Breast augmentation, augmentation mammoplasty continues to be one of the most popular and frequently requested procedures. Prospective patients are well served by recent innovations in implant technology, including the reintroduction of “responsive” and “cohesive” (gummy bear) silicone gel implants; age and gender restrictions do apply. Saline implant choices have been expanded by the introduction of mid-range and high profile implants, which reduce the possibility of lateral edge palpability. We enjoy guiding patients in selecting the ideal configuration: a) filler type, saline vs. silicone; b) surface type, smooth vs. textured; c) profile type, standard, mid-range, high or ultra-high; and d) volume, based on aesthetic ideals, profession and/or hobbies. The consultation includes an opportunity to “try on” various implants, thereby giving patients a better understanding of her choices. Ultimately, your breast augmentation should make you look and feel more confident and well-proportioned.
There are many reasons why women elect breast implants. Some include:
Breast Augmentation is most frequently scheduled under “twilight” (monitored anesthesia care). The procedure averages 1.5 hours. All aspects of surgical planning, incision choice, implant choice, the location will have been previously discussed. Frequent choices for incisions are a) periareolar: at the lower junction of pigmented nipple complex and breast skin; b) inframammary fold: at the base of the breast; c) trans-axillary: in hair bearing armpit. The relative advantages and disadvantages of the incisions will be weighed. Keller funnels are single use devices, which are used to facilitate placement of silicone gel implants while maintaining a “no-touch” technique. All incisions are repaired in multiple layers of dissolving sutures. Drains are rarely used.
You may feel tired and sore for several days, but many patients return to normal activities within a week. Post-op medications, bowel programs, activity schedule, use of ice, massage techniques, and scar therapy will be discussed during the post-op visits. All patients are encouraged to contact the office with any concerns. Warranty information, including options for extended warranty for saline breast implants are fully disclosed.
Dr. Chong is deeply committed to providing her patients care with personalized, caring service. She will be happy to consult with you to help you decide if a Breast Augmentation procedure is your best option.
Is silicone safe?
Yes. It is one of the most studied materials and is used in many products we use, daily, such as cosmetics, hair grooming products and antacids.
How do I know what implant size/style to choose?
The selection of implant size, style and substance is based on the patient’s aesthetic goals, anatomy and customary activities. We believe that “sizing” is an important exercise as it offers a patient the opportunity to both feel the weight of the implant, as well as see the projection and possibilities.
Is it better to have the implants under or on top of the muscle?
Technically, under the muscle is a “dual plane” approach, which has theoretical long term advantages of 1. Decreased rate of capsular contracture (CC); 2. Improved soft tissue coverage and drape in the upper pole (area below the collarbone and above the nipple); 3. Better visualization with mammography; and 4. Potential for better support of the implant weight. However, it is initially more uncomfortable. Women who have the following characteristics are better served with sub glandular (on top of the muscle) positioning: 1. Tubular or constricted breasts who refuse breast lift; 2. Ptosis (droopiness or majority of the breast volume and/or nipple lies below the breast fold) who refuse breast lift; 3. Adequate breast tissue to camouflage possible wrinkles and or palpability; 4. Body builders who cannot accept the possibility of “animation” deformity (movement of the breast implant upon chest muscle flexion).
Is it safe to do a mammogram after? How long after?
Absolutely! Mammography is a vital screening tool for breast cancer. Follow the ACS (American Cancer Society guidelines) or your Gynecologist’s recommendations. Additional views (Eklund protocol) are required, but all radiologic facilities routinely ask about the presence of breast implants. We recommend scheduling routine screening mammograms at least a year post-op. Of course, if a mass is identified, diagnostic mammography should be done sooner.
Can I breastfeed if I get pregnant?
Aesthetic breast surgery is intended to improve a woman’s appearance but also conserve her option to lactate. Many women will opt for an inframammary fold incision (below the breast base) to prevent any injury to either the nerves or milk ducts, however I have had many patients who have successfully breastfed with scars on the nipple areolar complex.
What will I tell my kids?
A wise parent knows her child. You may choose to refer to the ASPS book “My beautiful mommy”, by Salhauzer, M. to initiate the discussion.
How long are my stitches in?
Absorbable sutures are routinely used, hence suture removal is unnecessary. Sutures will “dissolve” in 3-6 months.
How soon after can I have sex?
We recommend avoidance of vigorous physical activity, including sexual intercourse (weight lifting, Pilates, yoga, etc.) involving your chest muscles for at least 4 weeks. Intimacy may have many manifestations and individual tolerance to discomfort is extremely variable. One absolute: we discourage kissing incisions for a month to avoid bacterial infection on a healing wound.
How long till the implants have settled?
Varies from 2-3 months, depending on the size, shape, substance (saline vs. silicone) of the implant, patient’s breast characteristics and the absence of any complications (i.e. CC capsular contracture, hematoma or infection). While complications are infrequent, the best outcomes result when we (patient and practice) work together.
When do I start wearing a normal bra?
As soon as the implants have settled, patients can resume wearing their bras of choice. Underwire bras are recommended for women who have both implants and lifts because although the breast skin is contoured to fit the implant, the intrinsic stretchiness of the breast skin has not been altered and definitely benefits from external support.
Will I be able to not wear a bra?
Occasionally. Like in everything, moderation is key. Breast implants do not make a breast rise up, unless CC is present. Bras aren’t always compatible with certain clothing and/or activities. Just an observation, some of the patients who have enjoyed the greatest longevity of their results, (softness, good positioning, and no recurrent sag) confide that they “support the girls”.