There has never been a better time to become the beauty you love! Recent innovations in breast implant technologies have provided prospective patients with the advantage of choice. Advances in technology have seen the expansion of saline implants, which now offer mid-range and high profile implants, reducing the possibility of lateral edge palpability. The industry has also seen the reintroduction of “responsive” and “cohesive” (gummy bear) silicone gel implants for our patients over 21 years of age.
Breast implants are not one-size fits all. During your consultation with female plastic surgeon, Dr. Lavinia Chong, she will review your goals and help you explore the options available to assist you in achieving those goals. Aesthetic goals, anatomy, and customary activities are all areas of consideration during the selection of implant filler, surface and profile type, and volume.
We enjoy guiding patients through the consultation and sizing process, selecting the ideal configuration:
- Filler type: Saline vs. Silicone
- Surface type: Smooth vs. Textured
- Profile type: Standard, Mid-Range, High or Ultra-High
- Volume: A variety of sizes are available to fill the needs of all patients based upon aesthetic ideals, profession, and level of activity.
Your consultation allows an opportunity for you to “try on” various implants, thereby giving you a better understanding of the options available to help you achieve your goal. During your “sizing” you have the opportunity to feel the weight of the implant, as well as see the projection. Ultimately, your breast augmentation should make you look and feel more confident and well-proportioned.
“I left my consult with Dr. Chong so happy. I left feeling understood, safe and felt like every possible question and concern had been addressed. Most importantly I felt she really wanted to help me achieve exactly what I wanted, which I hadn’t seen in other consults. A huge thank you to Dr. Chong and her staff!” -C.D. (Patient since 2016)
There are many reasons why women elect breast implants. Some include:
- Congenital hypomastia: Breast volume never developed to a patient’s satisfaction.
- Postpartum atrophy: Breast volume decreased after pregnancy, lactation. Typically the area between the nipple and collar bone appears “empty”.
- Loss of volume due to weight loss and aging.
- Pronounced asymmetry (differences in volume, and/or nipple position): Asymmetry is common but can be exacerbated by weight gain/loss, aging, pregnancy.
- Cosmetic: Simply want additional breast volume, projection, occasionally to “balance” upper torso with lower hips.
Additional areas of consideration prior to breast augmentation include:
- Personal and/or family history of breast cancer. Baseline mammograms may be recommended.
- Preferred sports and activities. A vast majority of our patients have vigorous and varied athletic lifestyles, from runners to yoga enthusiasts. We have even seen an uptick in weight lifting and CrossFit. In choosing the type and volume of implant, patients are advised to review their current activities with Dr. Chong and discuss how they can expect their implants to perform in conjunction with those activities.
- Quality of breast skin envelope. Individuals with excessive breast skin, who do not desire breast lifts, will be counseled on the limitations of sub-muscular placement.
- Previous breast surgical procedures, infections (mastitis).
- Time elapsed since cessation of lactation.
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, and placement will have been previously reviewed with you during your pre-operative appointment.
The relative advantages and disadvantages of the incisions will be discussed during your consultation appointment. Options for incisions include:
- Periareolar: the lower junction of pigmented nipple complex and breast skin
- Inframammary Fold: the base of the breast
A “no-touch” technique utilizing Keller funnels (single-use devices) is used to facilitate placement of silicone gel implants. Drains are rarely needed for primary breast augmentations. All incisions are repaired in multiple layers of dissolving sutures.
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 your post-operative visits. All patients are encouraged to contact the office with any concerns. Warranty information, including options for extended warranty of breast implants are fully disclosed.
Breast Augmentation FAQ’s
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.
Is it better to have the implants positioned under or on top of the muscle?
Technically, under the muscle is a “dual plane” approach, which has theoretical long term advantages of:
- Decreased rate of capsular contracture (CC)
- Improved soft tissue coverage and drape in the upper pole (area below the collarbone and above the nipple)
- Better visualization with mammography
- Potential for better support of the implant weight (however, it may be initially more uncomfortable than placement on top of the muscle)
Patients are better served with sub-glandular (on top of the muscle) positioning when the following characteristics are present:
- Tubular or constricted breasts which refuse breast lift
- Ptosis (droopiness or majority of the breast volume and/or nipple lies below the breast fold)
- Adequate breast tissue to camouflage possible wrinkles and or palpability
- Body builders who cannot accept the possibility of “animation” deformity (movement of the breast implant upon chest muscle flexion)
At what point will I be released to resume my regular activities?
Your activity restrictions will be based upon the type of procedure performed. You will likely be released for activity in increments, with full resumption of activity typically occurring 6-8 weeks post-operative. During each follow-up appointment activity restrictions will be released based upon based upon what is acceptable at each given point in your recovery process.
- Adult activity: We recommend avoidance of vigorous physical activity, and any activity which may raise the heart rate, until 4 weeks post-operative. It is important that all incisions be healed prior to resuming such activity so as to reduce risk of infection at the incision site and delay wound healing.
- Fitness: As a general guideline, expect activity the first 2-4 weeks to be restricted to low-impact. Examples include: lifting no more than 2-5 pounds, walking, and lower body activities.
- Caring for children: We suggest having a strong support system in place following surgery. In order to achieve optimal results, you will be weight restricted for the first 2-4 weeks of your recovery with a maximum weight restriction of lifting/carrying no more than 2-5 pounds.
How long will I have stitches?
Absorbable sutures are typically used, making routine suture removal unnecessary. While your body heals, it will slowly dissolve the sutures. This process can take up to 3-6 months. Minor delays in this wound healing process, while not common, occur when the body extrudes the stitch. This “spitting stitch” may feel like a little bump and may have a bit of discharge. If this occurs, simply call the office and we will set a time at your convenience to remove the stitch.
After surgery, when can I go back to wearing a normal bra?
As soon as the implants have settled, you can resume wearing your bra 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 go without wearing a bra?
Occasionally. Like in everything, moderation is key. 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”.
How long will it take the implants to settle?
The amount of time it takes to achieve final results ranges from 3-6 months with “dual plane” placement (creating a pocket for the implant partially sub-muscular, behind the pectoralis major muscle). This can depend, in part, on the size, shape, and fill of the implant. During this time of “settling” it is not uncommon for mild asymmetry to occur as the pectoralis slowly relaxes and stretches.
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.
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.
Contact our office in Newport Beach to schedule your breast augmentation consultation with Dr. Chong at (949) 644-1400.