hances are, you probably have friends, relatives, or neighbors who have undergone breast augmentation. With its rising popularity, and our year-round warm weather, breast augmentation is our most requested procedure. 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.
Women in their 20’s to 50’s 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.
Note: women under the age of 21 are not eligible to receive silicone-gel filled implants unless special criteria is met.
Today’s implants are available in a wide range of shapes and sizes, so it is Dr. James Matas, a board-certified plastic surgeon in Orlando, Florida, has extensive experience performing breast surgery and a reputation for natural outcomes.
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 OR 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 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. If you require a breast lift, and you are a smoker, he will require that you discontinue smoking one month prior to surgery for proper healing.
Once a surgical plan has been established, you will 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.
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 and do not require filling.
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 2 hours and is performed outpatient under general anesthesia.
You will be discharged wearing a supportive, comfortable surgical bra with front closure. 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 asked to perform several breast massage techniques that will help your implants shift into desired position.
Under the muscle placement of the implants may cause more discomfort than over the muscle, 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.
We expect you’ll be quite pleased with your new appearance, as this procedure has a very high satisfaction rate among patients. Having fuller, firmer and shapelier breasts will most likely increase your self-confidence and improve your feelings as a woman, not to mention making shopping more enjoyable. If you had a difference between each breast before surgery, you will find them to be closer in appearance.
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