Breast augmentation

Breast augmentation is performed to increase the size of the breast. Typically, with massive weight loss there is loss of fat throughout the body. Since most of the female breast is composed of fat, after massive weight loss, women experience a significant loss of fat in their breasts. Breast augmentation restores this loss of volume. Breast augmentation can be performed through a variety of incisions and with a variety of materials.

Incisions

Incisions are kept very small and are placed so they are inconspicuous and hidden. There are four commonly used breast augmentation incisions. Incision types include an incision around the nipple (periareolar incision), underneath the breast (inframammary incision), through the armpit (trans axillary), or through the belly button (TUBA). In most cases, these incisions and resulting scars heal well.

Implant material and shapes

Currently, there are three types of breast implant material; saline, silicone, and fat. There are two main types of breast implants: saline and silicone implants. Saline implants are delivered from the factory empty. During surgery, the saline implants are rolled up and inserted through a small breast incision. The implant is then tunneled to the appropriate position underneath the breast tissue. Then, Dr. Katzen inflates the implant through a small tube with saline. Unlike saline implants, silicone implants are delivered pre-filled and do not require filling during surgery. Silicone implants are ordered by size and come prepackaged as a sealed implant. During silicone breast augmentation surgery, before a permanent silicone breast implant is placed, often a temporary saline sizer is placed to determine the appropriate size of silicone implant. The patient is elevated on the surgery table and saline is carefully injected into the temporary breast sizer to determine the appropriate size of a permanent silicone implant. Once the size is determined, then the temporary sizer is removed and the permanent silicone implant is placed. Once the silicone implant is inserted, no further adjustments can be made in terms of addition or subtraction of volume. A third type of breast augmentation material is fat. This very new technique includes taking fat from one area of the body and placing this fat into the breast.

Breast implants also come in a variety of sizes and shapes including round and anatomic implants. Round implants have rounded edges and when inflated look like an orange that is cut in half. Anatomic implants have more volume at the lower aspect of the implant and less volume at the upper portion of the implant. When inflated, anatomic implants look like a pear that is cut in half.

Implant position

There are three main breast implant positions: under the breast gland (subglandular), under the muscle (submuscular), and partially under the muscle.  All these locations can be reached, through the periareolar, inframammary, trans axillary, or on the trans umbilical approach (TUBA).

Pre Operative visit

Dr. Katzen will go over with you very carefully your preoperative wishes and have you try on multiple implant sizes and shapes. If you have breast asymmetry, often this can be corrected with saline or silicone implants. Dr. Katzen will go over with you exactly what your body needs and your individual body proportions to achieve the breasts you are seeking.

The Procedure

The procedure takes approximately 1 to 2 hours. Dr. Katzen performs this procedure with a board certified anesthesiologist in a board certified surgery center or hospital. Before the surgery, markings are placed were the incisions are planned. The breasts are then sterilized and draped. Once the patient is completely asleep, an incision is made. Dissection is carried through the breast tissue. If a subglandular pocket is desired, a pocket is created under the breast tissue. If a submuscular pocket is desired, a pocket is created under the pectoralis muscle. If a partial submuscular pocket is desired, a pocket is created partially under the pectoralis muscle and partially under the breast tissue. The saline or silicone implant is placed. The patient is elevated on the table to confirm symmetry and to ensure size appropriateness. The incisions are then meticulously closed with sutures. Typically, you will spend 1 to 2 hours in the recovery room. After the recovery room, you will be allowed to go home. Dr. Katzen will see you several days later and the bandages will be changed. After surgery, your breasts will feel large, tight, and engorged. Over time the swelling will subside and your breasts will feel much more natural. Once Dr. Katzen determines that your incisions have healed, self breast massages will begin. Breast massaging is important to keep your breast implants soft and natural looking. Depending on their type of work, most patients are able to return to work approximately 3 to 5 days after the procedure.