Breast Augmentation
with Dr. ThomassenWhat is A Breast Augmentation?
What implants are used in a breast augmentation?
Breasts implants are made of a durable silicone shell called an elastomer, filled with either a silicone gel or saline. The shell can be either smooth or textured. Textured implants have fallen out of favor. This is due to their association with breast implant associated Anaplastic Large Cell Lymphoma (Bi-ALCL). The gel inside silicone gel implants is made of a highly cohesive form of silicone. This form avoids leaking if the shell were to break.
What Size Implants Are Used in Breast Augmentation?
What are the different shapes of breast implants?
Breast implants come in different shapes as well as sizes. They vary in their amount of projection and width. The more projecting and narrow implants are called High or Ultra High Profile Implants. The flatter, wider implants are called Low or Moderate Profile Implants.
In general, women that want a more voluptuous breast choose High Profile Devices. Women that wish a more natural look choose Low or Moderate Profile Devices. Another consideration is the width of the chest wall. If a woman has a narrow width, a higher profile device is needed to match the narrow chest wall.
through what approaches are breast implants placed
Where are implant placed on the chest wall?
Once the approach is decided, the next decision is where to place the implant. The two most common locations are the submuscular, or subpectoral plane. In this plane, Dr. Thomassen places the implant is placed under the pectoralis major muscle. The other choice is the subglandular or prepectoral, located directly underneath the breast tissue.
There is also a subfascial location. In this location, Dr. Thomassen places the implant under a thin layer of fascia. This is a dense connective tissue that covers the muscle. Yet this choice is still considered somewhat controversial about its benefits.
Most surgeons choose the subpectoral choice. This choice has less risk of capsular contracture. Capsular contracture is a condition where the breast implants become hard.
Who is a Good Candidate for a breast augmentation?
Preparing for your breast augmentation procedure
Medications
Smoking
Mammogram and Ultrasound
Physical Exam
Dr. Thomassen will examine you to find out how best to undergo the surgery. Key information gathered in the exam includes your current breast cup and any asymmetry. It also involves detecting any axillary or breast masses. The presence of breast ptosis or excess breast droop is assessed as well.
Breast ptosis is evaluated based on the relationship of the nipple-areola complex (NAC) to the inframammary fold. For patients with a NAC located at the inframammary fold, a breast implant will give a slight lift. This will correct a mild sag. For patients with more severe ptosis or significant asymmetry, a lift or mastopexy is required for optimal results.
Choosing the Breast Implants
Dr. Thomassen will take measurements of your chest width, breast skin pinch thickness, and breast skin stretch. These measurements help narrow the options of implant sizes and shapes suitable for your body frame.
He will place implants placed inside a thin bra. This will simulate your augmentation in the office. You can then visualize your result. When sizing for an implant, pay attention to the weight of the implant. Consider the appearance over a fitted blouse. This will help you get an idea of which implant will give you the look you want.
Preoperative Clearance
Days before Surgery
- Avoid strenuous exercise in the days leading up to your surgery. You should be well rested leading up to your surgery date. Also avoid excessive sun exposure.
- Refrain from alcohol the week before surgery.
- Pick up your prescriptions with plenty of time before your procedure. Set up a comfortable recovery area at home. Plan your meals. Include a light clear liquid meal for the first night.
- Plan for someone to be with you for 24 hours after surgery.
- You will get a call from our Operating Room Nurse a few days before your procedure. They will go over the consent and any preoperative details and instructions. This is to make sure you are ready for surgery.
- You will get a call from our Anesthesia Provider the day before surgery. They will go over your medications and discuss details about your anesthesia.
- Use antibacterial soap when showering the day before surgery.
- Remove any piercings or jewelry you have before coming in for the procedure.
What to expect the day of surgery
The day of surgery you will arrive at our office at the appointed time. Wear something loose and comfortable that you can easily remove and put back on after the procedure. A button down shirt and loose pajama bottoms are ideal.
You will meet the surgical team, including a preop nurse and anesthesia provider. Dr. Thomassen will answer any final questions you have about the procedure and do some markings.
What Anesthesia is Used for a Breast Augmentation Procedure?
How long does the breast augmentation procedure take?
The procedure itself takes about 1 to 1 1/2 hours to finish. When you wake up, you will have a bra and some gauze in place and should be comfortable.
You will go home after you meet criteria for discharge. Dr. Thomassen will call you the evening of the surgery to confirm you are doing well. The pain medications prescribed will make you comfortable. Dr. Thomassen give you a muscle relaxant. This will increase your comfort if the augmentation results in a tight soft tissue envelope.
What is the Recovery like for a breast augmentation
Your first follow up with Dr. Thomassen will be in 1-2 days after surgery. You will have small steri strips or tapes along your incisions. Dr. Thomassen will remove these on your second visit. Your breast size will be larger in the first few weeks due to swelling.
You should not undertake strenuous exercise for at least 4 weeks after surgery. Light walking is fine the first week and you can gradually increase exercise as you feel better.
You can start implant mobility exercises at 2-3 weeks after surgery. Implant mobility exercises are important for two reasons. First, they are helpful in preventing capsular contracture. Second, as patients can stretch their tissues with the exercises, they can become comfortable more quickly.
For more information on breast augmentation, you can contact the American Society of Aesthetic Surgery website.
