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Breast Augmentation

Breast Augmentation - Breast Implants - Sarasota, FL

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Overview

The talented cosmetic surgeons at Sarasota Plastic Surgery perform countless breast augmentation procedures each year. Breast augmentation enhances the size and shape of the breasts. If your breasts are naturally small, unequal in size, have become visibly smaller after pregnancy, or sag as a result of aging, you could benefit from cosmetic breast surgery. Using silicone or saline breast implants, or in some cases, a fat transfer, enhancement surgery can improve your self confidence and allow you to wear the clothes you have always wanted. During a thorough consultation, your aesthetic goals will be discussed, and all of the various options presented so that the best treatment plan can be implemented. Breast augmentation surgery produces gorgeous, natural looking, lasting results for our Sarasota patients.

Saline vs Silicone vs Fat

Saline Breast Implants

Saline filled breast implants remain a good choice for patients under 22 years of age (silicone gel implants have not been released by the FDA in patients under 22 years of age unless approved by the doctor because of specific anatomic reasons, it is important to get a doctors opinion before deciding on the best implant type) and in patients who desire saline filled implants over silicone gel filled implants. Because these implants are filled with a sterile saltwater solution, any potential leakage is absorbed easily by the body.  Saline implants also cost less than the silicone gel filled implants.  Disadvantages of saline implants include rippling that can be seen or felt and a tendency for the implants to gradually shift lower in the pocket, causing thinning of the breast tissue under the implant. This is important to consider for women who are thin and have a small amount of breast tissue. Those who opt for this type of implant must be at least 18 years old.

Silicone Breast Implants

Silicone breast implants are very popular today and are highly recommended by surgeons for patients who are thin and desire a natural look and feel to their breasts. Since the FDA validated their safety and efficacy, safety concerns surrounding these implants are today essentially no different than that of saline. The silicone shell is prefilled with silicone gel and comes in different sizes, shapes and textures. Unlike saline implants in which leakage is absorbed by the body and implant volume appears visibly less or flat, it may be difficult to always detect when a silicone implant ruptures. An MRI may be required to detect or verify a suspected rupture. Patients considering silicone implants must be at least 22 years old.

Fat Transfer

For patients who desire fuller breasts but do not want an artificial implant to achieve this look, there is also an option known as a fat transfer. In this procedure, the doctor will harvest fat from donor sites of the patient, such as the flanks, abdomen and thighs via liposuction. The fat collected will undergo a process of refinement and purification, and then gradually reinjected into the breasts with smaller syringes so the shape is evenly distributed.  Fat transfer may also be used to help improve results from breast augmentation using implants or during breast reconstruction surgery.

Product Information

Manufacturers

There are several manufacturers approved by the FDA.

  • Natrelle by Allergen – silicone and saline-based implants
  • Mentor – silicone and saline-based implants
  • Sientra – silicone-based implants

Profile

Breast implants come in a variety of different profiles. The selection is based on how enhanced the breasts’ projection would be, as well as how wide the implant will be on the chest wall in relation to the base width. Since the silicone implants are already pre-filled, the standard profiles come in low, moderate, high and extra high. Saline implants, however are inserted then filled with saline solution up to the patient’s preferred profile. Choosing the right profile can sometimes be a difficult decision and it is up to a skilled surgeon to help guide the patient accordingly. At Sarasota Plastic Surgery Center we often use Vectra 3-D which allows the use of 3 dimensional images of the patient to show actual changes with different implants.  This method is extremely helpful in making this all-important decision.

Shape

The standard shape of a breast implant can either be rounded or tear-shaped. Each shape serves a different aesthetic function as it pertains to the patient’s goals. Rounded implants produce a shapelier curve on the top portion of the breast. The teardrop implants are shaped to simulate a more natural appearance with less fullness along the top of the breast.  Both shapes give excellent results and the choice is based on the desires and goals of each individual patient.

Texture

Implants are made with either a smooth or a textured surface. In general, smooth implants cost less and are more commonly used for breast augmentation especially in younger patients and those who desire upper breast fullness. The textured implants were initially conceived out of the idea that it reduces the chances of capsular contracture (the constriction of scar tissue around the implant) . Most textured implant used today are   teardrop shaped (Allergan Style 410 Natrelle Inspira Cohesive Gel or Sientra Tear Drop Shaped Cohesive Gel Implants)and the textured surface allows the surrounding tissue to attach to the implant and hold the shaped implant in the proper position.  The textured implants are designed to give a more natural slope to the upper breast with less fullness.

Implant Placement

The two most common placements are on top of the chest muscle or under it. When the implant is placed under the muscle, a pocket is created under the pectoralis major muscle.   Many surgeons now prefer the submuscular approach (behind the muscle).   Placing the implant behind the muscle also provides a natural look and provides the implant with the long-term support it needs to stay in position.  Scientific studies also indicate there may be less chance of developing capsular contracture (hardening) of the implants in the submuscular position.

Incision Type

There are several standard incision approaches for breast implants. The most common is known as an inframammary incision, which is an incision near the breast fold. Second, is an incision made at the edge of the areola, which is known as a periareolar incision. A third option is to place the incision within the armpit, known as a transaxillary approach.  There is also an incision approach that takes place around the belly button, but this approach is limited to the use of saline filled implants. It is up to the patient’s desires and surgeon recommendation as to what approach is best to take. Scarring is also discussed at this time with each method.  At Sarasota Plastic Surgery we most commonly recommend the inframammary or perioareolar incision because both incisions heal with a nearly imperceptible line and both allow very precise positioning of the implants for the best overall results.

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Recovery Time  
2 Weeks
Average Procedure Time  
1.5 Hours
Post-op Follow-up  
Varies
Procedure Recovery Location  
Out-Patient
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During/After Surgery

Breast augmentation is an outpatient procedure that lasts about an hour. It is performed using general anesthesia in our surgical facility. All activities must be limited within 48 hours after surgery. There will be mild bruising and swelling,  support bra will also be worn to help in healing. It is normal to feel tightness around the chest area as the skin adjusts to the breast’s new shape. Most patients can resume normal activities within 7 days; exercise should be avoided for 3 weeks. It takes approximately 3 - 6 months for the breasts to look, feel and function normally in regards to softness, sensation and final implant position.

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Breast Augmentation FAQs

Natural or Artificial?

The decision to undergo natural or artificial breast augmentation depends on the patient’s breast make up. Those who opt for implants may choose between saline or silicone as each has its own advantages. Most patients choose silicone gel filled implants because they look and feel more like a natural breast.  At Sarasota Plastic Surgery Center, our surgeons believe they give patients an overall better result.  Generally, patients who have a small amount of breast tissue or are thin will benefit especially from silicone implants.  Fat transfer for breast enlargement is gradually becoming more accepted.  The amount of volume increase is limited compared to implants and there can be some resorption of the fat (decrease in volume over time).  More commonly fat-transfer is used to enhance the results from breast augmentation or reconstruction with implants.

Silicone Risk?

Negative notions about silicone started back in the early 90s when there were cases of leakage and complications. With today’s advancements in engineering, the silicone-based shells are made durable and safe, and have been proven so by the FDA. Today, in fact, silicone is more preferred than saline since they last longer and feel more natural. The rates of reported complications have significantly decreased in the last decade.

Implant or Lift?

Breast augmentation is a cosmetic procedure designed to enlarge breasts while a breast lift is designed to tighten the loose skin of a droopy breast.  Quite often these procedures are performed simultaneously when it is agreed that a breast lift with augmentation is necessary.

Silicone Leakage?

Today’s silicone implants are strong, durable and safe. Technical advancements have come so far, that even if a silicone implant does rupture, the shell of the implant will keep the silicone gel encased and protected from entering the body. In a rare case that a silicone implant does rupture, an MRI may be needed to detect the rupture. Because a rupture may be silent (causes no changes in how the breasts looks or feels) the FDA recommends that patients have an MRI scan 3 years after surgery and every 2 years succeeding the first MRI.  This is less concerning with todays cohesive gel implants since the silicone gel stays within the breast pocket and doesn’t harm the patient in any way.

Implant Replacement?

Implants may last up to 15 years or longer. As long as the implant shows no signs of damage or visible defects, such as breast rippling or a deformity, replacing them is not necessary. What’s necessary, however, is a periodic check of the implants to make sure that they are still intact.

The board-certified plastic surgeons of Sarasota Plastic Surgery Center, Dr. Braun Graham*, Dr. David Mobley*, Dr. Scott Engel*, and Dr. Brian Derby, offer a comprehensive range of cosmetic plastic surgery procedures. All information subject to change. Images may contain models. Individual results may vary. Individual results are not guaranteed.