INTRODUCTION

Every woman wants full, youthful breasts. Some women feel that their “small breasts” not only limit their fashion choices, but also cause problems with self-confidence, self-esteem, and a healthy body image.

Small breasts usually occur in one of two ways: (1) breasts just never really develop to a desired proportional size, or (2) breast tissue actually shrinks following pregnancy or weight loss.

The surgery to restore desired fullness, volume and projection to the breasts is called augmentation mammoplasty. The surgery involves the placement of a soft implant behind your normal breast tissue which makes your own tissue appear fuller.

There is absolutely no conclusive evidence that breast implants cause any form of autoimmune disease, connective tissue disorders, or cancer.

ANALYSIS

The goal of surgery is to make you happy. At your consultation we will obtain a very thorough medical history. We will want to know if you have had any previous problems, mammograms, or surgery of your breasts. We will want to know your goals of treatment, both in terms of the kind of look you would like to achieve as well as the kind of look you would like to avoid. We will carefully examine you and make measurements as indicated. We encourage you go bring photographs from magazines of breasts that you really like so we can best visualize your goals.

For all women over 30, a mammogram performed within six months of surgery is essential.

It is important to understand that women’s breasts are rarely exactly the same size or shape on the two sides. Whatever size is larger will have a greater weight which will stretch the skin envelope and thus make the breast more hang lower [ more “droopy”]. In other cases, the nipple, the amount of skin, and the crease beneath the breast can be different between the two sides. Such issues often make it very difficult or impossible to make both breasts exactly the same after surgery.

Many women seek breast augmentation and have breasts that are already sagging. If the sagging or droopiness is small, the implant alone will correct the problem. If the sagging or droopiness is moderate to severe, then additional surgery [“breast lifting”] may be necessary at the same time in order to achieve the best cosmetic result.

The objective of surgery is a very natural result. Patients commonly fear looking too big or disproportionately large. This is always the result of a disregard of the natural proportions of the patient and an over-aggressive treatment by the surgeon. We specifically avoid any form of overcorrection. That kind of “overdone” look is totally contrary to our artistic goals and treatment objectives, and is also known to be associated with a number of late postoperative problems.

Following the analysis we will present to you a comprehensive treatment strategy. We will discuss the procedure(s) recommended in detail. We will also advise you of the potential risks and complications of surgery. We will outline your recovery period and make focused suggestions to make your surgery experience safe, easy, and as pleasant as possible.

PROCEDURE

The surgery takes between 1 to 1½ hours to perform. The surgery consists of the placement of a soft implant behind your breast or chest wall tissues. We prefer to have our patients totally asleep for the surgery in order to minimize anxiety and to maximize comfort.

Implants are either made of saline [salt water] or silicone [gel]. They also come in several different shapes, but we prefer the classic “rounded” style.

The two classic “doorways” which can be used to insert the implant are: (1) in the fold under the breast [“inframammary”], or (2) around the lower edge of the areola [“periareolar”]. We have no preference on the incision and will always pick the approach that will give you the best cosmetic result.

The implant can be placed either on top of the pectoralis chest muscle [but completely behind your natural breast tissue], or slightly deeper under the pectoralis chest muscle. In the majority of patients we prefer to place the implant under the pectoralis chest muscle.

No drains are used during surgery, and no special dressings are used after surgery. You will go home from surgery in a comfortable bra.

There is no “best way” to perform augmentation mammoplasty, and it is essential to customize the surgery for each and every patient. Just because you had a friend who had the surgery successfully done a certain way does not necessarily mean that you should have the surgery done in the same way. Every patient is shaped differently, has different anatomy, and thus it is necessary to individualize the surgery for each patient.

AFTERCARE

Recovery from breast augmentation surgery is a “process” and takes several weeks to occur. Initial healing usually takes 7-10 days and most patients will return to work at that time. Discomfort is usually minimal during this time. Healing will continue for several additional weeks as swelling resolves, tissues relax, the implants take on a more natural shape and feel, and the incision lines begin to fade.

Most patients are permitted to return to work in 7-10 days depending on the kind of work that you do.

It usually takes about six weeks for the breast tissues to completely relax and take on a natural look and feel. It may take up to six months for all feeling to return to the breasts.

Breast augmentation surgery will not interfere with your monthly self-examination for breast cancer [remember the implants are deep to your own breast tissue].

Following surgery will recommend a customized program for maintaining your results. We stress the importance of daily displacement exercises four times daily after surgery to keep the breasts exceptionally soft and natural. We also recommend preventative antibiotics for all dental work to prevent the possibility of infection.

We use implants made by both Inamed [McGhan] and [Mentor]. They are both of the highest quality, yet we know that implants typically have a life expectancy of about 15 years. That means that it is possible that you may require another surgery at some point in time to exchange, replace, or remove you implants.

We recommend follow-up visits every two years to keep you informed of all the latest information about breast implants and to allow us to check your implants to confirm that they are OK.