GOALS: We can give you the breasts you desire with one of the most frequently performed cosmetic surgery procedures. If your breasts are small or unevenly sized, an implant can provide you with a fuller, firmer, better-proportioned look. Our goal is to:
You may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. Breast enlargement may need to be combined with another procedure such as a breast lift if you have any significant breast droop in order to achieve optimally aesthetic breasts. It is, of course, your choice whether to correct just the size or both size and droop. We can only determine this with an examination and discussion of your desires about how much enlargement you wish. A vast experience, including cofounding and participating in the Oklahoma Breast Center, allows us to help assure you get the results you desire.
IMPLANTS: Implants today come in many choices. All are silicone shells filled with either saline (salt water) or cohesive Silicone gel. (Before their general release, some people called cohesive gel implants “Gummy Bear” implants. Now, all silicone implants are cohesive gel.)
After being available only as part of an extensive study protocol for 14 years that Dr. Buchanan participated in and that proved their safety,Silicone implants were again released for use in augmentation in November, 2006 after being available only as part of an extensive study protocol for 14 years that proved their safety. Dr. Buchanan was among the first surgeons approved after their re-release to use them for augmentation. He participated in the post release studies again confirming their safety.
Another option is texturing of the implant surface. Textured implants are harder to use, but significantly modify the body’s scar response. This reduces the rate of capsular contracture (tightening of the scar around the implant making it feel hard), one of the body’s possible reactions to implants.Dr. Buchanan has been using textured implants as long as they have been available since they provide extra assurance of improved and natural results.
A further option is the shape of the implant. They come in either round or anatomic shapes. The anatomic implant has a more gentle upward slope, just like a natural breast when you are erect. The anatomic implant also comes in tall or wide forms and several projections, and the round implant comes in several projections. All this allows Dr. Buchanan to custom fit your body with the implant that will give you the look you desire. In order to choose the proper implant for you, we measure your body and select a range of different implants that will fit you without risking significant postoperative problems or an unnatural look. We then narrow the choices by discussing what your desires are, how big you want to be, what shape you like, etc. This allows us to select the implant that fits your needs and desires. This also reduces the risk of you being unhappy with your final size. Over the years, with thousands of cases followed for many years, Dr. Buchanan has only replaced the implants in 2 patients due to dissatisfaction with the size.
SURGERY: The procedure lasts about two hours under light general anesthesia as an outpatient. We use this anesthesia because it is, in our opinion, the safest, and you awaken faster with fewer side effects, such as nausea. With this type anesthesia and the technique we use to place the implant, we get many women back to many activities within just a few hours of surgery.
We choose the incision based on the implant used and your cosmetic concerns. The incision around the inferior edge of the areola (the colored area around the nipple) generally hides best, since it is at the junction with two different colored skins. The eye usually sees the change in color and not the scar. With the new cohesive gel Silicone implants, the area under the areola may not be large enough to get the implant in without risk of injury to the implant. (Research has demonstrated that injury from forceful insertion is one of the leading causes of late implant rupture.) Both approaches affect the sensation equally, since no more nerve fibers are cut by either incision. Most sensory loss generally returns in about a year, and most of the residual loss is due to the size of the implant, and, thus the amount of dissection necessary. We do not use the axillary (armpit) approach since it has a higher risk of complications.
In our usual population that is quite active, we generally prefer placement of the implant underneath your breast tissue rather than under the chest wall muscle. Placement above the muscle usually:
The procedure generally increases the bust line by several cup sizes, depending on your desires. If you have preexisting asymmetry, we use different sized implants on each side to provide as much balance as possible after surgery.
POST PROCEDURE: You will generally have only minimal discomfort and should be able to return to most light activities and work within one to two days. Most people require only Tylenol® after the second day. On the day after surgery, you can shower and change into a sports bra. You can return to sporting activities by 2-3 weeks. There will be some tapes on the incision that will come off by themselves in 7-14 days. There are no sutures to remove. We use a deep, dissolvable stitch that is absorbed in about 6 months. This helps assure that the scar is as invisible as possible.
RISKS: Although there are many things that can go wrong with Breast Augmentation, we do everything we can to reduce the risks as much as possible. Some of the risks include implant displacement, capsular contracture (scar causing the implant to feel firm), infection sometimes requiring removal of the implant, rippling (an occurrence even in natural breasts), asymmetry, blood or serum accumulation requiring drainage, rupture of the outer shell (you go flat with saline implants as the saline is absorbed; with silicone implants, the only way to tell is with an MRI X-Ray), occurrence of a quite rare type of sarcoma (Anaplastic Large Cell Lymphoma, curable by removing the implant and scar capsule) and disappointment in size or appearance. We reduce these risks by how we choose the proper implant, the care we take in inserting the implant and rinsing the implant in an antibiotic solution. By careful attention to detail, our revision rate is among the lowest in the country, around 1%. Most other risks are those associated with any surgery. We reduce these by the care we take in preparing you for surgery and specific prophylactic measures, such as anti-embolism stockings during surgery.
In spite of the possible risks, we believe this is an exceedingly safe operation that can provide you excellent satisfaction.
For more information on Breast Implant Safety click www.BreastImplantSafety.org
For more information on Breast Implants from the manufacturer click www.natrelle.com
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