| Section: |
Breast |
| Procedure Title: |
Breast Augmentation |
| Description: |
Plastic Surgery
Breast Augmentation
Breast Augmentation surgery or Augmentation Mammoplasty has evolved considerably from its inception in both technique and implant composition. The earliest known attempt at breast augmentation was in 1895 by Vincenz Czerny, using a woman's own adipose tissue from a benign growth on her back.
Modern day implants consist of saline or silicone polymers. They are offered in a wide variety of shapes, sizes, viscosity, and coatings. No one implant has emerged as the single best implant for every patient. The best implant for you will be selected when a clear understanding of your post-operative goals is reached with a qualified plastic surgeon.
There are two common placements of implants in the breast. The first is subglandular. This position closely resembles the plane of normal breast tissue. Many believe this gives the most pleasing aesthetic result after surgery. However, very thin patients may be able to detect wrinkles in the implant through the skin. This approach is also prone to a slightly higher rate of capsular contracture.
The second most common area of placement is submuscular. In this case the implant is placed between the pectoralis major and the chest wall. There is release of the lower and medial attachments of the pectoralis major allowing the lower pole of the implant to be partially covered by breast tissue alone. This is the most common implant placement in North America.
Incision site can also vary according to patient and surgeon preference. Incision sites described in the plastic surgery literature include.
1. Inframammary- This incision in places slightly above the inframammary fold in the lower portion of the breast. This incision is the most common approach and affords maximum access for precise dissection and placement of an implant. However, in small breasts, the breast may not drape over the inframammary fold leaving an exposed scar.
2. Periareolar- This incision is placed around the edge of the areola. The change in skin tones allows this scar to remain inconspicuous to the untrained eye. This is also an excellent approach if a breast lift is desired in combination with the augmentation. This approach is more prone to capsular contracture thought to be due to contamination of the implant with bacteria from the ducts of the glandular breast.
3. Transaxillary- This incision allows the implant to be placed through a well hidden incision in the axilla or armpit just anterior to the hairline.
4. Transumbilical Augmentation (TUBA)- Implants are placed through an incision in the umbilicus or belly-button. Tunneling is through blunt dissection to the breast. This approach makes accurate placement difficult but offers completely hidden scars. This approach is not appropriate for silicone implants.
Breast Augmentation Surgery Consultation
The consultation process can be rewarding or disappointing depending on your preparedness and expectations.
Step 1: Gain a clear understanding of your goals. Make a list of goals before meeting the surgeon in person. Breast Augmentation Pre-Consultation, available on this website can help you formulate your goals in a non-threatening and anonymous fashion.
Common questions to address are:
1. Do I need a breast lift also?
2. Should I get a breast lift at the same time or at a different time?
3. What happens if there is a complication? Who will help me? Will it cost extra?
4. How big is too big? Will this hurt my back?
5. What is the warranty? What is it pops in the first ten years? What about after ten years?
Step 2: Find a surgeon that you like. The most accepted measure of a plastic surgeonˇ¦s qualifications is making sure he or she is a board certified plastic surgeon. However, the importance of the plastic surgeonˇ¦s bedside manner cannot be understated. Getting plastic surgery is a journey that can lead to a vastly improved quality of life, higher self esteem, and improved self image. However, the journey relies on trust, understanding, and commitment between the surgeon and you, the patient. This trust and understanding of a common goal and realistic expectations can begin at SurgeonHouseCall.com during a Pre-Consultation, or it could begin in the office of a surgeon recommended by a trusted friend or doctor. Wherever it begins, it is of the highest importance that an excellent rapport be established prior to the first procedure.
Step 3: Getting the surgery. The plastic surgeonˇ¦s instructions must be followed to the letter in order to give the best chance of an excellent result and a safe surgery. This often involves smoking cessation, not eating the day of surgery, and avoiding medications and herbal supplements that may cause excessive bleeding. Also, arrange for someone to drive you home after the surgery. Plan on taking at least three days off of work for an office based job to allow adequate pain control and relaxation.
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