Breast Augmentation (mammaplasty)

Candidates for Surgery

Candidates for Breast Augmentation (Mammaplasty) arewomen who desire enhancement or restoration to the shape and size of the breasts. The operation is performed to enhance the breast shape and size due to a lack of development, congenital abnormalities, asymmetries or changes following pregnancy, weight loss, or aging. 

Studies indicate that over 90% of women are satisfied with the results of a breast augmentation and the procedure often improves a woman’s self esteem and quality of life. The wishes of our patients vary greatly from patient to patient in terms of size, shape, perkiness, and firmness.  Our goal is to match the right procedure and implant type and placement with your desires. The best results are obtained by Board Certified Plastic Surgeons who have had many years of experience and a dedicated career in Breast Cosmetic and Reconstructive surgery, such as the surgeons at Pacific Center for Plastic Surgery.  Prospective patients should know that the final appearance, shape, and texture are not exactly the same as natural breasts.  They are often more firm and the contours are slightly different than natural breasts – these changes are usually desired by our patients. However, they may be more noticeable in some patients.  The intended result of the procedure is to enhance the shape and size of the breasts to satisfy the patients’ body image desires. 

Both Saline and Silicone breast prostheses (implants) are the best means now available to enlarge the breast through surgery.  The saline implants (silastic bags filled with physiologic salt water) are placed either behind the pectoralis major muscle and breast tissue or in front of the muscle. Your plastic surgeon will determine which placement is best for you, although common guidelines suggest that women with minimal breast tissue should have the implant placed beneath the pectoralis muscle for more soft tissue padding and above the muscle in women with larger drooping (ptosis) breasts that do not want a breast lift

A Breast Augmentation with a saline implant can be placed through an incision 1 ½” to 2” long placed in one of four locations: under the breast by the crease, half way around the areola, the armpit, or through the belly button (umbilicus).

Silicone implants are usually placed through 2 common incisions: under the breast by the crease or half way around the areola.  In some occasions the armpit (axilla) can be used. The scar is slightly longer because the implant is pre-filled when received, whereas a saline implant is filled once inside.

If a lift is required, the incision created, for either saline or silicone implants, would also be used for the augmentation.

The final shape and size of the new breasts are seen several weeks after surgery. 

Anesthetic:  A general anesthetic is most common when the implant is placed under the pectoral muscle.  A local anesthetic with sedation can be used if the implant goes in front of the muscle

Safety of Prostheses: To the best of present medical knowledge the prostheses are made of safe, non-reactive material. They have been used and studied since the 1970’s – in fact, they are the most studied medical devise in the world.  No link to any diseases such as cancer, auto-immune disease, arthritis or other connective tissue disease, etc., has ever been shown and these problems occur at the same rate as a woman without breast surgery.  For example, the incidence of cancer in augmented breasts is the same as that in natural breasts. 

TUBA:  TUBA or the Trans-Umbilical Breast Augmentation is a procedure used to insert the implants without any scars on the breast in a more or less hidden manner.  The surgeon creates an incision inside the naval, or belly button, about an inch in length and then creates a small tunnel towards the breast.  The implant is inserted through the naval, belly button (umbilicus) to the breast and subsequently filled with sterile saline to the desired shape and size.  Most often, a temporary implant is initially inserted to help make the pocket and determine the size of the implant that will be placed in the area.  After each implant is sealed and closed, the endoscope allows the surgeon to examine the surrounding tissue and placement of the implant before closing the incision.  A prime advantage of the TUBA procedure is the incision site in the belly button, naval; the abdominal skin is more elastic than the areola, breast crease, or axillary locations which allows the scar to heal more quickly and inconspicuously.  Additionally, the implants are placed above or below the muscle and an endoscope can be used to directly visualize the implant pocket to make sure there are no problems.  Furthermore, the procedure requires less than an hour of surgical time, involves no breast scars, and uses a single incision for both breasts, thus, reducing anesthesia time, the chance of complications and recovery length.  This method is one of the most common techniques for placing saline implants by Dr Nichter and Horowitz.  

A word of caution: Make sure that the surgeon you choose has extensive experience in this technique and is board certified by the American Board of Plastic Surgery as there is a significant learning curve and there may be an increased risk of complications.

Transaxillary, Armpit Breast Augmentation: Similar to the TUBA procedure, no scars are placed on the breasts, only in the armpits.  An endoscope can also be used to assist in the surgery if required.

Mini-lift:The Mini-Lift is a procedures used to align breasts in conjunction with augmentation.  Oftentimes, patients desiring augmentation require a slight lift to compensate for the new breast size.  The mini-lift offers less scarring than a masteopexy and allows patients to achieve their desired results.

Following the operation, patients should plan to avoid activities that require raising the arms above the level of the head for 10 days after surgery. With great care, patients can drive a day or two after surgery.  Patients can usually return to work in a few days unless their occupation requires strenuous movements and lifting; in such cases, 2-3 weeks should be allowed.

General risks of surgery include infection, pain, delayed would healing, hematoma (a collection of blood at the surgical site), bleeding, hardness of the implant or reactions to anesthetic. The general risks are higher in smokers.