Surgery performed by Dr. Schenden and Dr. Elswick
Breast Augmentation using implants (saline or silicone) is one of the most common aesthetic plastic surgeries performed in the United States. It is important to individualize the aesthetic ideal for each patient, while ensuring proper communication, safety and realistic expectations. The concept of the ideal breast is influenced by a host of cultural, sociological and psychological factors.
Using 3D-Vectra technology, patient dimensions and desires are incorporated in choosing the proper implant and visualizing the potential outcome prior to surgery in a swimsuit, shirt or without any clothing. The following patient dimensions or characteristics that may be improved with breast augmentation include:
- Enhance size and shape
- Improve body contour
- Restore volume deflation after pregnancy or weight loss
- Restore volume secondary to under development of breast
- Achieve improved breast symmetry
- Correct disfigurement secondary to trauma, birth, cancer
- Improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure
THE BEST CANDIDATES FOR BREAST AUGMENTATION
Breast augmentation can enhance your appearance and your self-confidence. The best candidates are seeking an improvement but not perfection, healthy, and non-smokers. Patient compliance during the recovery process with activity level, exercises, and wound care will increase the probability of a successful outcome. The surgeon should be able to form an impression of the patient as a well-informed, psychiatrically stable person with appropriately realistic expectations for the procedure. Any concerns about the patient’s level of understanding, unrealistic expectations, or self-esteem issues should be fully explored prior to proceeding with surgery. Preoperative mammography is recommended for patients over 35 years of age or patients of any age with significant risk factors for breast cancer.
PLANNING YOUR SURGERY
Our doctors make sure your questions are answered and your goals are understood. Patient expectations are important to discuss at the consultation. Surgical approach and implants available are tailored to each patient. If your breasts are sagging, your doctor may also recommend a breast lift. A detailed history and physical examination will be performed to assess whether breast augmentation with implants is the right surgical option. Once the patient is determined to be a good candidate, a detailed discussion of the different types of implants available and the proper implant choice and surgical technique will be performed. Be sure to mention smoking, medications, medical history, and previous surgeries.
TYPES OF BREAST IMPLANTS
The ideal size and shape of the female breast is subjective and relates to both patient preference and breast size limitations. However, most surgeons will agree that there are certain characteristics which represent the aesthetic ideal of the female breast.
In addition to manual measurements, 3-D Vectra is available to facilitate the measurement process in addition to enhancing the patient’s overall experience by increasing physician–patient interaction in selecting the appropriate implant type and size. The visual display of the implant selected increases the confidence of the patient in the results that will be achieved.
Filling material: There are two types of breast implants from which to choose: saline- and silicone-filled implants. The decision between a saline-filled prosthesis and a silicone gel implant is one of the patient’s preferences after the surgeon’s conveyance of information.
Implant size: Selecting a specific implant size depends on the dimensions of the breast, the soft tissue envelope, and the desired volume of breast augmentation. In addition to a thorough discussion with the patient as to her desired breast shape and size, 3-D Vectra may be used to show the patient the outcome based on the selection of a particular implant.
Profile: The implant may have a low, medium or high projection (the depth of the implant from the base to the highest point of the implant curve).
Shape: The implant may have a round profile or one that is anatomic (teardrop or tapered shape).
Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA).
You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace the implants. Regular examinations for breast health and to evaluate the condition of your implants are important whether you have chosen saline or silicone breast implants.
PREPARING FOR YOUR SURGERY
Detailed instructions on activity before and after surgery will be discussed. Your surgeon will give you specific instructions to prepare for the procedure, including guidelines on diet, medications, activity level, and smoking. Carefully following these instructions will help your surgery and your recovery proceed more smoothly. A mammogram may be recommended prior to your procedure to ensure breast health after 35 years of age and serve as a baseline for future comparison.
If you smoke, plan to quit at least 4-6 weeks before the scheduled surgery otherwise an increased risk for infection and wound healing will occur. Avoid sun exposure before and after surgery as this may interfere with your scar.
WHERE YOUR SURGERY WILL BE PERFORMED
Patient preference will be incorporated into this decision. Breast surgery is performed as an outpatient procedure. Overnight hospital stay may be arranged based on associated medical conditions or combined surgical procedures being performed simultaneously with additional surgery such as abdominoplasty or liposuction. Patient preference will be incorporated into this decision. The facilities we are privileged to operate from include Columbia Surgery Center (our private surgical suite), William Beaumont Hospital of Troy and Royal Oak. Dr. Elwick also has privileges at McLaren Macomb Hospital.
TYPES OF ANESTHESIA
Breast augmentation is performed using general anesthesia.
Breast augmentation is usually performed to improve symmetry, enhance the size and shape, improve body contour, or as a reconstructive technique for correction of acquired or congenital breast deformities. Incisions and scars are concealed in inconspicuous locations such as the natural creases of the breast (around the nipple), or in the armpit. Breast implants are placed in precise pockets that match the implant size created under or above the muscle to avoid any shifting. After the implant insertion, breasts will appear larger in size, more symmetrical, and have improved cleavage. The surgery usually takes 1-2 hours. Special surgical Bra will be provided.
AFTER YOUR SURGERY
Pain control will be adequately managed with medications. Detailed instructions for wound care will be provided. You may also experience temporary sensory changes in your nipples for about two weeks but the bruising and swelling will slowly fade and nipple sensation will slowly return to normal.
Detailed wound care and activity instructions will be discussed at your consultation. Normally you may return to work after 1-2 weeks but with light duty and no heavy lifting or strenuous activity for 6 weeks. Expect the final outcome of the breast augmentation at 3-6 months after surgery. Your scars will slowly fade from pink to pale over several months.
YOUR NEW LOOK
For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance. Even if you believe your implants are functioning well, it is important that you follow-up as directed with your plastic surgeon to assess the condition of your breast implants. In addition, whether you choose to have breast implants or not, it is essential to your health that you practice a monthly breast self-exam and schedule regular diagnostic breast screening.
RISKS ASSOCIATED WITH BREAST AUGMENTATION
Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience complications, you should discuss them with your plastic surgeon to make sure you understand all possible consequences of breast augmentation.