BREAST AUGMENTATION
 

 
Look like a dream come true…you deserve it!!
 

Breast augmentation is amongst the plastic surgery procedures with the highest patient satisfaction ratings.
Breast augmentation is a procedure that is often assumed to be simple in nature and execution but is actually quite complex. Proper surgical technique and attention to detail are essential to good results.


What are the benefits of breast augmentation with implants?
This operation is performed to enhance or restore the size and shape of a woman's breasts. Breasts may be small because of lack of development or changes following pregnancy, weight loss or congenital abnormalities. Sometimes a woman's breasts are very asymmetric (uneven). This operation can improve a woman's self esteem and quality of life.
 

Clinical parameters and key considerations
There are six main clinical parameters for breast implants on initial consultation:
1. Patient's body build and height
2. Natural breast size, shape and symmetry
3. Nipple position in relation to the breast
4. The quality of breast skin
5. Chest wall shape and dimension
6. Patient's desire for new cup size and shape


The first consultation
In Sensual Body Dream during the first consultation the surgeon analyzes the conditions of the patient which is the best way to correct the defect.

The surgeon will recommend the best solution with respect to the intervention to be made and the best form to perform it. He will also answer all the questions that you have and tell the reasonable expectations that you can have regarding the final result.


Procedure
The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendation.
Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue (submammary or subglandular placement) or may be placed beneath the pectoral muscle and on top of the chest wall (submuscular placement). Once the implant is positioned within this pocket, the incisions are closed with sutures, skin adhesive and/or surgical tape. A gauze bandage may be applied over your breasts to help with healing.

Incision placement
There are three choices about where to make the skin incisions for breast enlargement. They can be in the breast fold (inframammary), around the nipple (periareolar) or underneath the armpit (transaxillary). These incisions can all produce scarring ranging from excellent to poor. Although patients may voice some initial concerns about the location of their scars, they are ultimately far more concerned with the final shape and size of their breasts.

Our Medical Team finds the periareolar incision particularly useful in some Asian and African patients with higher risk of keloid scarring but the nipple-areola must be at least 4.0 cm in diameter. Furthermore, the periareolar incision also allows one to perform the full Benelli breast lift or nipple lift where this may be indicated in mildly droopy breasts.
Transaxillary (armpit) incision carries high risk of cleavage problems (too much gap) and is reserved for a few select patients with small chest wall.

The transumbilical (belly button) incision popularized by the Fox reality show Dr 90210, is ONLY reserved for the use of saline implants. As we are not huge fans of saline implants due to extremely high risk of problematic "rippling" we do not favor the "belly button" incision.


Breast Implant Shape
The choice of implant varies from round to teardrop shapes. The round implant comes in both low and high-profile varieties. The shape variation is in the width and projection of the implant for any given size.

What are the differences between various breast implants in
           the Breast Augmentation Procedure?
There are a number of questions you need to ask your surgeon in regards to the breast implants that you will have.
The spectrum of breast implants available to the surgeon can therefore provide great versatility in achieving a more natural look.
The majority of patients in our experience elect to have round-shaped implants.
Since our surgeon prefer placing the implant in a submuscular pocket in most patients, implant edge visibility in the upper pole of the breast can be avoided. The round implant tends to be ideal for those patients with well-shaped natural breasts who desire a straightforward enlargement.
Use of the teardrop (anatomical) shape depends on the patient's desire, as well as her breast shape.
In general, there are two groups of women who benefit from teardrop-shaped breast implants. It can be the good choice for women who have droopy or tuberous breasts. Mild elevation of the nipple in relation to the breast mound can be achieved without the need for extra scars on the actual breast (unlike breast lift scars). In these cases, the implants will be inserted in a subglandular or subfascial pocket (under the breast tissue). In moderate to severe cases of droopiness, breast lift MUST be performed in order to restore aesthetic shape at the same time as breast augmentation.
Secondly, some patients specifically want less fullness in the upper quadrant. Teardrop breast implants certainly offer less fullness in these particular situations. It should be noted, however, that this request tends to be very personal, as most women are seeking breast augmentations in order to obtain upper pole fullness. It should be noted that teardrop or anatomical implants do have tendency, estimated at about 10 percent, to rotate. Unfortunately, this problem can only be corrected by secondary surgery. With a round-shaped implants you will avoid this problem.


Breast implant size
Breast implant size is one of the most important decisions in a breast augmentation procedure. Because of this, a good surgeon will take several approaches to help the patient make the best decision based on their anatomy, personal preferences and the appearance they wish to achieve. In general, attractive breast augmentation should be in proportion or slightly out of proportion to the woman's overall body shape.
In a recent survey, over 80 percent of patients undergoing breast augmentation stated an average to full C-cup was their desired postoperative goal. D-cup was the second most popular request. Small C-cup is the third commonest followed by full-D and Double D cups.
Final breast implant size is a complex function of the elasticity of patient's skin envelope., chest wall diameter and implant dimensions but most importantly preexisting breast volume.
Unfortunately, breast implants do not come in cup sizes. Rather, they are categorized by the volume of gel that they are designed to hold. There are several reasons for this. First, the final cup size will be partially determined by the preoperative breast size, and every patient is different in this regard. Second, a C-cup from one bra manufacturer is not necessarily the same as a C-cup from another manufacturer.

Although every woman is built differently and bras are not manufactured to a set standard, it can be expected that a B-cup implant size is approximately 250g (cc) or C-cup is 330cc in a woman of average height and average build. That number will ordinarily be higher if the woman is tall or has broad shoulders. Similarly, if the patient is shorter than average or has a narrower chest, that number can be expected to be slightly lower. Although a desire for a certain cup size is helpful in guiding the patient in the selection of the proper breast implants, the surgeons find it is more helpful to focus on the desired shape and appearance that patient wishes to achieve.


Breast implant position
The next consideration is where to place the breast implant - on top of or behind the muscle. In general, our surgeons prefer to place breast implants behind the muscle so they are partially covered. They find the pectorals muscle allows a smooth takeoff from the chest wall. If put directly on top of the muscle the breasts can look like rounded balls on the chest, which is another definite giveaway. It is also their opinion that placing the implant under the muscle will, in the long run will have impact on breast droopiness. Also for older women that need breast screening, it seems behind muscle placement is superior from a mammogram and ultrasound imaging point of view.

In women with mild droopy (ptotic) breasts, our surgeons use the dual-pocket technique of dissecting both on top of and underneath the pectoral muscle, but inserting the breast implant behind the muscle.
In rare cases of moderate droopy breasts where the patient does not wish to undergo a breast lift procedure for fear of scaring, our surgeons will consider full placement of implant on top of the muscle. This pocket is referred to in the plastic surgery literature as ‘Subglandular” or “subfacial”. Generally speaking is a relativity painless pocket with excellent short term benefits but in their opinion far less long-term advantages compared to the “Submuscular” or “Subpectoral” pocket placement.


Breast implant fill
Our surgeons use very commonly the cohesive silicone-gel and rarely the saline-filled breast implants. The new generation silicone-gel breast implant is very safe and generally feels and looks more like a natural breast.
The gel usually comes in low and high cohesiveness (soft touch or firm touch), and you should ask your plastic surgeon for different samples at the time of the consultation so that you can make the most informed choice possible.
Currently there are five main Implant manufacturers in the world:
• Allergan-McGhan (USA)
• Mentor (USA)
• ISD (USA)
• Eurosilicone (France)
• Silimed (Brazil)
All the implants we use are approved by the U.S. Food and Drug Administration (FDA).
 

Duration of the operation
The Procedure usually takes one to two hours to complete.


Anesthesia
Local anaesthesia and complementary sedation, or general anaesthesia.


Recovery
You're likely to feel tired and sore for a few days following your procedure, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.

Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

Post Op Follow up
In Sensual Body Dream the strictest norms of quality are followed, that go beyond the intervention. For that reason detailed postoperative controls are made, so the patient feels safe and accompanied. During your stay you will have several consultations, to check that the process follows the natural course and to ensure you that can leave Bolivia without any problem once in your country.


Note: The information offered in this Web site is directed to support and not to replace the relation between you and your doctor.


 

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