Breast Augmentation Breast Augmentation, also known as Breast Enlargement or Augmentation Mammoplasty, is a surgical procedure designed to add volume, form, and symmetry to the chest. Using either saline or silicone implants, breast implants can dramatically improve the shape and size of the chest. Breast Augmentation continues to be the most popular cosmetic surgery procedure performed in the United States. Despite the stereotypes associated with Breast Augmentation, there are many different reasons women seek implants. The one things that all women inquiring about Breast Augmentation procedures have in common is the desire for an aesthetically pleasing figure, with breast proportionate to their body type. Top Reasons for Breast Augmentation: Small, misshapen breasts Asymmetrical breasts (one larger than the other) Lost breast volume lost after childbirth/breast feeding Loss of breast shape after a dramatic weight loss Depletion of chest volume due to normal aging process Poorly fitting t-shirts, blouses, swimwear Less than optimal results from a previous breast augmentation Low confidence and self-esteem due to body image Lack of a proportionate figure Who makes an ideal candidate for Breast Augmentation? Any woman frustrated with the size and shape of her breasts may make a good candidate for this procedure. Ladies with a chest proportionate to their build, breasts different in size from each other, or who are experiencing a natural decrease in breast volume can benefit from an augmentation procedure. Excellent results are seen in patients of any age, including patients ages eighteen and older. As with all cosmetic surgery patients, women should be in generally good health, and have realistic expectations for their upcoming breast enhancement procedure. The first steps towards having a Breast Augmentation: Patients considering augmentation surgery should begin by doing extensive research. Start exploring the benefits, risks, and recovery time expected for this procedure, as well the various implant options available. Excellent resources can be found on the Internet. If a breast enlargement still sounds like the right procedure, patients should schedule a consultation appointment with Dr. Lohner. The surgeon will use the initial appointment as a time to get to know the needs and desires of an individual patient. Dr. Lohner will review the medical history and do a brief physical examination. This consultation is the perfect opportunity to ask any questions you may have after researching the procedure on your own. After explaining the procedure, the techniques available, and the recovery commitment, Dr. Lohner will help the patient visualize the results. If this is the right procedure for you, a unique surgical plan will be developed. Preparing for an Mammoplasty surgery: Once the surgery has been scheduled, it will be time to prepare for the procedure. A patient should carefully read all pre-operative and post-operative instructions given by Dr. Lohner. Patients should also keep the following tips in mind for a smooth surgical procedure and stress-free recovery period: 1. Ask questions Do not be afraid to ask any question. Contact Lohner Plastic Surgery immediately, if you have any questions or concerns. 2. Pick up prescriptions prior It is best to pick up your pain medications prior to your surgery. These should be on hand to start immediately after your procedure. 3. Schedule transportation A ride home is required after your surgical procedure. Arrange transportation assistance from the surgical center, as well as for all follow-up appointments, if necessary. 4. Buy supplies Gather books, magazines, extra pillows, icepacks, and simple foods to have on hand after surgery. This will ensure a smooth, peaceful recovery. 5. Take time off Appropriate recovery time is necessary for proper healing. Take the recommended amount of time off from work or school, allowing plenty of time for rest and relaxation. 6. Gather important numbers in a central location In case of an emergency, or any questions you may have for Dr. Lohner and his staff, collect all important phone numbers, and insurance cards in an easily accessible location. Share this location with whomever is assisting you during your recovery time. 7. Mark the calendar Get the follow-up appointments scheduled, so appropriate time can be taken off from work. Do not put off these important checkups with Dr. Lohner, as they are vital to your recovery. 8. Arrange for assistance Have a close friend or family member stop by daily, to assist with minor chores or to prepare a meal. It is common for patients to be sore and tired the first couple days after surgery; the extra help will be greatly appreciated. 9. Know what to tell others People close to you will know something has changed, either during the recovery or once the results become apparent. Be prepared with an explanation, when needed. 10. Relax Dr. Lohner will walk patients through your surgical journey. As long as the appropriate preparations are made, the procedure should provide life-changing results. Breast Implant Options: Just because one size breast looks great on someone, does not mean they will look equally fantastic on everyone. Height, weight, and build all factor into which size breast works best on an individual. Luckily there are many different combinations of breast implant size, shape, and texture, allowing the procedure to be tailored to each individual woman’s needs and desires. During the consultation appointment, Dr. Lohner will share Before and After photos of his Breast Augmentation patients, and will determine the best breast implant for each individual patient. Saline versus Silicone Implants: Saline Implants: Saline implants first introduced in the late 1960s. Since that time, they have provided safe, beautiful breast enhancement results. Saline implants provide a round, full, firm feeling breast, and more upper pole fullness compared to silicone. The implants are placed in the breast while empty, then filled once in position; thus requiring a smaller incision. Saline implants are normally cheaper than silicone. Failure of saline implants is much easier to detect, than with silicone as they deflate. Silicone Implants: Silicone Implants are by far the most popular choice. After being removed from the market for several years, silicone implants have been reintroduced to cosmetic surgery, and proven to be 100% safe for all women. The implants are composed of a soft, silicone gel; they are placed pre-filled into the breast pocket. Silicone implants look and feel more natural than saline. These implants can be placed either above (Subglandular) or below the muscle (Submuscular). Silicone has a lower deflation rate compared to Saline, as well as lower chance for a rippling effect. Submuscular versus Subglandular: Submuscular Placement: Implants placed submuscularly (under the muscle) have several benefits, including a lower chance for noticeable rippling and less chance for Capsular Contraction. They also provide greater upper pole fullness and look more natural than those over the muscle. The only downside of submuscular implants is the greater chance for animation distortion (change of breast shape with movement). Subglandular Implants: Implants placed subglandularly (over the muscle) can provide patients with the round, augmented look that are often desired. There is less chance for animation distortion with the subglandular placement, and patients note slightly less post-op discomfort. Unfortunately, implants placed over the muscle require a large amount of natural breast tissue to be present prior to surgery, and noticeable rippling is more likely to occur. A postoperative massage program is recommended for subglandular implants. Volume, Shape, and Texture: “Implants can be found in both round and anatomic shapes.” The volume of an implant, both saline and silicone, is noted in CC (not cup size). A large selection of different volumes is available, allowing women to be very specific about the size breast they prefer. The use of sizers in the office work well to assess the patient’s desires. Implants can be found in both round and anatomic shapes. Round implants are used the most often, and look the most natural and symmetric. Anatomic implants (tear drop shaped) are the best implant option for patients who want shape when little breast tissue is present. This implant, however, has a greater tendency to rotate, looking unnatural. Smooth implants move very well within the breast pocket. They are the most popular breast implant. Textured implants were originally thought to reduce the chance for Capsular Contraction, although this is not always the case. Texture implants have a higher chance for rippling and unnatural movement. The Surgery Process: All breast procedures are performed as an outpatient procedure, conducted under general anesthesia. Depending on the exact procedure, the surgery will usually take between an hour and an hour and a half to complete. To begin the procedure, Dr. Lohner will make an inframammary incision (along the breast crease), or a periareola (around the areola). Once the incisions are made, Dr. Lohner will place the implants, either above or below the muscle. Once the implant has been properly situated, Dr. Lohner will place buried dissolving sutures to promote appropriate healing. Potential risks from Breast Surgical Procedures: While breast enlargement is considered safe and effective, it is an invasive procedure, there is a small chance for complications. If potential complications arise, common complications may include: excessive bleeding, delayed wound healing, loss of nipple sensation, asymmetry, and very rarely, implant infection. Choosing a Board Certified Surgeon like Dr. Lohner will reduce the chance for any complications to occur. Do implants need to be replaced every 10 years? No, there is no ’10 year lifespan’ of breast implants. While saline and silicone implants are not designed to last forever, they are made to be long lasting, often for well over a decade. About 20% of all women who have breast implants will have their implants replaced over the first 10 years. This can be due to a variety of reasons; including rippling/wrinkling, Capsular Contraction (scarring), rupture, and implant displacement. More often, women may decide the initial implant is no longer the right size for their lifestyle and the image they want to present. Recovery after a Surgery: “Initially, women may experience mild to moderate pain.” Patients should expect the recovery to take from five to seven days. Subglandularly placed implants (above the muscle) will require only a few days of recovery, while Submuscular (under the muscle) implants will take closer to a week. Initially, women may experience mild to moderate pain. Dr. Lohner will prescribe the appropriate pain medications and muscle relaxants to keep patients resting comfortably at home. A pain pump is often utilized. While bruising and swelling are common, these will subside over the first three to five weeks. The breasts may be extremely sensitive to stimulation for the first few days. Additionally, temporary numbness around the nipple may also be experienced. It is normal for women to experience tightness across the chest, as their body adjusts to the new implants. Surgical tape, support garment, or special bra will be necessary to wear over the following several weeks, to promote healthy healing. Generally, patients feel well enough to return to work in three to five days. Strenuous activities should be postponed for a full four to six weeks after the surgery, but light aerobic exercise can be started two weeks after surgery. A dramatic improvement will be noticeable immediately the surgery. However, after the swelling has completely resolved, and the breasts have fully healed, in about two to three months, patients will be able to appreciate the final result from their augmentation. Breast Massage: The breast massage is an integral part of the healing process for implants placed above the muscle. Massages might also be helpful for submuscular implants, but are not absolutely necessary. This simple step will greatly reduce the chances of a Capsular Contraction, or the formation of scar tissue around the breast implant. For the next three to four weeks, after surgery, your job will be to gently massage each breast for about one minute, three times a day. Thereafter, for the life of your implants, massaging your implants daily will continue to decrease the possibility of future Capsular Contracture. Dr. Lohner will explain massage techniques before your surgery; it will also be reviewed during your follow-up appointment. FAQ: How much does breast enlargement cost? The exact cost of your Breast Augmentation is specific to each patient and varies according to the patient’s choice of implant. Lohner Plastic Surgery accepts financing through CareCredit. For a better estimate of the cost of your surgery, call (610)-519-0600 to schedule your consultation. How do I prepare for a breast enlargement procedure? Carefully read through all pre-operative and post-operative instructions provided by Dr. Lohner. If you have any questions or concerns, contact our office at once for assistance. How long is the recovery period after the surgery? The Breast Augmentation recovery generally takes between five and seven days. Patients normally feel well enough to return to work or school in just a few days. Strenuous exercise should be avoided for the first four to six weeks. How long will the procedure take? The Breast Augmentation procedure will take approximately one hour to one and a half hours to complete. Dr. Lohner has been providing patients with expert Breast Augmentation results for over 20 years. He is Board Certified in Plastic Surgery, as well as General Surgery. His office is located on the Mainline, close to the Philadelphia area. Call the office at 610.519.0060 to schedule your consultation appointment.