There are virtually countless reasons why breast augmentation is a longstanding leading plastic surgery procedure. While many women simply want to increase their breast size because their natural breasts are smaller than they would like, others pursue breast augmentation as a way of restoring the youthful shape of their breasts after age, weight change or pregnancy has caused unwanted changes. The experts at Westlake Plastic Surgery are here to help you realize exquisite breast augmentation results designed to your unique anatomy and preferences. We strive to deliver the best breast augmentation Austin has to offer. Schedule your Austin breast augmentation consultation to discuss your personalized treatment!
Breast augmentation started in 1964 when two young surgeons in Houston, Texas, implanted a silicone breast prosthesis in the first patient. Since that time, millions of women have undergone the procedure for enhancements to the appearance of their breasts. The surgical aspects of the procedure have not changed that much since, and the breast implants themselves are quite similar to the original breast implants except for some minor modifications to the silicone material used in manufacturing the device. National statistics continue to rank breast augmentation as the most popular cosmetic procedure performed by board-certified plastic surgeons.
American society places a high premium on the female breast, and many women have elected to change the shape and volume of their breasts to improve their appearance and self-esteem (among many other benefits). A breast enhancement today is a very reliable and safe procedure that enjoys tremendous patient satisfaction. Breast size and shape preferences are somewhat regional. Currently, in Austin, Texas, the demand is for moderation in size and “natural” appearance. Implants that create balance and proportions that do not make one look overweight are in vogue. Active patients in this fit city prefer to avoid large implants that can impede their lifestyle. Women prefer a size that doesn’t scream, “look at me.”
Proportional and natural are the buzzwords these days. Patients are very familiar with what they don’t want to happen — breasts that are too large, fake in appearance, balloon-like, unnatural, hard, “stuck on“ or not proportional. Cleavage is desirable, natural superior fullness is wonderful, and a sustainable size over the long haul is smart. Women prefer that the first thing someone sees when they walk into a room is not their breasts. We also have Austin breast augmentation patients who specifically seek out results that are not mainstream. Some prefer the “fake look” with larger rounded breasts. Having performed thousands of breast enhancements, our surgeon stresses that every patient is different in her goals and that we can work with almost all patients to safely and predictably reach her goals. There are many size choices between “go big or go home” and “I just want a little fullness.”
Most plastic surgeons offer breast enhancement. It’s important to select a surgeon who has an excellent reputation and vast experience with all forms of breast procedures. An excellent surgeon can also help those who have had previous work done and are looking for corrections and modifications. If you have had previous breast work and you are looking for improvements, take a moment and visit our breast revision center. Our vast selection of before-and-after “patient stories” speak volumes about our practice’s experience and the quality of our outcomes. If you are considering breast augmentation, we strongly encourage you to do your homework, choose your surgeon wisely, and avoid “impulse buying.” As common as the procedure is nowadays, it is still a major surgical procedure that requires serious considerations. Complications can happen, and you want to be in the best hands. Never assume that breast enhancement surgery is a simple routine endeavor. When it comes to your breasts, you always want the best.
The consultation process at Westlake Plastic Surgery is the most important time in your journey. This is when you and your surgeon will get to know one another and select the right implant for you. This means a lot of conversation and education. Our nurses and surgeon will spend the time necessary to try on the various breast implant sizers and determine what works best for you, your body, and your personality. There is no pressure to decide then; we insist on a return visit, at which time we will do it all over again to make sure that we get it right. My goal is to ensure that we don’t go too big or too small—we want it to be just the perfect fit. There are several patient imaging systems available today that are designed to offer simulated results of surgery. Although these systems are novel and fun, there is nothing better and more realistic than standing in front of the mirror with your breast implant size on to know, in real-time, how your results will appear. We recommend that you visit several surgeons before you proceed with surgery. It really helps to learn firsthand the differences among surgeons and the quality of their practices. You want to put yourself in the best hands, always. Great results and great care come from great doctors. Please take a moment and read our surgeon’s article on how to get the most from your consultation.
The beauty of breast implants is that the benefits extend well beyond the breasts. For instance, if you are pear-shaped, enhancing the size of your breasts creates a more balanced figure. Your abdomen will look smaller, and you will look like you have lost some weight. Women with “broad” or “strong” shoulders often benefit from larger breasts because their shoulders appear more balanced and less generous. Ample “bootie” is well balanced with some fullness on top. And curves are a great way to enhance those who are thin and narrow. Read my blog post about how the benefits go beyond breasts.
Choosing your breast size by simply requesting an “A, B, C, or D” won’t work for most Austin breast augmentation patients because there is no standard breast cup measurement, and you need to visualize what actual volume implant works best for your body type. This is a shot in the dark. Computer-generated examples of size changes on your figure are just that—computer-generated. If you want to know exactly what you will look like with a breast implant of a specific shape and volume, simply try them on, look in the mirror and give each your rating!
This is not only the critical part of your journey, it’s also the fun part. Most of the consultation time is spent choosing the breast implant size and shape that works with your figure and your personality. Every patient has a preconceived notion of what size and breast shape she thinks she wants. It must be understood that there are limits on implant choice based on the anatomy of your chest wall and your breasts. Engineering principles are involved in the decision. To provide you with an analogy, six people can’t fit at a table built for two. Large implants won’t work with a small chest. My primary goal is to make sure you make the best choice in implant size so that your results are long-lasting and pleasing. Having a large and shapely breast is not common because of the negative impact that a larger (heavier) implant has on the shape of the natural breast tissue over time. Ideal results are achieved when the best size and shape are created using the smallest implant possible. moderate size.
During your consultation you will try on silicone implant sizers and observe, firsthand, what volume works best for you. The A, B, C, D cup size system of breast measurement is imprecise and varies by bra manufacturer. Be aware that complications are directly related to implant size — larger implants are associated with more problems than smaller ones of Whatever implant size you choose, our surgeon typically adjusts the size up a bit because it will look smaller once it’s under your breast. I encourage my patients to be realistic when they choose the size. As you go through life, you will change the way you see yourself and your breasts, so it’s reasonable to assume that what works for you one day may be different the next. There is always worry about going too large or too small. How about getting it just right from the first try? That’s why our surgeon spends so much time determining the size: this is an important decision and it needs to be right on. Relying on your surgeon to choose your size without you trying on sizers often results in breasts that are too large (the logic being that larger breasts will make for a happier patient). Check out this blog post that goes more in depth on considerations when choosing implant size!
Choice of implant pocket location determines soft-tissue coverage for the patient’s lifetime and is the single most important technical decision. I place the vast majority of implants below the muscle. Implants are heavy, and the muscle helps support the weight of the implant (a 350cc implant weighs about 1.2 pounds!). Implants “behave” better below the muscle, and they are less likely to form a contracture. The more tissue covering your implant, the less likely you will experience implant irregularities. Implants placed below the muscle tend to feel more natural and have a more natural “take off,” or gradual transition (slope) between the chest wall and breast, which most women prefer.
Some surgeons have had a very nice experience with subglandular implants. They don’t move as much when placed below the muscle. There is also less pain associated with the procedure. If you prefer the “fake” look, it’s created by using saline implants on top of the muscle and inflating the implant to the maximal recommended fill. My biggest concern is the potential for implant contracture and palpable implant irregularities in thin patients with small breasts. The bottom line is that either location in the right patient will work quite well. It’s my job to help you choose the best location for your breast and skin type, so you enjoy all the benefits of your enhancement long into the future.
“Textured” means that the outer shell of the implant is rough, and it feels like very coarse sandpaper. These implants were originally designed to reduce the rate of capsular contracture but have not really produced the theoretical benefits. All shaped implants are textured. Round implants may be smooth or textured. It’s interesting that in the US most breast implants are smooth walled and in Europe most are textured. Obviously, the benefits, if any, of these implants when used for cosmetic breast augmentation is not obvious or we would all choose the same breast implant type. As mentioned above, textured implants are currently not popular and infrequently recommended until the association between textured implants and breast lymphoma is clarified. We recommend smooth walled, non-textured implants for breast augmentation.
Why consider silicone or saline breast implants if we could use the extra body fat that many of us have and would love to donate for a good cause? Since 2010 the use of fat grafting in plastic surgery has been popular in the mainstream media. Stories of using your own body fat to inject into the face, sculpt a heart shaped buttock or enhance the smaller breast were not uncommon. But does it work? The jury is finally out in 2019, and the verdict is that fat can be used when combined with breast implants to enhance the result but fat alone to augment the breast simply doesn’t work. In the best of hands it may make the breast slightly larger but the results have proven disappointing.
You still can’t beat the results from the breast implants currently on the market. I know this is disappointing to all of you seeking a natural breast augmentation with your own fat. We don’t know what the future holds. It’s entirely possible that we will come up with the “holy grail” of fat preservation that will allow us to take fat from anywhere on the body and fill up the breast to whatever size we choose – but we are not there yet. The good news is that a breast augmentation with the current saline and silicone implants works very well with high rates of patient satisfaction.
Currently, there are three breast implant manufacturers that sell FDA approved implants in the US market. They are Allergan, Mentor, and Sientra. Both silicone implants and saline implants are widely popular. About 90 percent of implants sold in America are the silicone variety. As you can probably determine after visiting our website, the majority of implants chosen in our practice are silicone. This is a patient’s decision, which is only made after appropriate education regarding the pros and cons of the two implant types. Like the saline implant, the filler is only saline, which some women like for peace of mind in case of a rupture or deflation. Like the silicone implant, it has a natural feel and doesn’t have a risk of silent rupture and FDA-recommended MRI scans.
Women can just look in the mirror and see that their implant is smaller and deflated. In November of 2006, the Food and Drug Administration approved the use of silicone implants after having removed them from the American market 14 years prior. Their reintroduction to the market was due to the lack of any scientific evidence that silicone is associated with disease conditions or adverse effects to your health (there was no evidence). The most convincing argument that favors silicone breast implants over saline comes from patients who have had experience with both. They almost unanimously recommend the silicone implants — they feel softer and more comfortable, as if a part of their breast rather than separate from their breast. The breast implant and the natural breast behave as one.
The inframammary incision is the gold standard of incisions, and is the location most frequently used by experienced surgeons. Not only does it provide the ultimate visualization and control for the surgeon, but it also involves the least soft-tissue trauma, the fewest potential nuisances and the lowest chance for postoperative complications. In the majority of patients, it’s the best incision. The reasons why this incision is so common and preferred are simply that it is efficient and the scars heal very well, often becoming almost invisible after a year or two. The saline incision is so small that it’s hard to justify any other incision. The breast silicone implant incision is larger, so this is often the best place to hide it. The axillary, or “armpit” incision is used to place the breast implant through the armpit. It is generally well hidden and there is no scar on the breast. There is a higher incidence of implant malposition with this technique. Additionally, if you require an adjustment of your implant, it’s not uncommon to need a second incision in a different location to correct the problem. Only the smallest silicone implants can be placed using the axillary incision. The potential for postoperative issues is also greater with the axillary approach, and operative and anesthesia times are also longer. This incision is used in our practice only when a patient demands that her incision be in that location.
The periareolar incision (incision around the of your areola) is not as common as it should be. It’s a wonderful approach if you have a large enough areola to accommodate the implant. There is no evidence that this incision, closer to the nipple, affects breast sensitivity compared to other incisions. Since there is a greater amount of dissection through the breast with this approach, it can, at times, lead to excessive scarring and a visible contour irregularity. This incision may also be associated with a greater inability to breastfeed, by some reports, although this is rare. For the right patient, this is a great incision as it is so discreet. The umbilicus or “belly button” is an option for the placement of saline implants. Thi,s is called the TUBA procedure (Trans-Umbilical Breast Augmentation). Read this blog post to learn why our surgeon doesn’t recommend this approach. Patients who have excellent outcomes, without complications or reoperations, rarely complain about any incisions. A skilled surgeon usually delivers excellent scar results.
A “shaped implant” refers to an implant that looks like a “teardrop.” They have less fullness at the top and more at the bottom of the breast — this resembles a natural breast more so than a round implant of the same size. These implants are typically referred to as “gummy bear implants” or “anatomic” implants as they are the firmest implants. They have to be firm so they don’t lose their shape, unlike a round implant. They are designed to be placed in a tight pocket beneath the breast and NOT to move. All these implants are textured and not smooth-walled. These implants were introduced to the general market in 2012, and there was a lot of anticipation that they would one day be very popular. This hasn’t quite turned out that way, and in 2017 these implants command a small segment of the market. The biggest issues with these implants are that they can rotate after placement, they don’t move and can be a bit unnatural, and there are studies that show neither the patient nor surgeon can tell which breast implants were used.
For these reasons and others, these implants are not popular at all and the current “thinking” amongst reputable plastic surgeons is that they simply don’t have a role in cosmetic breast enhancement. If your surgeon is comfortable using these implants and feels that he/she is getting superb results that can’t be achieved with standard round implants, you might want to consider them. Our surgeon recommends that you consider round implants before the anatomic variety. What we thought would be a good thing simply didn’t prove itself in the marketplace. In 2018, there were reported cases of a specific type of lymphoma seen very rarely with the use of textured breast implants. Research is underway to determine the nature of this condition, its frequency and its relationship to breast implants. Because all the cases involved the use of textured breast implants, they currently are not commonly recommended as surgeons are hesitant to use a product whose safety is not 100% assured.
An “implant profile” refers to how narrow or wide the implant is. Low profile implants are flat and high profile implants are narrow. The difference can be very significant in the final appearance of the breast. Currently, my patients overwhelmingly prefer the higher profile implants as they look perkier, more youthful and less matronly. You can often calculate an appropriate implant profile depending on your anatomy and the size of the implant that you are considering. Smaller implants often necessitate lower or moderate profile implants while larger breast implants benefit from the high profile shape. With higher profile implants, there is less side cleavage and less underarm fullness. During your consultation, we will often change the profile so you can see in the mirror how things look different depending on the implant profile.
A breast lift is considered when the breast is saggy, the nipple-areola complex is low on the face of the breast, and if the skin of the breast is quite lax. Experience is needed to know when to lift and when not to. Some patients will realize a beautiful result with an implant alone, while others may need an implant and a breast lift at the same time. It’s always possible to lift the breast as a secondary procedure if you think it is needed. An experienced surgeon can really help here as they know what will work best for you. Read my blog “How do I know if I need a breast lift?” Although a breast implant alone can provide some “lift” to a breast and take up some of the lax skin, we have seen many patients who wanted to place an enormous implant for the lift, but the result was overly large breasts that sit low and are not attractive.
Another common error is to perform a breast augmentation and a lift only around the areola simultaneously (Benelli procedure). This often results in funky-looking breasts with really big (stretched) areolas and poor scars. Women have concerns about a lift because it means breast scars. However, a beautifully shaped breast with a scar looks better than one that lacks fullness but has no scar. This has been proven to experienced surgeons time and time again. Women are concerned about how their partners will react to the scars, but this issue is often overblown. Men generally do not have a problem with a scar on the breast if the breast is shaped beautifully. They tend to see the “big picture” and not the details: a deflated breast with nipples pointing down is not ideal, while a breast that is full with nipples pointing to the sky reveals youth, vitality, and beauty.
The typical patient needs about two or three days to recover. After this time, you will be off narcotics, and you can take anti-inflammatories such as Motrin or Tylenol. There will be discomfort for several weeks afterward that gets better every day. You should avoid any major exercise for the first week and then gradually work back to a full schedule. Avoid heavy lifting (kids, weights) for about two weeks after surgery. Adding a breast lift or breast reduction to your procedure does not add much to your recovery. Most of the discomfort associated with the procedure is related to the placement of the implants below the muscle, which stretches the muscle and feels tight. The smaller the implant used, the less stretching of the muscle and, therefore, less discomfort.
Forty percent of our patients elect to use a postoperative pain pump for maximal pain relief. This system automatically and continuously delivers a local anesthetic to the breast through a tiny catheter placed into each breast. It lasts about two days, requires no care, and is removed at home. It will take some time for your chest to “settle” after a breast augmentation. The breast implants sit up high relative to the breast, with the nipple-areola complex on the low side. After a few weeks, the muscle and tissues relax and stretch, allowing the breast implant to drop, soften, and create a more natural appearance with a teardrop shape. It is actually quite exciting to see this occur! A breast band may be recommended for patients who need help lowering their implants and reducing excess upper breast fullness.
– These are 35 year old breast implants that were removed totally intact, showing the durability of many modern breast implants
|Do They Cause Disease?||No||No|
|Is Size Adjustable?||No||Yes|
The process of a breast enhancement does not end simply after your implant is inserted. After many years of practice and thousands of breast enhancements, we have clearly seen the benefit of breast molding or shaping during the postoperative period. We are actually able to use the breast implant to help mold or shape the new breast. This is how we can create cleavage when breasts are widely separated and how we can improve the appearance of narrow or poorly shaped asymmetrical breasts. It requires effort and some muscle so if there is someone who can help you during this time all the better. Molding should start about two weeks after surgery and is typically finished by six weeks. It should be done 2 or 3 times a day for 20 to 30 minutes.
In those rare patients who have perfectly symmetrical breasts on an even rib framework, not much work needs to be done. For the vast majority of patients, however, moving the implant in one direction or another will expand the tissues of the chest and breast and help to create a great shape. Cleavage is typically not made during breast enhancement surgery; it’s made after surgery by moving the implants towards the midline and expanding the tissues in the middle of the chest. Trying to make two differently shaped breasts look even is a combination of artwork by your cosmetic surgeon and a lot of hard work by the patient afterward. It should be noted that patients who elect for the placement of “gummy bear” or “anatomic” implants should NOT move their implants to shape the breast.
The term “failure” and “rupture” sounds a bit spooky when you are talking about something that you are putting in your body. However, in terms of breast implants, the consequences of either of these events happening is simply an inconvenience and not something that is causing you harm. We are now performing breast augmentations using fifth-generation implants, and like most manufactured goods, they are better than those from the previous generation. However, you must understand that ALL IMPLANTS WILL FAIL OVER TIME. It’s not a matter of if but when. The failure rate is measured by the percentage of implants per year that fail, as reported to the manufacturer. This rate is about 1-5% per year and is cumulative, meaning that the longer the implant has been in place, the higher the likelihood of failure. A saline implant is a water-filled bag. If it leaks or ruptures, it simply gets smaller or deflates. The water is absorbed by the body and is harmless.
A silicone implant is different in that the silicone material inside the implant does not leak into the body—it stays within the implant capsule that develops around all implants. You may not actually know that the implant is ruptured because it still works just like it did before. The best analogy would be to run flat tires — they work even if there is a disruption of the implant. We have heard from many patients who believe that their implants need to be changed after ten years. This is not usually the case. In the real world, patients with saline implants will seek a revision if they wake up one morning with a smaller breast, and those with silicone implants may not seek a revision until they have developed a breast implant contracture or noticed a change in their breast (pain or discomfort). Most women with implants will not seek to revise their breasts if they are not having any problems no matter how long they have had their implants. They are simply not going to fix something that they don’t think is broken.
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Age, health status, gravity, weight loss, and gain, hormones, and pregnancies will have a profound effect on the breast. (see the breast augmentation before and after photos of a patient who had a child after her breast augmentation). The female breast undergoes the most changes during a lifetime than any other organ in the human body. Your genetic makeup can profoundly influence the longevity of your breasts. This explains why some women who are older and have had children still have relatively youthful-looking breasts. How can you ensure that your breasts will have their best shape and appearance over your lifetime? It is important to maintain a healthy lifestyle by eating well and not smoking or abusing your body. As discussed before, your initial choice of breast implant size and position above or below the muscle is extremely important because these decisions have the most impact on the future of your breast enhancement. Posture is very important when it comes to the appearance of your breasts. Breasts always look more youthful and lifted when your shoulders are back. Hunching your shoulders forward and down makes your breasts appear droopy.
Good posture is an easy way to make your breasts look their best. Wearing a bra after a breast augmentation is the single most important factor in keeping your breasts their very best. There is no such thing as not wearing a bra after a breast enhancement. A bra will keep your implants in the ideal position, will minimize sagging related to the effects of gravity, and will keep you comfortable and supported during rest and activities. Wearing a bra at night that is supportive and comfortable will keep your breasts from falling to the side. Read our blog about wearing a push-up bra after breast augmentation. For your bra to work its best after an augmentation, it must be properly fitted to the size and shape of your breasts. The main function of your bra is to minimize the influence of gravity by transferring the load of the implant from your skin and muscle to the bra. Experts say that about 8 in 10 women wear the incorrect bra size. Most women wear a band size that is too large. A more snug band size—going from, say, a 34 to a 32—increases the size of the cup. You can wear a bra with an underwire if you have implants. A working bra does not necessarily mean it has to have a wire for support—there are many bras that work very well without the need for a built-in wire. Just as with implants, each and every bra is different, and you will have to try on many to find the few that work right for you. It’s important that you become your own bra expert so that over your lifetime, you will know exactly what your bra is supposed to do and how it’s supposed to feel.
The reason why breast augmentation is the most common procedure performed is because the risks are low, and the reward is very high. Serious complications are rare. Breast implants are not associated with cancer and do not cause disease or health problems. The procedure is not perfect, however, and there are problems associated with implants with which everyone considering a breast enhancement procedure should familiarize themselves. A very thorough review of the complications can be obtained from the three major manufacturers of implants. There are two categories of complications. The first occurs early after surgery. During this time it’s possible to develop a breast hematoma or infection. A hematoma is an accumulation of blood around an implant. If this occurs, it is usually necessary to return to surgery to remove the blood because it can cause an infection or implant contracture. An infection is rare in quality hands. If it does occur, it is necessary to remove the implants and wait for a year or so to replace them. It is definitely a big disappointment but not life-threatening. The second type of complication occurs after the initial surgery, say six months post-op. The two big issues that can arise during this phase are breast contracture and implant/breast shape irregularities. Although a breast contracture can happen any time, it generally occurs many years after an augmentation.
It’s a sign that you can be a “hard healer” or that your implants are ruptured. In my experience, subglandular implants contract more than those that are submuscular. A breast implant or shape issue is a big category that includes the common reasons for a breast revision. This could mean implant displacement that results in an unsatisfactory shape of the breast — lateral breasts, low breasts, ptosis, high riding implants, uni-boob and other conditions. ALCL is a new condition that we are trying to get a better understanding of. Called Anaplastic Large Cell Lymphoma, this is a rare problem that may be associated with breast implants, particularly textured implants. It usually manifests as swelling of the breast years after implant placement. It is typically a local type of cancer that is cured after removing the breast implant and implant capsule. There have been over 100 cases reported worldwide. As of this writing, we are learning more about it and its possible relationship to breast implants. Again, it is very rare but something we are keeping an eye on. Visit this link at the FDA website to learn more. You can review in detail many of the possible postoperative complications that require breast revision by learning from my extensive experience with breast revision.
A breast augmentation alone is not likely to interfere with a woman’s ability to breastfeed. It’s important to remember that fifteen percent of all women are not able to breastfeed in general, regardless of whether or not they had a breast enhancement. It is hard to find good scientific data to implicate breastfeeding problems with breast implants.
When it comes to improving your life, there’s no time like the present. The decisions you make today about your skin health, your body, and your beauty will impact you for the rest of your life. For more than three decades, Westlake Plastic Surgery has made the future brighter and more beautiful for patients just like you. Schedule your consultation today to begin your aesthetic journey at Westlake Plastic Surgery.Schedule An Online Consultation