Breast augmentation is one of the most common cosmetic operations performed today. Some women who seek breast augmentation have small breasts and want to balance out their figures. Others have lost breast tissue through aging or childbirth, and some would like to correct breast asymmetry which may be congenital.
Implants can be placed above or below the muscle. Placement is based on several factors: the appearance of your breasts at the time of the consultation, the size of the implant to be used, and desired/expected result. In a sub-glandular placement, the implant is placed over the pectoral muscle and under the breast tissue. This provides for a shorter recovery, but since it is closer to the surface, there is a greater chance that the implant will be more visible under the breast tissue. With sub-muscular placement, the implant is place below both the pectoral muscle and the overlying breast tissue. This area offers less risk of implant visibility and hardened scar tissue around the implant [capsular contracture] and less interference for future mammography. This implant placement requires a slightly longer recovery time to accommodate the stretching of the muscle.
Special consideration is taken in selecting the size of the implant. Since the implants come in measurements of volume [cc’s], not cup sizes, Dr. Barlow has samples/sizers available in the office so you can try several on to see which provides the best fit.
Dr. Barlow uses both saline and silicone implants. Saline implants have been FDA-approved since 1992. They can be pre-filled to a specific size or filled at the time of placement, which has the advantage of allowing smaller incisions to insert the implant and minor size adjustments are made during placement. If a saline-filled implant leaks or ruptures, it is readily noticeable because breast volume will diminish rapidly. The saline is completely absorbed by the body and naturally eliminated. Saline implants can feel firmer than natural breast tissue, particularly if they are filled to shell capacity. Silicone implants can be used in limited situations. These implants come pre-filled and require a slightly larger incision. Although FDA approval is still pending, these implants are a possibility if the patient meets certain criteria and agrees to participate in an on-going study.
There are two main incisions that Dr. Barlow uses: peri-areolar and inframmatory. The peri-areolar incision is made around the areola outside the edge of the nipple. This incision is usually made around the inferior or lower part of the areola skin where it joins with breast skin. When this incision heals there will be a fine white line that is hard to detect upon exam. The inframmatory incision is made in the fold under the breast tissue. This incision gives the best access to the breast tissue. When it heals well this incision will be a fine line that is hard to detect upon exam. It is hidden unless you show someone.
Breast augmentation is performed under general anesthesia in the ambulatory surgery center of Fairfax Hospital, or at Woodburn Surgery Center. All anesthesiologists are board certified. The procedure usually takes about an hour to an hour and a half.
Recovery time for the procedure varies per patient. You will be up and walking around the day of surgery, but will need a responsible adult to care for you and monitor your condition for at least 24 hours. Generally, you can remove the dressings and go into a non-underwire sports bra several days after the procedure, as well as shower. Most people are able to return to work within a week [performing non-physical tasks] and return to light exercising after 3-4 weeks. Scars begin to fade within four to six weeks. A lot of this recovery time is based on personal comfort level.
