Breast Enlargement St. Louis - Breast Enhancement Missouri
A breast augmentation is a procedure in which either a prosthetic implant, such as a silicone or saline implant, or someone’s own fat, is used to augment the breast. This procedure usually takes anywhere from 1 ½-2 hours to perform and is generally done under general anesthesia. When an implant is used, the implant is placed either through one of three different incisions: The incision can be around the areola, which is the pigmented area near the nipple, in the natural breast fold, or occasionally through the armpit. If a breast lift is being done those incisions that are used to make the breast lift will be utilized to insert the implant.
If fat is injected, very small incisions are made through which fat is inserted after liposuction is done.
Dr. Cabbabe performs hundreds of implant surgeries each year and he uses only FDA – approved breast implants. These come with various warranties in case of rupture/leaking or capsular contracture. The current choices for a breast implant are silicone and saline. A silicone implant has a silicone shell with silicone material inside. A saline implant is composed of a silicone shell with saline or salt water inside. Silicone implants are available as round or “shaped”/”gummy bear”.
A silicone implant tends to provide a more natural look and natural feel with less rippling. Current FDA recommendations state that women <22 years of age should have saline implants; otherwise, any woman can choose whichever is preferred. FDA recommendations are for MRI screening 2 years after augmentation then every 3 years thereafter. This is to detect silent ruptures of the implant which may require further surgery. These are recommendations, not requirements and Dr. Cabbabe will review his opinion on this recommendation with you at the time of your consultation.
The expected life of an implant is approximately 15 years. If an implant ruptures and it’s saline it will generally deflate the breast and one would know immediately. If it’s silicone the patient will likely feel a small bubble or some other sort of contour change or maybe some local irritation or discomfort. Either way, it is recommended that the implants be replaced and generally, if this has been several years, both implants will be replaced at the same time. We purchase our implants with lifetime warranties so that if this occurs the company will pick up the cost for the implants themselves for the lifetime of the implants. They will even give money towards surgical fees if this occurs in the first 10 years after placement.
Preparing for Surgery
Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin, ibuprofen or any other type of blood thinner. If you are older than 40, a mammogram within one year prior to the procedure is recommended as part of normal health screening. You will have an opportunity to try implants of various sizes inside a bra which will help you determine which size implant is best for you. Dr. Cabbabe will also measure your chest width to help you determine the best fit and shape for you.
A good candidate for a breast augmentation procedure is anyone who desires to have more fullness or enhancement of their breasts. If the breast is significantly ptotic or droopy, a breast lift may be recommended as well.The realistic expectations for a patient undergoing this procedure would be enlargement of the breast, filling both the upper and lower poles of the breast. This procedure in and of itself does not lift the breast. A breast lift only will do that and requires additional scars. The common reasons why someone pursues this would be that they’re either very small to begin with or perhaps they have lost volume in their breasts, most commonly after having had children, breastfeeding, or weight loss.
Most silicone implants are generally placed through an incision in the breast fold. although they can be placed around the areola if desired. If a saline implant is used occasionally they can be inserted through the armpit if one doesn’t desire any incisions on their breast at all. Most of the time the implants are placed underneath the muscle on the chest in order to keep them where they belong on the breast and to provide some additional thickness and to reduce the risk of seeing visible ripples. This also reduces the risk of what we call capsular contracture, which is abnormally tight scarring around the implant that can distort or potentially cause pain on the chest. The implant companies have begun to offer warranties in case this happens.
Breast augmentation surgery takes around 1 1/2 hours and antibiotics are given before and after the procedure, generally no drains are used and no massaging is generally needed either. Patients are able to shower the next day and go home in a bra. Early range of motion is done with the arms. Patients will generally follow-up within 1 day to 1 week and then approximately 3-4 weeks later and then in several months.
Nipple sensation and the ability to lactate are usually preserved in these procedures. Women are able to get mammograms after surgery and implants do not interfere with breast cancer detection.
Before and Afters
Recovery is approximately 1-2 weeks from a breast augmentation procedure depending on the size of the implant used and the type of work one does. Most women who have this procedure done will be up and about the next day, moving around although they may need pain medication occasionally, but most women state it was not as bad as they anticipated and most of them, if they’ve had it done on a Thursday or Friday, can usually return to work the following Monday.
Dr. Cabbabe strives to make the procedure as easy and comfortable as possible for his patients. Before surgery, patients usually receive anti-inflammatory pain medications that do not cause bleeding. At the time of surgery, local anesthesia numbing medicine is used that is long – lasting into the breast. After surgery, early range of motion is begun and pain medications are given. Dr. Cabbabe does not believe in the use of pain pumps for breast augmentation as studies have shown mixed results with their use, they are costly and they increase the risk of infections. Dr. Cabbabe has removed breast implants on patients from other practices that use pain pumps due to infection.
The complications that can occur are infections of the implant, rarely requiring the implant to be removed, or bleeding into the pocket around the implant requiring further surgery to evacuate blood or stop bleeding. Most women have some asymmetry to their breasts and most of the time the same sized implant is used on both sides but occasionally a different size implant will be used if needed. More significant asymmetries need to be addressed through further incisions on the breast in the form of a breast lift. Capsular contracture can occur although this has become less common in Dr. Cabbabe’s experience. An implant may rupture and further surgery would be needed during their lifetime. Finally, there are rare cancers, referred to ALCL, which have been linked to breast implants. Fortunately, these are rare and are still case reportable. They have been found in women who present with fluid around their implants after breast implant surgery.