Breast Augmentation
Located in Kirkland, WA to serve the Eastside Seattle area
Am I a Good Candidate for Breast Augmentation?
Breast augmentation is usually sought by patients who never had full breasts or who have experienced a loss of volume of their breasts with aging, breastfeeding, or weight loss. Asymmetry and congenital deformities of the breasts can also be corrected with implants. This is a commonly performed procedure that is requested for a variety of personal reasons.
What Should I Know About Breast Augmentation?
Types of Implants
The first differentiation between breast implants is the fill material, which can either be saline or silicone gel. Both options have a silastic, silicone shell, but saline implants are filled with salt water (the same substance in IV fluids), while silicone implants are filled with a cohesive gel. The advantage of saline implants is that detecting a leak/rupture is easier, as the body reabsorbs the fluid. Silicone implants, by the numbers, are much more popular due to their more natural feel and less detectable rippling.
Implant Surface and Shapes
The shell of a breast implant can either be smooth or textured. At one time, textured implants were favored because the slightly rough, irregular shell helped the implant stay in place and reduced the incidence of capsular contracture. However, certain rare complications have been associated with textured implants, and plastic surgeons have mostly shifted to using smooth implants. The shape of the implant can be round or “anatomic” – meaning that it is teardrop shaped and provides more projection at the lower pole of the breast. The downside of these implants is that they are only textured, in order to prevent rotation within the pocket.
Implant Location
Breast implants are typically placed below the pectoralis major muscle (subpectoral or “dual plane”) or above the muscle (prepectoral or subglandular). There are distinct advantages and disadvantages to both options. Subpectoral placement makes it more difficult to feel the implant, provides a smoother transition at the upper pole, reduces the chance of visible rippling and capsular contracture, and can facilitate mammography. The disadvantage is that the recovery may be more uncomfortable and “animation” may occur, where a slight distortion of the breasts results when the pectoralis major muscle is contracted. Prepectoral placement has the advantage in that recovery can be more comfortable, however, the implants may be more visible or able to be felt.
Incision Location
The scar pattern depends on your anatomy, previous procedures, and whether or not a breast lift (mastopexy) is recommended. A common approach is with a short, inframammary scar, located where the natural breast crease meets the chest wall. This scar heals well and gives excellent visualization of the implant pocket. Another choice is a peri-areolar incision, located along the bottom half of the areola. Finally, if a breast lift is to be performed simultaneously, the augmentation can often be performed through these incisions.
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Surgical Details
Breast augmentation is usually performed under general anesthesia and takes one to two hours to complete. The incision used typically is either at the inframammary fold or along the underside of the areola. The implant pocket is precisely created and after antibiotic irrigation of the tissue, the device is placed using a minimal-touch technique to reduce the chance of infection and capsular contracture. Absorbable sutures (which do not need to be removed) are used to close the incision.
Consultation Process
Dr. Austin Remington and Dr. Brad Remington are thoughtful plastic surgeons who involve their patients in the decision-making process. There is a lot to learn about if you are considering having breast implants! Your consultation will be very educational. You will have a customized treatment plan developed, go through a sizing process, and review important details regarding what you can expect following surgery. In some cases, a breast augmentation may need to be combined with a breast lift (mastopexy) to appropriately position the nipple on the breast mound.
Recovery and Results
Recovery following breast augmentation is relatively straightforward. There is a lot of marketing about “rapid recovery” – what matters is precise pocket dissection, long-acting local anesthesia, and appropriate postoperative guidelines. You can resume light activity on the day after surgery. Heavy lifting and strenuous activity usually can be started after two to three weeks. A surgical support bra will be important to minimize swelling. The final result may take several months to fully appreciate, particularly if the muscle needs time to relax.