There are several possible locations for the small incision that will be used for inserting the breast implant. The most frequent technique utilizes an incision made in the lower portion of the breast (inframammary). Another technique, though less frequently used, involves making an incision in the armpit (transaxillary). A third technique makes an incision around the areola (the darker skin surrounding the nipple). A newer technique uses an incision in the belly button, thus reducing the chance of scarring in the breast area. Dr. V will guide you in this process and decide the best technique for you.
During surgery, the breast tissue is raised to create an open pocket under the breast tissue or beneath the chest wall muscle (pectoralis muscle). Inserting an implant behind each breast can increase a woman’s breast size by one or more bra cup sizes. It is not true that implants should only be placed behind the muscle. For thin patients, who have minimal amount of breast tissue above the nipple, an implant placed behind the muscle gives a more natural appearance. In patients with adequate fullness in the upper part of the breast, implants can be placed above the muscle. There are other factors that should be considered and Dr. V will guide you in coming up with the best result for you.
Saline or silicone vs. gummy bear implants
In November 2006, the FDA approved the use of Cohesive or Memory Gel (silicone) implants. These new silicone implants are a special polymer that does not leak like the old style silicone implants. They remain in a cohesive state and do not leak into the pocket. After extensive study, gel implants failed to show any links to connective tissue disease and certain autoimmune diseases. These implants have a more natural feel and have become very popular today.
Saline implants have been the mainstay of implants through the previous 14 years, when silicone implants were banned by the FDA. If saline implants leak, the saline is reabsorbed by the body with little consequence. With correct sizing and dimensions, they also feel and look natural. Some women feel more comfortable with these implants because of the leak issue.
Gummy Bear implants are silicone implants that are form stable. This means they most naturally mimic the shape of breasts. There are now three companies that make these implants and we do offer the gummy bear implants. All the various implant types offer advantages and disadvantages. Gummy bear implants are NOT right for everyone. When you come for your consult, please ask Dr. V if they are right for you. Dr. V will find the best answer using the latest research on all types of implants.
How to choose a size?
This is perhaps the most fun part of the procedure. The goal of the augmentation is to restore volume and projection to the breast. During a consultation, patients can “try on” different sized implants to see which size will gives the most natural appearance. Being attentive to a patient’s wishes and desires is extremely crucial in finalizing the correct size.
The patient’s height and body shape, along with the pre-surgical dimensions of her breast plays a prominent role in determining the size to acheive a natural look. Implants come in various dimensions and profiles and implants that are too large can distort the anatomy. Dr. V will guide you in making the best choice to suite your individual goals.
Post-surgery recovery process (On-Q Pain Pump)
Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time. At South Shore Plastic Surgery, we use the On-Q pain pump system for post surgery pain relief. This is a tiny catheter that Dr. V leaves in the pocket after the surgery is finished. Over the course of the following 3 days after the surgery, the pain pump delivers a numbing medicine directly into the pocket. This has revolutionized post surgery recovery from breast augmentation! Ace wrap or a sports bra is applied right after surgery to aid the healing process and to minimize movement of the breasts. Once the bandages are removed, a specialized cupless sports bra will need to be worn for several weeks. Patients sometimes report minor pain associated with the surgery after the pain pump is removed. This pain can be treated effectively with oral medication like tylenol or motrin. While complications are rare, patients can minimize potential problems by carefully following the directions given by Dr. V after surgery.