Breast Augmentation Procedural Information
Breast enlargement also known as augmentation mammoplasty is a surgical procedure done with the goal of enhancing the size and shape of a woman’s breast. It is most often done because the woman feels that her breasts are too small for her frame or for her aesthetic ideal. Woman after pregnancy often find that the breasts have lost volume. They preferred the fullness of their breasts during pregnancy.
Breast augmentation from board-certified plastic surgeon Jay S. Orringer, MD involves placing an implant behind the breast or behind the pectoral muscle on the chest wall. The final result will to a large degree be determined by pre-operative breast shape, including the extent of breast droop, the amount of actual breast tissue and the breast skin tone. While most women are extremely pleased with their result, achievement of your exact goals will not likely occur.
- The Consultation
- Surgical Considerations
- Implant Types
- Implant Positions
- The Procedure
- The Recovery
- What are some of the particular concerns regarding Breast Augmentation?
- Making the Decision
Dr. Orringer, will typically spend at least an hour discussing your medical history and goals. Implants styles and sizes will be addressed. Examination will evaluate current breast size and shape, degree of droop (ptosis), apparent health of the breast tissue, skin tone and underlying bony changes, breast and chest wall asymmetry. While a particular “cup” size may be desired, Dr. Orringer believes that it is most important to do a dimensional analysis in an effort to determine what size and style implant might achieve the most aesthetic outcome. Sizers will be used as well in an effort to better understand an individual’s aesthetic goals. Actual bra cup size will tend to vary with the bra manufacturer and bra style. While we may aim for a particular cup range, selected implant dimensions and volume best determine a pleasing result-not a striving for a certain cup per se. We believe that every individual is unique and the detailed consultation addresses special goals and anatomical variations.
The surgery is done at the state-of-the-art Surgery Center of Santa Monica. This modern, accredited facility is located two blocks north of Saint John’s Hospital. Anesthesia is administered by Board-Certified anesthesiologists.
A variety of incisions exist including peri-areolar (around the lower border of the areola), axillary (from the armpit) and inframammary (in or near the fold under the breast).
There are a variety of breast implant types, shapes, and sizes. Dr. Orringer offers many options, including saline and silicone breast implants, and a number of different sizes, shapes, and textures.
Implants are placed either partially under the pectoral chest muscle or in the subglandular position (directly under the breast). Subpectoral placement tends to hide implant imperfections such as implant edge and wrinkling better. Implants also tend to stay softer longer in the subpectoral position. In certain situations such as the droop prone breast and in body builders with thick musculature, subglandular position may be chosen.
During the procedure, sizers (temporary implants) are typically used to assess implant position and size. Yes, you are brought up to a sitting position during the procedure to assess the result in the more upright position. Dr. Orringer chooses to take the time to use sizers and position changes in an effort obtain the best result possible. Time is not of the essence but the final result is. At the completion of the procedure, light tapes will be applied over the incisions and a bra will placed. A customized booklet which discusses further the procedure, risks, and pre- and post-operative instructions will be provided for you at your pre-operative visit.
At surgery, Dr. Orringer will do nerve blocks to help control early discomfort. The post-operative pain is the usually the most severe during the first three days. By the end of the first week, much of the pain has subsided and many normal activities have been resumed. Driving should not be done until oral narcotics are no longer required for pain control. Generally, full exercise activity should not be undertaken until about 3-4 weeks post-operative.
The decision to undergo breast augmentation is an important one and most be thoroughly considered. We now recognize that this decision involves a lifetime commitment to maintenance as implants could require replacement multiple times in the course of an individual’s life, depending upon how that individual does with her implants. Most common reasons for replacement are hardening of scar tissue around the implant (capsular contracture) and implant rupture or deflation. Implants interfere with mammography, although to a lesser degree when placed behind the muscle. This would be a particularly important issue in a woman with a strong family history of breast cancer. With any breast surgery, there is a risk of loss of sensation to the nipples and to other areas of breast skin sensation. While a generally small risk, this may certainly be a significant issue to some women. The augmented breast may be much more aesthetically pleasing for a given individual, however, the implanted breast does not look or feel entirely natural.
While every surgical procedure has definite risks involved, informed breast augmentation patients tend to be very pleased with their decision. Dr. Orringer wants you to feel comfortable asking any and every question that you may have at your initial consultation, pre-operative visit or at any time to assist you in determining whether breast augmentation is right for you. He believes that taking sufficient time to discuss, plan, individualize and perform your procedure is necessary time well spent.
If you would like more information on breast augmentation procedures, please contact Dr. Orringer today.
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Before and after images: