The breasts can be central to a woman’s body image. If you’ve never felt your breasts were in proportion with the rest of your figure, breast augmentation surgery can change that. If your breasts are somewhat asymmetrical that can be changed as well. Maybe you’ve lost volume after pregnancy and subsequent breastfeeding. Or maybe you’d simply like to have a curvier figure.
Whatever your reasons for seeking breast augmentation, Dr. Clukies and Dr. Babbitt have extensive experience with this procedure and you’ll be thrilled with your new figure. This is one of the many breast procedures we offer at Plastic Surgery of Southern New England.
What Is Breast Augmentation?
Breast augmentation has been the most popular cosmetic surgery in the United States for the past few years. In this procedure, saline or silicone breast implants are placed into pockets created during surgery behind the breasts. Augmentation changes the breast size, projection characteristics, and volume on the upper breast. Breast augmentation has incredibly high satisfaction ratings with past patients.
Candicacy For Breast Augmentation Surgery
This is a completely personal decision for a woman, and it needs to be her decision alone. During your consultation at Plastic Surgery of Southern New England, we reiterate that the decision to move forward with augmentation shouldn’t be made for a spouse, partner, or anyone else. It should be something you want to have to change your figure.
Augmentation will change the way you see your body, and it can really give your self-confidence a boost. It can be a great procedure if you’ve always been dissatisfied with your breasts. Asymmetry can be corrected. Subtle sagging can be reversed.
If you feel you have serious sagging, either from pregnancy and breastfeeding or from gain and loss of a good deal of weight, we will discuss the more complex approaches to correcting this, which can involve placement of implants at the same time as a lift, performing a breast lift alone, or performing a two stage operation where the two operations are done at separate times to ensure that the maximal result of each surgery can be acheived in the most challenging cases.
What Are The Different Types Of Breast Implants?
- Silicone gel
Silicone gel implants consist of a silicone outer shell filled with medical-grade silicone gel. Today’s silicone gel is more “cohesive,” meaning it stays together and within the shell more if the implant ruptures. Silicone gel was formerly more liquid in nature; today’s gels are more like gelatin.
The consensus is that silicone implants feel more like natural breast tissue when compared with saline implants. An obvious disadvantage is if the implant ruptures. This can allow some of the silicone gel to leak into the breast pocket that was created to hold the implant. When this happens, the patient doesn’t usually know, as the implant retains its shape. The leak will not usually show up on mammogram, and MRI is the best test available currently to check for ruptured implants. The ruptured implant and any leaked gel will need to be removed and the implant replaced.
Saline implants consist of a silicone outer shell filled with a sterile saline solution. Unlike silicone implants, which are filled at the factory, saline implants are placed into the breast pocket empty and are then filled in place. This allows these implants to be placed through smaller incisions. It also allows some flexibility with size.
If a saline implant ruptures, the body simply absorbs the salt water. But when this happens the implant will fully deflate, leaving the patient with one flattened breast. And, while the saline will be absorbed, the ruptured shell will still need to be surgically removed and replaced.
Ideal Implant® is a new option in saline implants that are becoming very popular with our patients. The Ideal Implant® is made with a series of nested implant shells and two separate chambers that hold the saline solution. These implants provide the security of saline solution (in case of rupture), but they feel more natural, like silicone implants. Plus, unlike regular saline implants, they don’t have the same problems with wrinkling and folding.
- Gummy bear implants
Although technically silicone, gummy bear implants are different and deserve their own description. Gummy bear implants are made with “highly cohesive” silicone gel — think of the consistency of a gummy bear. This gel is much thicker than the gel used in other silicone implants. If a gummy bear implant is cut in half, the gel will remain within the shell and not leak out.
Gummy bear implants are also created in a teardrop shape, which is closer to the shape of the natural breast.
Do I Choose How My Implants Are Inserted?
Breast augmentation with the team at Plastic Surgery of Southern New England involves many decisions. Beyond your choice of implant type, where the incision is made to place the implant will be discussed at your visit as well. The implants can be placed above or below the pectoral muscle, and the reasons for placing the implants in these locations are based on patient preference, the available tissue, previous surgery, and surgeon preference.
- Periareolar incisions — As the name suggests, these incisions are made just outside the dark skin of the areola on the lower side. The implants can be placed above or below the pectoral muscle.
- Inframammary crease incisions — This incision is designed to rest in the crease underneath the breast, and is the most common incision used for many reasons. The implant can be placed above or below the muscle through this incision, and the risk of capsular contracture is lowest with this approach. Also, in situations where revision breast surgery is being performed, the inframammary crease incision enables the surgeon to better perform the often complex maneuvers required to improve the result and restore the shape of the breast.
- Transaxillary incisions — These are made with a vertical incision in the armpit. This approach is not used commonly in our practice, for reasons that can be discussed in detail during a consultation.
Breast Augmentation Before And After
How to choose the size of your Implants
Some women assume breast implants are sized akin to bra sizes, but this isn’t the case. Implants are sized by the amount of material filling the implant shell, in cubic centimeters. The most popular size for implants is between 350 and 400 ccs, equating basically from a small to a large C cup in bra size. At Plastic Surgery of Southern New England, we have various tools to help you visualize how different implant sizes will look on your unique figure.
How Will I Choose The Implant Profile?
Implants have different profiles, which basically detail the amount the implant will project. Higher profile implant types have smaller bases and keep more of the volume up higher on the chest. Lower profile implants have wider bases and more of the implant is in the middle of the breast. Gummy bear implants have a teardrop shape, said to be more like a natural breast shape. Again, Dr. Clukies and Dr. Babbitt will help you understand your options with size and projection during your consultation.
How Is Breast Augmentation Surgery Done?
This is not a difficult procedure. Augmentation is performed as an outpatient surgery with the patient under general anesthesia. The surgery takes from 45 minutes to one hour. Incision length is generally about one inch for placement of saline breast implants and 1.5-2 inches for silicone implants. This difference is because saline implants are filled after placement, while silicone implants are placed already filled.
After the incisions are made, a pocket is created behind each breast that will hold the implant. Then the implants are inserted. We check for symmetry and position and then close the incisions with tiny sutures to minimize scarring.
Dr. Clukies and Dr. Babbitt have extensive experience with various incision locations. They take meticulous care to avoid injury the nipple (to not affect sensation) or the milk ducts (to not impact breastfeeding).
What Will My Recovery Be Like After Augmentation Surgery?
You’ll be surprised at how relatively easy your recovery is after breast augmentation. We send you home just a couple hours after your surgery is complete. Your breasts will be bandaged and we’ll have you in a surgical bra for support. You’ll need probably two days of pain medication, but this isn’t sharp acute pain. After one day, you’ll return to our offices and we’ll remove the bandages and check to be sure your healing looks to be going well. We’ll take this opportunity to show you how to massage your breasts to relax the muscles and help the implants settle into their breast pockets. This type of postoperative massage has been proven to significantly reduce the risk of capsular contracture (where scar tissue contracts and hardens around the implant) and decrease discomfort.
Most patients can return to work approximately 3-5 days after surgery. Your sutures will be removed after one week. You’ll wear a support bra 24 hours a day for one month after your surgery so as not to place any stress on your incisions. This is very important. Normal activities can resume in 1-2 weeks, but any impact exercise will need to wait for one month. Upper body exercise, such as lifting weights, will need to wait for six weeks.
The Risks Involved With Breast Augmentation Surgery
Beyond the general risks associated with any surgery, there are some risks specific to breast augmentation. These include:
- Capsular contracture
- Implant leakage or rupture
- Implant shifting
- Changes in nipple sensation
- Impaired ability to breastfeed
- Breast asymmetry
- Visible rippling of the implant
Dr. Clukies and Dr. Babbitt will discuss these risks with you during your consultation.
Does Breast Augmentation Increase My Risk Of Developing Breast Cancer?
Extensive research has been conducted both by the FDA and other entities into breast augmentation and breast cancer risk. All of these studies have found no increase in breast cancer risk among women with breast implants.
What Results to Expect After Breast Augmentation Surgery
This procedure has extremely high rates of satisfaction. A recent study from the American Society of Plastic Surgeons reports that 98 percent of women felt their augmentation either met or exceeded their expectations. Over 90 percent of the women also said they felt the procedure increased their self-esteem. For many women, this procedure changes their entire body image.
Implant durability is continuing to improve. Although most implants will need to be replaced at least once in a patient’s life, there is no specific timeline. Manufacturers guarantee their implants for at least 10 years, and many patients have implants that can last double that time. Plus, replacing implants is not difficult as we can simply enter through the same original incisions to remove the old implants and place the new ones.
Can I Combine Breast Augmentation With A Breast Lift?
We usually recommend combining these two procedures if the patient has a good deal of sagging breast skin and also needs a significant increase in volume. Augmentation alone won’t fill this back out. It’s best to remove the excess sagging skin and downsize the areolae in many cases before adding the implants. Adding implants to a breast lift is quite easy, as the incisions used to insert the implants have already been made for the lift.
Will I Have Scarring After Breast Augmentation?
Any time the human skin is cut a scar forms. This is no different with augmentation. The choice for your incision locations will dictate the amount of scarring you will have. Incisions made around the areolae are usually well hidden. Incisions made through the armpits don’t create any scarring on the breasts. There are only two vertical incisions in the armpits and they are hidden in a natural crease. Incisions made on the breast crease at the bottom of the breasts create the most scarring, but these incisions are placed so they are covered by a swimsuit top or a bra.