Breast Augmentation Baltimore
Breast augmentation (enlargement) is designed to increase the size of the breasts and also improve their shape by the insertion of an implant beneath the breast tissue. Breast augmentation is suitable for women who have naturally small breasts or where there has been shrinkage in size following a pregnancy or weight loss. This operation aims to produce a natural shape which enhances cleavage and will improve your figure by balancing the hips to emphasize your waist.
Breast implants rely on an outer shell and a filling which is usually silicone gel. Dr. Del Corral only uses “cohesive silicone gel” filled implants which do not leak because the silicone is actually a solid material (like jelly) rather than a liquid.
The decision regarding size will be carefully considered when you visit Dr. Del Corral for a consultation, and you will get the opportunity to wear trial implants in a special bra to simulate the result of your surgery.
Breast enlargement is certainly NOT an operation where one size fits all and Dr. Del Corral provides a very individual approach and achieve a bespoke result for each patient. He will also be honest in informing you if he feels you are not a good candidate for surgery and carefully explain why this is so.
WHAT TYPE OF BREAST IMPLANTS ARE USED & IS SILICONE SAFE?
Advances in the technology of silicone have led to cohesive silicone gel which has the consistency of jelly and does not leak even if there is a break in the implant. Dr. Del Corral uses silicone implants rather than saline (salt water containing) as they provide a better shape with a more natural feel and can also provide some degree of lift to the breast. When using silicone Dr. Del Corral only uses cohesive silicone gel implants which do not leak.
WHERE IS THE IMPLANT PLACED: IN FRONT OF OR BEHIND THE MUSCLE?
Breast implants can be placed in a pocket either in front of the chest muscle (referred to as the subglandular pocket as it lies directly under the breast itself) or behind the chest muscle (referred to as submuscular). The pocket in which the implant is placed is created by either lifting the breast tissue away from the underlying chest muscle (pectoral muscle) as in the case of the “subglandular” (above the muscle) approach or placing the implant behind the chest muscle as in the “submuscular” approach. It is important to understand that the majority of the chest muscle is floating as it is attached to the ribs only near the center of the chest. Placing the implant behind the muscle therefore does not require “cutting into muscle” to create the cavity as a potential space already exists there and the implant is placed under the floating part of the muscle.
The subglandular approach (above the muscle) suits women who have a fuller breast which allows the implant to be covered adequately so that it is not visible or palpable through the skin. In thin patients who have very little breast tissue, the implant will look more natural placed under the muscle as this gives better coverage of the upper pole and therefore does not look “stuck on”. The decision whether to go over or under the muscle will be discussed very carefully with you by Dr. Del Corral at the consultation but is usually a decision made by your body’s anatomy rather than by surgeon or patient.
WHAT IS DUAL PLANE BREAST AUGMENTATION?
The dual plane technique is a method of enlarging the breast but at the same time lifting the breast and nipple without the need for a full uplift which would leave visible scars around the nipple. It is a variation of the submuscular technique but which allows a greater degree of lifting to the nipple and is usually combined with the use of a tear drop implant. It is ideally suited to thinner women over 30 years of age who have either had children or perhaps lost weight and therefore have a little droop on the breast. Because this technique suits thinner women the implant is placed under the chest muscle which gives a smoother contour for the upper pole of the breast. However, if this was all that was done the droop might still be apparent so the second and essential part of the operation requires lifting the breast tissue off the muscle in the lower half of the breast so it can slide over the muscle. This is done through the same scar under the breast crease. When a tear drop implant is used the projection then pushes the nipple and breast tissue up a little, which because it has been separated from the muscle, can slide up vertically. As there have been pockets surgically dissected below the muscle for the implant and also above the muscle to allow the breast tissue to slide the technique is called “dual plane.”
CAN I HAVE A BREAST LIFT AT THE SAME TIME AS BREAST AUGMENTATION?
Breast augmentation and breast lift (mastopexy) are two opposite and competing procedures. The two procedures can be completed at the same time, although there are limitations in both the degree of augmentation and degree of lift that can be completed concurrently. It is Dr. Del Corral’s recommendation to proceed in a two-stage fashion for the best possible result. That said, we also recognize both financial, time, and recovery constraints of completing this in two stages, and for some patients this may be completed in a single surgery. A complete consultation with Dr. Del Corral is necessary to determine if you are a candidate for a single-stage procedure.
WHAT HAPPENS AT THE CONSULTATION?
At your initial consultation, Dr. Del Corral will evaluate your general health and chest, and explain which surgical techniques are most appropriate for you. For instance, if your breasts are sagging, he may also recommend a breast lift although a degree of lifting is achieved by the insertion of a breast implant alone. After discussing the proposed surgery Dr. Del Corral will give you an idea of your new look by using trial implants in a special bra to simulate the result of your surgery so you have some idea of the outcome.
BEFORE THE BREAST AUGMENTATION PROCEDURE
- Get lab testing or a medical evaluation as needed
- Take certain medications or adjust your current medications
- Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
- Stop smoking well in advance of your breast augmentation surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding (If OK with your primary care physician. If you cannot stop please let us know.)
- Pick up your prescriptions so they are ready on surgery day
THE DAY OF THE BREAST AUGMENTATION SURGERY
- Usually done as an outpatient procedure
- Nothing to eat or drink the day of surgery
- You will need someone to drive you home and stay with you for the first 24 hours
AFTER THE BREAST AUGMENTATION SURGERY
Recovery is patient dependent.
Seek medical attending immediately if you have any of the following:
- Shortness of breath
- Chest pains or unusual heart beats
WHAT ARE THE COMPLICATIONS REGARDING BREAST AUGMENTATION?
As with any procedure, there are risks. Fortunately, with breast augmentation, these risks are minimal but must be discussed. These include but are not limited to:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor healing of incisions
- Changes in nipple or breast sensation, may be temporary or permanent
- Capsular contracture, which is the formation of firm scar tissue around an implant leakage or rupture
- Wrinkling of the skin over the implant
- Anesthesia risks
- Fluid accumulation
- Blood clots
- Pain, which may persist
- Deep vein thrombosis, cardiac and pulmonary complications
- Possibility of revision surgery
- Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants
- Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime
HOW DO I PREPARE FOR SURGERY?
It is important to avoid taking any aspirin or products containing aspirin for 2 weeks on either side of the operation since aspirin has an adverse effect on bruising. The same is true for non-steroidal anti-inflammatory drugs. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days at home, if needed.
One item you must bring to the hospital with you in preparation for surgery is a soft bra (without underwire) of your new size. This is to provide support over your bandages and will be worn for four to six weeks after surgery (but can be removed whilst you are washing, etc.). This can be a soft sports bra but a stiff sports bra may be too painful so any soft bra is fine so long as it provides a degree of support and does not dig in too much below the breast. Dr. Del Corral will suggest what size will be suitable at your consultation.
HOW LONG DO I NEED TO RECOVER?
You will experience some pain, swelling and bruising immediately after breast implant surgery.
Your chest may feel tight and your breathing may be restricted. This is normal and your symptoms will start to improve over the next few weeks.
You will usually rest at the hospital or clinic in a semi-upright position. This will help keep you comfortable and minimize swelling.
You will be given painkillers if you need them.
After returning home, you can continue to take over-the-counter painkillers, such as Tylenol or ibuprofen. However, you should not take ibuprofen if you have stomach, kidney or liver problems, or if you have had them in the past.
After having breast augmentation, you may either be allowed home the same day or you may need to stay in the hospital or clinic overnight.
On returning home, you will need rest to give your body time to recover. Avoid excessive use of your arms and chest area as it may cause irritation and bleeding.
Following breast augmentation, your breasts may feel hard and you may experience some painful twinges or general discomfort. These symptoms will sometimes persist for a few weeks.
To get great results, follow the aftercare advice of your surgeon. You will usually need to attend a series of post-operative appointments so Dr. Del Corral can check your recovery.
Following breast implant surgery, avoid:
- Getting your wounds wet for one week
- Sleeping face down for one month
- Physical exercise for four weeks
- Heavy lifting for three to four weeks
- Driving for at least one week or until you can perform an emergency stop without discomfort
Dr. Del Corral also recommends wearing a tight-fitting sports bra 24 hours-a-day for up to three months following breast surgery.
It is recommended you take around two weeks off work after the operation to fully recover. You should be mobile from day one and back to full exercise within six weeks. You should keep the incision sites out of direct sunlight for about a year.
I AM INTERESTED! WHAT DO I DO NEXT?
If you are considering a breast augmentation we encourage you to contact us to schedule a consultation and/or treatment at Dr. Del Corral’s office. During this visit we will listen to your concerns and discuss your options. After careful analysis, we will tell you whether you are a suitable candidate for this procedure and inform you of the alternatives and potential risks of the procedure.