Breast Procedures

Breast Augmentation

Breast augmentation (augmentation mammoplasty) is a surgical procedure that add or restore volume to the breast with the placement of a breast implant. Many women choose to have breast augmentation for the following reasons:

• Enlarging the size of the natural breast
• Correcting asymmetry in breasts (breasts are two different sizes
• Restoring volume due to weight loss, pregnancy or breast-feeding
• Correct congenital issues such as tubular breast
• To boost self-esteem and overall self-confidence.

Breast Augmentation may also be used in conjunction with other Breast enhancement surgeries such as Breast Lift or breast reduction to achieve the best possible result. Overall, women who undergo breast augmentation surgery are very satisfied with their result.

During your initial consultation, Dr. Lesesne will review your general health, desired results, and discuss the implant options available based on your chest diameter, shape and size of your natural breasts. Dr. Lesesne will also discuss your breast implant placement options based on your height, weight, current breast anatomy, and skin elasticity.

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Choosing the Right Breast Implant- Implant Options

There has been significant innovation from breast implant manufacturers. Now more than ever, patients have many more options to choose from. The type of implant you choose depends on multiple factors including the look you want and how much of a breast enlargement you would like. The two primary types of FDA approved breast implants used today are silicone and saline.

Silicone Gel Implants

Silicone implants are constructed with an outer shell made of silicone rubber and filled with a silicone gel. These implants are also known as cohesive or gummy bear implants. Silicone implants come pre-filled from the manufacturer and are available in a broad range of sizes. Silicone implants are available in a round shape or a classic shape to mimic the look and feel of the natural breast. Both round and shaped implants can be coated with a smooth (implant surface is smooth and slippery) or textured (implant surface is rough and irregular) outer finish.

Saline Implants

Saline implants are constructed of an outer shell comprised of silicone rubber and is filled with a sterile saline solution. Saline implants are equipped with a small valve that allows Dr. Lesesne to fill the implant to the desired amount. Once the implant is filled with the saline solution, the value seals the saline solution automatically. To ensure a tight seal, a small secondary sealing tip is inserted into the top of the valve. Saline implants enable surgeons to easily make minor adjustments in size. There are benefits to both types of breast implants. Dr. Lesesne will recommend the best implant size, shape, and finish to achieve the best breast augmentation results.

Implant Placement

There is not “one size fits all” solution for breast augmentation surgery. Several factors are considered when choosing the best surgical technique and implant placement. Breast implants can be positioned under the pectoral muscle or over the pectoral muscle (directly behind the breast tissue). Dr. Lesesne will advise the best placement for you based on the type of implant used, desired breast increase, and your specific anatomical needs.

Above the Pectoral Muscle

Dr. Lesesne has found that placing the implant above (on top of) the pectoral muscle is the best solution for the following patients:

• Women who are older and suffer from breast ptosis (saggy breast)
• Women who are post pregnancy or have breast fed
• Women who are athletic
• Women who suffer from tubular breast, muscle, or rib deformities
• Women who want maximal cleavage

Placing breast implants above the pectoral muscle is the most straightforward technique in breast augmentation surgery. Using this technique, Dr. Lesesne places the implant between the breast tissue and the chest muscle. This approach allows insertion of large implants and is placed below the breast glands which does allow for breast feeding.

Below the Pectoral Muscle

Dr. Lesesne recommends placing the implant below the pectoral muscle for:

• Women who are thin or have a petite bone structure
• Women who have experienced hard capsules from earlier implants
• Women who have wound healing issues
• Women that have a family history of breast cancer
• Women who received multiple previous breast biopsies

Below the muscle or sub-muscular placement is a technique in which breast implants are positioned partially under the pectoral chest muscle. The implant is covered by the breast tissue and the muscle resulting in a more natural look. There is less risk of capsular contracture development and less distortion of mammograms when placing the implant below the pectoral muscle.

Breast Augmentation Incisions

Dr. Lesesne begins the procedure by making an incision in an easily hidden place. You and Dr. Lesesne will decide on the placement depending on the type of implant used and your body’s needs. Incision placement for breast augmentation include:

Axilla: Axilla incisions are made in the hollow area of the underarm. The incision is approximately 1.5 -2.0 inches (depending on the implant size) and is placed in the skin crease so the scar is well hidden. Once the incision in made, a small tunnel is then made to pectoral muscle to create a pocket for placement of the breast implant.

Areola: Incisions can also be made on the bottom half of the areola (the dark skin that encircles the nipple). This technique is commonly called periareolar breast augmentation. The scar will fade over time and is well hidden at between areolar tissue and skin.

Inframammary: A 1.5-2.0 inch incision can be made at the fold of the breast. This technique is called the inframammary incision. This is an excellent approach for patients using saline or silicone implants. Scars typically fade well, and are not visible in bras or swim suits.

Umbilical: Trans-umbilical breast augmentation (TUBA) is a type of breast augmentation in which the incision is made in the navel rather than the chest. Much like axilla technique, a tunnel is made from the navel to the pectoral muscle and the breast implants are then inserted in the breast pocket. This technique can not be used with saline or pre-filled implants.

Breast Augmentation Recovery and Results

Recovery time after breast augmentation surgery is usually 1-2 days for most healthy individuals. You may experience some swelling and soreness up to a week after surgery, but pain and discomfort us well tolerated. Sutures can be removed 5-7 days after surgery.

Breast implants can take up to a few weeks before they settle and look natural after surgery. At first, you may notice the implants are sitting higher on your chest, feel more firm, or are larger than you expected. You should wait at least three months before your final results are realized. Your implants will drop to sit in a more natural position on your chest and the swelling will come down so you can see the final size results of your breast augmentation surgery.