Magazine Feature - Rivaaj, July 2007
Breast Augmentation
Breast Augmentation was the most commonly performed cosmetic surgical procedure in 2006, according to the American Society of Plastic Surgery. It is a testament to the operation that 94% of women, after having it done, would recommend it to others. In my practice in Newport Beach and Santa Monica, CA, breast augmentation is certainly one of the most commonly requested operations. In fact, many women even come in knowing exactly what type and size of implant, incision location, and implant position they desire.
The truth about breast augmentation is that it is a life-long commitment and, as with any operation, it should not be taken lightly.
* All implants can wear out over time and leak.
* All implants are “foreign bodies” that your body has to form a capsule of scar tissue around.
* All implants will stretch skin and breast tissue over time.
* You made need a second operation at some point in your life.
And these are the points that I make sure all women understand before they commit to breast augmentation.
Breast augmentation generally comes in two patient variations. First is a young woman who is naturally small-breasted, never had children, and wants fuller breasts. Second is a more mature woman, who after finishing child-birth, notes that her breast size had decreased and she has loose skin leading to sagging, known as ptosis. For the former, an implant will need to be chosen that will not stretch the natural boundaries of her native breast, aka “fit her body”. This implant will also stretch out her breast skin gradually until it looks natural. For the latter, the implant will serve two purposes – replace the lost breast volume and provide a certain amount of “lift” to the low breast (if this is not enough, your surgeon may recommend a formal
breast lift, called a mastopexy).
Regardless of patient type, a decision needs to be made regarding implant type. All implants are composed of a solid silicone outer shell and a fill material of either saline (sterile salt-water) or elastic silicone gel. Both implants are currently FDA-approved, but it should be noted the silicone implants have only recently been re-introduced to the US in November 2006, after a 14-year hiatus, during which they were vigorously tested for safety.
You will also need to choose the location of the scar for implant placement. Briefly, there are four methods, of which I prefer the first two.
* Inframammary – a scar hidden in the fold on the bottom of the breast.
* Periareolar- a scar hidden in the perimeter of the areola.
* Transaxillary- a scar hidden in the armpit – less commonly performed.
* Transumbilical- a scar hidden in the belly button – least commonly performed, difficult to perform accurately.
In addition to the incision, your doctor will also discuss placing the implant either directly under the breast tissue or underneath the pec muscle, to provide additional padding on top of the implant.
One last issue to discuss in this limited article is capsular contracture, which is estimated to occur in 10-30% of women. Your body will form a capsule composed of scar tissue around the implant. If this capsule were to become thick and firm, it can result in capsular contracture. This contracture, depending on severity, can cause your breasts to feel firm, hard, or even painful, and is one of the common reasons for revision operation.
I have briefly covered the salient points of breast augmentation here, but obviously anyone considering breast augmentation needs to have a lengthy consultation with her plastic surgeon. It remains one of the most satisfying procedures I perform, as I can see an immediate rise in a woman’s self esteem and confidence (as well as the amount of attention they receive!).
Dr. Savalia practices at: 20072 S. Birch St., Suite 210,
Newport Beach, CA 92660, Tel: and 2001 Santa Monica Blvd, Suite 890W, Santa Monica, CA 90404, Tel: (310) 829-5977. He can be reached at: drsavalia@finesse-aesthetics.com. For further information please check www.finesse-aesthetics.com
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