Fuller Breasts, Increased Confidence

Breast enlargement or  breast augmentation is intended to make a woman’s breasts larger and fuller while maintaining their softness and natural contours.

A related procedure, breast lift or mastopexy, elevates, keeps the existing breast volume and re-balances the surrounding skin, thus elevating and firming up a relaxed breast. Sometimes a patient has less volume in the breast than desired, and an accompanying breast augmentation with an implant is simultaneously performed at the patient’s request.  It is important that after the operation it remains easy to carry out self-examination and mammograms.

Downey Plastic Surgery practices highly individualized care based on patient desires and tissue capabilities , which are jointly identified during a thorough consultation and examination. Dr. Downey will discuss treatment options available for breast augmentation, and provide you a plan of care individualized for your unique situation.

During your initial consultation, Dr. Downey will learn more about you and your goals for breast enlargement surgery. While there are limitations to the final volume of implant that your body can accommodate, it is helpful to know the size, shape, and profile of the breast you desire. He will discuss with you the different options available to you, as well as the types of implants and manufacturers. Currently a woman can select a permanent breast implant filled either with sterile salt water, called saline, or with silicone gel. Each implant fill type, gel-filled or saline-filled, has its unique advantages and possible outcomes that you will thoroughly learn about at consultation, so you will have confidence in the selections you make for your treatment.

He will also review the entire treatment journey with you, including anticipated results, possible risks and recovery expectations. You will also gain a perspective on how to preserve the healthiest long term result after breast augmentation.

Here is a description of both types of cosmetic breast surgery in greater detail:

Breast Enlargement Surgery – Most breast implant surgeries take two to three hours and are performed under general anesthesia. Typically, patients will return home the same day. You may be given a comfortable front-fastening bra, which will be used to secure your dressings. Dr. Downey will reevaluate your figure the day of surgery in order to properly size and elevate the breasts during the operation.

Once you are asleep, incisions are made and oval-shaped pockets are created under the breast tissues for the implant. The pockets for your implants are sized to determine what volume of implant your body will accommodate. The permanent implant is then carefully placed in each pocket and if it is a saline implant, it is filled to its final volume. The symmetry and the natural look of the breasts are carefully assessed before the breast incisions are closed. The goal of the operation is to create breasts that look and feel soft, without artificial roundness or hardness. Dressings and occasionally a soft bra are applied before you wake up.

Breast augmentation is normally safe and has a low risk of major complications when patients are in good health. Risks include reaction to anesthesia, bleeding, infection of the incision or of the implant pocket, thick or raised skin scar, numbness of the skin or nipple, implant leak or deflation, continued asymmetry of breast size or position, ripples or wrinkles of the implant surface which you can feel or see, capsular contracture (a tightening of scar tissue around the implant, making the breast feel hard), opening of the incision and exposure of the implant and interference with mammography or self-examination. If you select a silicone gel-filled breast implant for your augmentation, the U.S. Food and Drug Administration (FDA) recommends regular postoperative imaging of your implants to assess their integrity.

As with all surgeries, risks increase with smoking, obesity, diabetes, age and other medical conditions. You should discuss with us any medications, especially blood thinners, as well as natural or herbal remedies, to help avoid complications with your operation.

Great care is taken around the time of your operation to reduce these risks. After the surgery, your job is to control your pain, remain active and keep your incisions clean and dry. Communication with us about any questions or concerns you have is another part of your job in this relationship.

 

Breast Lift (Mastopexy) – The goal of a breast lift, or mastopexy, is to gather up the soft inner breast gland into a more compact, tighter and more upright breast skin “envelope”, and to redirect the nipple to project forward rather than downward. Sometimes a breast implant is also placed at the same time to increase breast volume. Good candidates for this surgery are women whose breasts are more relaxed than desired, typically following pregnancy and breast feeding or after major weight loss.

During the surgery, incisions are made around the areola and the crease beneath the breast. The breast tissue is pushed to a higher position on the chest producing a more upright, projecting shape. Breast implants are placed at the same time if appropriate.  Dr. Downey may advise you to consider postponing breast lift surgery if you plan to breast-feed a baby in the future.

Risks of breast lift include bleeding,infection, scar, numbness of the skin or nipple, implant leak or deflation, continued asymmetry of breast size or position, recurrent relaxation of the breast’s position, capsular contracture (which is a tightening of scar tissue around the implant that makes the breast feel hard), opening of the incision with exposure of the implant (which requires implant removal), interference with mammography or self-examination, and reaction to anesthesia.

Revisional Breast Implant Surgery – Dr. Downey also performs revisional breast implant surgery, which is a reconstructive breast operation for women with breast implants which need replacement, or those who have been referred due to complicated breast implant surgery histories. Patients who undergo revisional implant surgeries sometimes select silicone gel implants for their operation. You will be thoroughly educated about breast implants before you need to make a selection for your implant choice. Dr. Downey will discuss with you the risks against the benefits of repeated breast implant surgery.

Recuperation and Aftercare

Swelling, pain and tightness of the chest muscles is common for a few days following surgery. Oral pain medication usually works very well for comfort. Occasionally a small drain tube is placed during surgery to help control swelling for a few days following the operation.

Rest is important to the healing process, so you will need to limit activities following the surgery. Showers typically can be resumed after a few days, and a bra can be worn within a week. Most people can return to office work in five to seven days following the operation.

The stitches are removed in a week to ten days, but swelling may continue for weeks post surgery. Once the soreness has subsided, you should be able to resume exercise and normal physical activities within a couple of months. Over time, scars will become soft and skin colored.

Financial Considerations

Downey Plastic Surgery offers competitive pricing for your breast surgical procedure. We accept most major credit cards and will help coordinate with your insurance carrier whenever coverage is available.

In most cases, health insurance policies do not cover the cost of breast augmentation or breast lift surgery. However, under some circumstances, a portion of revisional breast implant surgery is a covered procedure. You will receive an estimate of fees during your initial consultation. Full payment for your procedure will be due at your pre-operative visit, which is usually two weeks prior to the surgery.

For more information, please visit the financial section of our web site.