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Surgeries / Procedures

• Abdominoplasty
• Blepharoplasty
• Brachioplasty
• Breast Augmentation
• Buttock Augmentation
• Calf Augmentation
• Cheek Reduction Surgery
• Chin Surgery
• Facelift
• Forehead lift
• Gynecomastia
• Lip Augmentation
• Liposuction
• Mastopexy
• Otoplasty
• Rhinoplasty

 

Your Breast Augmentation Surgery

Depending on your physician and the method of surgery that has been chosen, your breast augmentation procedure can be performed as an inpatient (requiring an overnight stay in the hospital) or as an outpatient (no overnight stay required). In general, breast augmentation is performed on an outpatient basis in a hospital operating room, surgery center or surgical suite in a surgeon's office. On average, the surgery lasts one to two hours.

General anesthesia is commonly used and local anesthesia also is an option. Your surgeon can discuss with you the most appropriate choice of anesthesia for your procedure.

Your surgeon will make an incision and create a "pocket," or space, within your breast tissues for the breast implant. The breast implant will be placed in the pocket, filled and positioned. Then, the incision will be closed, usually with stitches, and possibly taped.

Breast Augmentation Surgery Incision Sites

To permit the smallest possible incision, the breast implant is typically inserted empty and then filled with saline. You should discuss with your surgeon the pros and cons for the specific incision site recommended for you.

There are three common incision sites: under the arm (axillary), around the nipple (periareolar), or within the breast fold (inframammary). If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a "pocket" for the breast implant.

Periareolar – This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites.

Inframammary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding.

Axillary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast feeding.

Umbilical/endoscopic – This incision site has not been studied and is not recommended.

Breast Implant Placement

Breast implants may be placed subglandular, which is between the chest muscle and the breast tissue; or submuscular, which is below the chest muscle.

Subglandular Breast Implant Placement

Subglandular placement may make your surgery and recovery time shorter. It may be less painful and it may make the implant easier to access if reoperation is necessary. This placement also may make it easier to see and feel your implants through your skin after your surgery. Capsular contracture is more likely with subglandular placement and imaging of the breast with mammography may be more difficult.

Submuscular Breast Implant Placement

The submuscular placement may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some reoperation procedures than the subglandular placement. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography.

No one incision or placement choice is right for every woman. By knowing your options and discussing them with your physician, both of you can decide upon an incision/placement combination that is best for you.

Before Breast Augmentation Surgery

Breast augmentation, as with any other surgical procedure, requires you to be in good health. Any health concerns and problems that you may have should be discussed with your physician prior to your breast augmentation procedure.

Your doctor will give you specific instructions to follow in the day or two prior to your breast surgery. Here are a few general guidelines that you should follow:

• If you smoke, it's important to reduce or stop smoking before your procedure and for some time afterward.
• Certain medications such as aspirin or ibuprofen can cause bleeding problems during and after surgery. Therefore, do not take these medications for a few weeks before your procedure. Discuss with your physician any other medications that you are taking.
• Eat a healthy diet and avoid drinking alcohol a few days prior to your procedure.
• Exercise is generally good for your overall health; however, refrain from extremely vigorous exercise the day prior to your procedure.
• Do not eat or drink anything, including water, after midnight the night before your surgery. It also is important the night before to shower and wash your surgical areas with antimicrobial soap.
• The morning of your breast augmentation procedure you may brush your teeth, but do not swallow more than a sip of water. If your physician allows you to take any prescribed medication, swallow it with a minimal amount of water.
• It also is a good idea to take another shower with antimicrobial soap. However, after your shower do not wear any makeup, moisturizers, oils, creams or lotions – including deodorant.
• Remove nail polish from at least one fingernail and toenail to help the anesthesia person monitor your blood circulation during your procedure.
• When you go to your physician's office, wear loose-fitting clothes that open in the front and comfortable flat shoes that slip on.

Personal Arrangements

Bring as little as possible to your procedure. All you will usually need is your identification and a small bag to carry medications and paperwork. Make arrangements for someone to drive you to and from your procedure.

Arrange for a friend or relative to stay with you for the first 24 hours after your procedure. If you have small children, you may want to make arrangements for their care as well. Prepare extra food ahead of time and have plenty of fluids and crackers available. Clear your responsibilities at work and at home so that you can have a few worry-free, relaxing days to recover.

Make sure any prescription medications have been filled and are in a convenient location. Ask your physician when you may resume driving a car. Your physician will give you more detailed information when you schedule your surgery.

FAQ'S

Who are typical candidates for the breast augmentation procedure?

Most women who undergo Breast implant surgery in our Office fall into one of two groups. The largest group comprises women in their thirties with children. They have noticed a loss in skin tone with sagging of the breast. They often notice a decrease in size of the breast (most noticeable in the upper and outer portion). Sometimes the breast augmentation procedure is combined with a breast lift. The second group consists of women in their twenties who want larger breasts to balance the rest of their body.

How long does the breast augmentation procedure take?

The breast augmentation procedure takes under two or three hours.

When can I go back to work after my breast implant procedure?

You must plan to be out of work for 5 to 7 days. You can resume your regular activities within a week. Breast augmentation at the Baltimore office has a very high satisfaction rate. After the surgery many patients say they wish they had had done it sooner!

What Decisions do I need to make before my breast augmentation procedure?

Dr. Estrella will discuss the following decisions with you during your initial breast augmentation consultation:

1. saline or silicon
2. size of implants
3. round or oval (size of implants)
4. textured or smooth (surface of implants)
5. under or over the muscle (placement of implants)
6. location of incision site (implant placement)
7. with or without a lift

What types of complications can occur with breast augmentation?

Breast implants have been used for about 40 years. Most women have no problems. The most common problem that we see is tightening of the capsule that surrounds the implant. This often responds to massage but may occasionally need surgery to remove the capsule. Other rare problems include deflation of the implant. Detailed questions are discussed at your consultation.

How do I know what size I will I be after breast augmentation surgery?

Your breast size after surgery depends on two main factors: how big you were before surgery and the volume of implant inserted.

The volumes of the breast implants are measured in CCs. (30 cc= 1oz). The most popular implant size is 300ccs (10oz). You can get a rough idea of how big you look by placing the desired volume in a freezer bag and placing it in the lower part of your bra.

In our office patients try on actual implants by placing them in their bra. You should bring two different types of tops (a blouse and a tank top) with you to your consultation. This will help you make your decision about the implant size.