Thanks for taking your time to view this presentation
regarding breast enlargement. The subject can be discussed
for hours but I hope this brief summary will explain
what is involved.
First, who are candidates for breast enlargement?
Almost anyone with the desire. However you must know
what factors affect the surgery. For example what is
the shape of your chest -- broad, long, muscular? How
much breast tissue do you have? Is your breast placed
high or low on your chest? Are your nipples high or
low on your breast and chest wall? Is your problem lack
of breast tissue after childbirth? This commonly results
in a depression in the upper pole of your breasts giving
the appearance of sagging breasts. Finally, do you truly
have sagging breasts with lots of skin and with your
nipples pointing toward your toes?
For all these problems there are possible solutions.
But all solutions require surgery. In most instances
the desired result involve adding bulk (augmentation)
in the form of implants. In a few cases just removing
excess skin and reshaping the breasts (breast lift or
tuck) solves the problem. Finally there are patients
who require reshaping the skin and nipples along with
implants for enlargement.
For this presentation only breast enlargement will
be discussed. A separate discussion will go into detail
about breasts lifts, with and without the use of implants.
Basically, under anesthesia a pocket is surgically
created on the chest wall into which a breast implant
is placed. Simple? Not exactly! First one must determine
where to make an incision. The incision must be made
so the resultant scar, two inches in length usually,
will be inconspicuous. But the usual place to make the
incision is high in the armpit (axilla), under the breast
in the crease between the breast and the chest wall,
and around the inferior pole of the areola where the
darker areola blends into the lighter skin of the breast.
Why so many choices? Well patients have preferences
and surgeons may have strong recommendations depending
upon the structure of the chest, the position and size
of the breast, and the size of the areolae. For example
will the implants be placed above or below the chest
wall muscles? In general I feel that it is desirable
to place the implant above the muscle whenever possible.
The recovery time is faster with less discomfort; and
there is less possibility that the muscles might push
the implant down and laterally. In addition, although
quite uncommon, during exercise the pectoral muscles
may jerk the breasts around -- a disturbing problem
(but fixable). But there are times when the implants
should be placed under the chest muscles. These instances
are when there is very little breast tissue to cover
the implants and living tissue is needed. I much prefer
a peri-areola or inframammary incision for sub- muscular
placement of the implant. Why? Bleeding in the muscular
tissue is much easier to control from these incisions
and the pocket can be more accurately defined. The so
the proper incision placement is a combination of patient
desire and practicality.
Size is also determined by combining a number of factors.
How large you want to be? How wide and how long is your
chest? Where is your breast positioned on your chest,
high or low? Each size implant has a specific diameter
and projection. Some implants are a different shape
than others. Basically the larger the implant chosen
the broader or wider the implant will be; a tiny woman
will generally require smaller implants than a larger
woman. If the implants used are too large one will look
stuffed!
What type of implants are to be used? Smooth outer
shell, textured outer shell, saline (salt water) filled
or gel filled? There are specific reasons to use each,
or at least for the surgeon to recommend them.
I perform the surgery at my outpatient surgical center.
The center is a fully licensed outpatient surgical hospital,
certified by the federal government and the state of
Oklahoma. Anesthesia is provided by physicians who are
board certified in anesthesiology. Costs will vary according
to the type of implant used, but the average fees including
the surgeons fee, anesthesia, saline filled implants,
and the surgical facility are around $4000.
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