In the United States last year over 300,000 breast augmentations were performed. Historically it has been the most common cosmetic surgery procedure, only to be the surpassed last year by liposuction.
The modern era of breast augmentation 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. In 1991, because of unsubstantiated claims, the FDA suspended use of silicone implants except for breast reconstruction. However, many studies that were then performed have demonstrated the safety of breast implants. At this time, silicone breast implants are now approved by the FDA.
Be sure to look at our before and after breast implant photo gallery.
Many of our patients who desire breast implants 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 augmentation surgery on women throughout their forties. This can be commonly performed with an abdominoplasty (tummy tuck) as part of the “mommy makeover.”
Dr. Sherman will discuss the goal of your proposed breast augmentation surgery, and go over the entire procedure with you. The following information will help you understand breast implants and the operation itself.
Basically, there are three decisions that the patient must make. They are the following:
- The incision site (Below the breast, around the areolar, or through the axilla).
- The choice of the implant: silicone or saline
- textured or smooth implants
- round or anatomical (teardrop) implants
- saline implants
- cohesive gel versus standard silicone gel
- the placement of the implant either above or below muscle.
Watch Dr. Sherman’s Breast Augmentation Surgery Overview
Types of Breast Implants
The type of breast implant choice is one of the most important decisions that you have to make. Dr. Sherman will discuss the relative advantages of each type of breast implant, silicone or saline. We will also discuss the different types of silicone implants that are currently available.
Breast 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 was one of the original investigators for the Allergan 410 cohesive gel breast implant. These implants are now approved by the FDA.
About the Procedure
The operation may be performed in our fully accredited surgery center, or in the hospital as an outpatient. The breast augmentation surgery takes approximately 1 to 1 ½ hours. Occasionally, a simultaneous breast lift (see mastopexy) will be performed if the patient is ptotic (droopy breasts) which will add to the time of the operation.
You will stay in our recovery area until you feel comfortable to return home. If you are coming from more than an hour outside of New York, you should remain in New York overnight, so that Dr. Sherman could see you if the need arises. Suture removal is usually one week after your breast augmentation.
Breast implants have been known to help lessen the appearance of pectus excavatum. With this congenital disorder, the chest becomes sunken in, causing a concave depression. Also referred to as “funnel chest,” this condition can often have a negative effect on a person’s self-confidence, and breast augmentation surgery can help to remedy this experience.
Incisions for Breast Implants
The choice of incision is made by the patient after consultation with Dr. Sherman. Breast augmentation can be accomplished through either a transaxillary (armpit) incision; inframammary incision (below the breast, above the fold); or a periareolar incision (through the areola, the circle around the nipple). The selection of the breast implants as well as the goal for size, shape and placement each play a role in where the incision is made. Each approach has its advantages and disadvantages and varies from person to person. During your consultation, Dr. Sherman will discuss all of these with you.
Submuscular or Subglandular Breast Implants
This describes the position of the implants in relation to the pectoralis muscle. Depending on your anatomy, age, and vocation, there are advantages to each approach. Dr. Sherman will explain each, and help you understand the position that may be ideal for you. Usually if a patient has some degree of ptosis (droop) the implant is placed in the sub glandular position, above the muscle.
Cohesive Gel Breast Implants
The Natrelle 410 features an anatomically shaped silhouette, with contours that closely resemble the curve of a woman’s breast. On February 20 2013, the U.S. Food and Drug Administration approved the Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Gel Filled Breast Implant, which is designed to increase breast size (breast augmentation) in women at least 22 years old and to rebuild breast tissue (breast reconstruction) in women of any age.
Dr. Sherman was one the limited number of select investigators for the Allergan Natrelle 410 Cohesive Gel breast implants, and thus has a deep and thorough understanding of the nature of these implants. Dr. Sherman will be able to go over all the benefits as well as anything else you need to know during your detailed consultation if you are looking to use these anatomically shaped implants.
Breast Augmentation Revision:
Because of Dr. Sherman’s experience, he often corrects problems associated with previous augmentation surgeries. This may reflect the aging of the breast in relationship to the implant, or complications of the previous breast implant surgery. Read about Dr. Sherman’s New York patients’ experiences and reviews.
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 breast implants are placed below the muscle, the operation is usually performed under general anesthesia.
Recovery from Surgery
After your breast augmentation procedure it takes approximately three to four days to feel comfortable. You should refrain from exercise for roughly three weeks after surgery while you recover.
Breast augmentation surgery has several potential postoperative complications. These include capsular contracture, deflation of the implant, and wrinkling of the breast 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.
ALCL (anaplastic large cell lymphoma)
Each year over 1.5 million breast implants are implanted worldwide for breast augmentation. Over the past few years, researchers have found that women with breast implants may have a small but increased risk of developing ALCL. While the actual number of cases worldwide is not confirmed, it appears to be approaching 400 cases. This ALCL is a rare malignancy that can be effectively treated. While research continues, it appears to be associated with implants that are textured and in patients who develop a seroma (accumulation of fluid around the breast). To this date, there have only been two cases associated with smooth implants, and those patients had previously placed textured implants. With this worldwide alert, the database is expanding, with ALCL registries and recommendations for treatment.
Breast Augmentation Cost and Insurance Information
The cost of breast augmentation surgery is rarely covered by any insurance program. However, if there is a congenital mal-development of one or both breasts, this may be covered. Some insurance companies will cover the removal of ruptured silicone breast implants. If you do have a ruptured breast implant, you may contact your provider to determine if you have benefits for the removal.