Breast
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Overview
If you are like many women who desire larger, fuller, shapelier breasts, breast augmentation may be a good choice for you.
Breast augmentation is a common procedure used to enhance small breasts or correct breast volume reduction due to pregnancy, weight loss, or the natural aging process. The procedure results in fuller, more beautifully shaped breasts.
Options in Breast Augmentation
OUTER SHELL: MATERIAL & SHAPE
The outer shell of the breast implants is made of a solid silicone polymer. This substance is used for implants placed anywhere in the body because it is an inert substance with no possibility of allergic reaction or rejection. Based on individual factors, the outer shell may be smooth or textured. Smooth implants are usually preferred because of the reduced amount of wrinkling and more natural feel and appearance. Textured implants may be used for patients who have had implants before and have developed capsular contracture as it is believed by some surgeons that the use of textured implants may prevent the reoccurrence of capsular contracture.
Breast implants are round or anatomical (“teardrop-shaped”). Round implants are the most common and are designed to compliment the anatomy of most women. For women who are very tall and/or have a longer-than-average torso, anatomical shaped implants may be used. Anatomical implants have a greater vertical component and give some height to the breast when needed to proportionately fill the height of the chest.
One of the most important decisions to make is the implant size. During your consultation, Dr. Nguyen will discuss your desired results and will recommend a size that will be appropriate for your height, weight, body frame, and desired fullness. To help you visualize the results you can expect, your patient coordinator will try the sizes on with you. Your feedback from the sizing will be relayed to Dr. Nguyen and adjustments may be made to his recommendation.
There are also different profiles of implants, referring to the amount of projection given a certain implant volume. Determining which profile is appropriate depends on a combination of desired volume and chest width. A moderate profile implant is appropriate for most patients (ie. women who require a moderate enhancement). If the moderate implant diameter is significantly larger than the width of your breast, a high profile implant may be chosen – giving more projection with a smaller diameter. If your breast width is between the diameters of the moderate and high profile implants, you will be asked to decide if you prefer more upper pole fullness (more volume at the top of the breast) or more fullness to the side of the breast. For more fullness at the top of the breast a high profile implant will be chosen whereas for more fullness at the side of the breast, a moderate profile implant will be chosen.
Saline vs. Silicone
For most patients with a first time breast augmentation, the implant will be saline-filled. Saline breast implants are filled with sterile saline solution, a fluid of similar chemical composition to the fluid in your body. The advantage of saline breast implants is that the fluid is completely harmless and in case of a leak in the implant, the fluid would be easily absorbed by the body. Most patients are very happy with saline implants as they look beautiful and are very safe. Patients who are very thin or who have little breast tissue may feel the implant or notice some wrinkling of the implant on the lateral edge (closest to the underarm) or under the breast at the inframammary fold.
There may be some patients who would prefer silicone breast implants. The advantage of silicone breast implants is that they feel more like real breast tissue and have less wrinkling than saline implants. Women with very little breast tissue and/or very thin skin would benefit most from the reduction of wrinkling and the more natural feel of silicone breast implants. The disadvantage of silicone filled breast implants is that although there is promise for approval by the FDA in the near future, they are currently limited to patients who have had problems with saline implants (eg. capsular contracture) or who are undergoing reconstructive breast surgery (including breast lift and post-mastectomy reconstruction). There have been great advances in silicone implants since they were originally taken off the market. The current generation of silicone gel implants is filled with a cross-linked polymer of silicone making it a gel rather than a silicone liquid (as the previous generation contained). Inamed also uses a patented Intrabarrier Shield® to prevent migration of the silicone gel across the shell. We feel that these silicone implants, which are currently being widely used for qualifying patients, are relatively safe and will eventually be brought to the general market.
Implant Placement: Over vs. Under The Muscle
Implants may be placed directly under the breast tissue but it is more common to place the implant under the pectoral muscle. There are several important reasons to place the implant under the muscle. First, the muscle covers the top of the implant and provides a smooth transition, giving a natural look to the breast, even in revealing clothing. The muscle also provides additional support to the implant, giving longer lasting results. For mammograms, radiologists prefer the implant to be placed under the muscle so that the breast tissue can be isolated more easily for accuracy of the imaging. Finally, placing the implant under the muscle reduces the risk of capsular contracture (the hardening of scar tissue around the implant) by as much as two thirds. The rate of capsular contracture for implants placed over the muscle is approximately 10% whereas rate of capsular contracture under the muscle is approximately 3-5%.
Incision Area
The incision is approximately 2cm in length (less than one inch) and is usually placed either at the bottom edge of the areola (the pigmented area around the nipple) or along the inframammary fold (the natural crease under the breast). Scarring with the periareolar incision is minimal due to the color contrast provided by the areola and minimized tension on the incision at that site. The incision is thin and small under the inframammary fold and will hide most of the time, but some bras and bikinis may pull up on the breast revealing the incision at that location.
Alternate methods of implant placement include endoscopic techniques with incisions under the armpit (transaxillary) or through the belly button (transumbilical / TUBA). The TUBA technique does not allow for placement under the muscle and these techniques may also carry additional risks including internal scarring and malplacement of the implant and are therefore not preferred by most plastic surgeons.
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"The staff at ICRS are so nice and they make you feel very comfortable. I feel more confident after having had the procedure done and I love the way I look now. I would definitely recommend Dr. Nguyen to my friends. He's awesome and his work is amazing. He makes you feel comfortable and safe."
- Ashley
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The Consultation
Your consultation with the doctor is complimentary and there will never be any charges for office visits. During your initial consultation, you will be asked to give information about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal supplements, as these can affect your blood pressure and clotting ability. You also need to let the doctor know if you use any tobacco products, alcohol, steroids, or street drugs, as these may have a profound impact on your recovery period and your ability to heal following your procedure. After reviewing your medical history, Dr. Nguyen will discuss your desired results, your concerns, and your priorities. He will then explain the options that are available to you and explain the advantages and disadvantages of those options. In the end, he will present a surgical plan to help you achieve the appearance you desire.
After your consultation with the doctor, your patient coordinator will provide you with a written quotation for the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. We understand how important this decision is to you and you will not be pressured to make a decision. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.
Preparing For Surgery
On the day of your consultation, you will receive instructions on how to optimize your health before surgery. This will include what medications to stop and what testing will be required before surgery. If you are over 40, you will need a mammogram within one year of surgery for any breast procedure. If you are 45 years of age or older, or if you have any health problems, you will need to see your primary care physician to have bloodwork, an EKG, and obtain surgical clearance stating that there are no counterindications for you having surgery. You should not take aspirin containing products or smoke for two weeks before surgery. If you have health problems or a history of health problems, you may require additional testing or clearance.
For full details on our pre-operative requirements, Click Here To Download
“Optimizing Your Health Before Your Cosmetic Surgery.”
If you do not have a primary care physician, we recommend Dr. Chi Phan, located at 4050 Barranca Pkwy Suite 210; Irvine, Ca 92604 Phone: 949-654-7833. Dr. Phan accepts most insurance. For those who do not have insurance, Dr. Phan charges approximately $120 for surgical clearance, including EKG & bloodwork.
The Day of Surgery
While you're making preparations, be sure to arrange for someone to drive you home and be with you overnight. Your surgery will be performed in our outpatient surgery center at 11190 Warner Avenue, Suite 400; Fountain Valley, CA. You will not be allowed to have anything to eat after 9pm the evening before surgery or drink after midnight the night before surgery. You should shower prior to surgery but do not use any lotions or perfumed products on the chest area. You should not bring jewelry, contact lenses, or valuables on the day of surgery. Wear loose, comfortable clothing with a shirt that buttons or zips in the front (we don’t want to put anything on over your head when you get out of surgery). Arrive two hours prior to surgery.
The Procedure
The procedure takes between 1 to 1 1/2 hours and is performed as an outpatient surgery under general anesthesia. After surgery, you will recover in the recovery area for approximately one hour, until you are alert enough to go home. You will be wearing a supportive bra that you will continue to wear for several weeks after surgery. There will be tapes over the incision which should remain intact for 2 weeks.
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"I am very happy with my results. I am able to wear clothes with more confidence now. I have already recommended friends to Dr. Nguyen. He was so friendly and listend to what I wanted. Plus, I am so impressed with my scars. You can't even see them!"
- Britanny
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After Surgery
For the first day or two you will rest most of the time and limit your upper body activity. You should sleep with your head elevated (approximately 45 degree angle) so that you can get in and out of bed without using your arms. You will begin taking pain medication and antibiotics after surgery. Each time you take your pain medication, you should have a snack as the medication can be irritating to your stomach. For the first 24 to 48 hours you will have a sensitive stomach and you should eat mild foods such as you would normally eat if you had the flu (soups, crackers, etc.). Dr. Nguyen also strongly suggests Gatorade to replenish your fluid levels.
You will be able to return to most of your normal (light) activities within a couple of days. You will be able to shower once you feel comfortable being up for extended periods of time without lightheadedness, usually on the third day. The tapes over your incision will protect the incision from the soap and water so you may shower as normal and pat the tapes dry. Patients with an office job are often able to return to work within 3-5 days. More strenuous jobs may require work restrictions which you may request a certifying letter from the receptionist.
Your first follow-up visit will be at one week after surgery. You will be taught to massage your breasts at this time which will help the muscle to relax and the implant to settle into place. You will be reminded that the tapes over the incision may be removed after the second week.
During the first six weeks you will wear a supportive bra with no underwire. You may continue to wear the one we provide or purchase an alternative such as a soft sports bra with hooks or a zipper in the front. During this recovery period, you will also reduce your activities by eliminating strenuous aerobic exercise, limit lifting (to no more than 5 lbs), and reduce the amount of work you do with your arms. More strenuous activities may be reintroduced after six weeks. You should ask your doctor about specific activities.
Commonly Asked Questions
Is it likely that I will lose nipple sensation after breast augmentation?
No. It is extremely unlikely that normal nipple sensation will be disrupted in any way by breast augmentation. There will be some temporary changes in breast sensation which will resolve in approximately 8 weeks.
Are breast implants dangerous to my baby if I become pregnant or decide to breast feed?
No. Breast implants do not harm or pose a risk to normal pregnancy in any way.
Can I breast feed after breast augmentation?
Yes. Most women who have breast augmentation should be able to breast feed. However, there is some chance that the milk supply may be diminished from the pressure of the implant.
What will happen to my breasts if I become pregnant?
Pregnancy and breast feeding may result in some sagging of the breast. Because the implant maintains its own integrity and does not lose volume with breast feeding, women with implants will experience less changes than women without breast implants.
Your Results
Most women are very pleased with their new body image. You can expect to eliminate the need for padded bras and will be able to wear many of the fashions you have been wanting to—from plunging necklines to form-fitting tops to bikini tops with confidence. Your results will last for many years to come.
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"I am happier and more confident now. I have a natural look and am extremely happy that my scars are not visible to the naked eye. Everyone at ICRS was very curtious and treated me with the greatest respect. I felt very comfortable throughout my experience. I have already referred friends to Dr. Nguyen."
- Lyndsey |
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Warranty Program
Your breast implants are warrantied against deflation. You will be automatically enrolled in the ConfidencePlusTM Limited Warranty program at no cost to you. You are encouraged to sign up for the ConfidencePlusTM Platinum Limited Warranty which costs only $100 and doubles your coverage.
ConfidencePlus™ Limited Warranty
• Automatic Enrollment.
• Silicone filled and saline filled breast implants covered.
• Lifetime product replacement in case of deflation.
• 10 years of guaranteed financial assistance. Receive up to $1,200 of out-of pocket expenses for surgical fees, operating room and anesthesia expenses not covered by insurance.
ConfidencePlus™ Platinum Limited Warranty
• Low enrollment fee of $100.
• Silicone filled and saline filled breast implants covered.
• Lifetime product replacement in case of deflation.
• 10 years of guaranteed financial assistance. Receive up to $2,400 of out-of pocket expenses for surgical fees, operating room and anesthesia expenses not covered by insurance.
The Cost
These fees are approximate and are only to give you an idea of what you can expect. Fees may change without notice. An official binding quote (valid for 30 days) will be given on the day of your consultation. These fees include Surgeon’s Fee, OR Fee, Anesthesia Fee, Implants, Surgical Bra, and Follow-Up Visits.
Breast Augmentation with Saline Implants $5,200
(Under the Muscle/General Anesthesia)
Breast Augmentation with Silicone Implants $6,700
(Under the Muscle/General Anesthesia)
