When Should I Consider Breast Enlargement?
- Smaller than desired breasts
- Improvement with breast asymmetry
- Correction of Poland’s Syndrome (underdevelopment of one breast)
- Loss of fullness following pregnancy or breast feeding or weight loss
- Loss of volume in the upper portion of the breast
- Larger, more shapely breasts
- More full, youthful, uplifted breasts
- Breast symmetry improvements
Dr. Kimberly Short, a board certified plastic surgeon, has been a consultant for Mentor’s LEAD Program, which is the Leadership, Experience, and Development for Breast Augmentation. Dr. Short has also served on the National Council of Leaders for Breast Aesthetics. Dr. Short is also 1 out of 29 surgeons in the United States asked to be a principal investigator for an exciting new FDA breast implant protocol. Dr. Short will begin clinical trials in 2011 to evaluate this new implant. Breast augmentation is the most common procedure Dr. Short performs, over 300 breast augmentation surgeries a year. Dr. Short will individualize her recommendations during the consultation based on your desires, expectations, anatomy, and breast/chest measurements.
The Gillian Institute will discuss options for breast augmentation including implant selection, incision types, placement of the implant and desired cup size at the consultation. Every surgery is individualized to best fit each patients specific needs. The implants available are saline (salt water) or silicone (cohesive). A small incision may be made under the breast crease (inframammarybreast crease), around the inside part of the areola (periareolar), or in the axilla/armpit (transaxillary). The implant may be placed under the muscle (subpectoral), under the fascia (subfascial), partially under the muscle (dual plane), or above the muscle (subglandular). We will determine placement of the implant based on your pre-existing breast tissue, breast skin envelope characteristics, andanatomy. We will find the right size implant by taking breast and chest measurements during the consultation in addition to performing a physical examination. Dr. Short will also review visual pictures selected by you to determine the desired shape, volume, cleavage, and other breast characteristics desired after surgery. The doctor will utilize a sizing technique in surgery based on the information gathered at the consultation. The doctor will place implant “sizers” in the operating room and evaluate the implant sizer appearance in an upright position. Based on the appearance of the implant sizer, we will select the final implant to be used in the breast implant pocket. The decision of your breast augmentation options are multi-factorial and are customized for each patient.
To ensure a natural result, breast measurements are taken during the consultation to help determine the appropriate implant profile selection. The breast measurements and examination of the breast anatomy in combination with visual examples of your desired outcome will guide our doctors in surgery with selecting an implant sizer, and based on the implant sizer in the upright position, a final decision is determined. We encourage patients to select a desired cup size that is within the patients natural boundaries. The Gillian Institute is able to select from 3 implant saline and silicone profile options: Moderate Profile (MP), Moderate Profile Plus (M+), and High Profile (HP). Each profile has pre-determined standard measurements for implant width and projection. The MP implant has the most width and least amount of projection and the HP implant has the most narrow width and the most projection. For example, a patient whom has a very narrow chest diameter is able to achieve a Full C or Low D cup appearance by using a HP profile implant. An appropriate selected implant will achieve optimal cleavage, an increase in breast volume and projection without excessive lateral (side) fullness or artificial, exaggerated upper pole fullness.
Silicone implants are FDA approved. Silicone implants is the most “studied device” in the history of the FDA. The Gillian Institute is committed to patient safety and patient education and is excited to be able to offer this implant as a selection choice. Silicone gel filled implants are advantageous to some patients because they offer a softer feeling implant and a more natural appearance for some patients. Silicone implants also decrease the risk of implant wrinkling. For patients who do not have ample breast tissue for good coverage of an implant, silicone implants achieve a more natural upper pole appearance and offer a softer “feel”, resembling the feel of natural breast tissue. Silicone gel implants feature a cohesive silicone, not a liquid or semi-liquid, allowing the substance to hold together uniformly. This physical property allows the silicone to remain intact even with an event such as a rupture to the shell of the implant. Silicone implants can be placed either through an inframammary breast crease or periareolar incision.
The smooth round saline implants can enhance the breast size andare likely to give a more rounded curve to the breast area. But if a “too” rounded upper pole breast appearance is not desired, by placing a smooth round saline implant under the pectoralis major muscle (a subpectoralapproach) a more natural slope can be achieved. The smooth round surface of the saline implant design makes this implant feel softer andis less likely to wrinkle compared to the textured anatomical implant. Smooth round saline implants can still achieve a natural contour.
For some patients with minimal breast tissue, the textured anatomical implant may reflect a more natural slope of the breast, especially in the upper pole. The anatomical implants are required to be textured to maintain the position of the implant in the breast pocket; however the texture component also makes the implant feel more hard and firm after surgery. The texture on the implant can also increase the risk of wrinkling or rippling of the implant edges. This implant is not used as often due to the increased firmness andwrinkling of the implant compared to a smooth round saline or silicone implant.
Each Option Will Be Discussed At The Consultation:
Implant Type: Silicone OR Saline
Implant Placement: Subpectoral (Variation-Subfascial or Dual Plane) OR Subglandular
Implant Incision: Inframammary Breast Crease (IMC) OR Periareolar (PA) OR Transaxillary (TAX)
Implant Size: A/B/C/D/D+ Ranges (At the preoperative appointment, the use of breast sizers can be placed in a bra to demonstrate a visual of the desired outcome)
Planning the Surgery:
Time off Work:
7-10 days for implants placed under the muscle (Subpectoral Placement)
3 – 5 days for implants placed above the muscle (Subglandular Placement)
You will need a caregiver for the first 24-48 hours after your surgery. If you do not have someone to care for you a nurse can be provided for a minimal fee.
The Day of Surgery:
The procedure is performed as an outpatient basis under general anesthesia. The procedure takes approximately 1-1.5 hours.
You will return home with light dressings and you are able to take a shower after 72 hours. Skin glue or steri-strips are applied to the incisions for 2 weeks. Scar treatment options are available at your two week appointment. The scars will fade over time. The surgery does not eliminate the ability to breastfeed. Light activities can be resumed as tolerated at 14 days. Aerobic activity may resume at 4-6 weeks.
The Gillian Institute requires that you begin breast massage 3 days after surgery. The breast massage will aid in settling of the implants, decrease the swelling, and increase the softness of the implants. The breast massage will also decrease the risk of a breast capsular contracture (scar tissue formation around the breast implant). Our technique and post-operative instructions will yield a lower risk of a capsular contracture. You will be encouraged to continue the breast massage techniques aggressively for 6 weeks. Typically, it will take 6-8 weeks to “settle” the breast implants and achieve the appearance you desire.
Note: It is important to address any concerns with The Gillian Institute at the time of your consultation. There is some risk, as with any surgical procedure. Minor complications that do not affect the final outcome occur occasionally. Major complications are unusual. Our doctors can explain the procedure and potential complications to you in detail and she can assist you in determining if a breast enlargement is right for you.