Breast Augmentation with Silicone Implant
Breast augmentation adds volume to the breast with an implant to increase fullness and create better balance with the rest of your figure. Your clothing options will expand enormously and you’ll be comfortable wearing many styles that you were not confident about before the procedure.
There are different types of breast implants available and different approaches for augmentation. You and Dr. Morris will decide the best type of implant and approach for your augmentation after your consultation. Breasts are extremely different from person to person, and certain approaches give better results for some patients.
Small breasts usually result from either lack of development of the breast during puberty or loss of breast fullness following pregnancy.
During pregnancy breast enlargement occurs. This stretches the skin envelope of the breast. When pregnancy and nursing are completed, the tissue within the breast involutes or shrinks, usually to a smaller size than it was originally. The skin however remains slightly stretched and the smaller amount of breast tissue falls to the bottom of the stretched skin envelope. The result is usually a breast with somewhat loose skin, and a lack of fullness in the upper portion.
How much your breasts can be enlarged depends on your tissues and your desires regarding breast size. For example, if you have never been pregnant, and have a very small “A” cup breast, your skin may be very tight. This may limit the size that can be achieved. Remember, you want your breasts to be in proportion to the rest of your body.
At your consultation, Dr. Morris will discuss your preferences regarding breast size, and how you would like your breasts to look. He will ask you what your expectations are, and let you know if they are realistic. After examining you, he will recommend one or two procedures from a range of options that will be best for your breasts to balance with the rest of your figure. He will honor your choice of alternatives if he feels he can achieve an aesthetic breast using your preferences.
Breast implants do not cause breast cancer. Excellent scientific studies indicate that breast cancer occurs in about ten percent of women, regardless of whether they have had a breast augmentation or not.
Breast implants may make a mammogram somewhat more difficult to read. This does not mean that a mammogram can’t be adequately read, simply that the mammograms must be performed and interpreted by someone experienced in the proper techniques. When an implant is present, the breast should be pulled in front of the implant before compressing for a mammogram. This maneuver, combined with additional views if necessary, allows better visualization of the breast tissue. A diagnostic MRI may also be used – it is highly accurate and the implant does not interfere with the study.
During the Surgery
The incision for breast augmentation is placed in the fold beneath the breast, and a very meticulous closure of the incision minimizes the visibility of the scar and maximizes its quality.
In some patients implants are placed behind the breast tissue. In others, the implant may also be placed partially behind the pectoralis muscle on the chest wall. Dr. Morris will discuss the best option for your specific breast type and chest wall anatomy. In either case, your breast tissue is located in front of the implant where it can be readily examined.
After the Surgery
After final implant placement and position is achieved, Dr. Morris will spend time precisely closing your incisions to achieve the best possible result with as minimal a scar as your healing process will allow.
All of your incisions will be carefully closed with sutures placed beneath the skin, so there’s no chance of having “railroad track” type marks but rather, for most individuals, very fine line scars. You’ll be able to shower or bathe the next day if you do not elect to have the ON-Q PainBuster® placed
Following breast augmentation procedures, most patients have mild to moderate discomfort, which is handled well with oral pain medication. Most also experience nuisances such as tightness or fullness, both of which are temporary and resolve in a few days.
We offer the ON-Q® PainBuster® Post-Op Pain Relief System. This system helps reduce postoperative discomfort via a very tiny tube that is placed in the pocket where the breast implant is located, which delivers a constant supply of a local anesthetic solution. The system is in place 3-4 days and the tubes are painlessly removed by the patient at home.
Your breasts will feel rather tight to you for 48-72 hours, and this sensation will gradually resolve over the next several days as the swelling decreases. You may develop slight bruising beneath the breasts a day or two after surgery, which will resolve in about a week.
You will have some discomfort, the degree of which depends on your individual pain tolerance. We will prescribe pain medication to keep you as comfortable as possible. Most patients require medication for only 2-5 days.
The Stages of Recovery
For breast augmentation procedures, the average….
|Bruising and swelling resolve:||3-10 days|
|Return to work, social activity:||1-3 days|
|Aerobic or strenuous activity:||21 days|
We encourage immediate return to almost normal activity except as noted above as soon as you can. Don’t do any type of strenuous or jarring exercise or one that would push your pulse over 100 for about three weeks. Any aerobic activity that increases your pulse over 100 also increases your blood pressure, and could make you bleed. You may be asked to wear a special support bra for several days following the procedure depending on what type of implant is used and if you use the On-Q® System.
Differences always exist between your two breasts – they are different sizes, and the nipple locations are also different. After breast augmentation these differences may be less, but will always exist to some degree.
Breast implants are mechanical devices, which are manufactured to extremely high standards, and we use only those implants which Dr. Morris feels are thoroughly tested. Some patients have had breast implants in place for over 25 years, but no one can specify the life of a breast implant. At some point you may choose or need to have it replaced. With the current improvements in implant technology, we anticipate that for most patients they will last a lifetime.
When any implant is placed in your body, you form a lining or capsule around it. This capsule is similar in some ways to scar tissue and occasionally can shrink or contract. If it contracts markedly and squeezes on your implant, it can distort the implant or make the breast feel too firm. The use of newer, textured implants significantly reduces the likelihood of developing firmness, but so far the risk cannot be totally eliminated since it is the result of your normal healing mechanisms.
Very rarely, the outer shell of a breast implant can break. Usually, this is due to folds occurring with abrasion of the outer shell, and is more likely to follow the development of firmness due to capsular contracture.
In very uncommon instances, the valve mechanism in a saline-filled implant can leak with loss of harmless salt water into the surrounding tissues. Your body then absorbs this fluid. If implant rupture can be confirmed, or is strongly suspected, the implant can be inspected, removed if necessary, and replaced with a new implant.
Fortunately, women over the age of 22 are able to choose standard silicone gel implants for their breast enhancement. These gel implants offer a degree of naturalness not achieved by saline implants in Dr. Morris’ opinion. When a prospective patient holds a saline implant in one hand and a gel in the other, the decision is simple. Dr. Morris will give patients a choice – but virtually all choose silicone. Dr. Morris also offers the Natrelle Style 410 cohesive gel breast implant. This implant has a “teardrop” shape and adds another level of naturalness to the augmented breast. Also, the gel is cohesive – that means that if the outer shell becomes torn, the silicone inside will maintain its shape and will not travel anywhere: it stays in place and in its anatomical shape. Women 22 years of age and older are candidates for this implant.
Risks common to all surgical procedures such as bleeding, infection and scar tissue formation occur in a very small percentage of cases. Bleeding or infection may occur in 1-3% of cases, and may require another procedure for correction. Infection may necessitate temporary implant removal and subsequent replacement. We will give you more detailed information about these and other rare risks during your consultation.