Breast Augmentation with silicone implants and peri-areolar mastopexy
- Posted on: Dec 13 2021
This pleasant 22 year old woman came to see Dr. Daniel A. Medalie of Cleveland Plastic Surgery at his Beachwood office to inquire about breast augmentation and correction of protuberant areolae. She is 5’4″ and 135 lbs and wanted to be a full C cup after surgery. She was interested in reducing the size and protuberance of her areolae and elected to also have peri-areolar mastopexy (lifting). She chose to proceed with the surgery in an outpatient setting and had a successful 2.0 hour procedure. The implants placed were Allergan silicone 330 cc silicone breast implants. The patient is shown 6 months after her breast enhancement and areolar reduction and flattening procedure and is very pleased with the results.
A breast augmentation procedure includes the following steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. Dr. Medalie prefers light general anesthesia with the patient breathing fully on her own.
Step 2 – The Incision
Incisions are made in inconspicuous areas to minimize visible scarring.We will discuss which incision options are appropriate for your desired outcome. Incision options include: along the areolar edge (peri-areolar incision), the fold under the breast (inframammary fold) and in the armpit (axillary incision). I prefer the IM fold approach because recent literature suggests that it is associated with a lower incidence of capsular contracture. Ths incision for a silicone implant is by necessity larger than one for a saline implant because the silicone implant is pre-filled and the saline implant starts empty.
Incisions vary based on the type of breast implant, degree of enlargement desired, your particular anatomy and patient-surgeon preference.
Step 3 – Inserting And Placing The Breast Implant
After the incision is made, a breast implant is inserted into a pocket either:
A. Under the pectoral muscle (a submuscular placement)
B. Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)
C. Dual-plane which is partly under the muscle (in the upper pole) and partly under the breast (lower pole). This procedure is more frequently used in women who have had children and have some droop to their breasts.
The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.
Step 4 – Closing The Incisions
Incisions are closed with layered sutures (that dissolve) in the breast tissue and with sutures, skin adhesive and surgical tape to close the skin.
Over time the incision lines will fade. The quality of scar depends on many things, including your genetics, exposure of your body to nicotine and infection.
Step 5 – See The Results
The results of breast augmentation are immediately visible. Typically they start high and then over time settle to a lower and more natural appearance. I usually tell patients that what they see is not what they get until 3 months after the surgery.
*Plastic surgery results can vary from patient to patient and are not guaranteed
Posted in: Cool Case of the Week