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Breast Augmentation

Breast augmentation remains one of the most popular cosmetic procedures.  For many women, there may be several different reasons why they are considering breast augmentation. Here are just some of the most common reasons why women pick breast augmentation.

  • Enhance body appearance and imagine 
  • Adjust for a reduction in the size of your breasts after pregnancy or significant weight loss
  • Correct uneven breasts after breast surgery for other conditions
  • Improve self-confidence

While many patients choose an implant for their breast augmentation, newer techniques and natural options are now available. Fat grafting or fat transfer is growing as an exciting and natural option for small breast augmentation.

Options for breast augmentation

  • Breast implants
  • Breast fat transfer

Anesthesia for breast augmentation with implants

Most often, the procedure is outpatient and done under local anesthesia with sedation so that you are comfortable. Your plastic surgeon may recommend general anesthesia. Depending on exactly what type of procedure you are having done, it will take from one to three hours.

Potential Risks for breast augmentation with implants

Breast augmentation poses various risks, including:

  • Scar tissue that distorts the shape of the breast implant (capsular contracture)
  • Breast pain
  • Infection
  • Changes in nipple and breast sensation
  • Implant position changes
  • Implant leakage or rupture

Correcting these complications might require more surgery, to either remove or replace the implants.

Before you decide to have surgery, consider the following

  • Breast implants won’t prevent your breasts from sagging.  
  • Breast implants aren’t guaranteed to last a lifetime. The average lifespan of an implant is about 10 years. Implant rupture is a possibility.  
  • Mammograms might be more complicated.  
  • Breast implants might hamper breast-feeding. 
  • Insurance doesn’t cover breast implants. Unless it’s medically necessary
  • You might need additional surgery after breast implant removal. 
  • Screening for silicone implant rupture is recommended. The FDA recommends routine monitoring with a breast MRI five to six years after placement to screen for silicone breast implant rupture. 

What can you expect?

Breast augmentation can be done in a surgical center or hospital outpatient facility. You’ll go home the same day. Sometimes, breast augmentation is done during local anesthesia — you’re awake and your breast area is numbed. Often, though, breast augmentation is done during general anesthesia, in which you’re asleep for the surgery. Your plastic surgeon will review different anesthesia options with you.

How is breast augmentation with implants done?

To insert the breast implant, your plastic surgeon will make a single cut (incision) in one of three places:

  • The crease under your breast (inframammary)
  • Under your arm (axillary)
  • Around your nipple (periareolar)

After making an incision, the surgeon will separate your breast tissue from the muscles and connective tissue of your chest. This creates a pocket either behind or in front of the outermost muscle of the chest wall (pectoral muscle). The surgeon will insert the implant into this pocket and center it behind your nipple.

You may choose from one of two type implants: saline or silicone. Saline implants are inserted empty and then filled with sterile salt water once they’re in place. Silicone implants are pre-filled with silicone gel.

When the implant is in place, the surgeon will close the incision.

Long term results from breast augmentation with implants

Breast augmentation can change the size and shape of your breasts. The surgery might improve your body image and self-esteem. But keep your expectations realistic. Also, your breasts will continue to age after augmentation. Weight gain or weight loss might change the way your breasts look, too. If you become dissatisfied with the appearance of your breasts, you might need more surgery to correct these issues.

Saline and Silicone Breast Implants

There are two basic types of breast implants: saline and silicone gel.

Saline-filled implants are silicone shells filled with sterile salt water (saline).  Some are pre-filled and others are filled during the implant operation. 

Silicone gel-filled implants are silicone shells filled with a plastic gel (silicone). Although many women say that silicone gel implants feel more like real breasts than saline, they pose more of a risk if they leak. 

Both saline and silicone come in different sizes and have either smooth or textured shells. Each has its own pros and cons, so it is a matter of preference.

Recovery from breast implant procedure

Soreness and swelling are likely for a few weeks after surgery. Bruising is possible, too. Expect scars to fade over time but not disappear completely.

While you’re healing, it might help to wear a compression bandage or sports bra for extra support and positioning of the breast implants. Your surgeon might prescribe pain medication as well.

Follow your surgeon’s instructions about returning to regular activities. If you don’t have a physically demanding job, you might be able to return to work within a few weeks. Avoid strenuous activities — anything that could raise your pulse or blood pressure — for at least two weeks. While you’re healing, remember that your breasts will be sensitive to physical contact or jarring movements.

If you notice warmth and redness in your breast or you have a fever, you might have an infection. Contact your surgeon as soon as possible. Also contact your surgeon if you have shortness of breath or chest pain.

Breast augmentation with fat grafting

While breast implants are the most common method used to enhance the appearance of your breasts, this technique isn’t right for everyone. If you’d prefer to avoid inserting a foreign object (breast implant) into your body, Dr. Yuan also performs breast augmentation with fat transfer. This technique uses fat from your own body to enlarge and lift the breasts instead of silicone or saline implants. Iand provides an all-natural alternative that delivers beautiful results. Breast augmentation with fat transfer achieves results that look and feel natural.

Who can be a candidate for breast augmentation with fat transfer?

Because fat grafting uses fat from the patient’s own body for breast augmentation there is less chance for rejection. This means that the procedure is open to many candidates. It can be especially useful for people unsatisfied with their breasts who also have excess fat and would like to avoid the risks of breast implant.

Preparation for breast fat transfer

Before breast enhancement with fat transfer, you will meet with Dr. Yuan for consultation. He will discuss your medical history and goals for the procedure.

  • The fat harvesting sites
  • Your desired breast size and shape changes
  • The spots where the surgeon will make the tiny incisions for the procedure

How is the breast fat grafting procedure done?

The procedure begins with harvesting fat from your body, either from one location or multiple. If one area has a particularly large amount of excess fat, that might serve as the only harvest site. Body areas that are good as donor site include

  • Abdomen
  • Love handles
  • back
  • Outer thighs
  • Arms

Type of Anesthesia for breast fat grafting

Most structural fat grafting takes place under local anesthesia with anxiolytic medications. The procedure can also be performed under sedation or general anesthesia as requested.

Anticipated results of breast fat transfer

In general, each surgery can increase your breasts by one cup size. Depending on your condition, the total fat transfer could be between 200 cc to 400 cc. Any enlargement beyond that would usually require additional procedures.

Fat grafting can last longer than traditional implants. It does not need replacement over time. Whatever growth remains after about three or four months after surgery will become permanent.

Risks of breast fat transfer

Complications are rare with fat grafting, but those that can occur include:

  • Bleeding
  • Infection
  • Scarring
  • Irregularities
  • asymmetry
  • Need more surgery to achieve larger breast size
  • Calcification and lumps can appear after fat transfer.

The American Society of Plastic Surgery has determined that structural fat grafting to the breast is safe and does not lead to a higher rate of breast cancer. There also is no evidence that fat grafting to the breast makes it more difficult to detect breast cancer.

Benefits of Fat Grafting for Breast Augmentation

Breast augmentation can improve the size and shape of breasts and correct asymmetry.

Structural fat grafting specifically can lift sagging breasts, improve shape, and even cover up existing implants.

Other benefits of fat grafting for breast augmentation include:

  • A more natural procedure look and feeling.  
  • A long lasting result. 
  • Benefit from liposuction and body contouring. 
  • Possible better breast shape.  
  • Minimal incisions and scarring.

Candidate for Breast Augmentation with Fat Transfer

Ideal candidates for breast augmentation with fat transfer:

  • Are in good overall health
  • Want to have augmentation without implants
  • Have realistic expectations for the outcome of the procedure
  • Have sufficient excess fat in other regions of the body  

It’s important to understand that there are limitations to the increase in breast size that can be achieved using fat transfer. If you are looking for a significant change in the size of your breasts, implants may be a better option.

Recovery from breast fat transfer

Your recovery from structural fat grafting depends mainly on how many donor sites your doctor used for fat. You will likely experience bruising and swelling in those areas. Your breasts may be bruised and swollen, but in most cases, you’ll experience little or no pain. Soreness can last for approximately two weeks after the surgery, paresthesia may last several months before gradually returning to normal sensation.

You may be able to return to work in about a week. Most bruising and swelling should go away within about three weeks, but minor swelling can linger for up to six months.

You are encouraged to walk beginning the day after surgery and can return to light exercise in two weeks unless the procedure is done with fat grafting to another area. You can wear a soft supportive bra during the postoperative period.

Compare breast augmentation with implant to fat transfer

Traditionally, breast augmentation is performed with saline or silicone breast implants. This method delivers beautiful results that enhance the size and shape of your breasts. To a certain extent you can decide the size of your breasts after the surgery. You also avoid the discomfort in the area where fat is harvested. But there are some downsides for breast augmentation with implants

  • You will eventually need a revision procedure to replace your breast implants once they wear out.
  • You may experience complications such as capsular contracture, rippling or implant rupture.
  • For women with minimal natural breast tissue, it may be challenging to achieve results that feel or look natural with an implant.
  • Even though it is rare, implants can migrate downwards over time.

Breast augmentation with fat transfer eliminates these issues. Fat transfer provides permanent results that don’t require a revision procedure down the road. Many of the complications associated with breast implants are avoided by using fat graft. In the process you can also remove the unwanted fat from other areas and use it as graft for augmentation.  In addition, because you are using a natural enhancement method, your new breasts will look and feel natural. The potential downside of fat transfer include:

  • Complications from liposuction
  • Limitation of how much breasts can be enlarged after each procedure
  • Potential increased difficulty to diagnose breast cancer by imagining study.

If you are interested in breast augmentation or have further questions, please feel free to contact our office.

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