MIAMI BREAST AUGMENTATION SURGERY
Surgeons have performed breast augmentations
through the use of breast implants since the late 1960's.
Since the initial concept and first prototype of implants,
much has changed. Breast implants have been made from
different materials but since the mid to late 1970's
manufacturers have concentrated on Saline and Silicone
Gel. Other substances and fillers have been proposed
and attempted for breast augmentation surgery but at
the present time these two filler materials are the
mainstay of breast augmentation. In 1992 there was a
great deal of controversy regarding the use of silicone
gel implants. Questions were raised regarding their safety
and the government placed a moratorium on these types of
implants. The government then required the manufacturers
to provide safety data. Many scientific papers have been
written since 1992 and most have failed to place a direct
causal relationship between the concerns raised at the
time and actual disease processes. At the present time,
silicone gel implants may be used in certain breast
augmentation situations with participation by the patient
in an adjunct study. The cosmetic surgeon must be approved
for the use of silicone gel implants.
Breast size and shape seem to be directly associated
with our society's perception of feminine beauty.
There appears to be a predominance of breast augmentations
in the Western World in contrast to the Middle and
Far East regions of the world. Most women seeking breast
enlargement have suffered with small breasts for a number
of years prior to seeking out a solution through surgical
breast augmentation. Many have been affected by pregnancy
and breast-feeding.
A breast implant is comprised of an outer shell or
envelope of solid silicone that is then filled with
saline (or salt water) or silicone gel. The silicone gel
implants are pre-filled from the manufacturers and the saline
implants require filling at the time of surgery. Implants
are measured in cubic centimeters or cc. You will frequently
hear reference to a 330cc implant or other sizes. The size
of the implant does not always correlate to brassiere cup size.
Breast implants are inserted through the inframammary
fold (underneath the breast fold), through the areola or
the axilla. They are then placed in front or behind the
pectoral muscle. The breast augmentation recommendations will
vary from patient to patient. All patients are unique and have
different requirements in order to achieve the optimal aesthetic
result. What is recommended for you may be totally different than
what is recommended for your girlfriend. Remember all women were
not created equal.
BREAST AUGMENTATION PROCEDURE DETAILS
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Breast augmentations can be performed under local anesthesia
with intravenous sedation or general anesthesia. We have
found that our patients are most comfortable under general
anesthesia. The breast augmentation procedure is performed as
an outpatient, allowing you to go home afterwards.
Depending on your exact procedure, incisions will vary. At
this point dissection is undertaken with creation of a space
or "pocket that will accommodate the implant. This pocket is
created either underneath the glandular tissue (sub-glandular
or in front of the muscle) or underneath the pectoral muscle
(sub-pectoral). Having established this pocket, the implant
is then introduced. If the implant is silicone gel,
it will already be filled upon insertion. Saline implants are
inserted deflated and subsequently filled through a sterile
closed system with saline. The incisions are closed, a
surgical bra is placed and you are taken to the recovery room.
After allowing time for recuperation, you will be discharged
to go home.
BREAST AUGMENTATION POST-OP RECOVERY
You will be allowed to go home
after your breast augmentation surgery. You will
need to wear the surgical bra for the first few days.
We then suggest that you wear a sports bra. Some custom
surgical bras are available from different manufacturers
and our office will be happy to assist you in this purchase.
You will experience pain in the first 24-48 hours
and a feeling of tightness. This is normal. Pain
medication will be provided for you and we suggest that
all your post-operative medications be purchased prior
to surgery. You should not be the person controlling
the meds to avoid self-medication. At home, it is suggested
that you rest. You will be asked to come to the office
the next day. At this point some bandages may be removed.
We will need to see you within another week after the
breast augmentation surgery for suture removal. Most
patients require 3-4 days recovery before returning to
work and/or driving their car unless your work requires
strenuous activity in which case you may need7-10 days.
Exercise may be continued after two weeks for lower body
and 4-6 weeks for upper body. Household chores may be
started within the second post-operative week. Every
patient is unique and will recuperate differently.
If you feel great, don't over do it.
Please note that all implants, but particularly if
they are placed in a subpectoral position, will tend
to ride high on the chest wall during the first 10-12
weeks following your breast augmentation surgery.
This is normal and occurs as result of the implants
being placed in a tight space comprised of skin
and muscle. As each week goes by, the muscle and skin
start to adjust and stretch allowing the implants to
assume a more natural position. Occasionally this process
is not completed and the implants remain high on the chest
wall requiring further surgical correction.
COMPLICATIONS OF BREAST AUGMENTATION SURGERY
Although complications are not frequent and percentages
will vary, you need to be aware that the following complications
may occur:
INFECTION, HEMATOMA, CONTOUR DEFORMITIES, IMPLANT REJECTION,
IMPLANT DEFLATION, IMPLANT RIPPLING (may feel and see
implant "ripples" underneath skin), NIPPLE
AND SKIN SENSORY CHANGES (either increased or decreased),
CAPSULARCONTRACTURE, REMOTE POSSIBILITY OF LACTATION,
KELOID OR HYPERTROPHIC SCARS, DIFFICULTY IN MAMMOGRAPHY
Some of these breast augmentation surgery complications
if severe enough, may delay recovery time, require further
surgery for correction at additional costs and may involve
other specialists within the medical field. Please be
aware that smokers, diabetics and overweight individuals
have a higher incidence of complications when compared to
those who don’t smoke, have diabetes and/or are overweight.
You should also note that patients undergoing combined
procedures (i.e. breast augmentation and tummy tuck) also
have a higher complication rate than those undergoing
a single procedure.
BREAST AUGMENTATIONS – WHAT TO EXPECT
These breast augmentation procedures
are considered body contouring and enhancing in nature.
They are not meant as a substitute for normal breast
tissue. We have found that one of the key factors in
achieving patient satisfaction is patient expectation.
No guarantee implied or in writing is given regarding the
eventual bra cup size that you will wear. A suggestion is
made by Dr. Perez-Gurri based on his professional experience
as to the size of implant. Remember that many things are
taken into consideration but the one limiting factor is
the skin and availability of good tissue coverage for
the implant.
There seems to be an inverse
relationship with expectation and satisfaction.
That is, the higher the expectation, the lower the
satisfaction. Body image is unique and what the patient
frequently sees may not be what is seen by
the cosmetic surgeon. Therefore, it is important
that you become keenly aware of your expectations
for the procedure, know its limitations and fully
discuss any concerns that you may have regarding the
procedure with Dr. Perez-Gurri. We encourage questions
and have allowed ample time to answer them personally
or with our literature and videotapes.
MIAMI BREAST AUGMENTATIONS - OTHER QUESTIONS
What if I get pregnant?
Your breasts will grow under hormonal influence
just as they would without implants. Following your
pregnancy there is involution or "shrinking"
of your breast tissue but this will not affect the
implant. However, if you are left with excess skin,
the breast may sag.
Can I breast feed?
Maybe yes and maybe no. You need to fully understand
that some women cannot breast feed regardless of implants.
If you are able to breast feed there is no scientific
data that implants are harmful to the baby.
Will
I be able to feel the implants?
More than likely. Saline implants seem to have a higher
incidence of implant wrinkling or rippling which makes
the implants more palpable underneath the skin and
in some cases the patient may see the ripples on the
skin. This happens more frequently in thin patients
and with the use of bigger implants.
Can breast implants cause cancer?
Scientific studies have not proven a causal
relationship between breast implants and breast cancer.
Will I need to change my implants?
Manufacturers suggest that breast implants should
be changed after ten years. However, every case is
different and patients need to be evaluated on an
individual basis. You should know that further surgery
would be required in the future either because of
complications or normal wear and tear. This means
that you will undergo added expenses in the future.
Are my breast augmentation results permanent? Although
we cannot state that they are, we know of many cases
that were performed years ago, that have remained
shapely and full.
Will my stretch marks go away?
No. There are no permanent cures for stretch marks.
Different creams and remedies exist that temporarily
hydrate the skin making the stretch marks less visible
but they do not remove stretch marks. Lasers have
been utilized to treat stretch marks but are only
effective in reducing the color intensity of red/bluish
ones. By stretching the skin as a result of the implants,
the stretch marks may become less visible.
What happens if my implants "leak"?
If you have saline implants, the salt water will be
absorbed by the body, processed and eliminated in
the urine. Your breast will go flat within hours and
you will require further surgery to replace your old,
deflated implant. Do not worry; it is not an emergency.
If you have silicone gel implants, a leak is not readily
apparent from loss of breast volume and other diagnostic
tests will be required.
The above information has been compiled as a benefit
to you to help you know what to expect when undergoing
breast augmentation surgery. We hope that this document
has served to better inform you on the proposed procedure.
We encourage dialogue. Dr. Perez-Gurri and his staff at Imagos
Institute of Plastic Surgery, Inc welcome your questions.
It is our sincerest wish that your surgical
experience at IMAGOS INSTITUTE OF PLASTIC SURGERY,
INC. be a pleasant and informative one. We recognize
that all patients will experience pre-operative anxiety
and fear of elective surgical procedures is normal.
Our trained professional staff and doctors are here
to serve your needs and answer your questions.
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