Breast Enlargement St. Louis - Breast Enhancement Missouri

Do you wish that you could fill out your clothing a little more? Have you had children and found that your chest is now smaller or deflated? Have you had surgery on your breast for congenital, cancer, or traumatic reasons and now have asymmetry? If so, you may be a candidate for breast enhancement or augmentation.

Breast augmentation enlarges the breasts to create a more full appearance. This can be accomplished through the use of a silicone or saline implant or from fat that is transferred from another area of the boy.   Dr. Cabbabe uses the latest fat grafting equipment, the Coleman Fat Grafting System, to optimize your results.

If you have a significant amount of droopiness of the breast (“ptosis”), Dr. Cabbabe may recommend a breast lift/mastopexy procedure. This can often be done at the same time as the augmentation procedure. Dr. Cabbabe will discuss this in more detail at the time of your consultation.

Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the breast to give his patients the best results possible to meet their desires. He is an expert in cosmetic, reconstructive and minimally invasive breast surgery. During your consultation, Dr. Cabbabe will carefully examine you and will make recommendations in order to help you achieve your desired result.

We believe that patients, their desires, and anatomy are all unique. Dr. Cabbabe believes that the key to a successful surgery is proper planning and discussion with the patient about their goals. Therefore, Dr. Cabbabe evaluates each patient and creates a customized surgical plan for all of his patients to meet their expectations. To schedule a consultation, call us at 314-842-5885 or complete the contact us form.

Fat Grafting

If you are interested in augmenting your breasts but are not interested in using an implant, you may be a candidate for fat grafting.  In this procedure, Dr. Cabbabe removes fat from an unwanted area such as the abdomen, hips or thighs.  The fat is then purified and injected into the breast to enlarge the breast. 

Studies have found that this is a safe procedure and does not appear to increase the risk of breast cancer or hinder breast cancer detection. 

This technique is ideal for a woman interested in enlarging her breasts one cup size per session.  Therefore, more than one session may be needed for a larger increase in size. 

This procedure is also useful for woman undergoing a breast lift who would like more cleavage but are not interested in am implant.

Breast Implant Pocket Placement

Subglandular: implant is placed under the breast tissue but above the pectoralis muscle of the chest. This may not be ideal in a woman with thin breast tissue, particularly if a saline implant is used as more rippling may be visible. Also, the risk of “capsular contracture” has been shown to be higher in studies.

Subfascial: implant is placed under the breast tissue and under the fascia or strength layer of the pectoralis muscle. The benefits are questionable and the surgery is more involved.

Subpectoral: the most common placement. The implant is placed underneath the pectoralis muscle in the upper portion of the implant. The muscle fibers of the pectoralis muscle are released in order to increase “cleavage” while also allowing the lower pole of the breast to expand.

Methods of placement

Peri-areolar: an incision is placed around the lower half of the breast areola. An advantage is that the scar is concealed on the breast. This can be useful for saline implants; however, silicone implants may be difficult to place in this manner due to the longer length of incision necessary.  This incision is often utilized if a breastlift is also being done.

Inframammary: an incision is placed under the breast in the natural fold. The advantage is that most women are unable to see the incision and longer incisions can be concealed here. This is Dr. Cabbabe’s preferred approach for silicone implants due to the longer length of incision needed for placement.   Dr. Cabbabe may recommend using the “Keller Funnel” in order to minimize the scar length.

Transaxillary: an incision is placed in the armpit or “axilla” and a camera is used to assist in developing a pocket for the implant. Dr. Cabbabe is one of a few surgeons in St. Louis who is trained in this technique. The advantage with this technique is that no visible scars are placed on the breast. Silicone implants are difficult to place in this manner due to the larger tunnel which is created to insert the implant. This can cause a tendency for the implant to shift towards the armpit or axilla.

Transumbilical: an incision is placed around the belly button/umbilicus and the implant is tunneled up into the breast. The advantage is no visible scars on the breast itself. The disadvantage is that it is very difficult to get exact placement of the implant in the breast.

Sizing your Implants

Dr. Cabbabe strives to meet and exceed his patient’s expectations. After you decide which type of implant and the method of placement, 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 ask that you bring a sports bra and a tight – fitting shirt to help visualize your new chest. Dr. Cabbabe will also measure your chest width to help you determine the best fit for you.

Silicone and Saline Implants and Safety Issues

Breast implants have been in use in the United States since the 1960’s. The first implants were made of silicone and are referred to as 1st generation implants. They have evolved over time to become more viscous, or “cohesive” and softer. The present silicone implants in use today are 4th generation. The 5th generations implants are under research. They are more cohesive and less malleable than any before them.

Saline implants have also been used for some time. They have a silicone shell but are filled with saline. Their popularity increased when silicone gel implants were pulled by the FDA in 1992 in a moratorium in order to make sure that they were not causing any complications. In 2006, the FDA lifted its restrictions on gel implants and their popularity has been increasing since that time.

All of the studies done during the time of the moratorium showed no harm from the silicone implants. However, the FDA has recommended (not required) all women who receive these implants to undergo periodic MRI’s beginning 3 years after implantation then every 2 years subsequent in order to detect a “silent rupture”. Your insurance company will not cover this MRI exam.

Implants have never proven to be of any harm to a woman or her fetus, including breast – feeding mothers. Silicone levels have not been found to be elevated in the blood of a woman with a ruptured silicone implant. Implants do not interfere with mammograms or breast cancer detection.

The average life span of saline or silicone implant is approximately 15 years. When an implant is placed inside the body, a scar “capsule” or “pocket” forms around the foreign body. This is part of our normal immune response. When a saline implant deflates, the salt water inside the silicone shell is absorbed and excreted and is immediately noticeable. Surgery will be needed to replace the implant as soon as possible, prior to the pocket contracting into a smaller size.

When a silicone implant ruptures, it may not be immediately discernible. In fact, the patient may never even know because often times the silicone gel is contained within the capsule around the implant. However, some women may begin to have vague symptoms such as irritation or discomfort in the breast or referred pain to the shoulder. The silicone is not absorbed into the body and does not make a person ill. If a woman begins to experience these local symptoms, it is recommended to remove the implant and replace it.

Studies have been done comparing MRI and physical exam by plastic surgeons experienced in breast augmentation. These studies have suggested that a physical exam done by an experienced plastic surgeon is as reliable as an MRI; mainly because an MRI may show a “false – positive”, suggesting that there is a rupture when in fact there is not.

One of the potential complications with any breast implant surgery is the development of “capsular contracture”. This occurs when the capsule around the breast, which is composed of scar tissue, tightens around the breast. This may cause pain or discomfort or distortion of the implant. In severe cases, surgery may be recommended to remove the scar tissue and place the implant in a new pocket.

Advantages of Saline Implants

Saline implants can be placed into the breast through a small incision because they are filled after insertion. For this reason, they are the implant of choice when choosing transaxillary or transumbilical breast augmentation. Also, when they rupture, it is immediately noticeable. Replacing them is quick and straightforward if done promptly after rupture. They are less expensive than silicone implants.

Disadvantages of Saline Implants

Saline implants look and feel less natural than silicone implants. Also, they are more likely to show rippling in a woman who has thin or no breast tissue over them.

Advantages of Silicone Implants

Silicone implants look and feel more natural than saline.

Disadvantages of Silicone Implants

A woman may not know that her silicone implant has ruptured. If the gel inside the implant ruptures through the “capsule”, then surgery will need to be done to remove all of the silicone outside of the pocket. This is more involved than saline implants. Also, the FDA has recommended (not required) MRI scans for follow – up which are not covered by a person’s insurance company. Finally, silicone implants are more expensive than saline implants.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin 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.

Recovery

If this procedure is done by itself, most patients are able to go home the same day. Pain medication and antibiotics will be prescribed. There may be some numbness on the breast which improves with time. Most patients are able to shower within 24 hours.