Deep inside each and every one of us rests a unique sense of beauty. It is our vision of ourselves and how we would choose others to see us. Elective breast surgery is a common route to making our outward appearance match that inner vision. It is a personal choice.
Breast augmentation is performed to enlarge the breasts or fill breasts after volume has been lost due to pregnancy and breast feeding. Augmentation can be performed behind the pectoralis muscle (submuscular) or on top of the muscle (subglandular). Implant positioning requires multiple considerations including the amount of tissue present, type of implant chosen and individual anatomy. Augmentation can be performed with an incision below the areola, under the breast or in the armpit. There are a variety of implant options: silicone or saline, smooth or textured, round or teardrop. There are pros and cons for each of the various choices and require individual consultation.
COMMENTARY ON BREAST AUGMENTATION BY DR. HIGGINS
Breast Augmentation comprises a large portion of our practice. Although the concept of breast augmentation seems simple– it is best left to the extensively trained and educated Board Certified Plastic Surgeons. The consult for augmentation is perhaps the first critical step in achieving more beautiful breasts. It is at the consultation where you and your plastic surgeon will decide together about implant type, size, and surgical technique. I tend to use a preponderance of silicone breast implants. The more natural feel and decreased rippling of silicone as compared to saline (salt water) implants make the choice clear for most women.
When it comes to sizing, patients often come into the consult with their minds made up about a specific implant size. However, there is no way to say that a 300 cc implant is a “C” cup or that a 500 cc implant is a “D” cup. Imagine a woman who is a 5ft 1 in tall and weighs 100 lbs. Now imagine a woman who is 5ft 10in tall and weighs 170lbs. That same 300cc implant will look entirely different on these very different bodies.
The question regarding placement of the implants above or below the pectorals (PEC) muscle depends on two things–first, the amount of breast tissue that the patient has on her own before augmentation. And second, how big does the patient want to go in final cup size with her augmentation.
I tell my patients to think of the implants like a mattress that has it own bumps and buttons–if i cover the mattress with a thin sheet you can see the lumps, but if I cover the mattress with a thick down comforter you don’t see any lumps or contour irregularities of the mattress. So, whether its the patients own breast tissue or the PEC muscle– the implants need good coverage.
Mastopexy or Breast Lift
A mastopexy is performed when the breasts droop excessively. Mastopexy can be performed alone or with implants. Mastopexy requires a larger scar than augmentation alone. It can range from a crescent mastopexy, which involves an incision along the upper half of the areola to an incision that circles the areola and extends vertically from the nipple to the fold and, sometimes, along the lower fold of the breasts. The technique employed will depend on the amount of excess skin and how low the nipple sits.
A breast reduction (reduction mammoplasty) is performed to reduce the size of the breasts and lift the nipple/areola. It usually involves an incision which circles the areola and extends vertically to the lower breast fold (vertical or lollipop scar). It sometimes requires a horizontal incision along the lower breast as well (anchor scar).
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