Home » Plastic Surgery Procedures and Treatments for the Breast » Breast Augmentation
|Pain Level After Surgery||Moderate|
|Duration of Surgery||30 Minutes to 1.5 hour|
|Scars||Hidden in the armpit or breast crease|
|Final Results||6-12 months|
|Return to regular activity||1-2 weeks|
|Resume Exercise||4 weeks|
Breasts are the ageless sign of femininity and sex appeal. Breast augmentation is done now in ways that accentuate the natural healthy look and minimize the “done” look.
Small breasts can be enlarged with saline or silicone breast implants placed under the chest muscle to create nice cleavage and give a natural, sexy look and feel. The key to achieving a natural look is by choosing the right size implant, proper implant type, proper incision location, and proper implant placement.
We will try to address some of the issues that a patient faces when looking to have breast implants. We understand that every patient is unique, and we have a wide variety of options from implant type, to scar placement to different sizes to individualize the procedure to the patient’s wishes.
The decision of implant size can be a stressful decision for a woman choosing to have breast augmentations. The way to decide can be simplified and made stress-free. In the initial consult, the patient is asked to place a known sized silicone breast implants in her bra and wear a shirt that would reveal her silhouette clearly. The patient gets to try on different size implants until she finds the size she likes. We offer our patients the option to try sizes again on the second consultation. Usually, they come up with either the same size or a very close size to the one of the initial consultation.
One of the most effective ways of reducing dissatisfaction with breast size post operatively is to use photographs in the pre-op discussion. These photos give the patient and the surgeon a common point of visual reference from which to begin the discussion about size. The old adage that “a picture is worth a thousand words” is certainly true in this situation.
Huge implant sizes can be aesthetically unpleasant and create a higher chance of problems and complications in the future. Conversely, if a patient chooses a size that is too small, then the patient will come back asking for a bigger size implant. Therefore we encourage our patients to choose implants in the range of 150-550 cc’s (325 cc’s being the volume of a regular can of Coke), with exceptions in certain situations. In the vast majority of patients, their decision on size choice turns out to be perfect!
Very rarely are a woman’s breasts perfectly even, or symmetrical. Sometimes, the lack of symmetry can cause a woman to be distressed, adding prosthetic implants in her bra to achieve symmetry. This is a common situation that women do not like to discuss.
The solution is straight-forward. If a woman with uneven breasts seeks a breast augmentation, it is simple to fill one breast implant more than the other to make the breasts as symmetric as possible. Sometimes a breast augmentation is performed on one breast and a breast augmentation and lift, or a breast lift alone, or even a breast reduction is performed on the opposite breast simultaneously. The treatment plan is agreed upon during the consultation.
Both saline and silicone implants are FDA approved for primary breast augmentation, with silicone implants approved for patients 22 years and older. The choice between the two depends on patient preference, findings on breast examinations, and the surgeon’s recommendation. Silicone implants are advantageous in certain situations. Silicone breast implants feel more natural than saline. When a woman has had many breast procedures, has very little breast tissue and muscle remaining in the breast or naturally has very little breast tissue, silicone implants may be preferable. When a woman is very thin, silicone implants may provide an advantage by delivering more natural feeling results by reducing wrinkling and palpability. In these two situations, we offer our patients silicone breast augmentations. If a woman’s breasts have sufficient tissue and the saline implants are placed behind the muscle, as we place them routinely, the feel of the breast is very natural, making silicone implants unnecessary. Saline and silicone implants also differ considerably in price and the ability to detect rupture.
Like the majority of board-certified plastic surgeons, we prefer to place the implants under the muscle for the following reasons:
Implants placed behind the muscle do however cause more pain after surgery as they cause the pectoral muscles to stretch. In spite of this, we prefer placement behind the muscle and recommend it to most of our patients. The only exception would be for women who are professional athletes and bodybuilders in which implant placement behind the muscle might cause the implants to shift position.
The scar is about an inch and can be placed either in the under-arm (axillary, or armpit scar), the crease under the breast (the inframammary fold), or at the lower border of the areola (periareolar incision), or from a belly button approach (discussed below). We prefer either the under-arm or inframammary incision for the following reasons, but, at the request of patients, we will perform the procedure through any of the first three approaches. Under-arm (axillary, or armpit scar):
Peri-Areolar: The scar is about an inch long and is placed along the lower border of the areola and the breast skin. We do not typically recommend this approach for primary breast augmentation for several reasons;
Inframammary (under the breast): This is the most commonly used approach for primary breast augmentation. The scar is about one-two inches long placed in the natural fold of the breast. The length of the incision depends on the type of implant used (saline or silicone). This incision heals very well and is well concealed even without clothing. The advantages of this approach are:
Belly Button Approach or TUBA (Trans Umbilical Breast Augmentation): A belly button breast augmentation has recently been popularized by TV shows. We do not recommend this approach for several reasons:
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure. We also offer scar creams at an additional cost to optimize results.
To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.
At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.
There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.
We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.
We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.
Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar is a distinguished board certified plastic surgeon who stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.
For more information, call our office at 703-206-0506.
Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.