what to expect before and after breast augmentation

this video we'll talk about breastaugmentation which is sort of one of the most common procedures and popular procedures that plastic surgeons perform i'd say in my case of the non facial procedures performed it's the most popular, second is probably tummy tuck, but breast augmentation still is the most popular because it's a very straightforward procedure people get very nice resultsand its it's quite predictable. so, whenpatients come to me to ask about breast augmentation there's really a lot ofquestions that they had unfortunately there's a lot of information on theinternet about this. i'd say the quality of

the information on the internet has gotten betterover time, but there are still some misconceptions, so i'll try to clear some of these misconceptions in this video. first of all, the idea behind breast augmentation as most people know is to put in an implant just underneath the breast to reallypush the natural breast forward and in that way really augment the fullness and the contour of that breast area. i'dsay best candidates for the procedure usually are women who arerelatively fit who really just specifically justthe breast area they would like to

have a little bit more full i'd say in my patients they're divided into two types: one are where the breasts are in a nice normal position and they justmore fullness, and the second category is patients for whom maybe have had some weight loss or have had a pregnancy orbreastfeeding and those cases the breasts are actually sagging a little bit, and they feel they want a little more volume that second category is differentbecause those patients may also need a breast lift

but that really depends on what i determine during the consultation so that's one reason why i think it'simportant just to to see what the doctor has to say in consultationto really determine the best procedure. it's not always just a straight forward breast augmentation. anyways, getting back to breast augmentation as imentioned before those best candidates, people come to me with a variety of questions andi think when they first come there's a couple things to think about. i tell patients that there's a few decisions they'll have to make the first one is thelocation of incision

there's three standard location ofincisions where people do breast augmentation. the first is the inframammary fold incision or the under breast incision. the second one is periareolar around the nipple incision, usually on the bottom halfof the nipple and a third is the armpit incision. i say for meand my practice probably about 85%maybe 90% of patients choose the under the breast incision and the reason for that mostly beingbecause it really looks great

the incision is really well hidden underneath the breastespecially after the implant has had time to stretch out the breasttissue, sag a little bit over the incision. the incision is really hidden and almost imperceptible the second most common probably is periareolar i'd say probably in my practice maybe 10% of paitents get that and for a transaxillary, or the armpit incision, maybe about 5% of patients. other advantages of the inframmary incision for me as a surgeon i like it, itgives me very good access to the area it's easier for me to lift up the breast muscle

develop a pocket in a very precise fashion andreally but the implants close together so i can achieve a really nice, natural cleavage. what i've see is for patients who had other types for example the armpit incisions, i'v seen caseswhere patients that come to me having this transaxillary procedure done maybeyears ago and their implants are really far apart and i understand the reason for that isbecause probably when the surgeon was trying to dissect it was too far fromthe armpist to really get a nice cleavage for me, one of the importantaesthetic goals for breast augmentation surgery is to really get nice cleavage

and so i think that inframammary fold incisionworks really well for both me and my patients. second decision they'll have to make is sort of silicon or saline there's really a number ofdifference between the two i would say my practice, the most commonreason people choose silicone is because it really feels more natural it's a slightly newer implant, but it's been very heavily vetted by the fda and ensured to be very safe but overall that's the major reason people choose itbecause it just feels more natural

in my practice nowadays i'd say probably over probably 90% of patients use silicone there's still a small proportion of patients that use saline. saline is also great as well. in terms ofthe procedure what patients can expect is that it usually lasts about an hour and a half the idea is really to make first that incision, i'll talk about the mammary fold one since that's the most one we do, small insicionunderneath the breast and then basically lifting up to thebreast tissue as well as the muscle to develop a pocket underneath the muscle. in my patients probably most of my patients put the implant underneath the muscle andthat's because the

research over time as shown us that longterm results with the implant under the muscle is seemly better there's a less chance of infection, lesslong-term complication of the implant. overall things are just better in general, so that's what i choose for most of my patients lifteverything up and once i've developed a pocket i put atemporary implant inside the patient, we'll set themup on the operating table, assess for symmetry, make small adjustments to the pocket to make sure things look nice and even then once i'm happy, put the patient back down, temporary implants come out

and we put in the final implants. everything is washed with triple antibiotics to minimize chanceof infection or capsular contracture and overall at that point the skin is sewn up and they're all finished. so patient's are asleep the whole time, it's a pretty straightforward. patients usually are on pain medication for about five days or so. i've had patients off pain medications by two days but that's an anomaly. i would say to plan around five days or so. after the surgery

basically i have patients in asurgical bra with a lot of dressings in the area just to make sure everything heals well. itell patients just leave it alone, you don't have to do anything with it until i see themback at their first post-op apartment at that point i'll take things down , double check for signs of infection, and at that point since theswelling is still going to be there we wait for a few weeks for the swelling to come down andthen over the following few months the breast shape continues to improve as the skin slowly stretches out and thebreast implants

descend a little bit. as i said overall it's a straightforward procedure, and hour and a half long, the most popular procedure among plastic surgeons and for me the most popular non facial procedure that i perform and it works pretty well