If you have researched breast augmentation and breast implants in the Tampa Bay area, you undoubtedly have come across many different options. These options include surgeons, options regarding a breast lift versus breast implants alone (or having both performed), types of incisions used, different types of implants, and location of your surgery (hospital-based or located in a private outpatient surgery center). With so many options out there, it may be difficult to come to a decision. In order to help you with your decision, we have compiled information to answer these questions, and have included additional information to help you along your breast augmentation journey.
What Are My Options Regarding Surgeons?
The types of surgeons who most commonly perform breast augmentation are cosmetic surgeons and aesthetic plastic surgeons. The primary factor which influences the ability for the surgeon to consistently produce safe aesthetic results which meet or exceed the patients’ expectations is their experience – which includes their training and the focus of their surgical practice. When choosing a surgeon, carefully evaluate their training background and focus of their practice. Simply to state that a particular surgeon is a plastic or cosmetic surgeon does not provide adequate insight into their abilities. For example, if you are interested in breast augmentation, it would be best to go to a surgeon who very frequently performs breast augmentation, rather than a surgeon who focuses on facial or hand surgery (and vice-versa).
Another important factor regarding which surgeon to go with is if you trust and interact well with your surgeon. This is often an understated point. Keep in mind that aesthetic surgical procedures should not only involve expert surgical care, but also close follow-up during the recovery process. You need to be able to trust your surgeon and know that they always have your best interest in mind.
Do I Need A Breast Lift (Mastopexy) Instead?
With age and especially after pregnancy, a female’s breasts may droop (a condition known as “ptosis”). Ptosis is commonly divided into three classifications; these classifications help influence which type of breast surgery would provide the best aesthetic result for you. Grade 1 ptosis is where the nipple is at the same level as the inframammary crease, or up to one centimeter below the crease. Grade two ptosis is diagnosed when the nipple lies one to three centimeters below the inframammary fold. Finally, grade three ptosis describes a nipple that is more than three centimeters below the inframammary fold, or located at the bottom-most projection of the breast (pointing downwards). Grades two and three ptosis require a breast lift to re-center the nipple-areola complex on the breast mound. Grade one ptosis may require a breast lift; however, this may often also be corrected by breast implants alone. The decision to proceed with breast augmentation or breast lift (with or without implants) should be made with your surgeon to determine which procedure will provide the best aesthetic look for you.
What Are The Common Types Of Incisions Used For Breast Augmentation?
There are four types of incisions commonly used for breast augmentation – periareolar, inframammary, axillary (arm pit), and umbilical (belly button). The type of incision performed should be based on the inherent risks and benefits of each, your desires, and your surgeon’s experience/preference.
The periareolar incision is placed along the bottom one third to one half of the areola in a semicircular fashion at the border of the areola and surrounding breast skin. This incision generally heals extremely well and is one of the most preferred types of incisions by aesthetic surgeons. The other most preferred type of incision for breast augmentation is the inframammary incision which is made at the inferior most aspect of the breast, where the breast and chest skin meet. This type of incision also heals well, although arguably not quite as well as the periareolar incision. Both the periareolar and inframammary incisions have low complication rates, and very high patient satisfaction.
The third most common type of incision for breast augmentation is the axillary incision, which is an incision placed in the axilla (arm pit) to perform a “transaxillary” breast augmentation. Finally, the least commonly-performed type of incision is the umbilical (belly-button) incision, which is used for “transumbilical” breast augmentation. These last two types of incisions are performed much less commonly due to the safety and advantageous healing of the periareolar and inframammary incisions.
What Types Of Implants Are Commonly Used For Breast Augmentation?
There are many options when deciding on which breast implant to have placed. However, the options can be simplified into decisions regarding filler material (saline or silicone), shell texture (smooth or textured), and shape (projection, base width, round or anatomically shaped).
Both saline and silicone implants have been used for breast augmentation since the 1960’s, both types have undergone significant modifications then, and both have proven to be safe. In general, patients often state that silicone implants provide a more natural feel. Also, silicone implants are less likely to show rippling, which makes a big difference in thin patients.
Breast implant shells may be smooth or textured. Texturing was introduced in an attempt to minimize the risk of capsular contracture related to breast implants. However, since their introduction in the 1980’s, there has not been conclusive evidence that the use of textured implants reduces the risk of capsular contracture. In addition, the texturization has been associated with an increased likelihood of infection, implant failure, as well as a loose association with lymphoma. The texturization does help keep the implant from moving in the pocket, a situation which is generally only detrimental when anatomic (tear-shaped) implants are used. To a certain degree, it is desirable for round smooth implants to move in the pocket as this can provide an even more natural feel. Anatomic (tear-drop) shaped implants need to be textured to keep them from rotating, and round implants are generally smooth to forgo the risks associated with textured implants.
When considering cosmetic breast augmentation (not breast reconstruction), round implants are more commonly used and are of “moderate” or “full” projection (different manufactures use different terms to describe moderate vs full projection). For the same size of implant, meaning the same milliliters of silicone/saline filler per implant, as the base (the part against the chest wall) narrows, the projection increases. Moderate projection round implants have a wider base and less projection than full projection implants, while full projection implants have a narrower base and more projection. Anatomic breast implants have a sloped appearance, leading to a “tear drop” shape. Again, the textures implants generally used are textured to prevent rotation.
Where Should I Have My Breast Augmentation Performed? Should I Go To The Hospital?
Cosmetic breast augmentation is more and more commonly performed in private outpatient surgery centers. These outpatient surgery centers generally provide a better experience for patients regarding cost, ease of access, and privacy. A proper outpatient surgery center is licensed/accredited and undergoes rigorous inspections and ensure patient safety. These outpatient surgery centers are generally in close proximity to the aesthetic surgeon’s office, which make it more convenient and private for patients. In addition, when the outpatient surgery center is under the control of your aesthetic surgeon’s practice, the surgical prices quoted during your consultation are quite accurate and are often less than a hospital-based surgery center would charge.
In conclusion, there are many options regarding breast augmentation. The information provided above should be used to help you understand some of the nuances regarding this procedure. As always, safety is paramount, and it is important to speak with your surgeon openly to come to a joint decision regarding which surgical approach will be best for you.