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Breast Augmentation (Breast Enlargement)
If you’re considering breast enhancement….
Breast augmentation (also known as augmentation mammaplasty) is a surgical procedure designed to enhance the size and
shape of a woman’s breasts. Women who might elect to undergo this
procedure:
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To enlarge the breasts, when a woman feels they are
too small.
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To correct a loss of breast volume after pregnancy
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To balance a difference in size between the breasts
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In conjunction with a mastopexy (breast lift) to altar the breast size and shape.
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Breast Augmentation photos
By inserting the implant behind the breast, Dr.
Seidel is able to increase a woman’s bra size from one to several cup
sizes. If you’re considering breast augmentation , this information will
help you answer questions about the procedure… when it can help, how
it’s done, and what results you can expect. As this covers only some of
the most commonly asked questions, please ask Dr. Seidel to answer any
additional questions during your consultation.
Who are the best candidates for breast augmentation?
Breast Augmentation can enhance your appearance and
self-confidence, but it won’t necessarily change your looks to match an
ideal. Before you decide to have surgery, think carefully about your
expectations and discuss them with me.
The best candidates have minimal or no breast sagging
and are in good health. Every patient looks different with breast
implants. I have done breast augmentation on over a thousand women. No
two look exactly the same. Breast augmentation enhances what you already
have. As no two women start out with identical breast shape and size, it
stands to reason that they will look different with implants.
What types of implants are available and how do you
decide which will be best for me?
Currently, only saline implants are FDA approved for
straight forward augmentation . Silicone gel implants can only be used in
reconstruction for breast cancer, in cases in which a breast lift is
required and when certain problems have arisen with saline implants
(usually rippling).
There are two saline manufacturers in the U.S.
market. They are Inamed and Mentor. Both companies have FDA approval for
their saline implants. I currently use implants from both companies and am
very satisfied with them. The type that is chosen for you depends on
various criteria such as, your body shape and size increase you
desire.
Do you place the implants behind the pectoral muscle
or in front of it?
For most patients I place implants “subpectoral” or behind the chest muscle. I believe this offers certain advantages. The
two main ones are a reduced risk of capsular contracture (see below) and
less difficulty interpreting mammograms. The only significant disadvantage
is that there is more pain for about a week after surgery. I feel that the
advantages clearly outweigh the disadvantages.
Patients that have some sagging, but not enough to
warrant a breast lift, may be best-suited for “prepectoral” implant
placement. If you fall in that category I will tell you during your
consultation.
What type of anesthesia do you use and how long does
surgery take?
I strongly recommend general anesthesia for most
patients. The average procedure length is less than one hour.
How much pain should I expect after surgery and what
are my limitations?
Breast augmentation is quite painful for about a
week. Although everyone differs in their pain tolerance, most patients
take narcotic pain pills for about a week and then taper off. You will be
given adequate pain medication to control you pain.
You will not be allowed to lift anything the first
week with gradual increases thereafter. It will be four to six weeks
before you can do heavier lifting.
What about time off work?
The first week after surgery is very important for
positioning of the implants. For the first week after surgery you will not
be allowed to lift anything. I will allow a gradual increase in what you
can lift after a week. It will be four to six weeks before you can lift
any heavy weight. I recommend a week off of work for anyone with a desk
job and four to six weeks if you have to do significant lifting. The most
important thing about returning to work is that you are able to obey the
lifting restrictions. Do not underestimate the first week after surgery.
Most patients are very sore and don’t feel like working.
Where will the incisions be?
I perform breast augmentation through two different
incisions: inframammary (below the breast) or axillary (under the arm).
There are other methods, but these are the two that I prefer. Most
patients are allowed to pick their incision site. I will recommend a
specific type of incision for some patients depending on their build and
breast shape.
Do the implants look different with different
incisions and is one incision more painful than another?
The implants should look the same regardless of
incision site. The main thing to focus on is the location of the scar.
Also, I believe that pain is about the same with either incision. The main
source of pain in this operation is from placement of the implant under
the muscle and inflating it with saline. The implant is placed in the same
location regardless of the incision site.
Do implants ever leak?
Yes. The implants have a life span of approximately
ten years. Eventually every implant will leak or deflate. When an implant
leaks the patient notices a loss of size of that breast. This usually
occurs rather quickly. There is typically no pain or side effects.
Physical activity does not seem to play a role in causing deflation.
If an implant has leaked the only option for
correction is to replace it. There is a warranty on most implants. Ask us
for further details during your consultation.
What is “encapsulation” or “capsular
contracture”?
A capsule occurs when the patient’s body forms a
thickened tissue layer around an implant. Think of it as similar to scar
tissue. When it occurs, the patient notices that the breast becomes firm
or hard. It might also change shape or become painful. It can occur on one
side or both.
The cause of encapsulation is not known. Any patient
who gets breast implants runs the risk of getting this problem. It can
occur with any type of breast implant. The risk appears to be decreased
with implants beneath the chest muscle. That is one good reason to place
them there.
If I get a capsule what can be done?
There are several options. If the capsule is mild, a
patient might choose to do nothing. For others, the options include
surgical removal of scar tissue or removal of the implants. However, the
problem might recur after surgical removal of scar tissue.
How will my breast look if I ever have the implants
removed?
That varies. The larger implants and the longer
they’ve been in the more likely it is that there will be significant
ptosis (or sagging). Some patients will require a mastopexy (breast lift)
after implant removal.
What is rippling?
Rippling represents visible edges of the implant,
usually seen around the periphery. It is more likely to occur as the
implant size gets larger or in patients with very little natural breast
tissue.
Are there other potential problems that I need to
know about?
Yes. Other concerns include changes in nipple or breast sensation, need for subsequent surgeries, shifting of the implants
and calcifications in the tissue around the implant.
What about mammograms?
You should still have a mammogram when indicated
whether or not you have implants. Mammograms can still be read and
interpreted even with implants. Generally, mammograms are easier to
interpret in patients with submuscular implants. This is yet another
reason to place them at this level when possible.
Can I breast feed after augmentation?
For most patients the answer is yes, and there is no
known risk to the baby with saline implants. Of course, no woman knows for
sure if she can breast feed until the day comes.
How do I choose the size that’s right for me?
This is what patients agonize over the most. This is
an individual decision. When you come for you consultation you will be
shown photographs of other patients. That, along with your exam, will help
guide me. I will discuss this with you in detail and help you make the
right decision.
What is the cost?
You will be given an exact figure during you
consultation. This will include the total cost of your procedure and all
fees.
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