Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. and one of our most popular services. Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast.
Our patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under Dr. Ganchi’s expert care, patients enjoy beautiful, natural-feeling breasts that are one or more cup sizes larger after the operation.
Fully Customized Breast Enhancement
We understand that every woman is unique in both her desires and her body shape. With that in mind, Dr. Ganchi takes the time during pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type and implant placement is best. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind.
Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results.
Saline and Silicone Gel Breast Implants
Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. We will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle.
After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants.
Breast Augmentation Surgery – Incision Techniques
The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located:
- In the crease on the underside of the breast (inframammary),
- Around the areola, the dark skin around the nipple (periareolar), or
- In the armpit (transaxillary).
The breast is then lifted, creating a pocket into which the implant is inserted.
Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach. Please note this technique is not ideal due to lack of control in implant placement and difficulty in subpectoral positioning.
Breast Augmentation Surgery – Placement Options
Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include slightly increased post-operative discomfort. We will discuss which option may be best for you.
After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed and bandaged. The patient is then placed in a soft support bra.
Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week.
The stitches are self-dissolving and any post-operative pain, swelling, or sensitivity will diminish over the first few weeks.
Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years.
Complications following breast augmentation surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast.
If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. A silicone implant leak may not be as easily detected and an MRI may be helpful for diagnosis. In either case you will need to visit your surgeon for an assessment.
Breast Fat Grafting
Breast reconstruction surgery replaces the breast that is removed when a woman has a mastectomy to treat breast cancer. Although breast reconstruction often involves inserting a synthetic implant, there is an alternative, more natural treatment for rebuilding the breast(s).
“Autologous fat grafting” removes fat from an area of the body that has fat to spare, and places it in the reconstructed breast for results that look and feel natural. By using the patient’s own fat, the hard look and feel often associated with implants is eliminated. Many women also like the idea that a foreign material has not been inserted in their bodies. The cosmetic benefit of fat grafting is that the area, usually the abdomen, from which the fat is taken becomes slimmer and more contoured. Fat-grafting breast reconstruction is ideal for nearly any woman who wants a breast reconstructed, does not want to use a saline or silicone implant, and has enough body fat available to sufficiently rebuild the breast.
Fat-Grafting Breast-Reconstruction Procedure
For a number of weeks or months prior to fat grafting, a tissue expander is placed below the pectoralis major muscle of the chest wall to create a new breast “pocket.” When the tissue has expanded enough, breast reconstruction using fat grafting can begin. First, fat is removed using liposuction, in which a cannula (a thin, hollow tube) is inserted through small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or a cannula-attached syringe. The harvested fat cells are then purified. In the second procedure, which takes place on the same day, the fat is injected into the breast through small incisions.
The procedure takes 4 to 6 hours to perform under general anesthesia, or local anesthesia with sedation, depending on the preference of the patient and surgeon. Because some of the injected fat is reabsorbed by the body, some people may require two to five fat grafting procedures to achieve satisfactory results. Postoperative pain and swelling, which can be managed with prescription medication, are typical. A patient can return to work and other light activity after a few weeks.