What is breast augmentation?

An office visit/consultation is mandatory prior to scheduling the procedure. The following information is based on a breast augmentation procedure only. During the consultation we may determine that other procedures are better suited for your optimal outcome. Implant size is a complex decision process determined based on your desires, anatomy, practicality, availablility, picture review (i.e., Nicole's site), etc. This is usually determined at the time of the initial consultation but may need to be adjusted intra-operatively. As of November of 2006, women over the age of 22 years old are eligible to receive silicone breast implants under the guidelines established by the FDA. This requires you to review and complete prepared materials and informational brochures. Surgery is about 1-2 hours but the entire process takes about five hours and is performed on an outpatient basis. I generally prefer smooth implants placed under the muscle using an incision around the areola or under the breast.

Although I was trained using the axillary incision (armpit), in my experience I generally do not use it because:

1) If the scar is bad it is very visible in a t-shirt or bikini whereas a breast scar is not,

2) There is more bruising and

3) There is a higher risk of asymmetry.

The TUBA (transumbilical approach) is attractive because of the location of the scar but it is generally used to place implants in the subglandular (not submuscular) position and I prefer the submuscular approach. I have found that the submuscular location results in:

1)More tissue covering the implant for a more natural look 

2) Improved mammograms when compared to the subglandular implants and

3) Decreased rate of capsular contracture.

I reserve the textured implants for patients with capsular contracture or in patients with significant breast tissue and ptosis requiring a subglandular placement. Anatomic implants may sound sexy but they are textured (and more likely to be palpable); they have also rotated resulting in an abnormal look. I generally avoid these but use them for breast reconstruction.