Breast augmentation

BREAST AUGMENTATION (BREAST ENLARGEMENT)
Breast augmentation not only changes appearances, but has also positively affected how our patients feel about themselves.
During your consultation with Doctor Cenedese, options of size, shape and implant type will be reviewed. Our goal is to choose the best approach and implant for your breasts and body. Implants may be inserted around the areola (nipple), underneath the breast, through the axilla (armpit) or umbilicus. Implant placement behind the muscle is preferred by most patients. A more natural, sloping upper and outer breast shape is achieved.

Obtaining maximum cleavage is an important goal. The amount of cleavage that we can obtain is determined by the original distance between the breasts and pectoral muscle insertions.  The larger the implants and the closer together they are placed increase the resulting amount of cleavage.

The procedure lasts under two hours. You can recover and go home within two hours. Most patients experience some pain but can return to their new lifestyle in a few days. The safety of breast augmentation has become possible after 40 years of refining the technique and extensive product research.

Saline filled implants are placed through smaller incisions beneath the breast,  surrounding the areola or through the armpit or umbilicus. They are then filled with a special fill tube through a self sealing valve built into the silastic shell of the implant.  I prefer smooth implants as opposed to textured implants as they feel softer.  There are fewer infectious complications as opposed to textured implants.  The saline implant results in a very soft breast.  They are ideally suited for the women who begins with adequate breast tissues and desires a one to two cup increase in size. Saline implants can be inserted through the umbilicus resulting in a scar less breast.  This procedure although somewhat more technically demanding results in a very natural appearance.  Modifications in implant position are the most frequent reason for revision surgery. The axillary incision and approach requires more cutting of the central pectoral muscles to prevent the implant from being pushed up and out towards the armpit.  Implants tend to settle from one half to an inch over the first two years.

Patients requesting a more natural appearance will realize this as time passes.  The umbilical or axillary approaches may necessitate an additional incision in another area if repositioning becomes necessary.  High profile saline implants appear to ripple less.  If there is inadequate tissue to cover the implant or you desire to increase more than two cup sizes I suggest the use of Allergan Inspira gel filled implants.  When saline implants leak there is no pain but the breast will decrease in size over a few weeks.  Replacement of a leaking saline implant if addressed within a month is fairly straight  forward and nearly painless.  The rate of leaking is  higher than that of silicone gel filled implants.

Silicone gel implants on the other hand feel slightly firmer but more natural. The majority of my patients have been selecting silicone gel implants.  This follows the European and South American trends where saline implants are rarely used.

Since it is difficult to properly place a silicone gel implant larger than 350 cc from the axilla I have introduced a new technique which makes the peri-areolar incision even less prominent than in the past.  The statistics collected by the manufacturers indicate these to leak less often than saline filled implants. Please refer to http://www.breastimplantsafety.org

Silicone gel implants have become accepted as patients are becoming more aware of their safety, natural feel and appearance. Gel implants have  been approved by the FDA as safe for the average patient.  Silicone gel implants have been used for  over 30 years.  Advances in design and manufacturing have made the latest implants more resistant to leaking yet maintaining a natural feel.  A leaking gel implant can be replaced without complicated surgery if addressed within a few months of leakage. Failure of a silicone implant is usually detected by a change in shape or firmness of the affected breast.  Mammography, sonogram and MRI are helpful in confirming a suspected leak. A rare form of small cell lymphoma has been discovered to be associated with textured silicone implants.  Please refer  to www.plasticsurgery.org for more information.

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