Dr. Schusterman is a board certified plastic surgeon specializing in reconstruction of the breast. In Houston, breast implants and other types of breast augmentation services are rapidly getting more attention. Some women are making a change for medical reasons while most want to increase their breast size for cosmetic reasons. Dr. Schusterman has years of experience in both situations.
Breast augmentation is performed under general anesthesia so you’ll sleep through the entire operation. The method of inserting and positioning your implant will depend on your anatomy and Dr. Schusterman’s evaluation. Every effort will be made to assure the incision is placed to make scarring as inconspicuous as possible.
What Is Breast Augmentation
Breast augmentation, medically known as augmentation mammoplasty, is a surgical procedure used to enhance the size and shape of women’s breasts via the use of either saline or silicone gel implants. By inserting an implant behind each breast, plastic surgeons can increase a woman’s bust line by one or more bra cup sizes.
Breast Augmentation vs. Breast Implants
The terms breast augmentation and breast implants can be used interchangeably. Breast augmentation is simply the name of the surgical procedure to place breast implants.
Types of Breast Implants
There are three types of breast implants: gummy bear form stable implants, silicone gel filled, and saline filled.
- Gummy bear breast implants (so-called because they have the consistency of gummy bear candy) are the most recent development of implant. They are form stable, meaning they retain their shape. This feature is very desirable and beneficial to many patients. In addition, the gel is cohesive, meaning if the shell breaks, the gel stays put.
- Gel filled breast implants are filled with a less firm gel than the gummy bear but still cohesive. They feel more “natural” than gummy bear implants and are the implant of choice for most patients.
- Saline filled breast implants are filled at the time of the surgery with a saline solution. They don’t feel as “natural” as gel and are more prone to ruptures. The main advantage of the inflatable saline implant is that being inserted non-inflated (empty) permits the smallest possible incision. After insertion the implant is inflated with saline.
Incision Sites for Breast Implants
Dr. Schusterman will discuss the pros and cons with you for the incision site specifically suited to you. Every effort will be made to assure that the incision is placed so resulting scars are as inconspicuous as possible.
The common incision sites are:
- Around the nipple (periareolar): This incision is well concealed, but is associated with a higher incidence of inability to successfully breast feed as compared to other incision sites.
- Within the fold under the breast (inframammary): This incision is less concealed than periareolar but is associated with less breast feeding difficulties than periareolar incision sites.
Breast implant surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.
The Breast Implant Placement
Working through the incision, Dr. Schusterman lifts your breast tissue and skin to create a pocket, either underneath your chest wall muscle (Submuscular Placement) or directly behind the breast tissue (Subglandular Placement). The implants are then centered beneath your nipples.
- The Submuscular Placement: The breast implant is placed behind the chest wall muscle (pectoral muscle). This placement feels and looks more “natural” because the implant is further away from the skin. It may require a longer surgery and recovery period, but typically results in less capsular contracture (scar tissue formation), and easier imaging of the breast with mammography.
- The Subglandular Placement: A subglandular placement for the breast implant behind the breast tissue offers shorter surgery, less pain and discomfort and briefer recovery, since muscles are left intact and only skin and fat are cut. Larger implants may also be used. This placement may result in more palpable implants, more capsular contracture, and more difficult imaging of the breast with mammography. Keep in mind that the only thing supporting the implant is the skin and breast tissue.
Dr. Schusterman will discuss the pros and cons of the two possible implant placement sites with you , and recommend the site that best meets your needs.
Patients should be aware that breast implants aren’t always permanent. They often require a future operation to remove and replace the original implant.
Risks Associated with Breast Augmentation Surgery
As with any operation, there are risks and specific complications that may be associated with breast augmentation surgery including scarring, infection, hematoma, and implant leakage or rupture. While most women do not experience these complications, patients should discuss each of them with their plastic surgeon before committing to the procedure.
Planning Your Breast Augmentation Surgery
In your initial consultation, Dr. Schusterman will evaluate your health and explain which surgical techniques are most appropriate for you based on your age, health, and the condition of your breasts. Please be sure to inform him if you smoke and/or if you’re taking any medications, vitamins or other drugs. If your breasts are sagging, Dr. Schusterman may also recommend a breast lift.
Dr. Schusterman will also explain the type of anesthesia to be used and the costs involved. Because most insurance companies do not consider breast augmentation a medically necessary surgical procedure, carriers generally do not cover the cost of this procedure.
Preparing for Your Breast Augmentation Surgery
Dr. Schusterman will provide you instructions on how to prepare for surgery, including guidelines on eating, drinking, smoking and taking or avoiding certain vitamins and medications. While making preparations, you should arrange for someone to drive you home after surgery and to stay and help out for a few days, if needed.
Your surgery can be performed at the state-of-the-art Hermann Drive Surgical Hospital, conveniently located near our office. The center is designed to provide personalized care by friendly, thoughtful and experienced staff. Its ambulatory care concept offers the advantages of reduced cost, easy access and a brief stay in a pleasant environment.
Here is an article we published that discusses the 9 tips to prepare for a breast augmentation.
After Your Breast Augmentation Surgery
Patients will feel tired and sore for a few days following surgery. Dr. Schusterman will prescribe medication to alleviate the pain. Most patients are discharged the same day, but will need someone to drive them home. Patients may be given a surgical bra, which should be worn as directed by Dr. Schusterman. Patients may also experience a burning sensation in the nipples for about two weeks, which should subside as bruising fades. Dr. Schusterman uses absorbable suture material to close the incision which dissolves in 60 to 90 days. A small piece of the suture may extend out at each end of the incision. These ends will be trimmed 1 week after surgery. After that, no suture material will be visible, but the swelling in your breasts may take three to five weeks to disappear.
Getting Back to Normal
Most patients return to work within a few days. You will receive a list of limited activities that can be resumed immediately following your breast augmentation. Please follow Doctor Schusterman’s advice on when to resume exercises and normal activities.
Breasts will be sensitive to direct stimulation for two to three weeks following surgery so patients should avoid physical contact and strenuous exercise.
Scars will be firm and pink for at least six weeks. They may remain the same size for several months or even appear to widen before finally beginning to fade. Immediately after surgery breast implants may appear higher than desired but should drop into place after a few days.
Women in the appropriate age group should continue to undergo routine mammograms. Please inform the technician that you’ve undergone breast augmentation to assure you get a reliable reading as well as to assure that any complications with your implants, if they occur, can be detected and treated early.
If Breast Augmentation / Implants interests you and you would like to learn more, please contact Dr. Schusterman’s office at 713-794-0368 or email us today.