General Procedure Information
Breast augmentation surgery is one of the most popular cosmetic procedures, and there are many different reasons why women chose to have this procedure. Some women may simply feel nature has “short-changed” them, and feel they would be more self-confident with a larger breasts. Alternatively, some women may have had children and want to restore fullness that was lost after pregnancy. The goals of a breast augmentation vary from patient to patient. Some patients want a very natural, subtle result, while others are aiming for a rounder, fuller look.
There are many types, shapes, and sizes of implants to choose from. Firstly, patients should think about what type of implant they would like: saline or silicone. Both implants are FDA approved and each have pros and cons. Dr. Breister Ghosh actually served as an investigator in an FDA-approved clinical study of silicone breast implants. The main advantage of silicone implants is that they have a softer, more natural feel when compared with saline. While it is relatively uncommon, there is a risk of implant rupture in both saline and silicone implants. When a saline implant leaks or ruptures, the breast will deflate, making it apparent that the implant has ruptured. With silicone implants, ruptures are often not noticed right away, and may need to be evaluated by MRI to detect a problem.
After deciding on the type of implant, patients can start thinking about the shape and size of implant they might like. Dr. Breister Ghosh thoroughly discusses the benefits and drawbacks of each type of implant, and uses her years of extensive training and experience to help patients choose the right shape and size of implant to reach their personal goals.
About the Surgery
The Procedure Incisions can be made either around the border of the areolas (periareolar) or underneath breasts in the inframammary crease. Next, a pocket is made either above (subglandular) or below (submuscular) the pectoral muscle for the implant to be placed in.
Submuscular essentially means that the implant is placed in a pocket under the pectoralis muscle. This location is generally acknowledged as the gold standard for breast augmentations. Having the implant under the muscle provides an extra layer of coverage which can create to a more natural look. Also it should be noted that there is a slightly, lesser degree of capsular contracture in the submuscular position.
There are some instances, however, where a subglandular position is chosen, and the implants are placed between the breast tissue and the chest muscle. This placement may be selected if the woman has an adequate amount of subcutaneous tissue to cover the implant, or possibly in other instances where the patient has ptosis and a double bubble type breast phenomenon.
After the implants are placed in the appropriate position, Dr. Breister Ghosh checks the breasts for symmetry before closing the incisions. Once she is satisfied with the results, incisions are meticulously closed in layers.
Procedure Length Approximately 1.5-2 hours under general anesthesia.
Surgery Location Accredited, outpatient surgical facility with the support of a board-certified anesthesiologist.
Recovery A compression bra is placed on the patient after surgery to provide support and help resolve swelling quicker. Sometimes a bandeau is placed as well to encourage the implants to drop. The support bra is worn for at least four weeks. During this time, patients should not exercise. Patients should talk with Dr. Breister Ghosh about the physical demands of their job, but should usually plan for around 5 days off work. Dr. Breister Ghosh follows up with patients for at least four months to ensure adequate healing with no hypertrophic scarring or development of capsular contracture.
Duration of Results Breast implants (both saline and silicone) are usually not lifetime devices. This means there is a possibility a patient will require another breast surgery in the future to remove or replace their implants. On the other hand, unless a patient is having problems or concerns with their breast implants, it is not necessary to undergo another breast surgery. It is a myth that implants must be replaced every 10 years.
A complication that should be mentioned is capsular contracture. Capsular contracture is essentially the body's formation of a scar around the implant. Every woman forms a scar around the implant; some scarring remains soft and thin, while others can become hard and firm. If that scar becomes hard and firm, it is considered a symptomatic capsule. If it is causing asymmetry in the breasts or pain, then possible surgical removal of the scar should be investigated. Surgical removal consists of going to the operating room and either incising the capsule or removing it. It is unknown why capsules form. Some theories are that there could be some blood in the pocket or possibly a small amount of bacteria. There is no guarantee that a capsule will not reoccur.