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Breast Implant Procedure Description:
One of the most commonly performed cosmetic surgery procedures, breast augmentation or breast enhancement is centered around creating larger but at the same time soft, proportionate and naturally appearing breasts.
Dr Klainer always performs breast augmentation in a hospital or ambulatory surgery center setting with the patient under general anesthesia. There are three commonly used incisions used for the placement of the breast implants; the periareolar (under the nipple), the inframammary (under the breast) and the transaxillary (under the arm). Dr. Klainer believes that the periareolar breast augmentation approach is superior for the following reasons:
Firstly, this incision for breast augmentation is central to the breast mound allowing symmetric development of the breast pocket (where the implant will be placed). Secondly, it is the least obvious and relatively best healing of the three possible incisions. Thirdly, as it is the closest incision to the midline, Dr. Klainer feels it gives the best access to achieve a closer, more naturally appearing cleavage. Lastly, in the rare case of poor scar formation, the scar is always hidden in any type of clothing including strapless, sleeveless and bathing suit apparel. Incisions are normally closed with two layers of sutures. The first set of sutures is removed at your one week visit and the second set at your two week visit. You will be instructed on how to care for your surgical incisions to give them the best chance to heal.
There is a choice of breast implants, either saline (salt water) or silicone gel implants are available. Dr. Klainer will discuss the pros and cons of each with you at your breast augmentation consultation and then again at your pre-op visit if you are proceeding with surgery. Silicone breast implants are now approved by the FDA and are safe for use. The new silicone breast implants have a greatly improved shell allowing for minimal migration of the internal silicone particles; therefore there is less chance of capsular contracture. The cohesive gel also prevents the silicone gel from traveling in the case of leakage or rupture. Saline (salt-water) breast implants are inherently safe, as approximately 70% of your body is salt water. If the saline solution leaks, the saline is simply absorbed without risk to the patient. The choice of which type of implant to use is based on the patient’s desires and comfort. The few circumstances where Dr. Klainer recommends gel implants more strongly is in the breast reconstruction and in women who begin with minimal natural breast tissue.
The results of your breast augmentation surgery will be long-lasting. You may find it more comfortable to wear certain styles of clothing or swimwear. Like many women who have had Breast Augmentation surgery, you may also notice a boost in your self-confidence.
Dr. Klainer’s breast augmentation before and after photos are meant to show many different starting points and how breast implants can enhance a person’s appearance.
Breast Augmentation Surgery and Downtime
Before breast augmentation surgery and for your safety, you may be asked to undergo lab tests or medical evaluation. Certain medications may need to be discontinued or an adjustment made in your current medications. All breast augmentation surgery patients are asked to stop smoking well in advance of surgery and avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they may increase bleeding. Dr. Klainer will discuss these matters with you at your breast augmentation surgery pre-op visit.
After breast augmentation normal activities will be curtailed for approximately one week. At both the time of your one week and two week visits, Dr. Klainer will remove the sutures, instruct you on care of the incision and teach you about breast massage. The downtime time after breast augmentation surgery varies depending on the patient; most normal activities including vigorous exercise can be gradually resumed 3-4 weeks after surgery. At the one month point scarring will still be noticeable, but over the following months it will gradually fade to its permanent appearance.
Discomfort levels resulting from breast augmentation surgery can be significant but they are very manageable with medications and sensible post-op care. After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks. As mentioned previously, exercise and normal activity can resumed around 3-4 weeks after your procedure.
Over time, post-surgical swelling will decrease and breast implant incision lines will fade. At each of your post surgerical visits you will be given specific instructions that include how to care for your breast implants following surgery, medications to apply to the scar, or oral medications to aid healing and reduce the risk of infection and when to follow-up with Dr. Klainer.
Breast Implants FAQ:
Q: What happens if the breast implant leaks?
A: The body will absorb the saline and the breast implant will deflate leaving the breast appearing smaller. It is not an emergency and you will experience no ill effects. A new breast implant can be placed through the previous incision with minimal discomfort and time off from work. There is no risk to the patient if the saline leaks.
In the case of silicone gel implants, the material stays close to the breast implant. There have been no proven side effects from contact with the gel matrix. As there is little change in the breast with an implant leak or rupture, the FDA has recommended MRI examination periodically to examine the integrity of the implants. If a leak is identified, the breast implant can be replaced through the previous incision with minimal discomfort and time off from work.
Q: What is a capsule or capsular contracture?
A: A capsule is the body’s natural protective mechanism against foreign objects (i.e., the breast implant). This only becomes a problem if the capsule begins to shrink, thicken, or tighten resulting in hardening and/or visible changes in breast shape (capsular contracture). With breast implants this occurs in approximately 5-10% of patients. If this happens it usually requires a second surgery to correct the problem. You will be taught techniques of massaging the implants after surgery that may help in preventing the occurrence of a capsular contracture.
Q: Why place the breast implant under the muscle?
A: Although the implant can safely be placed either above or below the chest wall muscle, Dr. Klainer believes below the muscle has many advantages and strongly recommends this approach. The placement below the muscle gives more support to the breast implant thereby slowing the natural drooping of the breast. This placement makes the result breast augmentation appear and feel softer and more natural. Most importantly, placement of the breast implant below the muscle has been shown to decrease the interference in mammography, making the mammogram easier to interpret.
Q: Can I lose nipple sensation?
A: Yes, but this is very rare, with complete and permanent loss of sensation occurring in 1% or less of patients. Many women will experience a transient change in nipple sensation but this usually returns to normal within 6-18 months following surgery.
Q: Can I breast feed?
A: Although scarring may effect a woman’s ability to breast-feed, most women can breast-feed after breast augmentation with either saline or silicone gel implants. It is also important to note that it is safe for the child.
Q: What type of anesthesia is used?
A: Dr. Klainer recommends general anesthesia both for comfort and to allow complete relaxation of the chest wall muscle.
Q: Where is the procedure performed?
A: The procedure is performed either in a hospital or ambulatory surgery center setting.
Q: How can I find out more about breast augmentation surgery?
A: Dr. Klainer is available to answer your questions about breast augmentation surgery. Schedule your free consultation today at 703-988-2246.
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