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Breast Augmentation
Introduction
What is breast augmentation?
The breast evaluation
The breast augmentation procedure
Choice of implants
Preparing for surgery
Recovery and healing
Cost of surgery
Introduction
Breast enlargement is the most commonly performed cosmetic operations done in the United States. The original surgical procedure, developed in the mid 1960’s, has been greatly improved and today Dr. Ress is able to offer each patient seeking breast augmentation, an operation specifically customized for each individual patient addressing the issues of improved size, symmetry and shape.
Your breasts should compliment who you are but not define who you are. Dr. Ress’ aesthetic ideal is to create a full look proportionate to hi patient’s overall appearance and body structure, reflecting a healthy vibrant you.
Many women feel that small breast not only limit their fashion choices but result in dissatisfaction with their own body image. Breast enlargement increases fullness and projection of the breasts and can improve a woman’s overall figure making them proportionate and fuller.
The most common reasons women seek breast augmentation are to be able to fill out clothing in a dress, be able to wear a bikini comfortably without being self-conscious, to be able to wear strapless or sleeveless dress and to feel more self confident during intimate relations.
What is breast augmentation?
The Breast augmentation procedure involves surgical placement of an implant behind the breast, typically behind the muscle, to increase the overall size, volume and projection of the breast in order to meet your specific goals of improved increased size and shape. Patient’s seeking Dr. Ress’ expertise in breast augmentation range from young women in their late teens to women in their 60’s. The reasons women seek breast augmentation are straight forward:
- To enlarge naturally small breast.
- To restore, replace and improve upon breast volume, which was lost from pregnancy or significant weight loss.
- To correct size and shape differences between breast when they happen to have been mis-shapend due to hereditary causes.
The best candidates for surgery are women who are healthy, non-smokers and who have a clear picture of what they want to achieve with breast augmentation that is realistic and achievable.
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The breast evaluation.
Dr. Ress takes special care to review how you wish to improve the appearance of your breast. He first takes a full medical history. It is important for you to be candid about how you wish to improve the size and shape of your breast as well as to provide a full medical history including other surgeries, allergies and other medical treatments you have had. Dr. Ress will take specialized measurements of your breast looking for any asymmetries as well as positioning of the nipple and the crease underneath the breast. These measurements help Dr. Ress plan your customized surgery much like a fashion designer does with couture clothing.
Dr. Ress will also ask you about any family history of breast cancer.
Once the examination is complete Dr. Ress will make his treatment recommendations based on your physical examination and the size that you wish to achieve. While each operation is uniquely modified to suit each individual patient, the vast majority of the time, patients will require a straightforward breast augmentation with either silicone or saline type implants alone. Occasionally, due to lower positioning of the nipple, Dr. Ress may recommended that you also have a breast lift procedure done at the same time. ( See breast lift)
The breast augmentation procedure.
The key to breast surgery, whether restoring or enhancing the female breast, is to improve symmetry while enhancing the natural breast, contour and shape. Dr. Ress will evaluate your breast tissue, skin elasticity and upper body dimensions to determine which solution will work best for your needs and cosmetic desires.
Dr. Ress customizes each breast augmentation procedure to each individual patient, taking into account the patient’s overall appearance, height, weight, dress size, current breast size and bra size and breast shape. The various options that are discussed during the pre-operative consultation will be which type of incision to use (under the arm, around the areola or in the crease underneath the breast) the size of implants, type of implants, and the placement of the implant above or below the muscle and whether to perform any additional procedures such as a lift.
Dr. Ress has a unique approach to obtaining the patient’s desired breast size. During surgery he will place a temporary breast implants that can be inflated to various different sizes. Based on the size the patient wishes to get to, Dr. Ress has available to him a wide variety of different sizes and types of implants. Much like picking out the correct size shoe at a boutique shoe store, Dr. Ress will select the best sized implant to achieve your goal.
Dr. Ress is one of the few surgeons in the South Florida area to routinely employ the tran-axillary or underarm incision for most breast augmentation procedures. This incision has the advantage of being located away from the breast and making it difficult for anyone to know that you had breast augmentation by means of visibility of an incision. The other typical incision is a areola incision or one located around the border of the areola’s darker and lighter skin edge.
The breast implant will replace or improve your breast volume. The shape of the breast is largely determined by the shape of the pocket created at the time of surgery. Dr. Ress places breast implants most commonly behind the muscle for a number or reasons. These include preserving the blood supply to the nipple, creating a barrier between the breast implant and tissue making mammography more reliable, and creating more tissue padding above the implant making the implant appear more natural.
The breast augmentation procedure is performed in an accredited operating room, either in an outpatient surgical center or at the hospital. Surgery is performed under general anesthesia for your maximal safety and comfort. The procedure itself lasts approximately 1-2 hours depending on the complexity of the planned surgery.
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Choice of implants.
Breast implants come in different materials, shapes, sizes and textures. The most commonly used implant is a saline implant. This implant has a soft pliable solid silicone shell and is filled with salt water solution in the center. The advantages of these implants is that they are safe and that if they do leak or rupture the saline is absorbed and is eliminated through the kidneys. The new “gummy bear” type silicone gel implants are close to being fully approved by the FDA for regular breast augmentation procedure. These have the advantage of mimicking the natural feel of breast tissue the best. Since the silicone gel is “cohesive” is sticks to itself and there is little to no risk of leakage of silicone into the breast or body should there be a problem with the implant. Generally the cost of the silicone implants is higher than saline implants. Saline implants are more useful when trying to correct asymmetries or significant size or shape differences between uneven breasts.
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Preparing for surgery.
Dr. Ress and his surgical assistant will carefully review your breast augmentation procedure with you at a pre-operative consultation. At that consultation you will receive your instructions on what you should and shouldn’t do before and after surgery, obtain your prescriptions for after surgery and pre-operative photographs will be obtained.
Dr. Ress will also review all the risks, benefits, goals and alternatives to the procedures carefully with you. It is important to have any and all of your questions answered during this consultation. Typical questions that patient’s ask are “what are the risks and complications associated with having breast implants”, “how many operations on my implanted breasts can I expect over my lifetime”, “what size surface texturing, incision site and placement site are recommended for me”, “how will my ability to breast feed will be affected”, “how can I expect my implanted breasts to look over time”, “ how can I expect my implanted breast to look after pregnancy or breast feeding”, “how soon can I resume exercising or have intimate relations following surgery”, “will my breast change size or shape after surgery or after pregnancy”, “what are silicone”, “are silicone implants safe”, “how will breast implants affect mammography”, “do implants influence the occurrence of breast cancer”, “is it possible to have a silicone allergy”, “what is the average life expectancy of an implant”, “can I go to a tanning salon or sun bath if I have implants”, “when can I fly or scuba dive”, “when can I wear an under wire bra”, “will my breast still move like normal breast”, “will getting implants cause stretch marks on my breasts”, “what affect does smoking have on the healing process of surgery”, “will I loose nipple sensation”, “should I be at my ideal weight before I have a breast implant procedure”, “I am over 50 years old, am I too old to get breast implants”, “ what will happen after pregnancy”, “can I still breast feed”.
Recovery and healing.
After surgery you will wear a light support bra or a compressive dressing will be applied. Initial healing may include mild swelling and discomfort at the incision sites and a feeling of being stretched or pulled over the mid chest. This amount of discomfort is generally mild and is controlled with pain medication taken by mouth. Dr. Ress generally recommended his patient’s wear a support bra for a week or two nearly constantly. You may take a shower the next day following surgery but he recommends you not swim in either a pool or the ocean for several weeks.
Most importantly it is crucial not to lift any object over the weight of a coffee cup for several weeks time. This helps prevent the pectoral muscles from squeezing the breast implant into an abnormal position. As the pectoral muscle stretches this restriction is eliminated and you may resume your normal activities and exercise between three to six weeks following surgery. In general stitches are left completely under the skin and dissolve on their own.
Healing continues for several weeks as swelling resolves. The implants generally will settle into the pocket created for them and the swelling within the breast tissue also resolves allowing for a very natural and pleasant appearance.
Cost of surgery.
At the time of your initial consultation you will be quoted a price of Dr. Ress’ fee as well as the fee for the hospital, anesthesiologist and the direct cost of the implants themselves. Fees are due in full at least two weeks prior to surgery and a security deposit will reserve a specific time and date for your surgery.
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