outpatient basis. This means that you will be discharged to home from the surgery center once you are awake and stable. It is reasonable to take off from work for at least one week following surgery. You are instructed not to lift more than 15 pounds for the first two weeks. Therefore if you have a more strenuous job, you may require two weeks off from work.

While Breast Augmentation suregry is generally a safe procedure and the vast majority of patients do not suffer significant complications, any surgery has inherent risk and the potential for complications does exist.  Hypertropic scarring, post-operative bleeding, wound separation, infection, asymmetry,capsular contraction, altered sensation and deflation the implant are potential risks associated with this type of procedure.  Careful surgical planning, excellent surgical execution and close follow up with your surgeon are means to minimize the possibility of suffering a post-operative complication.

I get this question frequently.  It seems that many women believe that breast implants must be changed every ten years.  The reality is that breast implants can potentially last a lifetime.  If at ten years, your implants are intact and there is no significant capsular contracture, there is no need to replace the implants.  The FDA recommends that persons with silicone breast implants get an MRI 2 years after the initial surgery and then rvery 3 years thereafter.  The MRI demonstrates the integrity of the implant shell.  An MRI is not necessary with saline implants because if a saline implant ruptures, the saline is quickly absorbed by the body the breast obviously deflates within a few days after rupture.  If a silicone implant leaks or ruptures, the silicone gel typically stays localized within the capsule pocket.  

Both saline and silicone breast implants have a silicone outer shell.  Saline implants are filled with saline while silicone implants are filled with silicone matrix.  Saline implants come empty.  The implant is typically placed in the pocket empty and then filled with saline by the surgeon.  This advantage allows for smaller incisions.  Silicone implats come pre-filled and therefore require larger incisions in order to squeeze the implant into the pre- dissected breast pocket.  Saine implants cost less to purchase than silicone implants.  There is an approximately $1000 additional cost of silicone implants vs saline implants.  Silicone implants are softer to the touch than saline implants.  Silicone implants offer a more natural feel compared to saline implants.  Both saline and silicone implants look good.  Many observers will think that silicone implants look better than saline implants but this statement is a generality and not a fact.  While silicone implants seem to be the "better" choice at this time, there is nothing wrong with saline implant use.  At this time there are a few reasons a woman would choose saline breast implants.  First is cost.  Silicone implants typically increase the cost of the procedure by $1000. Second is age.  Currently a person needs to be 22 years of age to get silicone implants.  This age requirement defined by the FDA is somewhat arbitrary but it is the rule.  A third reason why a woman may choose saline breast implants is that she wants a "scarless" procedure. As stated above, aline implants come flat and are filled once they are placed under the breast tissue.  A transumbilical breast augmentation can only be performed using a saline implant.  With the tranumbilical approach, one small incision is made inside the belly-button.  It is not possible to place a filled silicone implant through this small opening.

This is a very important consideration after deciding that you want to undergo breast augmentation surgery.  I take considerable time counseling my patients regarding an appropriate breast implant volume.  Many individual factors go into making this decision.  Before I describe some of the factors to consider when choosing implant size, let me tell you that the most common patient criticism after this surgery is that she wished that she went bigger.