Breast Augmentation ("enhancement", "enlargement", "augmentation mammaplasty")
Who are good candidates?
Breast Augmentation is a surgical procedure that enhances the size & shape of a woman's breast. This is often desirable in patients that have lost significant volume after pregnancy and breast feeding ("involutional mammary hypoplasia"). It is also beneficial in patients that have underdeveloped or absent breast tissue. This can be a genetic predisposition or in association with congenital deformities such as Poland Syndrome (absent chest wall muscle with or without upper extremity anomalies) The procedure is also helpful in correcting breast asymmetries where the size and shape of each breast is notably different. Finally, it can be a balancing procedure in patients that have undergone mastectomy reconstruction to enhance the non-cancer side.
How is it performed?
The surgery takes about one hour. We perform the procedure in our office surgical unit under local anesthesia with sedation so patients are asleep but not on a machine to breathe. The implants used are saline (salt water) Mentor or McGhan prostheses. They are usually round and smooth unless a particular circumstance requires otherwise. Saline implants have been proven to be safe and effective and are fully approved by the FDA.
We prefer an axillary approach (small incision in a natural crease of the armpit) and a submuscular position (behind the chest muscle) as this provides a better shape, lessens the chance of hardening and provides an additional layer of soft tissue covering the implant, helping to obscure visible "wrinkling". There are no scars on the breast.
How much time off do I need?
We suggest a week if possible, although many of our patients go back to work after an extended weekend (we usually perform breast augmentations on Tuesdays and Fridays). Since local is used, there is not much pain for the first four hours after surgery, but after it wears off, your chest will be very sore for several days because we go behind the muscle. We give a generous amount of pain medicine to make the recovery easier, so you will need somebody to oversee your care. The shape of the breast out of clothing is "artificial" for the first few weeks with tight skin and too much fullness at the top. Once the skin & muscles have relaxed, however, you can expect an amazing improvement in your breast contour.
What about cost & scheduling
Because we perform 400-450 augmentations per year and use the office surgical unit instead of the hospital, we are able to provide the surgery at a very affordable rate. We offer bilateral breast augmentation for $4,500 which includes implant cost, facility, surgeon's fee, anesthesia and all follow-up visits. We perform 4-10 pairs every Friday so our schedule is flexible. Financing is available through the American Society of Plastic Surgeons if patients request it.
Can there be complications?
Any surgery carries risk. Fortunately, breast augmentation is extremely safe. Consult the Mentor or McGhan websites for their reported complication rates. We are currently underway in tabulating our data and we'll be publishing our ten-year series of patients in the spring of 2004. Current statistics are as follows:
2,238 Submuscular saline augmentations (7/94 - 7/03)
This series does not include secondary augmentations, silicone gel augmentations,
augmentation lift combinations or augmentation in mastectomy patients.
I. DEFLATIONS: n=36 (1.6%)
* type of implants used:
7/94 - 12/99 Mentor siltex (2600) and McGhan textured (168) used nearly equally.
1/00 - 7/03 Mentor smooth round and McGhan smooth (68) moderate and high profile.
*Deflations specifics:
20 Mentor siltex style
16 McGhan all style 168 (textured) except 2 style 68 (s
