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Breast augmentation can dramatically improve the appearance of a woman’s breasts. During your breast augmentation consultation, you’ll learn more about your options for creating your ideal breast appearance, including:

• Implant size
• Implant material (silicone gel or saline)
• Implant position (above or below the pectoralis muscle)
• Implant incision method

The size of the implant is a very personal choice as each woman has her own preferences and ideal body image. Our doctors listen to your input on sizing to help pick an implant size that satisfies each patient’s expectations as well as fits with the patient’s anatomy to maximize surgical success. When assessing implant size, patients should be aware that very large implants will result in sagging of the breast tissue faster than smaller implants.

There are generally two choices in implant fill material: silicone or saline implants. Below you will find the advantages and disadvantages of both silicone and saline implants. In addition, breast implants can have either a textured or smooth surface and each type has its role in cosmetic surgery of the breast. The type most appropriate for each case is explained to all patients by Dr. Spikes

There are two types of implant shapes: round and anatomic implants. In addition, implants come in three ranges of projection or profiles. All of these factors are taken into account to ensure patient satisfaction when it comes to the final surgical shape as well as the amount of projection and cleavage created from breast enhancement.

There are three options for implant placement when undergoing breast augmentation. The implant can be placed in the following places:

• Subglandular – Above the muscle, but under gland.
• Submuscular – Under the muscle. The amount of muscle coverage is individualized to each patient and depends on the location of the nipple preoperatively. By utilizing this dual plane technique, the nipple-areola complex can be raised without making further unnecessary incisions.
• Subfascial – Under the gland and fascia of the muscle.

Breast augmentation is commonly performed on an outpatient basis at a hospital or surgical center while the patient is under general anesthesia. During the procedure, local anesthetics are used around the breast to block the nerves that produce pain before the surgery. Our experienced cosmetic surgeons frequently perform transaxillary endoscopic augmentation mammoplasty. The minimally invasive breast augmentation technique is performed by placing the incision in the armpit to ensure NO scars on the breast itself. The incision under the armpit heals quite well and after 1 year will likely be imperceptible. A precise pocket is created under the muscle with the assistance of a small video camera after which a silicone or saline implant is placed. Immediately after the implant is placed, the incision is closed in a layered manner to prevent implant exposure or scar widening.

Every patient’s body heals differently, so the exact length of breast augmentation recovery periods vary. Post-operative recovery begins with plenty of fluids and resuming walking as soon as possible. Bandages are placed over the incision for about a week, though patients are able to shower the same day of surgery.

Patients are asked to take a short course of antibiotics after the operation to prevent an infection. A supportive bra is worn to help support the breast as the incisions heal and the implants settle into position.

As the incision begins to heal (after 3 weeks), there are a number of things you can use to help minimize the size and appearance of the scar. Massaging the scar with firm finger pressure will help minimize the appearance of the scar and decrease the swelling. In addition, paper tape and silicone gel sheeting have both been shown to help minimize the scars with time. Some commercially available products such as Mederma or vitamin E may also have some benefit.

Generally, patients can expect to resume their normal activities after about a week of downtime. You should refrain from any vigorous exercise for the first month to prevent postoperative bleeding. Since swelling takes time to fully dissipate, the final results of your breast augmentation surgery may not be apparent for several months.

Women who are born with large pendulous breasts, or who have developed them over time due to pregnancy or other factors, can have substantial health concerns. Large breasts can result in neck, back, or shoulder pain, as well as skin irritation. In addition, grooves from bra straps can develop. For these women, breast reduction surgery can help eliminate the associated pain, improve breast shape and size, and make the breasts more proportionate in relation to the body.

A reduction mammoplasty (i.e. breast reduction) is performed by removing the excess glandular breast tissue and skin as well as relocating the nipple to a higher position. There are a number of plastic surgeons who perform breast reductions; however, not all breast reduction techniques are the same. Some of the traditional techniques for breast reduction can result in a boxy shape or a “bottoming out” of the breast with time, and they can create large scars or lead to the loss of nipple sensation. Dr. Spikes has experience with the latest techniques that can minimize scarring, allow the breasts to have more projection, last longer without bottoming out, have a natural shape, and maintain nipple sensation.

Breast reduction surgery is performed by making incisions around the nipple-areola complex and below in a vertical direction. The nipple is left attached to the breast tissue so that the blood vessels and nerves going to the nipple are preserved. The excess skin and breast tissue is removed, and the breasts are contoured to create a natural shape that is proportionate with the rest of your body. The procedure is performed on an outpatient basis under general anesthesia.

Patients should wear a supportive bra for three to four weeks after the operation. Under most circumstances, no drains are used after surgery and all the sutures are dissolvable. Many patients are able to resume normal daily routines approximately two weeks following surgery; however, this will depend on each patient’s unique needs during the recovery process. Lifting of heavy objects and strenuous exercise/activities should be avoided for several weeks after surgery, or until Dr. Spikes recommends otherwise.

The location and extent of scarring will ultimately depend on the specific breast reduction technique that is used in the procedure. As the incision begins to heal (i.e. after three weeks), there are a number of things you can do to help minimize the size and appearance of the scar. Massaging the scar with firm finger pressure can help it blend in and decrease the swelling. In addition, paper tape and silicone gel sheeting have both been shown to help minimize the scars with time. Some commercially available products such as Mederma® or vitamin E may also have some benefit. While it is not possible to have surgical breast reduction without scars resulting from the procedure, Dr. Spikes strives to place incisions in areas that allow residual scarring to be easily concealed under clothing (even bathing suits).

Breast augmentation is one of the most popular cosmetic surgery procedures in America, and has helped millions of women enhance both the volume and shape of their breasts with long-lasting results. With that in mind, breast implants that are placed during breast augmentation are not designed to be permanent, and removal (explantation) of the implants will be necessary at some point. Many individuals choose to simply exchange their breast implants for newer models when it is time for implant removal due to warranty expiration. Others may request implant removal because they would like to upgrade their implants to a different type, shape, or size, or because they no longer desire implants at all. Some patients may need breast implant removal to address a complication (such as an implant rupture or capsular contraction), irregular position, or asymmetry. Breast implant removal is a form of revision breast augmentation surgery, a procedure Dr. Spikes has performed many times.  At Allure, we can formulate a customized breast implant removal treatment plan designed to meet your needs with successful results.

How the breast implant removal procedure will be performed is dependent on your individual needs and goals, which will determine the most ideal technique utilized for the surgery. In many cases, the implants can be removed via the same incisions created for the initial breast augmentation to avoid additional scarring. For patients who are not having their implants replaced, and even for some individuals who are exchanging their implants for new ones, a breast lift can be performed in combination with implant removal surgery, if desired. Breast lift surgery can address lax skin and sagginess that may be present after implant removal.

The exact nature of the recovery process from breast implant removal will differ among each patient; however, in many cases, individuals are typically able to resume many of their normal daily routines after just a few days. Some degree of swelling and bruising can be expected in the breasts for a few weeks. Any discomfort experienced during the recovery process can often be managed with pain medication. Strenuous activities should be avoided for at least six weeks following breast implant removal. Our team will provide you with detailed post-operative instructions to help you experience a safe and effective recovery.

With time, the effects of gravity, breastfeeding, pregnancy, and weight loss can result in decreased skin elasticity and sagging of the breasts. Your breasts may appear deflated as a result of lost volume and/or the nipple/areola may be enlarged from prior stretching. Fortunately for many women, these concerns can often be effectively addressed with a breast lift.

A breast lift (also known as a mastopexy) can reshape the breasts and tighten the existing skin. In addition, a breast lift can create fuller, more natural-appearing breasts and raise the position of the nipples. In some cases, the insertion of breast implants can be combined with a breast lift to create fuller, firmer, more youthful breasts. There are a number of plastic surgeons performing breast lifts; however, not all techniques are the same. Most of the traditional mastopexy techniques only excise the excess skin and rely on the skin to maintain the result over time. This generally results in recurrent drooping of the breasts with time since loss of skin elasticity was the source of the initial problem. In addition to the removal of skin, the breast gland has to be reshaped and elevated to create a longer, more natural-appearing outcome. In addition, we use your own body’s tissue to augment your breast shape and volume. Dr. Spikes has experience with the latest techniques that minimize scars and allow the breasts to have more projection, results that last longer, and have a natural shape.

A breast lift can be performed in tandem with breast augmentation to add volume to the breasts while giving them a firmer appearance. Medically referred to as an augmentation mastopexy, this procedure can give the breasts a firmer, more youthful appearance while adding volume to the breasts with silicone breast implants or saline breast implants. A breast lift with implants can address a number of concerns and provide a more comprehensive rejuvenation of the breasts.

A breast lift is performed by making incisions around the nipple-areola complex and, in some cases, extending vertically below and possibly also horizontally along the inframammary fold. The nipple is left attached to the breast tissue so that the blood vessels and nerves going to the nipple are preserved. The excess skin tissue is removed, and the breast is reshaped to create internal lasting support and elevated to create a natural shape and contour that is better proportioned to your body. In some instances your body’s own tissue is utilized to create a fuller upper pole of the breast.

When you first return home, your breasts will be covered with a surgical bra to assist with healing and typically all sutures are dissolvable and do not require removal. Typically, you can take a quick shower and raise your arms above your head the first day after surgery. After a few days, this can be replaced with a soft support bra that should be worn at all times throughout your recovery process. Any pain or discomfort can be managed through the use of over-the-counter medication or pain medication that will be guided by your doctor. Your breasts will be swollen and bruised at first, and you should refrain from vigorous exercise until one of our plastic surgeons informs you it is safe. As long as your job is not physically demanding, you should be able to return to work after about a week of downtime.

Like virtually all surgical procedures, it is not possible to have a breast lift without scars forming at the incision sites. However, in the hands of our skilled cosmetic surgeons, scarring can be minimized to the point where it is hardly noticeable. Furthermore, your incisions will be made in areas that are easily covered by a bra or bathing suit. Your scars will appear red for the first few months after surgery, but over time they should progressively fade.