Indications: The modern era of breast enlargement started in 1961 when the first silicone implant was used to improve the appearance of the breast. Since that time, the basic implant has undergone many modifications and improvements. At this time, the silicone implants are now approved by the FDA. In our practice, approximately 50% of patients undergoing new breast autmentations are choosing silicone implants.
Many of our patients who desire breast enlargement are in their early twenties and thirties. Many of our patients are women who have lost breast volume due to pregnancy, and wish to return to their pre-pregnancy breast size. It is therefore not uncommon to perform breast enlargement surgery on women throughout their forties.
Dr. Sherman will discuss the goal of your proposed breast enlargement surgery, and go over the entire procedure with you. The following information will help you understand the operation.
Breast augmentation overview by John E. Sherman, MD, FACS New York Plastic Surgeon
Choice of Implant: choice of the implant is one of the most important decisions that you have to make. Dr. Sherman will discuss the relative advantages of each implant, silicone or saline. In addition, implants now come in various widths, heights, and projections. These are all individualized to create the desired goal of the patient. In addition, Dr. Sherman has worked with the Allergan 410 cohesive gel implant for the past five years. He is authorized by the company and the FDA to use this implant in select patients for a study group.
Operation: The operation may be performed in our fully accredited office surgery center, or in the hospital as an out-patient. The breast enlargement operation itself lasts for 1 to 1 1/2 hours. You will stay in our recovery area until you feel comfortable to return home. If you are coming from out of town, you should remain in New York overnite, so that Dr. Sherman could see you if the need arises. Suture removal is usually one week after surgery.
There are several options that you may choose for breast enlargement surgery. These consist of the site of the placement of the implant and relationship to the pectoralis muscle, and the choice of the incision through which the implant is placed.
Incisions: the choice of incision is made by the patient after consultation with Dr Sherman. Breast augmentation can be accomplished through either a transaxillary (arm pit) incision; inframammary incision (below the breast, above the fold); or a periareolar incision (through the areolar, the circle around the nipple). Each approach has its advantages and disadvantages. Dr. Sherman will discuss all of these with you.
Submuscular or Subglandular implantation: This describes the position of the breast implant in relation to the pectoralis muscle. Depending on your anatomy, age, and vocation, there are advbantages to each approach for breast enlargement. Dr. Sherman will explain each, and help you understand the position that may be ideal for you.
Revision of Breast Augmentation: because of Dr. Sherman's experience, he often corrects problems associated with previous breast augmentation surgery. This may reflect the aging of the breast in relationship to the implant, or complications of the implant surgery.
Anesthesia: Patients have a choice of either a general anesthesia or intravenous sedation anesthesia. As in all of our operations, the anesthesiologist is a board-certified, and highly skilled, experienced anesthesiologist. If the implant is placed below the muscle, the operation is usually performed under general anesthesia.
Convalescence: After breast augmentation surgery, it takes approximately one week to feel comfortable. You should refrain from exercise for roughly three weeks after surgery.
Complications: The breast enlargement procedure has several potential postoperative complications. These include capsular contracture, deflation of the implant, and wrinkling of the implant. Dr. Sherman will discuss the incidence of each of these and relate it to your individual surgery.
In addition, some patients experience a temporary numbness of the nipple for several weeks after surgery. This may last longer or may be permanent in a very small group of patients.
Insurance Information: Breast enlargement is rarely covered by any insurance program. However, if there is a congenital maldevelopment of one or both breasts, this may be covered, and would depend on which carrier that you might have.Some insurance companies will cover the removal of ruptured silicone implants. If you do havce a ruptured implant, our office will contact your insurance carrier to help you determine if you are covered.