Breast Enlargement

The goal of Breast Augmentation is to achieve a pleasing fullness and roundness to the breast that will enhance a woman's femininity and allow her to feel better about herself. When making decisions about size of implant, location of incisions and ultimate shape, Dr. Galoob tries to find out what the patient's desires are and then using his judgment and past experience, recommend the size of implant, location of incision and method of procedure that will be most acceptable to that particular patient.

Before Surgery

Prior to surgery, a medical history is taken and physical examination performed to evaluate the patient's general health. Photographs are taken before and after surgery in order to determine the amount of improvement. Dr. Galoob will discuss the type of anesthesia to be used, the procedure, and the possible risks and complications. Patients are given standard brochures that discuss the procedure and its risks and goals in detail. A copy of these brochures are available on (www.Loveyourlook.com ) and can be downloaded to your computer.

Preoperative instructions may include the elimination of certain drugs (aspirin, garlic, Arthritis medication, etc.) for a week before surgery to minimize the possibility of excess bleeding. Patients are instructed to shower the night before surgery and the morning of surgery. Patients are advised to refrain from smoking before surgery for at least one week and for two weeks after the procedure. Patients who smoke have a higher risk of poor healing and other problems.

The Procedure

Dr. Galoob normally performs Breast Augmentation in his AAAHC accredited Office Surgical Facility (www.AAAHC.com). A hospital outpatient surgery may also be used depending on the patient's needs or other considerations. IV Sedation with local anesthesia is commonly used and provides a twilight state of consciousness that is well tolerated by most individuals. The surgery usually lasts 1 to 2 hours. After the patient is asleep, an incision is made in the area decided on by the patient and Dr. Galoob, and a pocket created to accept the breast implant. Then the breast implant is placed in the pocket, filled, and positioned. Finally, the incision is closed, usually with stitches and tape.

After Surgery

After the surgery is completed, the patient is allowed to awaken and kept in the recovery area for a short time. The patient is then transferred to a local hotel if from out of town, or to home if local. It is normal to be groggy for the first 12 hours. All patients are required to have someone with them to drive and assist them. Patients commonly feel somewhat tired and sore for several days following the operation. The breasts may remain swollen and sensitive to physical contact for a month or longer. Patients may also experience a feeling of tightness in the breast area as the skin adjusts to the new breast size. Postoperative care may involve the use of a postoperative bra, compression bandage, or jog bra for extra support and positioning while healing occurs. Most patients may return to work within a few days. For at least a few weeks reduced activity is recommended. Dr. Galoob commonly recommends breast massage exercises to keep the pocket open and maintain breast softness. External ultrasound treatments are given at postoperative visits to reduce swelling and discomfort and promote softness of the breasts.

Questions and Answers:

What Gives the Breast Its Shape?

The breast consists of milk ducts and glands, surrounded by fatty tissue that provides its shape and feel. Situated beneath the breast is the pectoralis major muscle or chest muscle. Factors such as pregnancy (when milk glands are temporarily enlarged), rapid weight loss, and the effects of gravity as you age combine to stretch the skin, which may cause the breast to droop or sag.

What is Silicone?

The silicone elastomer (rubber) contains the following substances: 1) small amounts (parts per million) of various smaller silicones; 2) small amounts (parts per million) of metals like tin and platinum and very trace amounts of other metals; 3) trace amounts of volatile materials like xylene and other organic compounds; and 4) considerable amounts (approximately 20 parts per hundred) of finely powdered silica that is tightly bound to the silicone rubber pouch.

What Is a Saline-Filled Breast Implant?

A breast implant is a sac (implant shell) of silicone elastomer (rubber), which is surgically implanted under your chest tissues, and then filled with saline, a saltwater solution, through a valve.

What is a Silicone-Gel- Filled Implant?

A Silicone Gel filled breast implant is a sac (implant shell) of silicone elastomer (rubber), which is surgically implanted under your chest tissues. It is prefilled with Silicone Gel.

Implant Placement considerations?

In augmentation surgery, a breast implant can be placed either over the pectoralis muscle (subglandularly), under the muscle fascia (the thick tough covering of the muscle) or partially under this muscle (submuscularly). There are advantages and disadvantages to each approach. Dr. Galoob will discuss his experience with each approach if you wish.

What Are Important Factors for You to Consider When Deciding to Have Implants?

Whether you are undergoing augmentation or reconstruction be aware that breast implantation may not be a one-time surgery. You may have additional surgery and doctor visits over the course of your life. Breast implants are not considered lifetime devices. You may undergo implant removal with or without replacement over the course of your life. Many of the changes to your breast following implantation may be irreversible (cannot be undone). If you later choose to have your implant(s) removed, you may experience unacceptable dimpling, puckering, wrinkling, or other cosmetic changes of the breast.

Breast implants may affect your ability to produce milk for breast-feeding. Also, breast implants will not prevent your breasts from sagging after pregnancy. With breast implants, routine screening mammography will be more difficult and you will need to have additional x-ray views, which means more time and radiation.

Will my insurance help?
Augmentation - Insurance does not cover Breast Augmentation and may not cover re-operation (additional surgery) and additional doctor's visits following augmentation.

Reconstruction - Most insurance covers the first breast reconstruction operation. Insurance coverage for re-operation procedures or additional doctor's visits following reconstruction may not be covered, depending on the policy.

What about Mammograms?

Pre-implantation Mammography ? You may wish to undergo a preoperative mammogram and another one 6 months to 1 year after implantation to establish a baseline.

Interference with Mammography ? The implant may interfere with finding breast cancer during mammography and also may make it difficult to perform mammography. Therefore, it is essential that you tell your mammography technologist that you have an implant before the procedure. The technologist can use special techniques to minimize the possibility of rupture and to get the best possible views of the breast tissue. Because the breast is squeezed during mammography, it is possible for an implant to rupture during the procedure. More x-ray views are necessary with these special techniques; therefore, women with breast implants will receive more radiation. However, the benefit of the mammogram in finding cancer outweighs the risk of the additional x-rays.

Will I be able to do self-examinations of my Breast?

You should perform breast self-examination monthly on your implanted breast. In order to do this effectively, you should ask your surgeon to help you distinguish the implant from your breast tissue. Any new lumps or suspicious lesions (sores) should be evaluated with a biopsy. If a biopsy is performed, care must be taken to avoid puncturing the implant.

What are the long-term effects of Breast implants?

Information about the long term effects of breast implants is available from the manufacturer's web site at www.loveyourlook.com . Dr. Galoob provides detailed brochures to each new patient.

What causes hardness of the breast?

Hardness of the breast may occur after Breast Augmentation. The scar tissue that normally surrounds the implant (the capsule) is the body's normal response to an implant. Most of the time, the scar tissue is flexible and soft. Occasionally, the scar becomes hard and contracts around the implant causing it to be firm or even painful. Treatment of this may include re-operation with release or removal of scar tissue and/or replacement of the implant.

What Types of Breast Implants Are Available?

Implants come in a variety of shapes, surface textures, and sizes. Dr. Galoob prefers the smooth surface round implant for most of his patients. Other implants are available depending on the patient's needs.

How do I go about choosing a surgeon for Breast Augmentation?

· When choosing a surgeon who is experienced with breast implantation, you should know the answers to the following questions:
· How many Breast Augmentation or reconstruction implantation procedures does he/she perform per year?
· How many years has he/she performed breast implantation procedures?
· Is he/she board certified, and if so, with which board?
· In which states is he/she licensed to practice surgery? Note that some states provide information on disciplinary action and malpractice claims/ settlements to prospective patients either by request or on the World Wide Web.
· What is the most common complication he/she encounters with breast implantation?
· What is his/her re-operation rate with breast implantation and what is the most common type of re-operation he/she performs?
· Familiarize yourself with the following options in breast implant surgery and be prepared to discuss with your surgeon the following issues:

Are there different shapes and sizes of Breast Implants?

Depending on the desired shape you wish to achieve, you and Dr. Galoob may choose a round or contoured implant shape. Generally, the larger you want your cup size, the larger the breast implant the surgeon will consider (measured in cubic centimeters, or cc's).

What about implant Size?

Dr. Galoob will also evaluate your existing tissue to determine if you have enough to cover the breast implant. If you desire a breast implant size too large for your tissue, the doctor may warn you that breast implant edges may be apparent or visible postoperatively. You may even risk surgical complications. Also, excessively large breast implants may speed up the effects of gravity and result in earlier droop or sag.

Is there an advantage to surface texturing of the implant?

Textured-surface implants were designed to reduce the chance of capsular contracture. Some information in the literature on small numbers of patients suggests that surface texturing reduces the chance of severe capsular contracture. However, textured implants have a greater chance of rippling, a greater tendency to leak and may not offer any advantage to a particular patient. Information from studies of a large number of women with implants show no difference in the likelihood of developing capsular contracture with textured implants compared to smooth implants.

Will I be able to feel the implant?

The following may cause implants to be more easily felt: textured implants, larger implants, sub glandular placement, and the amount of skin/tissue available to cover the implant.

What are the alternatives to Breast Augmentation?

Accept your breasts as they are.
Wear a padded bra or external prostheses.
Fat transplants have been found to be only marginally successful in breast enlargement and are not widely used by surgeons.

What Questions should I ask my surgeon about Breast Augmentation?

The following list of questions may help to remind you of topics to discuss with
your doctor:

1. What are the risks and complications associated with having breast implants?
2. How many additional operations in my implanted breast(s) can I expect over my lifetime?
3. How will my breasts look if I opt to have the implants removed without replacement?
4. What shape, size, surface texturing, incision site, and placement site are recommended for me?
5. How will my ability to breast feed be affected?
6. How can I expect my implanted breasts to look over time?
7. How can I expect my implanted breasts to look after pregnancy? After breast feeding?
8. What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts?
9. What alternate procedures or products are available if I choose not to have breast implants?
10. Do you have before? and ?after photos I can look at for each procedure, and what results are reasonable for me?

Each year thousands of Breast Augmentations are successfully performed. Complications connected with this surgery are rare, however, there are certain inherent risks connected with every surgical procedure which should be discussed with the physician prior to surgery. Patients can minimize complications by carefully following directions given by the physician.

Contact us
If you are interested in learning more about Breast Enlargement, call or email our office or leave your name and address on this web page and we will be happy to answer your questions.