Breast Augmentation

The decision to consider breast enhancement with implants is sometimes quite easy but often more complex.  The fun part is the immediate resulting fullness and shape that boosts confidence both in and out of clothes, allowing for a more proportional figure.  Getting there requires getting to know your history, lifestyle, and goals.  We will look at different options and discuss what to expect and what choices will work best to achieve your desired results.  Whether you are a single 23 year old seeking volume that just never developed or a 45 year old mom who loved your size while breastfeeding but feels deflated and wants that perky fullness back, together we will make a plan that suits your needs and delivers results that you will love!

During the consultation we will discuss the important details of incision location, placement of the implant over or under the chest muscle, desired implant profile, and perhaps most importantly, what type of implant.

Implant Choice

All implants currently available in the United States are silicone shells filled with either saline or silicone gel.

Silicone Filled

Silicone gel has evolved through many generations of cohesiveness over the years, and the current generation of implants is available in structures with less chance of rupture than earlier generations.  These implants are soft in feel and for that reason are more often used in breast reconstruction.  If the shell breaks (‘ruptures”), the gel most often tends to stay within the shell rather than leak out of the shell.  Usually there are no obvious clinical signs of rupture, known as the phenomenon of silent rupture. You may not be able to tell if your silicone implant is ruptured. For that reason, the FDA currently recommends screening with MRI at 3 years post op and every other year thereafter for all patients with silicone gel breast implants, in addition to routine yearly screening mammograms for patients over age 40 with silicone gel breast implants.

Saline Filled

Saline (salt water) implants are filled with the same fluid often used in intravenous fluids.  They are an economical choice and reasonable for those with a moderate amount of native breast tissue to camouflage the implant.  Saline implants can be filled within a range of volumes, which is a useful feature for those patients with minor asymmetry.  If the shell breaks, the saline leaks out and is absorbed safely by the body, causing a deflation that is usually quite obvious.

Structured Saline Filled (Ideal Implant TM)

An implant choice that bridges the gap between silicone and saline, the structured saline implant is constructed of multiple silicone shells filled with saline.  This allows for a softer feel than most standard saline implants but does not require MRI to monitor for rupture.  If the shell breaks, the saline leaks out and is absorbed by the body in the same way as is seen with standard saline filled implants.

Incision Locations

Several options are available for placement of breast implants, including inframammary, periareolar, and transaxillary. 

Because data has shown the increased chances of requiring revision surgery at some point following implant placement and due to the increased risks of complications with other approaches, Dr. Owens recommends using an inframammary incision (within the breast fold) in most cases. 

What Problems Can Happen With Breast Implants?

Rupture is the term used to describe a break in the shell of the implant.  It sounds very dramatic, but in reality is most often the result of normal wear and tear on the implant from motion causing folding of the implant shell.  Rarely a trauma can result in rupture.  Depending on the type of implant, the device may either deflate (if saline filled) or there may be no obvious change (if silicone filled).  If an implant is known to be ruptured, it should be replaced.  Rupture happens rarely overall, ranging from 2%-14% over 8 year data depending on the implant type.

Capsular Contracture happens more frequently than rupture, and is thought to be multifactorial.  Risk is higher when implants are placed above the muscle (subglandular), or through axillary or periareolar incisions.  Capsular contracture has been linked to low grade bacterial contamination or biofilm formation, so Dr. Owens incorporates several steps during surgery to decrease this risk as much as possible.

Because of the known device-related risks of rupture and capsular contracture, implants are not expected to be lifetime devices and you should be prepared that there will be a need for additional surgeries over your lifetime if considering breast implant surgery.

During your consultation Dr. Owens will fully review other possible risks and tradeoffs of breast augmentation so that you can make an informed and safe decision that you are comfortable with.

Preparing For Breast Augmentation Surgery

Please avoid taking Advil, Aleve, aspirin, ibuprofen, Motrin, and Naprosyn for two weeks prior to your surgery. High dose vitamins and herbal medications should also be avoided. Most other medications that you take regularly can be taken before your procedure. It is especially important if you are prescribed blood pressure medication to take that as normal so that your blood pressure remains controlled during surgery.  You will receive prescriptions for your post op meds at your pre-surgical appointment and we recommend you fill those and have available at home for immediately following surgery.

Your breast augmentation will be performed at one of the outpatient surgery centers where Dr. Owens holds privileges. Be sure to have someone available to drive you home and stay with you for at least the first 24 hours, as you will be drowsy from the anesthesia and may need assistance with personal care in the first day or two after surgery.

Your Breast Augmentation Surgery

Breast augmentation surgery typically takes about 1 ½ hours and is performed under general anesthesia.  You will be instructed not to eat or drink anything for at least 8 hours prior to surgery, and you will be asked to arrive an hour or two early so that the surgery center staff can get you prepared.  Dr. Owens will see you before the procedure to answer any last minute questions and mark you for surgery.  When you wake up in recovery you will be dressed in a supportive bra and your new figure will be immediately obvious! Ice packs and medications will be used to control any post-operative discomfort, and you will be sent home with instructions for care and activity limitations.

Recovery From Breast Augmentation

You will be instructed to wear your surgical bra for support day and night for a few weeks. Drains are not usually necessary after breast augmentation, and you may shower beginning the day after surgery.

Some bruising, swelling, soreness, tightness, and itching are normal after breast augmentation. You will notice glue or paper tape strips on the incision sites, which will come off over time.  Leave this cover in place, as it protects the incision during early healing. You can take medication, if necessary, to ease discomfort. These symptoms will gradually subside during the first 7-10 days. As a result, most patients take 1 week off from work to recover, and it is best if you don’t drive for the first week after surgery. Please avoid heavy lifting and strenuous activity for 6 weeks.

We will give you instructions for massaging the scars to reduce scar tissue, redness, and swelling. You will love the immediate fullness you see, but remember that it does take about 6-12 weeks to see things settle to a more stable result.  

Revision Procedures/Implant Ruptures

If you have had a complication from a previous breast augmentation, such as a rupture, infection, or capsular contracture, Dr. Owens has extensive experience in managing these issues. Care usually involves removal of the current implants and replacing them with new implants, and Dr. Owens will lead a comprehensive discussion of all options, including removal without replacement or possible breast lift.

Call to schedule your consultation with Dr. Owens today, and find out how breast augmentation at Avalon Plastic Surgery can help you feel more self-confident.