Breast Enlargement Surgery
Cosmetic breast augmentation is a very common request of many women in America today. Much technology has been developed since its first introduction 50-years ago. Breast augmentation can be safely completed by breast implants or the use of fat grafting as defined by Best Practice Guidelines from the American Society of Plastic Surgeons.
The most common method of breast augmentation involves the placement of a breast implant either beneath the pectoralis major muscle (subpectoral) or just beneath the breast tissue itself (subglandular). Subpectoral implant placement is believed to have lower rates of scarring around cosmetic breast implants over time.
Operative times are less than 90-minutes in an outpatient setting typically under general anesthesia. Patients are encouraged not lift objects greater than 5-pounds for six weeks post operatively with most returning to work within one week after surgery.
A variety of incisions can be used to place breast implants for augmentation. Smaller incisions can be used for saline filled devices versus silicone filled devices. Incisions may be placed either at the juncture of the areola or at the level of the inframammary fold. Incisions in the axilla are avoided given concern for possible future breast cancer risk and the need for an axillary sentinel lymph node procedure in that setting. Incisions at the level of the umbilicus (belly button) are limited to saline-filled devices.
We offer expertise with a variety of implant types, and with several implant production companies including Mentor, Allergan and Sientra:
- Round & Anatomic (Natural Sloped) Shapes
- Smooth & Textured External Shells
- Saline & Silicone Fill Materials
- Low Crosslinked Silicone & Cohesive Silicone Gel (“Gummy Bear”) Implants
- Traditional & High Projection Profiles
Breast augmentation surgery is an elective cosmetic intervention not covered by health insurance. Reconstructive implant placement for contra-lateral symmetry is a covered benefit for women requiring mastectomy in the setting of breast cancer care.
Common complications associated with implant breast augmentation include scaring around the implant over time, infection, pain, device rupture and malposition. These complications often require unplanned surgical interventions – additional surgeries typically not covered by health insurance.
Textured breast implants have been associated with the development of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and as such, are rarely used in our practice at this time.
It is important to remember that breast implants are medical devices that do not last a lifetime. Breast augmentation implants require replacement as the devices may fail therefore resulting in a breast deformity or systemic exposure to silicone. Silicone gel implants can be monitored for “silent rupture” by serial breast MRI examinations. It is important to inform your mammography technician of your breast implant surgery such that accommodations may be made to ensure adequate imaging.
Autologous fat graft augmentation has emerged as a natural means to approach breast enlargement. Fat is harvested using liposuction through several 2 mm incisions either in the abdominal wall, lateral or medial thighs, medial lower legs, flanks or posterior trunk. Fat is then transferred to the breast using a blunt-tipped needle. Patients are encouraged to protect the breasts from direct pressure for 6-weeks after surgery. Most patients return to work within several days depending on the level of physical activity required. Patients are followed post operatively through routine screen mammography as is recommended by the American Cancer Society.
Dr. Marga would be pleased to address all of your concerns regarding implant-based and fat grafting breast augmentation in the setting of an in-person consultation in the Charleston Office adjacent to the downtown Roper St Francis Hospital.