Breast Augmentation

Mississippi Gulf Coast Board Certified Plastic Surgeon

Breast augmentation is the surgical placement of breast implants to increase the fullness and projection of the breasts or to improve symmetry of the breasts. Clinically referred to as augmentation mammaplasty, the procedure is used cosmetically to:

  • Enlarge a naturally small breast, most commonly the result of heredity
  • Restore breast volume lost following pregnancy, as a result of breast-feeding or due to weight loss
  • Achieve better symmetry when breasts are moderately disproportionate in size and shape.

Adult women of any age can benefit from breast augmentation, enhancing small breast size, or restoring fullness. However, it is recommended that the breasts be fully developed prior to augmentation. You also should be aware that breast augmentation generally does not interfere with a woman’s ability to breastfeed. A woman who is motivated by her own personal desire to enhance breast contour is most likely to be satisfied with the results of breast augmentation surgery. Good candidates are defined as the following:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and/or specific goals in mind for improving their body image

As a global leader in breast aesthetics and augmentation, Allergan—the maker of Natrelle®—is committed to you and the long-term safety of all Natrelle® breast implants. Dr. Dees has found Allergan’s Natrelle line of breast implants to be the highest in patient satisfaction and uses them exclusively in his practice.

Silicone Implants

The outer solid silicone shell is the same as used in the saline-filled bag, but since they are pre-filled at the factory, no valve is necessary. These implants are filled with a silicone gel and are more natural (like normal breast tissue) in feel, touch, and consistency. They, in general, cause less rippling and are softer and more “real.” In November, 2006, after 15 years of controlled clinical trials supervised by the FDA, they found that silicone-filled breast implants were safe and effective for use in breast reconstruction and enhancement.  They were released for general use in the population.  Disadvantages include the need for slightly longer incisions (1-1.5 cm), more difficult to detect rupture, higher cost,  and age limits (22 years of age as opposed to 18 for saline-filled).

Cohesive Gel Implant

Cohesive gel implants are silicone implants that are filled with a thicker silicone gel that holds its shape and form like a “gummy bear.” These shaped implants are designed with a focus upon a natural look and maintaining their shape in an upright position which decreases the incidence of folding of the implant shell or rippling. If you cut into a standard gel implant, the liquid silicone gel escapes from the implant shell. In contrast, when you cut into a cohesive gel implant, the implant itself maintains its shape and integrity.

Saline Implants

The saline implant has an exterior sack made of solid silicone. Sterile saline solution, similar to that of the salt-water solution administered for intravenous fluids, is used to fill the bag at the time of surgery. For the past 15 years, this has been the most commonly-used type of breast implant. Advantages of this type of implant include the use of a natural body-filler solution in case of rupture and eventual leakage, as well as a reduced cost to the patient. Greater flexibility in filling for correction of asymmetry of breast size in the same patient is thought to be easier by some surgeons. A slightly small skin incision could be used in many patients. There are two main disadvantages of saline breast implants when compared to those filled with silicone. Because these implants are filled with a liquid (salt water), they have a higher incidence of visible and palpable ripples on their edges. They are in essence “water balloons.” They also have a significantly higher rate of deflation than the gel-filled implants. Saline-filled implants seem to work best when they are placed submuscularly, filled to manufacturer’s recommendations, and used in patients with a thicker amount of breast tissue.

Scheduling

Before beginning the process, Dr. Dees recommends that you research breast augmentation on the American Society of Plastic Surgery website to ensure that you completely understand the procedure along with the facts that the surgery delivers different results for each patient. The first step in the process of getting a breast augmentation begins by simply picking up the phone to call Dr. Dees’s office to schedule your free initial cosmetic consultation. During this consultation, you and Dr. Dees will go over the surgical techniques that are best for you. A personalized augmentation plan will be agreed upon and photos will be taken. After you have the necessary information and Dr. Dees is comfortable with your knowledge of the augmentation plan, you will return home and spend time reviewing the information in order to decide if the surgery is right for you. If you decide to proceed, call the office to schedule your surgery.

Preparation and Pre-Op

Once your surgery is scheduled, it is important to organize your life; job, school, and family. Recovery times vary from patient-to-patient; therefore, it is recommended that you be prepared in advance. Approximately two-to-three days prior to surgery, you will have a preoperative office visit. After you are cleared for surgery, Dr. Dees will give you written preoperative instructions, prescriptions,  and order an evaluation by the anesthesia department at the surgery center. Lab work may be required. Fees will be paid at this time.

The Day Of

On the day of your surgery, you may take a preoperative oral sedation before arriving at the outpatient surgery center. This will require you to have someone drive you to and from the surgery. Upon your arrival at the center, you will complete any required paperwork, verify all of your information, and give your final consent for the surgery. Before surgery can begin, you will have one final anesthesia evaluation. After you are cleared for surgery, an IV will be started, and medication will be given. Once the procedure is complete, the healing process begins, which will vary from patient-to-patient. You will be in recovery for at least two hours. After you are released from the anesthesiologist and given post operative instructions and a follow-up appointment time, your driver may take you home.

Here is a list of questions you may want ask your surgeon if they are not explored in your consultation.

  • What are your credentials?  Do you have a particular area of expertise?
  • How will my breasts look if I decide to have the implants removed without replacement?
  • How will my ability to breastfeed be affected?
  • How can I expect my implanted breasts to look after pregnancy? After breastfeeding?
  • What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts?
  • What alternate procedures or products are available if I choose not to have breast implants?
  • Do you have before and after photos I can look at with results that are reasonable for me?
  • What type of experience have you had with performing breast augmentation on women with similar breasts to mine?

It is important for Dr. Dees to know about your health history and any issues you may have.  Remember, your information is confidential.

  • Make sure you tell Dr. Dees about your current health and also your health history.
  • Tell him about any infections you might have. Anything from a yeast infection, urinary tract infection, bronchitis, and even if you have a cold.
  • Please tell Dr. Dees if you are allergic to anything such as penicillin, latex, foods, or anything else.
  • Make sure you tell him if you or any member of your family has ever had a bad reaction to anesthesia.
  • Tell him if you have ever had a biopsy, found a lump in your breast, or if breast cancer runs in your family.
  • It is very important to tell him if you are pregnant or could possibly be pregnant, or if you recently had a baby. Also let him know if you are breastfeeding.
  • Please bring a list of every medication you take. This includes prescription medications, over the counter medication,  and even vitamins. Do not leave anything out.
  • It is very important that you tell Dr. Dees if you smoke. This could affect your surgery and it needs to be discussed with him.

Frequently Asked Questions

Q: How long will the procedure take? A: 1 to 2 hours Q: What kind of anesthesia will I receive? A: General:  completely asleep as you would for any major surgery. Q: What are the potential side effects that can occur after having breast implants? A: Temporary soreness, swelling, change in nipple sensation, and bruising. Breast will be sensitive to stimulation for a few weeks. Q: What are the potential risks of having breast implants? A: Any surgery carries a risk of bleeding and infection as complications; thus, further surgical treatment is usually needed.     The scar that forms around all implanted silicone material is called a capsule.  Small percentages of patients form too much capsule causing contracture, deformity, and pain of the implanted breast.   Most patients experience nipple sensation changes that eventually resolve. These changes range from hypersensitive to totally numb.  A small percentage are permanent.  Mammography, x-ray procedures used to detect breast cancer, require special techniques. Lack of implant permanence—surgical removal, or replacement of the implants may be required to treat problems, including: deflation, the formation of scar tissue around the implant (capsular contracture), which may cause the breast to feel tight or hard, bleeding or infection can also occur.  Increase or decrease in sensitivity of nipples or breast skin, occasionally permanent. Mammography requires a special technique. Q: Are the results permanent? A: Variable:  implants may require removal or replacement. Q: What is the recovery time? A: Back to work: 1-2 weeks, depending on the type of occupation. Physical contact with breasts: 3 to 4 weeks. Fading of scars should occur over several months to a year or more. Q: What are the potential risks of having breast implants? A: All surgeries carry a risk for bleeding or infection. Although these are uncommon, they are very significant problems that can lead to or require further surgeries and generate more expenses. Q: What happens if the implants break? A: Broken saline-filled implants will deflate to almost flat in a very short time.  The rupture of silicone gel-filled implants is most often silent without symptoms. Neither deflation is likely to cause harm to your health. If rupture is detected, the implant should be removed. The implants are much stronger than previous generations of products, and the leakage rate is variable depending on saline vs. gel-filled implants. They are both extremely low. Currently, both of the implant manufacturers that Dr. Dees uses are covered by a replacement warranty. The implants themselves are not meant to be permanent devices and can have the following effects: -Deflation -Formation of excess scar tissue leading to hardening -Decrease or loss of sensitivity around the nipples Breast implants do not provide an increased risk for breast cancer.

This material is provided by the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. It is not intended to make any representatives or warranties about the outcome of any procedure and is not a substitute for a thorough, in-person consultation with a board-certified plastic surgeon.

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