Breast enlargement or augmentation is a surgery which places a silicone or saline breast implant behind the breast tissue to produce a desired amount of fullness. The decided size of the implant
either submuscular (behind a part of the pectoralis major muscle and breast tissue) or subglandular (behind the breast tissue only). A dual plane placement may help provide some internal lift to the breast. Two incisions are available: inferior periareolar, around the bottom edge of the areola; inframammary, just above the inferior breast crease.
The created breast space must be precise and trial implants help determine the final volume of the implant. The selected implant must be placed as aseptically as possible into the breast space, and always washing implant and breast space with antibiotic solutions during the final insertion.
I use breast implants manufactured by the Mentor Corporation, the only implant made in the USA. I always use round implants, which are available in different profiles and are available in a smooth or textures surface. I feel that anatomical implants are best for breast reconstruction.
Women's breasts change over time, losing their youthful shape and firmness and elasticity. A breast lift will relocate the nipple to a higher pre-measured location, and will tighten the skin and breast tissue below. If there is significant loss of superior fullness, a breast augmentation as part of the breast lift surgery, will provide a fuller appearance.
I perform a vertical breast lift, first with temporary sutures to reshape the breast, and checking shape and elevation, by placing my patients in temporary sitting position. When the final shape is created the area to be tightened is outlined and the breast is surgically reshaped.
The usual incisions after closure, encircle the areola, then extend vertically down from the bottom of the areola toward the breast crease.
Liposuction of the lateral breast may be of benefit to further contour the outer breast.
Reducing the size of overly large breasts may benefit both health and emotional problems. The weight of excess breast tissue can interfere with physical activity and may cause back, neck and shoulder discomfort, and may produce skin irritation beneath the breast crease. Self image issues and difficulty of fitting into clothes may be a concern.
I use a vertical breast reduction technique for my surgery on large breasts. Closure of the incisions encircle the areola, then extend vertically down from the bottom of the areola toward the breast crease, and then horizontally at the breast crease. The final size of the breast should approximate what the patient desires. Liposuction often is used for further contouring.