What is Breast Augmentation?
A breast augmentation, also known as an augmentation mammaplasty or breast enlargement, is a surgical procedure that increases the size of the breasts. It is one of the most common cosmetic procedure performed in the world. Patients choose to have a breast augmentation in order to increase breast size, correct asymmetry or replenish lost breast tissue from weight loss or pregnancy.
Benefits of Breast Augmentation
We believe that Breast Augmentation may be the happiest patient operation that we do! Patient satisfaction is incredible as we work closely with our patients before surgery to help her determine the most proportional size. As we place the breast implants beneath the muscle, the implants feel and look like natural breasts. A recent study has shown that a submuscular breast implant has made it easier for the detection of breast lumps by self-breast exam and mammography.
Can breast augmentation fix asymmetry?
Asymmetry of breasts is a very concerning problem for many women. We always say that natural breasts are “sisters, but not twins.” The difference in the shape of the chest wall (pectus excavatum), the chest wall muscle, the difference in the volume of glandular breast tissue, breast fat, and a fine of the skin can all contribute to breast asymmetries.
Simply placing a larger implant on the smaller side may not completely improve breast asymmetry. It is important that patients understand that breast augmentation is making your breasts bigger, and not necessarily perfectly symmetrical. If a patient has anatomically two very different breasts, balancing procedures by moving tissue or removing tissue may be necessary.
It is not uncommon for a patient with a significant breast asymmetry to be “botched” by a surgeon with limited experience who thinks that a larger or smaller implant on one side will solve the problem. The doctor should perform a careful exam and review pre-operative photographs with the patient before surgery so that expectations can be determined and a proper treatment plan can be made together.
Who is a Candidate for an Augmentation Mammaplasty?
Mammaplasty candidates include women that want larger breasts, to fix asymmetrical breasts, or to restore breast tissue. However, before undergoing surgery patients must have fully developed breasts, be physically healthy and have realistic expectations of their surgical outcome.
Types of Breast Implants
- Gummy Bear
The Breast Augmentation Procedure
Austin Cosmetic Surgery performs all breast surgeries in its outpatient surgery center. The breast augmentation procedure typically takes about 1 to 2 hours under general or local anesthesia. First, Drs. Carlotti will make inconspicuous incisions to place the implants. They place these incisions in the armpit, the crease on the underside of the breast, or around the areola to minimize scar visibility. Next, Drs. Carlotti will lift the breast and create a pocket to insert the implant. The implants and then placed and the incisions are closed.
It is important to note that breast augmentation does not lift the breasts like a mastopexy. Therefore, many patients choose to have an augmentation mammaplasty in combination with a breast lift. This combination extends the amount of time spent in surgery but provides patients an opportunity to recover from two procedures at once. During your consultation, Drs. Carlotti will discuss your options and plan the surgery that works best for you!
Before & After Breast Augmentation
Can Breast Augmentation be Combined with Other Procedures?
Breast augmentation is often combined with many other procedures such as Mastopexy (breast lift), abdominoplasty (tummy tuck), liposuction and many other facial and body cosmetic procedures. We have Board Certifed Anesthesiologists which help us ensure patient safety for our procedures. As Drs. Albert & Michelle Carlotti are a Surgical Team, they are able to safely perform multiple procedures more quickly, and safely, than a single surgeon alone. Plus the patient has the benefit of a male’s and female’s perspective!
Will my Breasts Feel Real After Breast Augmentation?
Right after surgery, breast implants sit high, feel firm and look a little funny. However, as the progressive relaxation of the chest wall muscles, the breast implants fall into position and soften over a period of months. Then, the breasts will feel natural and look natural. Most women forget they even have breast implants over time.
Breast Augmentation With Fat Transfer
Using your own natural tissue to build your breasts without the placement of an implant sounds wonderful. There are a few problems, however. First, when you harvest fat from another location in the body via liposuction and then graft the fat to the breasts, we know that only about 50% of the transferred fat gets appropriate blood supply and survives. This means that initial results may look fabulous and over time total breast volume will get smaller. As we gain weight, fat cells get bigger and when we lose weight, of course, fat cells get smaller. So if the patient gains or loses weight their breasts will get bigger or smaller too. The biggest concern surgeons have about high volume fat transfer to the breasts is that that 50% of transferred fat dies; It may form small internal scarring that may incorporate microcalcifications of the breast.
In breast cancer screening, radiologists are looking for microcalcifications on breast imaging to identify possible breast cancerous lesions. These fat transfer microcalcifications could lead to false positive results. Meaning, the patient could be altered that an area might be cancer when it’s not and needs to undergo a fine needle biopsy of the area to prove otherwise.
So, in general, we do not frequently do a fat transfer to the breasts for the purpose of breast augmentation. We do use it to correct defects from botched results in revision breast procedures. Grafting a small amount of fat to a specific area can also be used to correct defects after lumpectomy or other breast asymmetries of volume.
Breast Augmentation at Austin Cosmetic Surgery
We tell every patient the same thing, breast augmentation is the “happiest operation we do.” Most women after surgery say that they wish they had done it sooner as it gives them more confidence in and out of clothing. With a male and female perspective, the advantage of having two experienced surgeons, two sets of hands and two sets of critical eyes, the patient truly benefits in our practice.
“Upon researching other recommended surgeons, I am more than happy with my ultimate decision of choosing The Carlottis for my procedure. From my initial phone call to my primary consultation and then some, I was impressed by their expertise and concerns. I felt like more than just a patient, and they answered any questions and doubts that I had. Even after the procedure, they still made me a priority. The result is a more natural look and feel than I could have ever expected. I am beyond happy and grateful for The Carlottis. I wholeheartedly recommend them for any procedure for their top-notch service.” – Crystalle C.
Can I Breastfeed With Breast Implants?
After a total submuscular breast augmentation (our technique) there is no interference in the glandular breast tissue and the mere presence of breast implants will not interfere in breastfeeding. Patients who have had breast lift whereby glandular breast tissue has been removed and some internal scarring occurs may not be able to breastfeed as well. Women seeking breast lift before motherhood should consult with their surgeon before so that they understand the risks and benefits
If I Am Currently Breastfeeding, How Long Do I Have To Wait To Get Implants?
This is a common question we get. It is our standard practice to wait for a minimum of 8 weeks (ideally 12 weeks) after cessation of lactation (production of breast milk). The two important reasons to wait include
(1) Allowing the breast volume and skin to shrink after engorgement during lactation.
(2) To allow the nipple duct system to narrow and to minimize postoperative infection.
Recovery From A Breast Augmentation
When recovering from surgery, patients commonly complain about tightness in the chest. This pain is due to muscle expansion when placing the implant. Typically, this tightness will subside significantly in 24 hours and can be controlled with pain medication. Patients often return to work in about a week for a follow-up appointment at Austin Cosmetic Surgery.
Drs. Carlotti will check in with your progress and remove the stitches. Patients should avoid exercise and heavy lifting for a few weeks after surgery. Drs. Carlotti recommends wearing compressions garments during recovery to minimize swelling and provide support. Your final results should be apparent about 3 months after surgery when the breasts have settled.
Will I Have A Scar After Breast Augmentation?
There are four different breast implant placement incision locations: (1) Under the breast in the crease (inframammary), (2) around the nipple (periareolar), (3) in the armpit (transaxillary) and finally (4) around the belly button (transumbilical). For the placement of silicone gel implants, #3 and #4 is ill-advised but are acceptable for saline implant augmentation. We do not use #2 (periareolar) because the tension on the incision due to the implant placement usually leaves a noticeable scar.
The most common placement for a silicone gel breast implant is beneath the breast or inframammary. When the patient properly takes care of these incisions they tend to heal well. We advise the use of vitamin E (or Mederma) starting at about 4 weeks out and use of sunblock (zinc oxide) underneath bikini tops for 3-6 months following surgery. Genetics and patient compliance affect the ultimate result of a scar following the placement of a breast implant. The scar should fade to a thin white line over the course of a year.
Patients in our practice very rarely complain about their incisions and its almost unheard of that we have to do touch up procedures (scar revision) on breast implant placement scars.
Dr. Albert Carlotti sits down with patient Carmen to answer some frequently asked questions about breast augmentation
What Are the Risks of an Augmentation Mammaplasty?
There are risks associated with any surgery, however, the following risks are specific to augmentation mammaplasty using implants:
- Capsular contracture
- Implant leaks and ruptures
- Implant deflation or shifting
- Temporary or permanent change in nipple/breast sensation
- Irregularities in breast contour/shape
- Partial or total loss of nipple/areola
Can My Breast Implants Be Removed?
If your breast implants need to be removed, it is a simple quick operation to perform. Recovery is quite easy with the exception of compression for 1-2 weeks. If a woman has large implants, it may be likely that upon breast implant removal that there will be droopy (ptotic) skin and breast tissue. The patient’s nipples may point down. In that situation, breast lift (mastopexy) may need to be performed to help rejuvenate the breast tissues by lifting things back up properly