Posts Tagged ‘breast augmentation’

What Every Woman Considering Breast Augmentation Should Know

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Breast augmentation is one of the most popular cosmetic surgery procedures worldwide. In the United States, it is second to liposuction in popularity with approximately 300,000 women undergoing breast enlargement each year. The results of breast augmentation are immediately apparent and the patient satisfaction rates are very high. However, as with any cosmetic procedure, there can be problems. I have pulled together a list of information every woman should know when considering breast augmentation. This will help prepare you when making the decision, as well as help to avoid any surprises along the away.

  • Breast implants are not permanent. All implants will eventually leak and have to be replaced. The typical lifespan is 15 to 20 years, although I have seen many last beyond 25 years.
  • The procedure is not maintenance free. There is a risk of “capsular contracture” or hardening of the breast if scar tissue builds up around the implant. This may necessitate further surgery to soften the breast.
  • There are differences between saline filled and gel filled implants. Although the outer shells are similar, saline implants are filled with saline after they are placed under the breast. Gel implants are filled with silicone gel by the manufacturer. Saline implants cost less and may have a less “natural” feel. In general, gel implants result in a more natural feel and appearance, especially in thinner women. Leaks are easier to detect with saline than with gel.
  • The current “5th generation” of gel implants, some of which are known as “Cohesive Gel”, “Gummy Bear” or “Form Stable”, are superior to previous gel implants.
  • Beyond saline or gel there are other options to include when choosing an implant – a smooth or textured surface implant, a shaped or round implant. Each one actually has a purpose. Your surgeon will be able to discuss the differences with you, and make a recommendation based on your individual anatomy, breast shape and size.
  • Scarring will result. There are four “scar” options for placement of the implant – these include incisions in the armpit, around the nipple, in the crease below the breast and even through the belly button. Your surgeon will be able to suggest which incision is best suited to your breast.
  • Breast implants can be placed over or under the chest muscle (pectoralis major). Generally in thin women the placement under the muscle is best, as it adds a layer of the muscle as cover over the implant. Your surgeon will be able to discuss placement with you as recommendations for location are best made on an individual basis.
  • Breast implants will not affect your ability to breastfeed.
  • Breast implants may obscure small parts of the breast on mammography. This is less so when the implants are placed under the muscle.
  • After age 40, a mammogram is advisable prior to breast augmentation.

If you are considering breast surgery, come in for a complimentary consultation with one of the board certified cosmetic surgeons of the Emory Aesthetic Center. We can help you define your goals and determine what would be best for you and your desires.

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About Dr. Nahai

Foad Nahai, MDFoad Nahai, MD, FACS is internationally recognized as an innovator in the field of plastic surgery where he has developed and refined many procedures. He has co-authored ten books and published over 190 scientific articles on all aspects of plastic surgery. The latest book he authored and edited, published in 2011, is the second edition of his three volume text entitled The Art of Aesthetic Surgery.

He has been invited to lecture and demonstrate plastic surgical procedures all over the world. In addition to numerous professional honors and awards, he is listed in the “Best Doctors in America”, the “Best Doctors in the U.S.”, Town & Country Magazine, Good Housekeeping, More Magazine and Atlanta Magazine as one of the country’s top plastic surgeons. He has been listed in W Magazine as one of the top plastic surgeons in the world. Dr. Nahai is in demand internationally to speak at plastic surgery meetings and to demonstrate surgical procedures.

Dr. Nahai served as the 2008-2010 president of the International Society of Aesthetic Plastic Surgery (ISAPS), he is a past president of the American Society of Aesthetic Plastic Surgery (ASAPS), a former director of the American Board of Plastic Surgery, and is currently Editor-in-Chief of Aesthetic Surgery Journal.

His primary area of expertise is in Face, Neck and Eyelid surgery where he has made significant contributions to the advancement of the art and science of Facial Rejuvenation.

Ask the Doctor: Breast Augmentation Surgery & Recovery

Breast AugmentationOK ladies, if you’re reading this blog, most likely, you have been thinking about or at one point have thought about breast surgery. Maybe you’ve even seen a physician for consultation. And maybe the only thing stopping you from having your breast surgery is the concern about your recovery. Let me review what to expect after breast augmentation surgery to help you decide if it is the right time for you.

Breast augmentation surgery is a very popular procedure, and one of the reasons for that is the fast recovery time. The procedure takes about an hour to perform under general anesthesia. It is considered an outpatient procedure because it does not require you to stay overnight in the hospital. Immediately after surgery, you may have some nausea as the anesthesia wears off, but you are treated with medications to prevent this from becoming a major issue. You will not be discharged from the facility until you are feeling well enough to leave and your pain is under control.

These days breast augmentation can be done in a variety of ways, and each of these techniques can affect the necessary recovery. Augmentation can be done with either implants or fat retrieved by liposuction. Implants can be placed above the muscle (sub glandular) or below the muscle (sub pectoral). Having the implants placed below the muscle typically has the longest recovery time, though usually only by a few days. What works well for some of my patients is having surgery on a Thursday or a Friday, and then taking the following week off of work to recover.

As you consider your recovery, it is a good idea to take into account your job requirements or your daily routine. If you have a very physical job, more than a week may be needed for recovery. Similarly, if you are running around after small children, extra hands to help will be appreciated for a longer duration.

As far as returning to exercise, it is reasonable to take walks or ride a bike about a week after surgery. I would wait at least 2 weeks to begin any rigorous exercise routine. You will likely still be sore and won’t want to do it anyhow.

Finally, I caution you not to go out and buy new super pretty bras immediately after surgery. It will be tempting, trust me. After surgery, we provide a supportive bra for comfort. There will be weeks of swelling, and your final breast size will generally result 4-6weeks after surgery. Your physician can guide you during the recovery period as to when it would be a good time to invest in nice ones. What to do with all your gently worn bras that no longer fit? Consider donating them to a worthy cause. Visit www.breastoasis.org for information.

I hope this brief review helps in your decision to undergo breast augmentation surgery. If you have additional questions or would like to be evaluated by one of the board-certified cosmetic surgeons at the Emory Aesthetic Center, call us for a complimentary consultation to determine what would be best for you and your desires.

About Dr. Anderson

Erica Anderson, MDErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

Breast Implants with a Breast Lift: Do You Really Need Both?

Decide on Breast LiftThroughout the years plastic surgeons have often had strong opinions about when to do a breast lift alone, when to just put in breast implants, and when to do both. In addition to this, over the past several years there have been new developments in breast augmentation surgery, including short scar breast lifts (or mastopexy), fat grafting, and new breast implant options. These have provided surgeons with even more tools to help patients obtain more youthful, uplifted breasts. If you look in the mirror and you don’t like what you see – perhaps the breasts have become droopy after children or weight loss, or they just seem to have deflated after breastfeeding – there are now more options than ever before. But how do you know what is right for you – breast implants, a breast lift, or both?

Every surgeon has a different way of guiding patients through these options, but the first, most critical step is to really understand what your goals are. Patients may come in for a consultation saying something like “I’m not sure what I want, really. I just know I don’t like the way my breasts look now. I want to look fuller up top, but I don’t want to be too big either, and I want to look natural.” This is very helpful; however, it doesn’t answer the question about a lift, an implant, or both. Separating a lift or implants in your mind can bring a lot of clarity. One way to do this is to simply hold your breast up (replicating a lift) so that the breast is no longer in a low hanging position. This is something your surgeon can do for you during your consultation, or you can even do at home in front of the mirror. This will help you get a sense of your actual breast volume without an implant. If you like the relative size when the breast is manually lifted up, then you may be a great candidate for a breast lift alone. On the other hand, if the breasts are held up and the size just doesn’t give you what you want, then you need to think about breast implants, either with or without a lift.

To figure out this part, you’ll want to rely heavily on the judgment of your surgeon, who will make some measurements of the breast and note the degree of ptosis, or droopiness. If there is very little ptosis, then an implant alone (without a lift) will probably serve you very well. If the ptosis is severe, then putting in an implant alone will not look right, as the breast will appear to “fall off” of the implant. Therefore, a breast lift would be needed in addition to the implant. Not infrequently, however, a patient may lie in a gray zone somewhere in between: in these cases an implant alone may suffice, however will give a more mature or slightly low hanging appearance. The decision then becomes one of personal preference. If you feel that getting the breast as “perky” as possible is important, then a lift in addition to the implant is in order. If you feel that a more mature look is desirable, then you can forgo the lift and the additional scars that are required.

Of course there are advantages and disadvantages of each of the options – a lift alone, a lift with implants, or implants alone. Implants alone typically have the shortest scar, but have only a limited effect in making the breast look more uplifted. When implants are placed there is also the risk that the implants may become mal-positioned, may become encapsulated (firm with scar), or may need to be replaced, all of which may require additional surgeries in the future. A lift alone typically produces longer scars; however, it doesn’t carry the implant-related risks for additional surgery. A combined implant-lift provides control over both breast size and shape, but it also produces both the longer scars and the risk of additional “maintenance” surgeries related to implants. The differences in recovery between these options are usually small, and most women feel they can return to work in about a week after any of these options.

The surgeons at the Emory Aesthetic Center are experts in helping you think through all your options. We use the most up-to-date techniques, implants, imaging systems, and adjunct therapies (like scar therapy) to help you achieve the results that you want. We’ll take the time to thoroughly explore your goals and get a deep understanding of your desires. At the same time, we will work hard to make sure you really understand what options will give you the best results in the long run.

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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Understanding Breast Augmentation Revision Surgery

Breast Augmentation Revision SurgeryStudies show that the vast majority of women are satisfied with the results of their breast augmentation surgery. Women report that the decision to enhance their breasts was a positive process and they would recommend it to others. There are times however, that patients may not achieve the results they were expecting. And more often, as bodies alter with weight loss, gain or pregnancy, the result changes such that a patient may want a revision. There are even cases when implants become hard and painful that women look for alternative solutions. Whatever the reason, physicians at the Emory Aesthetic Center can help you explore your options for breast augmentation revision surgery. Let’s consider some common scenarios to help guide your decision making process.

Scenario 1: You recently had a breast augmentation and you think the size is wrong. Is it too big or do you wish you had gone bigger? Either way, make sure you do not decide too quickly. Allow time for swelling to subside and implants to settle. Allow time for you to incorporate these changes into your body image. If at approximately 6months after surgery you still are unsatisfied, it is reasonable to consider an exchange of implants to better match your desired size. Implant exchange is relatively straightforward and recovery time is minimal, typically less than the recovery of the initial surgery.

Scenario 2: You have been happy with your saline implants but you have a friend with silicone gel implants that feel much more like natural breasts. An exchange from saline to gel can be done with relative ease, particularly if your overall size and shape remains acceptable to you. Recovery time in this case is also minimal.

Scenario 3: Your body has changed after pregnancy and the breasts do not look as they did when they were first enhanced. Sometimes in this case, decisions need to be made about the implants. If you are happy with overall volume, a breast lift – also known as a mastopexy – can be done leaving the implants in place to correct the droop but maintain the volume. If the size of the breasts is now too large, the implants can be removed and a breast lift performed. Alternatively, if you have lost volume in your breasts, implants can be exchanged for larger ones and a lift can also be done to correct the shape. Recovery from a mastopexy combined with changes to implants can be slightly longer than the cases mentioned above.

Scenario 4: There is a progressive hardening to the breasts that has become painful. You are likely experiencing capsular contracture. Though it is reasonable to be concerned about this process, it does not generally cause any significant health problems and it can be fixed. In these cases, the implants and the scar tissue are removed. When replacing the implant, the location is typically changed, i.e. from below the muscle to above or vice versa. Additional materials, such as biologic mesh (e.g. Strattice) can also be used in difficult cases to help prevent recurrence of the problem.

As you can see, there are many reasons for revisional breast augmentation surgery. The basic approach involves identifying the issue and then creating a surgical care plan that addresses the problem. The answer may be a simple solution of implant exchange with little recovery and downtime. Or the solution may be more complicated requiring a breast lift with conversion of the implants. Either way, the surgeons at the Emory Aesthetic Center can help guide your decision process and make breast augmentation revision surgery a success for you. Come in today for a consultation to determine what approach is best for you.

About Dr. Anderson

Erica Anderson, MDErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.