Cosmetic Surgery Tips

Best plastic surgeons in nyc breast augmentation

Breast augmentation is a surgical procedure to enhance the appearance of the breasts by increasing their size. The most common reasons for breast augmentation are to restore volume lost after weight loss or pregnancy, to create a more balanced and proportionate look to the breasts, or to fix deformities caused by congenital anomalies and other causes. Breast augmentation can be done using different techniques and materials, including saline implants, saline-filled implants filled with fat tissue, or silicone gel-filled implants.

The type of implant used will depend on your preference, your body type, how much you want to increase your breast size, and whether you have had breast surgery before. The procedure takes about an hour and is performed under general anesthesia in a hospital or outpatient surgery center. There are usually no visible scars after the surgery since incisions are made around the nipple area or around the inframammary fold (IMF). The incisions heal quickly with minimal discomfort and can be easily covered by bras or clothing.

You may find it hard to access the right information on the internet, so we are here to help you in the following article, providing the best and updated information on Best plastic surgeons in nyc breast augmentation, Breast augmentation recovery and results. Read on to learn more. We at cosmeticsurgerytips have all the information that you need about Natural looking breast implants. Read on to learn more.

Best plastic surgeons in nyc breast augmentation

At the New York practice of Joshua A. Greenwald, MD, FACS, many women request augmentation mammoplasty, or breast augmentation surgery, with saline or silicone breast implants to enhance their breast profile. Dr. Greenwald performs breast augmentation surgery for patients who would like to:

  • Increase their breast cup size
  • Improve the appearance of sagging breasts that look flattened or deflated (often due to major weight loss or pregnancy/breastfeeding).
  • Improve undesirable shape or contour of their breasts
  • Improve breast asymmetry

Who Is a Suitable Candidate?

Breast augmentation in Westchester

Only a board-certified plastic surgeon such as Dr. Greenwald is qualified to determine if someone is an appropriate candidate for breast augmentation. Nevertheless, in general, suitable breast augmentation candidates include those who:

  • Desire larger or fuller breasts
  • Desire a greater degree of cleavage or of outward projection from the chest wall
  • Desire breasts that appear higher up on the chest wall
  • On the whole, have a positive self-image, but are frustrated with certain aspects of their breasts
  • Are in good physical and mental health overall
  • Have sensible expectations for the outcome of breast augmentation surgery, and are seeking aesthetic improvement — not necessarily perfection
  • Are pursuing breast augmentation of their own volition
  • Are not breastfeeding (Women who are currently nursing should wait 12 weeks after they have stopped breastfeeding to undergo breast surgery, so their true breast size can be established.)

Saline vs. Silicone Breast Implants

Saline vs. Silicone implants


Dr. Greenwald offers his breast enhancement patients saline and silicone breast implants.

Saline breast implants have a silicone outer shell but are filled with saline solution, or sterile saltwater. 

The main benefits of saline implants are that:

  • Dr. Greenwald can use smaller incisions with saline implants (than he would with silicone implants) because they are filled after they are inserted into the implant pocket.
  • The body can safely absorb the saline filling material in case the implant ruptures.

The principal drawbacks of saline implants are that:

  • They do not resemble the look and feel of natural breast tissue as closely as silicone implants do.
  • They are more prone to folding or wrinkling in the implant pocket.
  • They may be visible under the surface of the skin, especially in women with thin skin or little body fat.

In contrast, silicone breast implants have both a silicone outer shell and a silicone-gel filling.The greatest advantage of silicone implants is that they more closely look and feel like natural breasts than their saline counterparts. MemoryGel® breast implants are composed of an outer silicone shell and filled with a cohesive gel formulation that acts as a solid rather than a liquid, and holds together uniformly. Numerous studies have demonstrated the safety of silicone implants.

The principal disadvantages of silicone implants are that:

  • They arrive from the manufacturer pre-filled, so the Manhattan breast augmentation surgeon must use slightly larger incisions through which to insert them.
  • Patients with silicone implants are at risk of “silent rupture,” a condition in which the breast implant has ruptured, but the patient is not aware of it because the body cannot absorb silicone, causing the filling material to remain intact inside the implant pocket.

Because of the risk of silent rupture, the FDA recommends that women with silicone breast implants undergo a breast imaging exam such as an MRI or mammogram every three years, starting the third year after the initial breast enhancement procedure.

Silicone Implants

Allergan manufactures three main types of silicone gel implants: Natrelle Inspira Repsonsive, Natrelle Inspira Soft Touch and Natrelle Inspira Cohesive. All of these implants are made of cohesive silicone gel (not liquid silicone!). The Natrelle implants are smooth round implants that are available in various sizes and projections. Dr. Greenwald prefers cohesive silicone gel implants in cosmetic breast surgery for their more natural feel. All of Natrelle implants are “gummy bear implants”.

Summary of differences between saline and silicone

SalineSilicone
Incision lengthApproximately 2.5 cmApproximately 3.5 to 4 cm
Outer shellSiliconeSilicone
Implant FillSalineSilicone
Implant SurfaceSmooth and textured surfaces available. Dr. Greenwald places all implants in a submuscular pocket and uses primarily smooth implants.Smooth and textured surfaces available. Dr. Greenwald places all implants in a submuscular pocket and uses primarily smooth implants.
Risk of “rippling”Rippling more common than with silicone implants especially in very thin patientsLess rippling than with saline implants
FeelSoft particularly in patients that are not very thin. In thin patients, may feel firmer and ripple more than silicone implants.Soft and more natural feeling than with saline implants. Consistency more like breast tissue.
Average implant lifespanImplants are made to last a lifetime and are warrantied by the implant company for life. Patients are told there is .5% chance per year of having an implant-related issue.Implants are made to last a lifetime and are warrantied by the implant company for life. Patients are told there is .5% chance per year of having an implant-related issue.
RuptureEasy to detectHarder to detect
Harder to detectCost less than siliconeCosts slightly more than saline implants

Breast Implants Placement Options

Dr. Greenwald offers two breast implant placement options: subglandular and submuscular.

With submuscular placement, Dr. Greenwald positions breast implants under the pectoral, or chest, muscle. Dr. Greenwald places more than 95 percent of his implants in the submuscular position. A lower incidence of capsular contracture, the ability to obtain high-quality mammograms and a more natural look are some of the reasons he prefers the submuscular position over the subglandular position.

With subglandular placement, Dr. Greenwald positions the breast implants under the glandular, or breast, tissue. However, subglandular placement may not be a suitable option for women with thin skin or little body fat because, in this case, the implant might be visible under the skin.

Incision Approaches

Breast implants in New York City


Dr. Greenwald offers three incision approaches: inframammary (crease incision), periareolar and transaxillary.

The inframammary approach – Dr. Greenwald makes the inframammary incision in or near the breast’s natural crease. This incision is easily concealed by the overlying breast and is rarely visible during normal activities. The inframammary approach allows for the precise creation of the implant pocket and the cleanest entry for the implant. It is associated with the lowest incidence of capsular contracture and the lowest incidence of sensory changes of the nipple-areola complex.

The periareolar approach – With this incision option, the breast plastic surgeon creates an incision around the outer perimeter of the areola (the darkly pigmented skin encircling the nipple). The periareolar incision is perhaps the least visible in properly selected patients because it is concealed by the darker skin of the areola. The incision can be reused if the patient requires revision surgery for bleeding or capsular contracture. It is the preferred approach if a mastopexy (breast lift) is needed. It has similar rates of capsular contracture to other incisions and a comparable rate of decreased nipple sensation.

The transaxillary approach – With this approach, Dr. Greenwald positions the incision required for breast augmentation in the armpit area. He utilizes an endoscope, or lighted camera, to help tunnel through the fat that is found under the skin (i.e., subcutaneous fat), creating an implant pocket behind the breast tissue. He typically uses this incision approach to insert unfilled saline implants.  One of the drawbacks of this is incision is the increased incidence of implant malposition (i.e., lateral displacement of the implant pocket). If breast lift is also required, it cannot be done through an axillary approach.

How to Choose Breast Implants

Aside from choosing the size and type of breast implants, the implant placement method and the incision approach, breast augmentation patients must also choose the shape and texture of breast implants. Dr. Greenwald prefers smooth round implants. The different profiles (i.e., moderate, moderate plus and high profile) available will be discussed during your consultation.

During your consultation, Dr. Greenwald will review the patient’s unique anatomy and aesthetic desires, and will help her decide on a suitable surgical treatment protocol that will best meet all her needs. This includes making decisions about the size, shape and texture of breast implants as well as the incision approach and placement method.

Dr. Greenwald will review before-and-after photos of breast augmentation surgery patients with you during your consultation to help educate you on sizing and expectations. He also utilizes the Mentor® Volume Sizing System to help you determine what size implants will work best for you.  This will help you get an excellent idea of what your new breasts will look like.

Recovering from Surgery

Video: Breast Augmentation Recovery

Learn more about the expected breast augmentation recovery time after breast implants surgery in New York City with Dr. Greenwald.

Recovery from breast surgery

Before breast augmentation surgery, patients receive comprehensive pre- and post-surgical care instructions. Following breast augmentation surgery with Dr. Greenwald:

  • Most patients are able to resume normal activities within days of their surgery.
  • Many patients require a small amount of or no pain medication.
  • Most patients have little or no bruising.
  • Some patients experience temporary or possibly permanent changes in breast and nipple sensation; this may include pain, tenderness, a tingling sensation or numbness in the treated area. Nipple sensation returns to normal in the majority of cases. 
  • Patients are permitted to go the gym at three weeks.
  • Patients are encouraged to sleep in a sports bra for three months.
  • It is also important to keep in mind that some patients look great immediately following their surgery while other patients’ implants take time (up to eight weeks) to settle into a more natural position.

Recovery Chart

PreoperativePatient’s preoperative testing and mammogram (if needed) is reviewed. Patient will have filled prescriptions for pain medications, antibiotics and muscle relaxants. Meet with Dr. Greenwald, our anesthesiologist and nurses.
Day of
Surgery
A primary augmentation takes between 45 and 60 minutes. Patient receives an intravenous antibiotic prior to beginning procedure.
Recovery
Room
Approximately 1 hour – you must be sent home with a responsible adult who should plan on spending the night with you.
After SurgeryPatients are sent home in a surgical bra with incisions covered with steristrips and gauze. No heavy lifting or exercising. ABLE TO SHOWER 36 hours after surgery after removing the gauze but leaving the steristrips in place (usually the night after)
Postoperative
Visit #1
Typically 5-7 days after surgery. Any sutures requiring removal are removed. Steristrips are replaced on the incisions as needed. Continue to wear a soft bra or underwire bra depending on implant position. Begin medial massage of implants.
Postoperative
Visit #2
Typically 18-21 days after surgery. Incisions are checked. Silicone scar therapy is begun. Able to return to gym. Typically underwire bra during day and soft supportive bra at night. Begin medial and superior-inferior massage of implants.
Postoperative
Visit #3
Patient’s are typically seen 3-4 months after surgery and then yearly.

How Much Does Breast Augmentation Cost?

The overall cost of breast augmentation surgery in New York City includes the plastic surgeon’s fee, the anesthesiologist’s fee, the operating room fee, the cost of breast implants and the miscellaneous costs associated with breast augmentation surgery (e.g., the cost of: any needed lab testing, the surgical bra, pain medication, etc.). The final cost of breast augmentation may vary, depending on the patient’s unique anatomical needs and aesthetic desires for surgery, the complexity of the surgical procedure, if an adjunct procedure is being performed at the same time (e.g., breast lift surgery) and the type of breast implants chosen.

That said, Dr. Greenwald is temporarily offering special prices on breast augmentation surgery. For a limited time, primary breast augmentation surgery with silicone breast implants costs $7,295.00; primary breast augmentation surgery with saline breast implants costs $6,795.00. (These prices include the plastic surgeon’s fee, the anesthesiologist’s fee, the operating room fee and the cost of the breast implants.)

How Long Do Breast Implants Last?

There is a common misconception among patients that breast implants need to be replaced every 10 years. The reality is that the rupture rate or implant failure rate at 10 years is approximately 10%. Most implant companies offer a lifetime replacement warranty. If the implants rupture, you receive a new implant from the company (not the physician’s office). Certainly, the breast implant companies are not in the business of losing money. They offer this warranty because implant rupture is a rare event. Most surgeons tell their patients that there is a .5-1 percent incidence of rupture per year. At 10 years, there is a 10 percent chance that you may experience an implant rupture and a 50% chance at 50 years!

Does It Matter Where And By Whom I Have My Surgery Performed?

Be sure that your surgery is performed in an accredited surgery center. Be sure there is an anesthesiologist present for your case. Be sure your surgeon is certified by the American Board of Plastic Surgery and has significant experience in breast augmentation surgery (primary and secondary surgeries). Dr. Greenwald has significant experience with both primary and revision breast augmentation surgery.

When Do I Know If My Breasts Have Stopped Growing?

Breast growth is usually complete 3–4 years after your first menstrual period. Continued fluctuations in breast size and shape is impacted by fluctuations in body weight, pregnancy and certain medications.

What Expectations Should I Have If I Decide To Have Breast Augmentation Surgery?

Provided you are a good candidate for breast augmentation surgery, your new breasts will be a larger version of your old breasts. Breast implants alone can correct volume deficiencies but it is important to realize that an implant alone will not provide you with perfect symmetry, and will not change the shape of your breast. All patients have asymmetric breasts both before and after surgery. During your consultation, Dr. Greenwald will note your natural asymmetries and discuss a plan to address them. Often times, severe difference in the breasts are best addressed with a combination of breast procedures (i.e. a breast lift at the time of augmentation).

What If My Breasts Are Two Different Sizes Or Shapes?

All women have some degree of breast asymmetry. While women are aware of severe differences they may have, it is important to realize that all patients do have subtle breast asymmetries. It is important to be made aware of these differences prior to your procedure so you understand how they will be addressed during your procedure.

What Can I Do To Prepare For My Consultation With Dr. Greenwald?

Most patients who come to Dr. Greenwald are referred by a friend, family member or another physician. These people — particularly a prior patient — are an excellent resource for a new patient. They will be able to provide with a lot of information that will be reinforced during your consultation. It is always a great idea to look at pictures of breast augmentation and take a picture of the patients you like. It is also helpful if you come to your consultation wearing your favorite bra — this is often a really great way to show Dr. Greenwald the size and look you hope to achieve. During your consultation, all aspects of the procedure will be reviewed in detail and photos will be taken.

What Will My Recovery After Breast Augmentation Be Like?

Recovery after breast augmentation is as variable as the patients we take care of. As far as timing, patients are permitted to shower the day after their procedure. Most patients should expect to experience tightness and swelling that usually subsides within a week. The implants will continue to soften for the first few months after your procedure. You will be given muscle relaxants and pain medications. Some patients never take a pain pill while others take them all! Some patients look great immediately after surgery while some take a few months to settle in. Do not worry if you do not look like you envisioned immediately after surgery. Bruising is variable from patient to patient as well and will resolve. Patients should plan to “take it easy” for a few days and return to work at 5–7 days after surgery and typically back to exercise at 3 weeks. Most patients will feel like going to the gym before this time but it is important not to! You will be seen by Dr. Greenwald 1 week and 3 weeks after your procedure. If you are concerned about something at any point, you will be seen!

Breast augmentation recovery and results

After an hour or so in the recovery room, you will be discharged to the care of another adult who needs to stay with you for the evening. You will need someone to bring you to your first post-operative recheck, since you should not drive a car for the first two days after breast enlargement surgery, or while taking pain medication. Virtually every patient can resume normal everyday activities within 24 hours after surgery, including showering, doing one’s hair or applying cosmetics, dressing, eating normal meals, and moving about the house. You should avoid stretching or repetitive activities that might raise your pulse or blood pressure, which can increase the risk of bleeding and re-operation. Our superior anesthesia protocols (TIVA), as well as careful, minimal-trauma surgery may allow most patients to feel well enough to go out for pizza on the way home from surgery, or to go dancing the next day. But really, this makes no sense, since every patient having an operation must heal tissues and seal blood vessels. The less strenuous activity you engage in, the less likelihood of bleeding, bruising, discomfort, capsular contracture, or re-operation. Taking things easy, even if you feel great, is an investment in your final cosmetic result! Anything else that seeks to imply a superior surgical skill, “special” technique, or proprietary way to circumvent normal healing is simply marketing.

Avoid Exercising

You should avoid exercising, lifting, or strenuous activity for a full two weeks following surgery, to limit the possibility of bleeding. If you have bleeding, re-operation is necessary to remove the blood, cauterize or suture the source, and re-close the incision. Most patients prefer to reduce activities rather than risk re-operation and the higher rate of capsular contracture that may result if this occurs. This generally means no exercise or other strenuous activity for the first two weeks. Jogging, horseback riding, weightlifting (bench press, military press, curls, etc.), yoga, or any activities that bounce the breasts or stretch/contract the chest muscles should be avoided for a full month or longer, depending on intensity.

Breast augmentation–submuscular silicone implants

This 20 year-old woman came to Minneapolis Plastic Surgery for breast augmentation with implants. She underwent submuscular silicone gel implant placement as a light general (TIVA) anesthetic outpatient procedure in our nationally-accredited (AAAASF) on-site surgical facility. She returned to everyday (non-strenuous) activities in 24 hours, light exercise in 2 weeks, and more vigorous work-outs in 4 weeks. (Note the large mole in her cleavage area was removed at the time of her surgery; the small mole on the right breast remains.)

Breast augmentation–submuscular saline implants

This 47 year-old mother of 3 lost most of her breast volume after breast feeding, and came to Minneapolis Plastic Surgery for augmentation mammoplasty (breast enlargement with implants). Her surgery was one month before the FDA again released silicone gel implants for elective breast augmentation (2006), so this patient had submuscular saline implants placed. Proper “over”filling minimized implant rippling. Her TIVA general anesthetic allowed her to leave the recovery room in just one hour–alert, comfortable, and without nausea or vomiting.

Breast augmentation–submuscular saline implants

This 19 year-old mother of one came to Minneapolis Plastic Surgery for breast implants to restore fullness lost after breast feeding. She had saline implants placed beneath her pectoralis muscles in our nationally-accredited (AAAASF) office surgical facility as a 1-hour outpatient operation. Note the natural “teardrop” appearance of her breasts with smooth round submuscular implants.

Breast augmentation–submuscular silicone implants

This 20 year-old health care professional from Rochester, Minnesota wanted larger breasts. After much research, she decided she wanted the latest generation of cohesive silicone gel implants instead of saline ones. Even though she is not yet 22, it is perfectly legal and appropriate for her to request silicone gel implants, particularly when we agree that this is the best choice for her goals and anatomy. Use of silicone gel implants in a woman under age 22 is considered “off-label” use, just as when Botox is used for treatment of facial lines or wrinkles of the neck or upper forehead (Botox Cosmetic is FDA-approved only for use in treating frown lines between the brows and “crows feet” lines; use anywhere else is considered “off-label” use that is completely legal and quite common). She sized with 550cc and 600cc implants in a bra and stretchy top; in her 55 minute outpatient breast augmentation operation at Minneapolis Plastic Surgery, she had 650cc high-profile cohesive silicone gel implants placed. She has been thrilled with her results, and at her most recent office recheck appointment said that she is contemplating increasing to 800cc implants.

Breast augmentation–submuscular saline implants

This 31 year-old woman breast-fed three children, and told us these were the only times she had any breast fullness. She requested breast enlargement, but did so during the time (1991-2006) when the FDA restricted cosmetic silicone gel augmentation, and therefore had submuscular saline implants placed at Minneapolis Plastic Surgery’s nationally accredited (AAAASF) on-site outpatient surgical facility. Three years later she requested additional saline fill to reduce rippling (despite proper “over”filling initially).

Breast augmentation–submuscular saline implants

This 33 year-old woman breast-fed both of her children and developed Grade II (moderate) breast ptosis (droop) and significant loss of breast volume. She requested restoration of breast size without breast lift if possible. Submuscular breast augmentation was performed as an outpatient light general anesthetic (TIVA) procedure that nicely corrected her loose breast skin without breast lift (mastopexy) scars or increased cost being necessary.

Breast augmentation–submuscular silicone implants

This 21 year-old woman told us she has always been bothered by her small, unattractive breasts. She underwent augmentation mammoplasty at Minneapolis Plastic Surgery’s AAAASF-accredited on-site surgical facility, and had 575cc silicone gel implants (cohesive latest-generation) placed below her pectoralis muscles in a 50-minute operation. Use of silicone gel implants in a woman under age 22 is perfectly legal and appropriate as long as informed consent regarding “off-label” use is obtained, and the patient requests their use. Her TIVA anesthesia allowed her to leave the facility in 1 hour feeling comfortable and relaxed without nausea or that bloated, gassy, dizzy, inhalation anesthesia smell (and higher nausea risk). After photo at 1 year post-op.

Breast enlargement with cohesive silicone implants–89

This 23 year old woman from North Dakota desired larger and more shapely breasts, but did not want an obvious, round, “fake” look. She came to Minneapolis Plastic Surgery for breast augmentation with cohesive silicone gel implants, and chose smooth round implants because they have a soft teardrop appearance when upright, and flatten and round out to the sides of her chest when reclining–significantly more natural and “anatomic” than form-stable teardrop-shaped textured implants. Her outpatient operation was performed in our nationally accredited (AAAASF) on-site office surgical facility under a light TIVA general anesthetic. She returned to her daily routine and traveled back to her home the next day, and resumed exercise and strenuous activities in 3-4 weeks. After photographs were taken 6 weeks post-op.

breast augmentation with silicone implants

This 30 year old woman and her husband are done with their family and breastfeeding her 2 children left her with deflated breasts. She came to Minneapolis Plastic Surgery for breast augmentation with silicone implants, as well as liposuction of various other areas. She is 5′ 4″ tall and weighs 133 lbs. so she is an excellent candidate for liposculpture as well as breast enlargement for improved body contours. Her TIVA anesthetic allowed nausea-free recovery and rapid discharge home to her caregiver. She had 5 pounds of fat removal via her same-procedure liposuction, combining multiple areas of surgery into one operation and one recovery.

Breast augmentation–submuscular silicone implants

This 20 year-old woman came to Minneapolis Plastic Surgery for breast augmentation with implants. She underwent submuscular silicone gel implant placement as a light general (TIVA) anesthetic outpatient procedure in our nationally-accredited (AAAASF) on-site surgical facility. She returned to everyday (non-strenuous) activities in 24 hours, light exercise in 2 weeks, and more vigorous work-outs in 4 weeks. (Note the large mole in her cleavage area was removed at the time of her surgery; the small mole on the right breast remains.)

Breast augmentation–submuscular saline implants

This 47 year-old mother of 3 lost most of her breast volume after breast feeding, and came to Minneapolis Plastic Surgery for augmentation mammoplasty (breast enlargement with implants). Her surgery was one month before the FDA again released silicone gel implants for elective breast augmentation (2006), so this patient had submuscular saline implants placed. Proper “over”filling minimized implant rippling. Her TIVA general anesthetic allowed her to leave the recovery room in just one hour–alert, comfortable, and without nausea or vomiting.

Breast augmentation–submuscular saline implants

This 19 year-old mother of one came to Minneapolis Plastic Surgery for breast implants to restore fullness lost after breast feeding. She had saline implants placed beneath her pectoralis muscles in our nationally-accredited (AAAASF) office surgical facility as a 1-hour outpatient operation. Note the natural “teardrop” appearance of her breasts with smooth round submuscular implants.

Breast augmentation–submuscular silicone implants

This 20 year-old health care professional from Rochester, Minnesota wanted larger breasts. After much research, she decided she wanted the latest generation of cohesive silicone gel implants instead of saline ones. Even though she is not yet 22, it is perfectly legal and appropriate for her to request silicone gel implants, particularly when we agree that this is the best choice for her goals and anatomy. Use of silicone gel implants in a woman under age 22 is considered “off-label” use, just as when Botox is used for treatment of facial lines or wrinkles of the neck or upper forehead (Botox Cosmetic is FDA-approved only for use in treating frown lines between the brows and “crows feet” lines; use anywhere else is considered “off-label” use that is completely legal and quite common). She sized with 550cc and 600cc implants in a bra and stretchy top; in her 55 minute outpatient breast augmentation operation at Minneapolis Plastic Surgery, she had 650cc high-profile cohesive silicone gel implants placed. She has been thrilled with her results, and at her most recent office recheck appointment said that she is contemplating increasing to 800cc implants.

Breast augmentation–submuscular saline implants

This 31 year-old woman breast-fed three children, and told us these were the only times she had any breast fullness. She requested breast enlargement, but did so during the time (1991-2006) when the FDA restricted cosmetic silicone gel augmentation, and therefore had submuscular saline implants placed at Minneapolis Plastic Surgery’s nationally accredited (AAAASF) on-site outpatient surgical facility. Three years later she requested additional saline fill to reduce rippling (despite proper “over”filling initially).

Breast augmentation–submuscular saline implants

This 33 year-old woman breast-fed both of her children and developed Grade II (moderate) breast ptosis (droop) and significant loss of breast volume. She requested restoration of breast size without breast lift if possible. Submuscular breast augmentation was performed as an outpatient light general anesthetic (TIVA) procedure that nicely corrected her loose breast skin without breast lift (mastopexy) scars or increased cost being necessary.

Breast augmentation–submuscular silicone implants

This 21 year-old woman told us she has always been bothered by her small, unattractive breasts. She underwent augmentation mammoplasty at Minneapolis Plastic Surgery’s AAAASF-accredited on-site surgical facility, and had 575cc silicone gel implants (cohesive latest-generation) placed below her pectoralis muscles in a 50-minute operation. Use of silicone gel implants in a woman under age 22 is perfectly legal and appropriate as long as informed consent regarding “off-label” use is obtained, and the patient requests their use. Her TIVA anesthesia allowed her to leave the facility in 1 hour feeling comfortable and relaxed without nausea or that bloated, gassy, dizzy, inhalation anesthesia smell (and higher nausea risk). After photo at 1 year post-op.

Breast enlargement with cohesive silicone implants–89

This 23 year old woman from North Dakota desired larger and more shapely breasts, but did not want an obvious, round, “fake” look. She came to Minneapolis Plastic Surgery for breast augmentation with cohesive silicone gel implants, and chose smooth round implants because they have a soft teardrop appearance when upright, and flatten and round out to the sides of her chest when reclining–significantly more natural and “anatomic” than form-stable teardrop-shaped textured implants. Her outpatient operation was performed in our nationally accredited (AAAASF) on-site office surgical facility under a light TIVA general anesthetic. She returned to her daily routine and traveled back to her home the next day, and resumed exercise and strenuous activities in 3-4 weeks. After photographs were taken 6 weeks post-op.

breast augmentation with silicone implants

This 30 year old woman and her husband are done with their family and breastfeeding her 2 children left her with deflated breasts. She came to Minneapolis Plastic Surgery for breast augmentation with silicone implants, as well as liposuction of various other areas. She is 5′ 4″ tall and weighs 133 lbs. so she is an excellent candidate for liposculpture as well as breast enlargement for improved body contours. Her TIVA anesthetic allowed nausea-free recovery and rapid discharge home to her caregiver. She had 5 pounds of fat removal via her same-procedure liposuction, combining multiple areas of surgery into one operation and one recovery.

Individual results may vary.

Minneapolis Plastic Surgery Patient Recovery

Some breast augmentation surgeons or websites state or imply that they utilize special techniques to minimize postoperative pain, swelling, or restriction of activities. One website even emphasizes the implied “superiority” of their procedure by showing a photograph of a breast enlargement patient out dancing with her arms above her head shortly after surgery, or by showing testimonials by patients who go out to dinner the night after surgery. We also employ all of these “special” techniques, and in fact 97-98 percent of Minneapolis Plastic Surgery’s breast enhancement patients have NO nausea, NO vomiting, NO anesthetic hangover, and are able to eat normal food and be up and about the night after surgery. Do we encourage dancing and dining the night after surgery? Of course not; there still are the two-three percent of patients who will have some degree of nausea or more discomfort, and do best by minimizing the potential for raising the blood pressure that accompanies vomiting, and the risk of re-operation or capsular contracture that goes with elevating the blood pressure or pulse. Most of our breast enhancement patients are thrilled by their lack of post-operative pain, bruising, or swelling, not to mention the avoidance of nausea and vomiting our superior anesthesia techniques permit! But we want ALL of our patients to have a great result, so we recommend moderation in activities that might adversely impact your result (and our reputation).

Although limitation of strenuous activity requirements are simple, straightforward, and in your best interest, a few patients each year feel they can bypass this rule, think they are doing so well that this doesn’t apply to them, or decide that they “got away with (an inappropriate activity) once, so it must be OK,” and end up in the operating room again.  This is usually avoidable, but bleeding can still occur despite everyone’s (patient and surgeon) best effort. If this is the case, timely re-operation can remove the blood (usually only a few ounces), control the bleeding source, and avoid or limit any untoward effect on the final result. If you have significant swelling on one or both sides post-operatively, notify your surgeon.

Avoiding Infection

Infection is extremely rare in this operation. It can occur, however, and you must take the prescribed antibiotics until gone to reduce this risk as much as humanly possible. If an implant becomes infected, it must be removed (usually with the other implant, infected or not) and will need to be left out for several weeks to as long as a year, to allow all bacteria to be destroyed by antibiotic therapy and your own antibodies, as well as to allow scar tissue to soften enough to permit replacement of the implants.

You can also reduce the risk of infection by showering rather than bathing, and you should absolutely stay out of the lake, Jacuzzi, pool, hot tub, or sauna for three weeks after breast enlargement surgery. Close contact with animals or household pets (especially cats) should be limited as well during this time. Taking your antibiotics as prescribed does not eliminate the need to follow these recommendations!

Typical Breast Augmentation Recovery Prescriptions

You will also receive prescriptions for muscle relaxants and anti-inflammatory before you leave our Clinic (these are now e-prescribed and can be picked up prior to surgery so you don’t have to stop on the way home after surgery!) In our office, pain medication cannot be “called-in” or e-scribed–on the day of surgery your adult caregiver will be given a written prescription for these medications. Take your medication as advised to reduce nausea, vomiting, and the resultant increase of blood pressure that might start bleeding. Your breasts will NOT have drains (they are not necessary with our precise surgical technique and meticulous hemostasis), but you will have a long-acting local anesthetic placed in your implant pocket to minimize immediate post-operative discomfort. We also inject a 3-4 day extended-release local anesthetic (Exparel) into the tissue around your breasts to reduce discomfort for an extended period. This multi-pronged approach is why the vast majority of our breast enlargement patients do so well and report minimal post-op discomfort.

Typical Breast Augmentation Activity Recommendations

Keep fluid intake up and walk, move around, and flex your calf muscles to reduce the risk of blood clots. This is important to reduce the risk of heart attack, stroke, pulmonary embolism, or sudden death. Do not take aspirin, ibuprofen, Aleve™, etc. during the four weeks after surgery. Resume other medications as advised by your doctor. Return to work based on the activity levels required at your job, and resume exercise or strenuous activity gradually, no sooner than the two weeks discussed above. Jogging, horseback riding, weightlifting, vigorous sexual activity, or similar strenuous exertion should be avoided for four weeks to decrease the risk of bleeding, re-operation, and/or capsular contracture.

Your bleeding risk is actually highest 10 to 33 days AFTER surgery, as pain and soreness resolve, and activities naturally increase. Healing tissues are not durable and supple enough for vigorous stretching or strenuous muscular contraction until one month from surgery, and then only if started gradually. This information is meant to help you avoid re-operation for bleeding! (And those “quick-recovery” “brand-name” operations don’t have any magical stop-bleeding tricks either—in fact, implying activity is OK or encouraged only increases these doctors’ re-operation rates for evacuation of hematomas.) Ask who pays for that?  Hospital charges for bleeding re-operation can cost thousands; we offer minimal-cost, no surgeon’s fee  re-operation (around $1000) in the unlikely event that one of our patients bleeds.

Following these recommendations will make the likelihood of a successful outcome as high as possible, and the risk of complications low. After your breast enlargement surgery, your final appearance will take some time to be achieved. During this time your muscle, breast tissue, and skin must heal, stretch, soften, and settle over time. Some patients look fabulous days after surgery; most take somewhat longer!

Most patients are sent home with a Velcro® bandeau placed on the upper part of the breasts. This will be worn at night, and in most cases, patients will be asked to remain braless during the day. This will allow your breast implants to drop into the proper position over time. The amount of time necessary for final softening and settling of implant position is different for each patient, and so will the time recommended to start wearing a bra. Some patients will have tapes and a surgical bra right after surgery. Do not judge your recovery by the yardstick of a friend’s or relative’s experience; every patient is unique, and every recovery and result is also unique. Your surgeon will guide you as time goes by and advise you on how to enhance your result. At Minneapolis Plastic Surgery, Ltd. we offer our patients a lifetime of no-charge rechecks and will keep you apprised of the best advice we are capable of giving.

Most patients look good in clothing within days after surgery; unclothed, a soft, natural appearance will take longer to develop. Final softening, settling, and the return of sensation can take several months to as long as a year or so. During this time, or at least as long as your scars are pink, you must avoid tanning booths or any source of ultraviolet exposure in order to reduce the chance of permanently darkening the scars. Vitamin E oil or ointment massage of the scars after three week’s time can help to soften and fade them; you should not begin this prior to three weeks after surgery in order to avoid the risk of prematurely softening and stretching the scars. If you have a tendency to form thick or heavy scars, your surgeon may instruct you in the use of scar pads ( silicone sheets ) or other scar-treatment remedies as  ways of helping to reduce this concern.

A Smooth Recovery Process

All in all, with superior anesthesia, careful surgery, meticulous technique, precise hemostasis, attention to medications, not resuming strenuous activity prematurely, and equally attentive patient compliance, breast enlargement is a safe, straightforward procedure with a very high satisfaction rate. This information and these recommendations are not intended to be complete or all-inclusive. Post-operative rechecks are important and are designed to monitor your progress, make appropriate recommendations, and address any specific concerns or questions. 

Natural looking breast implants

natural breast implants

Breast augmentation continues to be one of the most commonly performed cosmetic surgery operations in the UK, with over 2000 procedures carried out in London each year. Breast enlargement surgery is designed to alter the size and shape of the breast with an improvement in breast texture.

Breast implants come in two main types, silicone implants or saline implants. Saline implants are composed of a silicone outer and are filled with a sterile saltwater solution (saline). In contrast, silicone implants are composed of a cohesive gel-like material enclosed by a silicone shall. Saline implants are rarely used in the UK due to the high risk of implant rupture and the inability to achieve natural-looking results. There are also more prone to developing implant rippling, which may be visible through the skin. Silicone breast implants are most commonly used in the UK and have a more natural consistency with a reduced likelihood of developing implant rippling or wrinkling. All types of breast implants have a finite lifespan of approximately 10 to 15 years, and it is recommended to have them removed or replaced at this time. Some women may also want to improve the size and shape of their breasts after a period of time due to the development of breast sagging, and different-sized implants, whether bigger or smaller, may be used to replace old breast implants.

Which types of breast implants look natural?

We commonly get asked how women can achieve a natural look with breast implants. There are several different ways to ensure a natural-looking appearance with breast implants.

Getting natural-looking results with breast augmentation

The first step is to have a consultation with an expert breast augmentation surgeon at Centre for Surgery. At the consultation, your surgeon will assist you in helping to select the most appropriate type of implant to match your chest anatomy. We offer two different brands of breast implants, including Mentor and Sebbin implants. Both types of implants are MHRA-approved for breast augmentation and have a proven track record of safety and quality. Implants come in various sizes and shapes, including round implants, anatomical implants or teardrop implants.

Implants also come in a variety of different profiles, from low profile to very high profile. Implant profile is used to describe the distance of projection from the chest, with low profile implants having a more shallow edge resulting in a more natural appearance. Very high-profile implants project further outwards with more defined edges and help improve breast cleavage. High-profile implants have a lower potential for creating a natural appearance but are often preferred by many patients who want to achieve bigger breasts with enhanced cleavage.

Your surgeon will also discuss optimal breast implant placement with two main techniques for placing the implants, which can be either below the pectoralis muscle or placed on top of the muscle. There are pros and cons to both approaches depending on your desired look. Achieving a natural appearance to the breasts will often depend on where the implants are placed, and you can discuss this further with your surgeon at the consultation.

Natural-looking breast implants can be enhanced further with the addition of fat transfer to the breasts, which is an effective technique for disguising the edges of the implant in thin-skinned patients.

Following the post-operative instructions after breast augmentation surgery is essential to get the best results. You will be provided with a post-operative support bra to maintain the breast implants in the correct position and avoid unnecessary irritation of the healing scars.

We would advise avoiding certain types of strenuous exercise, including cardiovascular exercises and sporting activities such as tennis, which involve raising your arms above your shoulder level. Excessive movements of the arms above the shoulders may result in a risk of developing implant malposition. This complication may require corrective breast surgery further down the line. Avoiding excessive arm movements will also help your breast augmentation scars to heal properly.

How can breast implants look fake?

Fake-looking breast implants often have several characteristics. Choosing very high-profile implants often results in breasts that appear less natural. The position of the implant can also play a factor in creating breast implants that look fake, whether the implant is placed above the breast muscle or beneath it.

The anatomy of the female chest and the size of the breast implant selected can often determine whether breast enhancement results appear fake. Women who only go up one or 2 cup sizes after breast augmentation surgery have a higher likelihood of achieving natural-looking results than women who go up 5 or 6 breast cup sizes. If you are keen to achieve a natural-looking breast augmentation, please discuss this with your surgeon, who will be able to use years of experience in helping you select implants that will appear natural for your body shape.

What is the most natural breast implant?

Compared with saline implants, silicone breast implants have the most natural-looking appearance and optimum feel. At Centre for Surgery, we have extensive experience with Sebbin breast implants manufactured in France. These implants have over 20 years of safety data proving their effectiveness. Sebbin implants contain a highly cohesive silicone gel contained in an outer silicone shell. Patients often tell us how the implants feel similar to the natural breast tissue. Successful breast augmentation surgery to achieve a natural appearance depends on choosing the correct implant size, shape and profile, which must always be customised to each patient to get optimal results.

What kind of breast implant is right for you?

Are there any natural alternatives to breast implants?

Breast augmentation with implants is the most common method of surgically enhancing the breasts. However, fat transfer breast augmentation has emerged as a highly effective way to enhance breast volume without the need for implants.

Centre for Surgery experts in all types of fat transfer surgery, including breast augmentation fat transfer which involves enhancing breast volume by injecting fat into the breasts. Many patients often prefer having breast augmentation with fat transfer as the procedure does not involve the use of artificial substances such as silicone implants and is known for producing natural-looking results.

What are the natural alternatives to breast implants?

Natural breast augmentation with fat transfer to breast involves liposuction to remove fat from unwanted body areas such as the abdomen, thighs or hips, followed by its purification. The purified fat is then injected into the breasts using small diameter cannulas. Many patients appreciate having areas of stubborn fat removed to contour and sculpt body regions such as the stomach. This procedure is often viewed as a two-in-one procedure with the body contouring benefits of liposuction combined with breast fat transfer to increase breast volume in the same procedure. Natural breast augmentation with fat transfer results in fewer scars compared with breast implant surgery.

The risk of complications such as bleeding is much less with breast fat transfer than with breast implant surgery. Not having implants inserted means any risk of infection is minimal. Fat transfer breast augmentation is commonly requested by patients who may be unhappy with the results of a breast implant procedure. Some patients may have had surgery for breast cancer, such as a mastectomy and will require breast reconstruction surgery to restore the shape of the breasts and get rid of breast asymmetry.

Fat transfer breast augmentation is most commonly carried out under a general anaesthetic. At Centre for Surgery, we specialise in TIVA anaesthesia to ensure a quick recovery with minimal risk of post-operative sickness. The procedure takes, on average, between one and three hours, depending on the amount of liposuction carried out and the quantity of fat injected into the breasts.

The recovery time after that transfer to breasts is generally between one week and four weeks. Your surgeon may recommend taking one week off work and restricting physical activities until any post-operative swelling has settled down, which will help improve the quality of your recovery. Once you have seen your surgeon at your six-week review, you may undertake complete activities without restrictions.

Fat transfer to the breasts can be carried out with or without breast implant surgery. When breast fat transfer is combined with breast implants, the procedure is called hybrid breast augmentation. By combining the two procedures, patients can benefit by having a significant increase in breast volume with implants with the natural-looking results achievable with fat transfer. Liposuction can be carried out to other body areas if desired to create a flatter stomach or slimmer-looking thighs.

Some of our surgeons are experienced in 3-D virtual imaging to give you an idea of how you could look after your breast implant surgery. 3-D imaging may help you develop a better idea of what can be achieved and whether your expectations are realistic.

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