Breast Augmentation
Breast Enlargement with Silicone Implants in Baltimore, Maryland
Silicone Implants Approved by the FDA
After nearly 2 decades of restricted use and intensive evaluation, the FDA has approved silicone breast implants as safe for general use. Due to the controversy regarding their saftey, silicone implants have been more rigorously evaluated than any other medical device. The FDA approval effectively ends the debate on the safety of silicone breast implants, although laboratory and clinical studies are on-going.
It should be noted that the latest silicone implants are much better than the older silicone implants. Changes in the silicone gel manufacturing process have resulted in a "cohesive" gel -- this has been compared to the consistency of a "gummy bear". The advantage is that, in the event of an implant shell rupture, there will be little to no leakage of actual silicone. According to Dr. Summers, patients implanted with older silicone gel implants should consider having their implants replaced with this newer, safer implant. We can perform this procedure at the Maryland Plastic Surgery Center under a light sedation, enabling patients to return to normal, light activities immediately afterward.
Note: After extensive review of available literature, Dr. Summers does not believe that silicone gel-filled implants cause autoimmune diseases (e.g. fibromyalgia, rheumatoid arthritis, etc.)
Breast augmentation adds volume to the breast with an implant to increase fullness and create better balance with the rest of your figure. Your clothing options will expand tremendously, and you'll be comfortable wearing many styles that you were not confident about before the procedure. The availability of silicone gel-filled implants for routine breast augmentation provides women with an excellent option to achieve a natural appearance.
Breast Enlargement Overview
There are different types of breast implants available and different approaches for augmentation. You and Dr. Summers will decide the best type of implant and approach for your augmentation after your consultation. Breasts are extremely different from person to person, and some approaches give the best results in certain patients.
Small breasts usually result from one of two causes:
- Lack of development of the breast during puberty
- Loss of breast fullness following pregnancy
During pregnancy breast enlargement occurs and this stretches the skin envelope of the breast. When pregnancy and nursing are over, the tissue within the breast involutes or shrinks, usually to a smaller size than it was originally. The skin however remains slightly stretched and the smaller amount of breast tissue falls to the bottom of the stretched skin envelope. The result is usually a breast with somewhat loose skin, and a lack of fullness in the upper portion.
How much your breasts can be enlarged depends on your tissues and your desires regarding breast size. For example, if you have never been pregnant, and have a very small 'A' cup breast, your skin may be very tight. This may limit the size that can be achieved. Remember that you want your breasts to be in proportion to the rest of your body.
At your consultation, Dr. Summers will discuss your preferences regarding breast size, and how you would like your breasts to look. After examining you, he will recommend one or two procedures from a range of options that will be best for your breasts to balance with the rest of your figure. He will honor your choice of alternatives if he feels he can achieve an aesthetic breast using your preferences.
Breast implants do not cause breast cancer. Excellent scientific studies indicate that breast cancer occurs in about ten percent of women, regardless of whether they have had breast augmentation or not. Some studies have even suggested that women undergoing breast augmentation have a lower risk for breast cancer - this is thought to be due to the fact that these women have less breast tissue and, thus, are at reduced risk for breast cancer.
Breast implants may make a mammogram somewhat more difficult to read. This does not mean that a mammogram can't be adequately read, simply that the mammograms must be performed and interpreted by someone experienced in the proper techniques. When an implant is present, the breast should be pulled in front of the implant before compressing for a mammogram. This maneuver, combined with additional views if necessary, allows better visualization of the breast tissue.
The Operation
The incisions for breast augmentation are placed in the fold beneath the breast, at the junction of the areola and the skin, or under the arm. Regardless of the incision site, a very meticulous closure of the incision minimizes the visibility of the scar and maximizes its quality.
In some patients, breast implants are placed behind the breast tissue - this is known as a sub-glandular (or above the muscle) implant. However, in most patients, the implant is placed behind the pectoralis muscle on the chest wall - this is known as a sub-muscular implant. Dr. Summers will discuss the best option for your specific breast type and chest wall anatomy. In either case, your breast tissue is located in front of the implant where it can be readily examined.
After final implant placement and position is achieved, Dr. Summers will spend time precisely closing your incisions to achieve the best possible result with as minimal a scar as your healing process will allow.
All of your incisions will be carefully closed with sutures placed beneath the skin, so there's no chance of having "railroad track" type marks but rather very fine line scars. You'll be able to shower the day after surgery!
Recovery
Following breast augmentation procedures, most patients have moderate discomfort, which is handled well with oral pain medication. Most patients require medication for only 2-3 days, after which time ibuprofen is adequate for pain relief. Your breasts will feel rather tight to for 48-72 hours, and this sensation will gradually resolve over the next several days as the swelling decreases. You may develop slight bruising beneath the breasts a day or two after surgery, which will resolve in about a week. Also, it is not uncommon for the abdominal region to feel full or swollen on the 2nd or 3ed day after surgery - this resolves quickly with ambulation.
In general, our patients have experienced the following after a routine breast augmentation procedure:
- Time at the Surgery Center: 4-5 hours
- First post-operative visit: 1 day after surgery
- Bruising resolves: 3-10 days
- Swelling resolves: 3-6 weeks
- Return to light work & social activity: 2-3 days
- Aerobic or strenuous activity: 3 weeks
- Sexual activity: 2-3 weeks
We encourage immediate return to light, normal activity as soon as you can. Just don't do any type of strenuous or jarring exercise that would push your pulse over 100 for about two to three weeks. Any aerobic activity that increases your pulse over 100 also increases your blood pressure, and could make you bleed. You should wear a support bra 24-hours daily (except when showering) for the first week following the procedure.
Breast Enhancement Limitations
Differences typically exist between a woman's breasts - they may be different sizes or the nipple locations may be different. Although one of the goals of breast augmentation is to achieve "perfect" symmetry, after breast augmentation surgery these differences will usually persist and, in some cases, become more noticable. Dr. Summers will discuss your particular situation in detail with you at the time of your consultation.
Breast implants are mechanical devices, which are manufactured to extremely high standards. Some patients have had breast implants in place for over 25 years, but no one can specify the life of a breast implant. At some point you may choose or need to have it replaced.
When any implant is placed in your body, the body forms a lining or capsule around it. This capsule is similar in some ways to scar tissue and can shrink or contract. If the capsule contracts markedly and squeezes on your implant, it can distort the implant or make the breast feel firm. The use of a "no touch" technique, use of antibiotic irrigation, and meticulous care to prevent hematomas can significantly reduce the likelihood of developing firmness, but so far the risk cannot be totally eliminated since it is the result of your normal healing mechanisms.
Rarely, the outer shell of a breast implant can break. Usually, this is due to folds occurring with abrasion of the outer shell, and is more likely to follow the development of firmness due to capsular contracture. Very rarely the valve mechanism in a saline-filled implant can leak with loss of harmless salt water into the surrounding tissues which your body absorbs. If an implant rupture is confirmed, or is strongly suspected, the implant can be inspected, removed if necessary, and replaced with a new implant.
Risks of Breast Enlargement Surgery
Risks common to all surgical procedures such as bleeding, infection and scar tissue formation occur in a very small percentage of cases. Bleeding or infection occur in less than 1% of cases, and may require another procedure for correction. Infection may necessitate temporary implant removal and subsequent replacement. We will give you more detailed information about these and other rare risks in our written information, and encourage you to discuss any which concern you during your consultation.
If you have been considering cosmetic breast surgery, contact us through our online form and schedule your consultation today!