Breast Augmentation Charlotte
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What is a Charlotte breast augmentation?
- Breast augmentation is a procedure that will enlarge, or “augment,” a patient’s existing breast size. The procedure is also referred to as an augmentation mammoplasty. The surgery involves the use of implants to provide the added a volume necessary to achieve fuller breasts. Breast augmentation is consistently one of the most common cosmetic surgical procedures performed annually in the United States and around the world. Breast size can easily be increased by one or more bra cup sizes, depending on patient desires. Breast augmentation can also provide desired “cleavage” that would otherwise not be possible. Breast augmentation can also correct breasts of different sizes in order to achieve better symmetry. By increasing the fullness and projection of the breasts, breast augmentation can greatly enhance self-image and self-confidence. The patient satisfaction with this surgery is extremely high (over 93%).
Female breasts have historically reflected a woman’s femininity and sexuality in cultures around the world. The curvaceous feminine form has been admired throughout the centuries in art, literature, and the media. With the social emphasis that has been placed on the breasts, it is not surprising that so many women seek breast augmentation. This demand continues to increase based on statistical information regarding breast augmentation surgery. The safety and affordability of the procedure have now made it available to a much broader patient population. There is also no longer the stigma related to cosmetic procedures that existed in years past. Breast augmentation is a highly individualized procedure and a patient should never undergo the surgery in order to fulfill someone else’s desires or to try to fit any sort of ideal image.
Medical and surgical descriptions of breast augmentation techniques have been documented in the medical literature since the early 1900s. Early breast augmentation methods involved the injection of substances such as paraffin or silicone which was fraught with complications. Prosthetic implantation has been used since the 1950s, and the earliest silicone breast implants were first used in the 1960s. The science and surgical knowledge related to breast augmentation surgery has evolved immensely in recent decades. The technology of implant material has also changed drastically over the years. Although complications can arise with any surgical procedure, these factors have resulted in a historically low rate of complications related to breast augmentation surgery. In the United States, the FDA has currently approved the use of breast implants from three different companies (Mentor, Allergan, and Sientra).
Patient’s currently have more options than ever for breast augmentation. The procedure can be performed through several different incision locations. Most patients opt for an inframammary incision which is underneath the breast, but incisions around the areola or in the axilla (underarm) are also options. Breast implants can be placed in a subpectoral position underneath the muscle or in a subglandular position above the muscle. There are also options for silicone or saline implant types. Within these implant types there are further options regarding implant shape and projection. Textured or smooth shell implants are further options. Dr. Miles will spend a great deal of time during the consultation process discussing these options in order to determine which of them will best fulfill a patient’s goals and desires. Patients will be able to see and feel the different implants during the consultation.
Is a breast augmentation safe?
- Safety is always the foremost priority with any surgical procedure at North Charlotte Plastic and Reconstructive Surgery. Breast augmentation is the most common surgical cosmetic breast procedure performed in the United States, with 300,000-400,000 breast augmentation procedures performed annually. The surgery does not require deeply invasive surgical maneuvers near vital structures that would potentially place the patient at increased risks. Prior to any surgery, all patients undergo a thorough medical history screening during the consultation process. In some instances, Dr. Miles may recommend a baseline mammogram before surgery and another mammographic examination several months after surgery. This will help to detect any future changes in the breast tissue. Although there is no scientific evidence that breast augmentation increases the risk of breast cancer, the implants can make it more difficult to take and read mammograms. Placement of the implant underneath the pectoralis major muscle may interfere less with mammography, but other factors should also be considered with regard to implant placement. Radiologists are now quite adept at reading mammograms after breast augmentation, as there are millions of women who have undergone the procedure. Following breast augmentation, patients should continue performing breast self-examination and routine mammography. Smokers should stop smoking in advance of surgery. Aspirin and other anti-inflammatory drugs such as ibuprofen can cause increased bleeding risks and should be avoided prior to surgery. Dr. Miles will provide specific instructions to optimize outcomes. Medical testing and clearance for surgery from other providers is sometimes necessary. Dr. Miles performs the surgery in the hospital setting under general anesthesia using board certified anesthesiologists. He also works with an experienced and highly qualified team of assistants that have assisted with these procedures for many years. Dr. Miles is a double board certified surgeon who has extensive experience with breast augmentation surgery. Although complications can occur with any procedure, they are very rare with breast augmentation surgery. In rare instances when complications related to this procedure do occur, they are usually minor and can be managed effectively in the office based setting without a return to the operating room.
Despite some misinformation to the contrary, breast implants do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and diseases. Their specific conclusion after numerous exhaustive studies was that “There is no evidence that silicone implants are responsible for any major diseases of the whole body. Women are exposed to silicone constantly in their daily lives.” The FDA has accepted the findings of these extensive clinical trials and has approved the use of both silicone and saline breast implants.
Another very important factor related to patient safety is that the procedure should only be performed by a surgeon who is board certified by the American Board of Plastic Surgery. Surgeons with this qualification have met the highest standards of training and board certification. Dr. Miles has these qualifications.
How long does a breast augmentation usually take to perform?
- Breast augmentation surgery is an individualized procedure and surgery times will vary depending on the techniques used. The procedure generally takes about an hour to an hour and a half of operative time. Because every patient is different and has different goals, the time to complete the surgery will vary. Keep in mind that attaining an aesthetically pleasing result is a high priority with Dr. Miles, and he will take as long as necessary to reach that goal. Dr. Miles uses breast sizers during breast a augmentation procedure which also slightly adds to the operative time. These devices enable him to evaluate how different size implants will look before selecting and inserting the permanent implants.
How do you perform a breast augmentation?
- The goal of breast augmentation surgery is to enlarge the size of the breasts while achieving breast symmetry and an aesthetically pleasing shape. Therefore every breast augmentation procedure is tailored to meet the needs of the specific patient. Dr. Miles places great importance on the surgical consultation and spends a great deal of time with patients prior to surgery. He will listen to patient’s desires regarding breast size and other concerns related to the appearance of the breasts. As with any elective surgical procedure, safety is of utmost importance and appropriate prescreening and safety measures are always followed. A patient’s medical and surgical history is thoroughly evaluated prior to surgery.
There are various techniques that are used for breast augmentation surgery. The breast augmentation procedure is typically performed under general anesthesia as an outpatient procedure. Incisions are made in inconspicuous areas to minimize visible scarring. Breast augmentation can be performed through an inframammary incision (underneath the breast), a transaxillary incision (in the axilla or underarm area), or a periareolar incision (around the areola). Dr. Miles does not perform breast augmentation procedures through an incision around the belly button. This procedure is referred to as a TUBA, or transumbilical breast augmentation, and has not gained widespread acceptance. More predictable and satisfying results can be achieved through the other incisional approaches. Dr. Miles will discuss which incision option is most appropriate keeping in mind your desires and goals. The type of implant used, the degree of breast enlargement desired, and a patient’s prior surgical history are all factors that are important to consider when discussing incision location.
Patients can now choose between saline and silicone breast implants. Both implant types are very safe and have been approved for use by the Food and Drug Administration (FDA). Currently the FDA has approved saline breast implants for augmentation in women 18 years of age and older, and silicone breast implants for augmentation in women 22 years of age and older. Either implant can be used for reconstructive purposes regardless of age.
Saline breast implants are filled with sterile saline (salt water). They can be filled with varying amounts of saline which can affect the size, shape, firmness and feel of the breast. Minor asymmetries can often be corrected by using different amounts of saline on each side. Because saline implants are filled after they are inserted into the body, a slightly smaller incision can often be made as compared to a silicone implant which has a prefilled volume that cannot be adjusted. In the rare instance that a saline breast implant leaks, the shell will collapse and the saline will be absorbed by the body and naturally expelled.
Silicone breast implants are filled with a soft, pliable silicone gel. The gel is designed to move and feel much like natural breast tissue. These implants are placed through the incision using a recently developed funnel system (Keller Funnel) that allows for a smaller incision and eliminates the requirement to physically touch the implant. This process is thought to reduce infection and capsular contracture rates. Breast asymmetries are corrected using silicone implants of different sizes. If the silicone implant ruptures or leaks, the gel is usually contained within the breast implant pocket. Because the implants feel so natural, an MRI study is sometimes recommended to assess their condition. There are currently three approved manufactures of breast implants in the United States. These companies are Mentor, Allergan, and Sientra.
Silicone and saline breast implants come in many shapes and sizes. Some are wider with less projection and some offer a higher breast profile. Textured shells are also used at times. Finally, patients can choose between round or anatomically shaped “teardrop” breast implants. The scope of implant choices is complex. The type of implants that will best suit your goals is dependent on your desires, breast anatomy, skin elasticity and body type, and can best be determined after a thorough consultation with Dr. Miles. Patients can touch and feel these implants during their consultation to give them a better understanding.
After the incision is made, the breast implant pocket is created. Most of the time, the implant will be placed into a pocket under the pectoralis major muscle. This is called a submuscular position. Other times it can be placed on top of the muscle, directly behind the glandular breast tissue. This is called the subglandular position. This is also an important decision that will be made during the preoperative planning process. Incisions are closed with layers of absorbable sutures. There are no sutures to remove after the procedure. Skin adhesive or surgical tapes are used over the incisions. The incision lines generally heal very well and will fade over time.
Who is a good candidate for a breast augmentation in Charlotte?
- Women choose to undergo breast augmentation for a variety of personal reasons. Patients must first be mature enough to make the important decision to undergo any elective cosmetic surgical procedure. Patients who undergo breast augmentation should also be at least 18 years of age and have breasts that are fully developed. Patients should come to the consultation prepared to discuss their medical history, including information about any medical conditions, drug allergies, medical treatments that they have received, any previous breast biopsies or breast surgery, and current medications. Patients should also discuss any personal or family history of breast disease and previous or planned pregnancies.
Breast augmentation should only be performed to satisfy personal goals and should not be pursued in an attempt to achieve an ideal body image based on cultural or social pressures. Some women are constantly bothered by the feeling that their breasts are naturally too small. This can cause self-esteem issues related to a negative body image. Sometimes patients who are self-conscious about their small breast size will avoid certain social situations. These patients will often avoid wearing clothing such as swimsuits or form-fitting tops. Other women seek to restore breast volume lost after aging, weight loss, pregnancy, or breast-feeding. It is common that patients will present with breasts of different sizes. Sometimes this causes challenges finding clothes that fit properly. Breast augmentation is an excellent way to address these asymmetries. Breast augmentation is an excellent way to restore self-confidence and self-esteem.
What are realistic expectations for a patient having a breast augmentation?
- Breast augmentation patients are overwhelmingly very satisfied with their results. However patients need to honestly discuss their expectations prior to surgery to avoid disappointment. The ideal implant size for a particular patient is determined not only by the patient’s desired size increase, but also depends on breast anatomy, skin elasticity and body type. Many patients are not suited for very large implants. Breast asymmetry can be greatly improved by breast augmentation, however it is unrealistic to expect a perfectly symmetrical correction. Remember that breast implants simply augment or enlarge the existing breasts. Breast augmentation also does not correct breasts that are severely drooping, or “ptotic.” Some patients will require a breast lift, or mastopexy, in conjunction with breast augmentation to achieve the optimum results. Breast lifting can sometimes be performed at the same time as the augmentation or it may require a separate operation. These issues will be discussed thoroughly during the consultation with Dr. Miles and he will make recommendations about how to best meet a patient’s goals.
Patients considering cosmetic surgery should be aware of both the benefits and risks of the procedure that they desire. Potential complications include reactions to anesthesia, hematoma (blood accumulation) around the implant, infection, implant malposition, and capsular contracture. All patients are given antibiotics and infections are very rare, however an infection that does not resolve may require temporary removal of the implant. Although usually temporary, changes in nipple or breast sensation may result from breast augmentation surgery. The scar tissue that naturally forms around breast implants is known as the capsule. The capsule may sometimes tighten around the implant, causing the breast to feel firmer than normal. This is known as a capsular contracture and can occur to varying degrees. If severe, it can cause discomfort or changes in the breast’s appearance. In such cases, more surgery may be recommended to modify or remove the scar tissue, or perhaps remove or replace the implant. Breast implants are not lifetime devices and cannot be expected to last forever. Implant rupture is very rare, however when it occurs the implants s should be replaced.
The results of breast augmentation surgery are generally long-lasting. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. Some women seek further surgery after a period of years to once again restore their breasts to a more youthful appearance.
What are the common reasons why a patient wants a breast augmentation in North Carolina?
- Women choose to undergo breast augmentation for various personal reasons. Breast implant surgery performed by plastic surgeons is the most popular way to improve breast size and shape. Perception about the ideal breast size varies greatly between patients. Some women desire fuller breasts because they feel that their breasts are naturally too small or under developed. This can cause self-esteem issues related to a negative body image. Other women seek to restore breast volume lost after aging, weight loss, pregnancy, or breast-feeding. It is common for patients to have breasts of different sizes. Sometimes this causes challenges finding clothes that fit properly. Breast augmentation is an excellent way to address these asymmetries. These patients will often avoid wearing clothing such as swimsuits or form-fitting tops. Breast enhancement with implants is an excellent way to give a woman a more proportional shape and improve self-esteem.
How long does it take for a patient to recover from a breast augmentation?
- The results of breast augmentation surgery are immediately visible. The breasts will appear to be very full and the implants may seem to be in an unusually position high immediately after surgery. This is normal and should not cause concern. The appearance will improve in the weeks following surgery and the breasts will look much more natural 6-8 weeks after the procedure. It is also common for patients to experience some sensory changes to the breast skin or nipples after the surgery. These changes are almost always temporary. Patients should not engage in heavy lifting or any other strenuous activity for at least the first few weeks following surgery. After that, care must be taken to be gentle with the breasts for at least the next month. Mild bruising is normal in the postoperative period. Most patients have only mild discomfort, and usually off of their pain medication by the end of the first week. Over time, post-surgical swelling will resolve and incision lines will fade. Complications are rare, and most breast augmentation patients resume normal activities within a week of their surgery depending on the type of activities that are required. It is important to follow all patient care instructions as directed by Charlotte Plastic Surgeon, Dr. Miles.
