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Reasons For Breast AugmentationBy Expert Author: Dr. Nick Masri
Breast augmentation surgery is the process of restoring or increasing size and symmetry
of the breasts. The loss of symmetry or fullness can be due to hereditary factors, pregnancy or after an extreme weight loss. This procedure is also used as a reconstructive surgery for women who have had a mastectomy.
The procedure consists of the placement of implants that will increase the projection and fullness of the breasts. The clinical term is augmentation mammaplasty.
It is used cosmetically to improve several conditions.
• To achieve symmetry if the breasts are disproportionate in size and/or shape
• To enlarge small breasts that may be the result of heredity
• To enhance the patient's self-confidence and self-image
• To restore lost volume after breastfeeding or as a result of weight loss
When a woman is dissatisfied with her breasts it can result in poor self-image. If this occurs, a breast augmentation may be a good choice to consider.
It is important to realize that a breast augmentation procedure will not fix drooping breasts. If the breasts are sagging, a breast lift may have to be done along with the augmentation. It is possible, and common, to do both procedures at the same time by a qualified plastic surgeon in Miami.
According to the American Society of Plastic Surgeons, the cost of breast augmentation averages about $3500 in the United States. This is the surgeon's fee. There are other fees to consider including hospital fees and anesthesia fees. Costs can vary according with your location and the experience of the surgeon as well as the type of implants that are used. This is considered an elective surgery and therefore seldom covered by insurance. Payment arrangements should be discussed with the surgeon on the initial visit. Some insurance carriers exclude breast diseases if the patient has had implants. You will need to study your policy carefully. The insurers will likely also exclude any complications that arise as a result of the procedure.
Other costs involved with the procedure include:
• The surgical facility costs. These vary depending on whether it is a free-standing facility or a hospital
• Fees for anesthesia
• Medication that are prescribed for post op period
• Cost of breast implant
• Garments that will be needed post operatively
• Laboratory tests needed before the procedure
During your initial visit to the Miami surgeon, you would be wise to ask to see photographs of before and after surgical procedures completed by that particular surgeon. Ask to see photos of women who have had the type of procedure you are considering and are in the same size range that you are considering. It is important that you have this procedure for your own satisfaction not that of another person.
There are certain criteria that must be met in order to have a successful outcome. Some of these include:
• Good physical and mental health
• Realistic expectations
• You have reached an age where your breasts are fully developed
• The fact that your breasts are small is bothering you emotionally or not permitting you to wear clothing that you wish to wear
• After a significant weight loss, pregnancy or natural aging, you do not like the volume or size of your breasts.
• Your breasts are different sizes
• Breasts have failed to develop to what you consider "normal"
Part of the process of deciding to have breast augmentation being aware of the risks involved. Are the potential complications acceptable to you?
Possible risks and complications of breast augmentation
• There is a possibility of excessive and unfavorable scarring
• Hematoma can occur. This is an accumulation of excess bleeding in the area of the surgery
• There can be permanent or temporary changes in sensation in the nipple area
• Incisions may heal poorly
• The scar tissue in the surgical area becomes very firm. This is called capsular contracture
• Rupture of the implant or some leakage
• Skin wrinkling over the area of implant
• Fluid accumulation
• The risk of anesthesia
• There can be blood clots that may appear as deep vein thrombosis. This increases the risk of lung and heart complications
• Persistent pain
• There is a possibility that surgery to revise the procedure may be necessary
Although there are potential complications, the impairment of breast health is not one of them. The Institute of Medicine has published reports stating that there is no link between breast augmentation and systemic diseases or the autoimmune system.
Age can take its toll on breast implants. There is no guarantee that the implant will last a lifetime. It is possible that one or both will require replacement at some point. Menopause, the aging process, weight loss or gain and pregnancy can alter the appearance of your breasts.
As you speak with your Miami plastic surgeon or their designated staff member, the risks of the surgery should be explained in detail. There will be a consent form that you will sign stating that you understand all of the potential risks.
During your Initial Consultation
Your initial consultation is your opportunity to be totally candid with your surgeon. Be actively involved in every aspect of breast augmentation. Be sure to include any concerns, problems and any questions you may have. You will be asked a series of questions as well.
You should be prepared to discuss aspects of your life including:
• What is your desire as far as breast augmentation is concerned? What are your expectations?
• What medical conditions do you have that may impact the procedure? What allergies do you have? What medications do you take? This includes prescriptions, supplements, alcohol and tobacco.
• What previous surgeries have you had and how did you respond to the procedures? Have you ever had problems with anesthesia?
• Is there a family history of breast cancer and have you had any biopsies or mammograms.
• What is your health status? Are they any risk factors that need to be told to the surgeon?
In addition to the above medical history questions, the surgeon will take measurements of your breasts which include size, shape, placement of nipples and the skin quality. You will have before photos taken on your visit. These will remain in your medical records.
Your surgeon will discuss your surgical treatment options. The outcome of breast augmentation as well as complications and risks will be discussed. Your Miami surgeon will tell you about the use of anesthesia during your breast augmentation procedure.
It will be important to prepare for your surgery. Your plastic surgeon will ask you to:
• Have a complete medical evaluation and laboratory tests
• Adjust your certain medications or take additional medications
You may have a baseline mammogram before surgery and one after the procedure. This will help to detect changes in your breast tissue in the future.
You will be told to stop taking aspirin or other anti-inflammatory drugs as well as herbal supplements. All of these can increase the potential of excess bleeding.
Your physician will tell you what to do on the surgery date, your postoperative period and follow up care. This will be the time when you are told where your breast augmentation will be performed. It may be in an ambulatory center, a hospital or an accredited office-based surgical center. In the event that you are having an outpatient procedure, be sure to arrange for transportation to and from the surgery and someone that will be with you the night of the surgery.
During the Procedure
You will be administered medications to provide you with comfort before, during and after the breast augmentation procedure.
There are several different types of incisions that may be made. This will depend on the type of procedure you are having. One is the inframammary, which is at the lower part of the breast in an inconspicuous area. Another is the trans-axillary incision. This is done under the arm in an inconspicuous area. The third is the periareolar incision. This is done around the nipple.
The type of incision will depend on the type of procedure and the degree of enlargement, your anatomy, the surgeon's preference, and your agreement as to the type and extent of the breast augmentation. The condition of your skin is also a factor. Your surgeon may advise you against your initial desire. It is something that you must agree on before the surgery is performed.
Types of Implants
There are two types of implants, saline and silicone. The size and shape are important and the feeling produced by each should be considered.
Saline breast implants contain sterile salt water. The amount of saline in the implant will affect the feel, firmness and shape of the breast. A saline filled implant will collapse if leakage occurs. The body will absorb and expel the excess.
Silicone implants contain an elastic gel. These implants feel more like a natural breast. The gel is very pliable. If the silicone implant leaks, the gel will either escape into the body or stay within the shell of the implant. One filled with silicone may not completely collapse. If you choose silicone, it will be necessary to visit the surgeon on a regular basis to be assured they are working as they should.
The FDA has approved saline implants for women that are eighteen years or older. They have approved the silicone implants for women twenty-to and older. If the implants are being used for a reconstruction procedure, an earlier age may be permitted.
Your surgeon may recommend one of two areas to insert the implant. They can be placed under the pectoral muscle which is between the chest wall and breast tissue, or placed under the pectoral muscle. This will be dependent upon your body type, the size of the enlargement, type of implant and the recommendations of your surgeon.
Closing the Incision
Your incision will be closed with layers of sutures in the tissue with either skin adhesive, surgical tape of sutures in the skin. Incision lines will fade with time and the proper care.
You will see the result of your surgery immediately. The swelling will subside and the lines will fade. As you recover, you will feel fulfilled. You will have a new sense of self-esteem as your outcome is achieved.
Your recovery period will last a few days. There will be 24-48 hours of complete rest followed by a reduction in daily activity for a bit longer. There will be some noticeable swelling and soreness for several weeks after your breast augmentation. Your Miami surgeon will tell you when you can resume exercise and other normal activities.
There will be medications for you to either apply to the surgical incision or to take by mouth. These will reduce the possibility of infection and help you to heal more quickly. You will also be advised as to when to return to the doctor's office.
Make a list of questions you will need to ask after your breast augmentation. It is possible that all of them will be answered with your discharge instructions. These may include:
• Where will I wake up from surgery?
• Will I have to take medication after surgery? Will it be given to me or will it be prescribed?
• When will the bandages and dressings be removed and where?
• How long will I have stitches in? Where will they be removed?
• How long will I need to rest before resuming normal activity?
• When will my next appointment be with the Miami plastic surgeon?
Once you go home, be aware of any changes in your condition. Should you become short of breath, have chest pains or irregular heartbeat, you need to contact your physician. If any of these occur, you may need additional hospitalization.
One point to remember is that medicine is not an exact science. Occasionally the best-laid plans can go awry. It is possible that all will go well, but it is also possible that you may require another surgery to get the optimal result.
Use caution when you return home. Do not overdo activity if you are feeling great. Follow the directions that you are given by your surgeon. Do not allow any excessive force, motion or abrasion to be close to your incisions.
Your self-confidence may soar as you enjoy the results of your breast augmentation. You may be able to wear clothing you have not been able to wear in the past. Knowing the results are long lasting is a huge benefit towards your increased self-esteem.
It is possible that your breasts will change over the years. It can be due to gravity, hormonal factors or weight fluctuations. In the event that you become dissatisfied with your breasts after a number of years, there is always the choice to have a breast lift or a change in your implant. This will usually result in a more youthful contour.
Breast Augmentation Vocabulary
Augmentation mammaplasty is a term used as a term for breast enlargement or enhancement by a surgical procedure.
Implants are the prosthetics placed in the breast to achieve the desired result. They are filled with either silicone or saline.
General anesthesia is the administration of drugs and/or gases that alter your consciousness to prevent pain during the procedure.
Hematoma is blood that pools under the skin
Mammogram is an x-ray of the breast
MRI is magnetic resonance imaging that is similar to x-ray. It will give a more detailed look at the breast tissue.
Mastectomy is the removal of breast tissue. This is generally done to remove cancer or, if genetic profiling or family history indicates, to prevent cancer.
Ultrasound is a procedure that will project sound waves into the bodies and records the echoes as pictures.
You will want to be assured that you have the best plastic surgeon for the type of procedure you are about to have. Be sure that the surgeon is certified by the American Board of Plastic Surgery. This will indicate a five-year surgical residency with at least two years in plastic surgery.
If you are of childbearing age and intend to breastfeed, you will need to know how the surgery will affect your potential ability to do so.
You may want to ask how many potential future surgeries you will need to retain your youthful appearance. This will depend on your age at the initial surgery as well as your lifestyle, weight changes, hormonal changes and the natural gravity that occurs as a woman ages.
Be sure to ask to see before and after photographs of procedures that your potential surgeon has performed.
While breast augmentation is a personal choice, it involves your family, friends and your doctor. Friends who have had the surgery may be willing to share their experience with you. They may also suggest surgeons that have a good reputation in Miami. Visit the surgeons at Face + Body Cosmetic Surgery at their Miami area office for the answers to all of your questions.
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