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Breast Augmentation

Breast augmentation involves using breast implants to increase the size of your breasts or restore the volume that has been lost. Click below to learn more about Breast Augmentation.

Goals

  • Increase fullness and projection of your breasts
  • Improve the balance of your figure
  • Enhance self-image and confidence

What Breast Augmentation Will Not Do

  • Augmentation alone will not correct severe drooping of the breasts.
    • While it WILL correct some drooping, it will not correct severe drooping (breast ptosis).  
  • If you want your breasts to look fuller and to be lifted due to sagging, a breast lift (mastopexy) may also be required along with breast implant augmentation.

Types of Implants

Saline

  • Filled with sterile salt water (saline). “Heavier” than silicone implants. Firm like a water balloon and less like natural breast feel than silicone; however, most women are satisfied with their saline implants. Visible rippling of the implant edges is the major drawback. 
  • Should the implant shell leak, a saline implant will collapse and saline will be naturally expelled by the body.
  • Approved for breast augmentation in women age 18 or older.

Silicone

  • Filled with silicone gel. Gel feels more like natural breast tissue. 
  • If the implant shell leaks, the gel will remain either within the implant shell, or in the breast implant pocket. A leaking implant filled with silicone gel will not collapse.
  • Approved for breast augmentation in women 22 or older.
     

Implant Deflation & Rupture

Disruption of the implant shell

  • Saline and silicone implants both have a shell made of solid silicone. This shell is soft, but it may also tear. If a saline implant shell tears, it is called a “deflation” because the saline leaks out and is absorbed by the body. This leads to breast shrinkage. When a silicone implant shell tears, it is called a “rupture.” The silicone may remain within the shell, or may extrude into the breast implant pocket to varying degrees, but the breast does not change in size.

Risk

  • Saline deflation – about 1% chance per implant each year.
  • Silicone rupture – about 4% during the first four years.
  • This makes them roughly the same during the 4 year time frame.

Saline Deflation

  • If your implant deflates, chances are it will be obvious and almost immediate.

Silicone Rupture

  • If your silicone implant shell ruptures, the silicone gel may stay within the shell (because it is very thick), or it may leak into the breast pocket. When this happens it can cause a capsular contracture, which is usually the first and only sign of a rupture.
  • Capsular contracture is a thickening of the scar tissue around the breast implant, which can deform the breast shape, cause excessive firmness, and in more severe cases, cause pain.
  • Not all ruptures cause capsular contractures.
  • MRI can help diagnose a rupture; however they are only about 90% accurate in identifying ruptures. Also, an MRI scan that “shows” a rupture does not necessarily mean you truly have a rupture. Because of this, many women choose not get MRI scans unless they notice a problem. Despite this, the FDA recommends MRIs every 2 years starting 3 years after augmentation. This MRI is not covered by insurance and so has to be paid for out of pocket.

If I am careful, can I prevent deflation or rupture?

  • You would think so, but treating your implanted breasts different than un-implanted breasts does not prevent deflation or rupture. After your initial recovery from surgery, you should treat them the same as before. You should not be extra guarded or concerned about your significant other handling your breasts.
  • Mammograms do not cause deflation or rupture.
  • Performed under general anesthesia.
  • Incision types: 
    • Inframammary – hidden within the lower breast fold
    • Periareolar – hidden around the areola
    • Transaxillary – hidden within armpit
    • Depends on choice, type of breast implant, degree of enlargement, your anatomy
  • Implants are generally placed beneath the pectoralis muscle; occasionally above the pectoralis muscle, just behind the breast tissue.
  • Results are immediately visible.
  • Scars continue to mature and fade for 1 year, and most are virtually unnoticeable. The best way to predict how you scar is how you have scarred before.
  • After surgery you will be taken to a recovery area to be closely monitored after surgery.
  • You will wear a support bra given to you by our team. This will minimize swelling and support the breasts as they heal.
  • You will be allowed to go home a few hours after surgery. 
  • You will need to wear the surgical support bra for the first 2-4 weeks. 
  • After 48 hours, you will have reduced activity for a few days, and you will experience soreness for the first week.
    • Intermittent soreness can last for a few weeks.
  • Generally, jogging is not permitted until 4 weeks, and weight lifting until about 6 weeks.
  • You should wait 4 weeks to shop for new bras since swelling and settling take time to resolve.
  • Many patients find it helpful to review breast augmentation photos and learn about what to expect during recovery as they navigate the decision-making process to have surgery.

Photos are a great way to discuss a procedure, which is why we love to use them!

Photos are also a great way to help you understand your individualized and realistic outcome. Because each person is different in size, shape, body type, and desire, we feel that photos are best “interpreted” and discussed together in consultation. That is why we will use them in a one-on-one discussion that will help you understand the process and results that are achievable in your particular case.

(515) 247-3121
1111 6th Avenue
Des Moines, Iowa 50314

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