Breast augmentation (augmentation mammaplasty) is a cosmetic procedure that uses breast implants to enlarge and shape the breasts. If you have small underdeveloped breasts, breasts of unequal size, or breasts that have shrunk or atrophied after childbearing, breast augmentation can help.
Breast augmentation will not only bring you greater freedom with fashion, but will also improve your self-image and make you feel better about yourself. For many women, along with a new figure comes a new attitude and enhanced self-confidence.
The incision used to insert the implants often depends on surgeon preference. The three most common incisions include inframammary (in the breast crease), periareolar (at the lower border of the areola) and axillary (in an armpit crease) or transumbilical (via the belly-button, the so-called TUBA procedure). Each incision has its advantages and disadvantages all of which will be thoroughly explained during the initial consultation. In many instances, the incision chosen is interplay between the patient’s wishes and the surgeon’s preferences.
Once the incision is made, the surgeon creates a pocket or space for the implant. This space can either be made above the pectoralis muscle (subglandular or below the breast gland tissue) or below the pectoralis muscle (submuscular). Once the pocket is created, the saline implants are inserted empty, they are then filled to their predetermined volume and the incisions are sutured closed. The shape and size of your implants will be determined during your preoperative consultation when you will have the opportunity to trial the various implants and choose for yourself the exact size you desire.
As of late November 2006, the FDA has granted approval for the use of silicone gel filled implants. This new generation of silicone implant is now available to those seeking primary breast augmentation that are 22 years old or older. Unlike saline implants, silicone implants are pre-filled thereby requiring a slightly longer incision. Transumbilical placement is not possible with silicone implants. For additional information about silicone gel implants refer to the LINKS section of this website.
During your initial consultation, information will be provided to you regarding the safety, risks and complications related to breast augmentation surgery and breast implants. Statistics regarding implant durability will be discussed and the implant-warranties will be reviewed. In some cases, depending on the droop and contour of your breasts, mastopexy or breast lift surgery may also be necessary. Recommendations will be made regarding specific techniques available to optimize the shape, fullness, and contour of your breasts.
Most breast augmentation procedures are performed under general anesthesia, so you will sleep through the entire procedure.
45min. – 1hr.
Breast augmentation surgery is performed on an outpatient basis whether done at a hospital, outpatient surgery center, or office-based surgical suite. The incisions heal quickly. Steri-strips are removed in 7 days, with all sutures being dis-solvable. Initial discomfort is controlled with oral medications including pain relievers and muscle-relaxants. You are given intravenous antibiotics during the surgery and are given 10 days of oral antibiotics after the procedure. We recommend one week off from work however many patients return much earlier.
Implants placed below muscle require a period of settling to achieve their final shape and position. These sub muscular implants tend to appear “high” on the chest wall until the tissues and particularly the muscles relax and accommodate the implants. This “settling” may take 2-6 weeks to finalize. The results with saline filled implants placed under the muscle are more natural-looking implants with less incidence of rippling, folding and hardening as compared to above-muscle implants.
For implants placed above muscle, most typically silicone gel implants, recovery tends to be quick, easy, and minimally painful. Because the muscle in not involved, there is no settling time required, no need for massage exercises, and no activity restrictions. Recovery is typically 24 hours with immediate return to work and realization of aesthetic results in less than a week. Only minimal pain medications are prescribed without the need for muscle relaxers.
The entire surgical process begins well before your actual surgery date. Detailed descriptions of the entire pre and post-surgical course will be explained. Surgical consents will be signed once any and all questions are addressed. All prescriptions are provided and explained. During this entire surgical experience, Dr. Hainer and the entire staff at North Oakland Plastic Surgery is committed toward availability. Dr. Hainer will provide each patient with his personal beeper number that is available 24hrs a day. Your well-being and smooth recovery is of utmost importance to us all. We strive to meet all of your needs and make ourselves available at all times for any questions that may arise. Our goal through the entire process is to inform and educate you so that there are no surprises and that all your expectations are fulfilled. Care is individualized and personalized to make this entire experience a pleasant one.
You will be seen in the office 1-2 days after your breast augmentation procedure. The initial dressing is simply a 6 inch elastic Ace wrap used to compress the breasts. A banbeau wrap is also applied over the top edge of the ace wrap to gently provide downward pressure on the implants. Only Dr. Hainer or a staff member is allowed to remove the initial bandage.
The breasts initially will appear “high” and “flat” due to the bandage and the tightness of the muscles and tissue swelling. A cotton bra will be provided to you on your first visit. We recommend wearing this bra or a similar one for the first 2-3 weeks before purchasing new, expensive bras. You are allowed to shower once the initial bandage is removed on either post-op day 1 or 2. Paper steri-strips cover the incisions. They are allowed to get wet but should not be removed.
At one week, you will be seen for steri-strip removal. You will be instructed to begin once daily application of Scarguard on your incisions. An instruction sheet will be provided to you at this time describing daily massage of your implants. We encourage you to massage your breasts daily in the shower or tub. This will help to soften and shape the breasts and will help in settling of the implants. Underwire or push-up bras are to be avoided until the implants have had a chance to settle. Aerobic activities can be resumed at one week. To allow for implant settling, upper-body exercises, weight–training and swimming are restricted the first four to six weeks.
At 6 weeks, the implants have typically settled into their final position, your breasts have assumed their final shape and projection. The incisions are now nearly imperceptible. All activities can now be resumed. Underwire and push-up bras can now be worn. Sunscreen should be applied to all incisions for the first year to avoid darkening of the incisions if exposed to sun or a tanning bed.