Breast Procedures

Breast Procedures

 

Breast Augmentation

Whether you are looking to fill in your bra cup without looking unnatural, or you want a larger breast enhancement, breast augmentation can be a very satisfying procedure. There should never be a “one size fits all” method, and we combine our training and experience with an artistic approach to design a surgical plan that will best help you achieve your goals.

During your first consultation, Dr. Hall will ask you about your past medical history and any history of prior breast disorders or procedures. After a careful exam, your specific measurements will be recorded and all options will be discussed. Decisions to make include incision location (transaxillary, periareolar, or inframammary), implant location (superficial to or beneath the pectoralis muscle), and type of implant (silicone or saline, and the amount of projection of the implant).

It is important when planning your augmentation that your body’s design be taken into account. There is an optimal implant diameter for each patient. Exceeding that can create complications or a “heavy” look, whereas falling short can create too much space between the breasts and create an unaesthetic outcome.

We make it all about you- your underlying anatomy, desires, and many other factors are all taken into account. Quality thought and analysis go into planning your specific procedure. We want you to have an enjoyable surgical outcome that will last as long as possible.

Breast Implant Options: Saline vs Silicone

There are two main options when it comes to breast implants: silicone and saline. Silicone implants and saline implants have a silicone shell. They are filled with different materials. Silicone implants come pre-filled from the manufacturer with a volume of silicone. The silicone on the inside of the implant can have variable cohesivity (or thickness). Some refer  to highly cohesive implants as “gummy bear” implants. The newer generation of silicone implants have a good safety profile, and a very low leak rate. The FDA recommends that any person with a silicone breast implant undergo an MRI to screen for an implant leak at three years after they are placed and every two years after that.

Saline breast implants come unfilled in the box and are sterilely filled during breast augmentation surgery. Each implant has a recommended volume range per the manufacturer. Saline implants do not require MRI screening.

Each implant has a characteristic feel. It is recommended that the patient examine each type of implant in their plastic surgeon’s office when making a decision for breast augmentation.

Silicone implant

saline implant (unfilled)

Breast Reduction

Breast reduction surgery is one of the most gratifying surgeries available for both the patient and the surgeon. It utilizes a number of techniques to reshape the breast and give it a more lifted appearance while reducing the weight of the breasts. In most cases, this alleviates chronic neck, shoulder and back strain caused by heavy pendulous breasts. The patients frequently report immediate relief of pain, and the aesthetic enhancement can be remarkable.

Often, patients have tried nonsurgical means of improving their neck and back pain without success. Additionally, there may be difficulty with exercise and finding a comfortable bra. There may be issues with skin breakdown from moisture beneath the breasts.

Breast reduction consultation starts with a history of symptoms, overall health history and exam, and discussion of the surgical details and the anticipated recovery and outcome.

Many patients are concerned that their breasts may be too small or too large after the surgery. This concern is entirely normal. It is important to understand that your breasts will be smaller after surgery, but that every effort will be made to leave you with breasts that look appropriate for your body. Cup sizes are very arbitrary, and cannot be predicted very well as they vary among brands and body types.

 

 

Breast Lift

The ptotic (saggy ) breast prior to breast lift

The rejuvenated breast contour following breast lift

 

 

Breast lift (mastopexy) makes the breasts higher, tighter, and more youthful appearing. There are a number of surgical methods available, and we tailor your plan to your needs. The scar pattern may simply be around the areola, or may include around the areola, down the lower midline, and across the inferior fold. This depends entirely on the amount of excess skin that needs to be treated, and the distance the nipple areolar complex needs to be lifted.

The surgery typically takes 3 hours, and can usually be done in the outpatient setting (going home the same day). The typical recovery is 2 weeks.

Breast lift is a great way to rejuvenate the breasts after pregnancy or weight loss. It is also used to enhance breast shape when women are genetically predisposed to breast ptosis (sag) or tubular breasts.

Sometimes people develop an aged look to the augmented breasts over time. Often, patients are very happy after having a “reset” procedure to lift the breasts.

 

Breast Reconstruction

Breast reconstruction is a broad heading that includes but is not limited to methods used to reestablish a breast mound after the breasts have been removed for breast cancer.

There are two broad categories of breast reconstructive methods: Autologous (using your own tissues) and Implant based. Below we have listed some of the more common methods of breast reconstruction.

Autologous

TRAM flap

Free Flap (tissue that is transferred from another part of the body to the breasts with microsurgery being used to connect the blood vessels at the breast level)

Fat Grafting- using the patient’s own fat grafts to fill in the volume of the missing breast which typically requires multiple sessions of fat grafting over time.

Other- There are other, less commonly utilized methods of breast reconstruction which are available in special circumstances.

Implant-Based

Often, an expander is placed first and is filled over months (usually every two weeks in the office) until the goal expansion is reached. The expander fills are reported as being comfortable and a patient can usually return to work immediately afterward each fill.

A breast tissue expander

The second stage of this method involves another surgery to exchange the expander to an implant. The typical recovery from this is 2 weeks.

Finally, three months later, the patient may undergo a procedure to reconstruct a nipple followed later by a tattoo, or may desire a tattoo that has color and highlights to add dimension and appear to have a nipple.

The entire process of breast reconstruction done with implants may take 9 months to up to a year.

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