Introduction to Breast Augmentation
(Augmentation Mammaplasty)
Chances are, you probably have friends, relatives, or
neighbors who have undergone breast augmentation: in the
past five years, the number of women who have had this
procedure has more than tripled. Along with its rising
popularity, breast augmentation is our most requested
procedure due to our year-round warm weather here in central
Florida!
For the woman born with small breasts, or the woman
who finds her breasts have changed after childbirth
or breastfeeding, breast augmentation can be a very
rewarding procedure.
Best Candidates for Breast Augmentation
Women in their 20’s to 50’s (by law, women
under 18 cannot receive implants), who have small breasts
in proportion to their lower body, or who have marked
changes to their breasts after children, breastfeeding,
weight loss/weight gain or aging. Women with asymmetric
breasts, where one side is larger than another, may
be candidates for augmentation on one or both sides.
Note: women with a significant, strong family history
of breast cancer are counseled to consider the procedure
very carefully because implants pose an interference
with mammography.
What to Expect at Your Consultation
Today’s implants are available in a wide range
of shapes and sizes, so it is
VERY IMPORTANT that you choose a surgeon that customizes
the procedure for you based on your specific goals and
physical anatomy. Dr. James Matas, a board-certified
plastic surgeon in Orlando, Florida, has extensive experience
performing breast surgery and a reputation for outstanding
results based on this type of careful analysis.
During your initial consultation, he will consider
the following factors: implant size, implant type (saline
versus silicone-gel filled), implant shape (round versus
anatomic, low profile versus high profile), placement
of the implant (under the muscle-subpectoral versus
over the muscle-suprapectoral) and placement of the
incision (under the breast in the fold-inframammary,
under the armpit-transaxillary or around the nipple-periareolar).
He will ask you about your motivations for breast surgery,
along with assessing your physical and emotional health
and reviewing information you provide about previous
surgeries, previous pregnancies/breastfeeding, past
and current medical conditions, as well as nutritional
supplements, herbal remedies and pharmaceutical medications
you take.
He will carefully examine your breasts and chest wall,
considering the following factors: amount of breast
tissue you have to cover your implant, thickness and
symmetry of the chest (pectoralis) muscles, position
of your nipple areola in relation to the breast tissue,
degree of sag, thickness of skin and skin tone. He will
also take specific measurements of your chest area to
scientifically determine the dimensions or space available
for the implant to fit.
He will recommend the exact procedure, or procedures,
needed to bring about the desired result, outlining
the size, style and placement of the implant, location
of the incision, the type of anesthesia, where the surgery
will be performed and the risks and possibility of complications.
If a woman has a significant sag or looseness of skin,
he may also recommend a mastopexy, or breast lift, be
done at the same time.
He will advise you to avoid taking aspirin, ibuprofen
products, Vitamin E and certain herbal medications before
surgery, as these can cause increased bleeding or have
undesirable effects with anesthesia. He may also ask
you to discontinue upper body workouts in order to reduce
muscle strength before surgery.
A staff member may take photographs of you, and using
computer imaging technology, provide you with a before/after
comparison for discussion purposes. You will also be
provided with the financial details, along with a suggested
plan of action should you decide to take the next step
towards breast augmentation surgery.
How Augmentation Surgery is Performed
First, an incision is made beneath the breast that
measures about 2” in length.
If the implants are being positioned under the muscle,
then a portion of the pectoralis muscle is cut to allow
access beneath it. A pocket is then developed over the
rib cage and below the muscle where the implant will
be positioned. If the implants are being positioned
over the muscle, the pocket is developed over the muscle
and under the breast tissue.
Sometimes, breast sizers are inserted first before
final determinations are made with respect to implant
size. To permit the smallest incision, an empty implant
is inserted through the incision, placed in the pocket,
filled with sterile saline solution and positioned.
Note: silicone-gel filled implants arrive pre-filled
by manufacturer
If there was asymmetry noted between the breasts, Dr.
Matas may adjust the fill volume of one or both implants
to compensate for this difference.
Once the implants are properly positioned and he is
satisfied with the appearance of both breasts, the incision
is closed using several layers of dissolvable sutures
and a butterfly is used on the skin’s surface,
so there are no visible sutures.
The procedure itself takes about 1.5 hours and is performed
outpatient under general anesthesia.
Recovery from Breast Augmentation Surgery
You will be discharged wearing a supportive, comfortable
surgical bra. Once you get home, you will want to rest
for the remainder of the night. There is moderate pain
associated with this procedure, but the discomfort can
be managed by taking the prescribed pain medication
and applying cold compresses.
Initially, you may feel tightness in your chest, due
to your skin adjusting to your new breast size, along
with bruising, mild swelling and sensitivity to physical
contact. The day following surgery, you will be shown
several breast massage techniques that will help your
implants shift into desired position.
Subpectoral placement of the implants may cause more
discomfort than suprapectoral, and you may have to restrict
arm motion for a few days. Some patients experience
a temporary change in nipple sensation, and this is
usually resolved within a matter or days or weeks.
Most patients return to office work within 5-7 days,
although you should avoid any strenuous activities that
raise your pulse and blood pressure for at least 2 weeks.
Strenuous upper body activities, such as tennis, weightlifting
or water-skiing, can be resumed after 6 weeks. Fading
of the incisional scar will occur within several months
to a year.
Your New Look
We expect you’ll be quite pleased with your new
appearance. Having fuller, firmer and shapelier breasts
will most likely increase your self-confidence and improve
your feelings as a woman. If shopping was a chore in
the past, you’ll enjoy it now – as you’ll
fill out bras, lingerie, clothing and bathing suits
like never before!
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