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Breast Augmentation (Augmentation Mammoplasty)

Breast augmentation is an extremely common procedure that enjoys a very high patient satisfaction profile. Popularized almost 50 years ago, the operation has evolved and has been progressively improved upon. Additionally, breast implant designs have been updated and optimized to maximize safety, longevity and comfort. There now exists a wide variety of shapes and styles of breast implants to suit the unique requirements of each patient’s needs.

Seemingly a simple operation on it’s surface, breast augmentation surgery requires thorough understanding of both the aesthetic and anatomical components of the procedure. A very comprehensive evaluation is first performed utilizing an interactive approach with the patient. A complete analysis of the breast is performed with respect to dimensional analysis and tissue quality and volume. The proper use of breast implants is then introduced, evaluating implant parameters such as diameter, projection and fill volume. Implant positioning and access incisions are discussed thoroughly, with emphasis on pocket creation and implant position and stability.

Similar to all plastic surgery procedures, breast augmentation surgery enjoys high success rates when performed by surgeons that have a high level of training and experience. The pre-operative and operative approach employed by Dr. Carpenter reflects both this training and vast experience with these procedures. A commitment to excellence, years’ of experience, and uncommon skill allow for predictable, stable results.

Breast Augmentation Procedure

Thorough analysis and surgical planning is completed preoperatively, and reviewed on the day of surgery. The procedure is typically performed utilizing a general anesthetic, though brief. Surgical time is usually less than an hour. A short access incision is made, as discussed pre-operatively, then pocket dissection is performed entirely utilizing electrocautery technique. This allows for extremely minimal loss of blood, and no blunt or tearing dissection to complete the pocket. Utilizing this approach produces the least blood loss, the least tissue disruption and therefore a more precise and stable implant pocket. Breast augmentation procedures performed utilizing these principles- employing precise visualization, electrocautery dissection, and preservation of the structural elements of the breast provide more consistent and better aesthetic results while minimizing complications. Additionally, these techniques are associated with reductions in swelling, bruising, and pain which is associated with faster recovery.

Recovery After Breast Augmentation

A short period of observation follows the surgical procedure. Patients are given thorough instructions regarding the post-operative protocol, which is very simple. Most patients can resume typical activities and work almost immediately, however some obvious restrictions apply and are outlined. Initially, the appearance of the breast is tight, which diminishes within a few weeks. This tight appearance is expected, as discussed pre-operatively. No tight wraps or binding dressings are employed. A comfortable bra may be fitted immediately following the procedure. A post-op visit is scheduled at one week, then six weeks, then six months’ time. Long term follow-up with breast implants is stressed, with protocols discussed pre-operatively.

Breast Implants

Breast Implants have been employed in breast surgery for many years, with silicone breast implants having been used extensively for almost 50 years. Breast implants are used in a number of ways to achieve improvements in the breast. Implants are used to enlarge the breast (breast augmentation), rebuild the breast (breast reconstruction) after loss due to cancer surgery, or to assist in reshaping the breast during breast lift (mastopexy).
Implants are also often used in cases of breast asymmetry or malformation.

With regard to choice, the plastic surgeon has a wide variety of modern implants to fit specific needs with each individual surgical case.

Dr. Carpenter has a vast experience in use of breast implants, having placed thousands of implants in a number of surgical applications. He has been instrumental in the development and testing of implants and is well versed in the latest designs and application techniques. He is involved in educational initiatives, in coordination with the implant manufacturers, with surgeons visiting and observing Dr. Carpenter in the operating room utilizing state of the art implants and surgical techniques.

Silicone Breast Implants

Silicone breast implants are the most commonly used implants for cosmetic and reconstructive surgery of the breast. Originally developed almost 50 years ago, silicone breast implants have evolved and have been modified significantly over the years in an effort to maximize aesthetics and improved implant stability. These implants are composed of an outer flexible silicone “shell”, which is either smooth or textured, and an inner silicone “fill”, which is a gel of various degree of cohesiveness. The outer shell is either round in shape or “anatomic”. Anatomic silicone gel implants are usually textured, whereas round implants are either smooth or textured.

Saline Breast Implants

Saline implants are composed of a silicone “shell” and a saline “fill”. The saline is typically filled after positioning the implant in surgery. Saline breast implants are an excellent choice for many patients, usually those seeking breast augmentation or mastopexy. These implants may feel slightly firmer and may be more “palpable” in very thin patients compared to silicone implants, but otherwise perform very well. Since these implants are filled with sterile saline solution after placement, access incisions can be very small.