Augmentation mammoplasty is a surgical and artistic procedure that enhances the size and the shape of the breast using saline or silicone breast implants. A patient chooses augmentation mammoplasty to balance the size of uneven breasts, to restore lost volume after pregnancy, to enhance the size and shape of her breasts, or as a reconstructive procedure after mastectomy.
A flawlessly executed breast augmentation incorporates and builds upon an individual's natural chest shape, muscle tone, skin elasticity, and breast structure. Dr. Nezami considers each of these factors, together with your desired breast size and shape, in order to help you choose the most fitting breast implants for you.
Our practice is equipped with virtual 3D imaging capabilities that not only allow patients to visualize their post-surgical results, but also help them select and refine a personalized, aesthetic approach based upon visualizations of the available options.
Dr. Nezami will discuss the optimal placement of the breast implants with each patient. Each person's anatomy will determine whether the implants should be placed above or beneath the pectoral muscles. Clinical studies indicate that placing the implants beneath the pectoral muscles decreases the incidence of capsular contracture. Also, it is believed that placing the breast implants under the muscles will improve mammographic imaging, since the breast tissue and the muscles are pushed forward. In the long run, placement of breast implants beneath the pectoral muscles will result in a more natural look for many patients.
Learn More about the differences between Saline implants and silicone implants. And in our blog, read "Breast Augmentation with Saline or Silicone Implants" for an explaination about the differences between saline & silicone implants.
One Month before Surgery
Smoking patients must refrain from smoking at least one month before the surgery, and must continue to refrain for one month afterward. Smoking interferes with blood flow to the skin, which prevents rapid healing and causes tissue loss. Patients should stop taking their birth control piles or any hormonal replacement therapy pills one month before and one month after their surgery to prevent any chance of blood clot.
Two Weeks before Surgery
Patients must avoid certain medications such as aspirin, Ibuprofen, vitamin E, and any other blood thinning medication. Patients who are taking prescription blood thinners will require authorization from their prescribing doctor before cessation. No herbal medications should be taken without the approval of Dr. Nezami.
One Week before Surgery
The patient will meet with Dr. Nezami for a pre-operative consultation. During this visit, she will make the final implant selection. Dr. Nezami will review the patient's medical history, and perform the pre-surgical measurements and final examination. A surgical assistant will review the pre- and post-operative patient instructions at this time. Alcoholic beverages must not be consumed beginning two days before the surgery.
The Day of Surgery
The patient should have fasted eight hours beforehand. She will continue to wash her body, especially her chest, breast and under arms, with Hibiclean (as she has already been doing for three days). The patient will arrive for surgery dressed in a front opening sweatshirt and comfortable, slip-on shoes. Any jewelry, including any jewelry on pierced body parts, should be removed. She will refrain from applying deodorant or lotion on the day of the surgery.
Breast augmentation surgery can take up to two and one half hours, and is performed under general anesthesia administered by a board certified anesthesiologist. Located within the Baptist Medical Center Complex, our surgical suite is accredited by the American Association for the Accreditation of Ambulatory Surgical Facilities, Inc.
As with all surgical procedures, breast augmentation surgery involves some degree of risk. There are some risks that are beyond the control of your plastic surgeon, no matter how expertly he performs the surgery. Although very rare, capsular contracture (hardening of the breast tissue due to tightening of the breast capsule which is a scar around the implant) may occur, causing deformity, hardening, and even some pain. If capsular contracture occurs, the tight scars around the implant need to be surgically cut to give more space to the implant. Massaging the breast after breast implant surgery as instructed by your Plastic Surgeon can help reduce this risk.
During the breast enhancement surgery, the patient is given intravenous antibiotics to reduce the risk of infection. In the rare event of infection, the implant must be removed for three months until the infection is resolved.
In rare cases, especially if the patient does not follow the instruction given to her , abnormal bleeding can occur after surgery. In this case, the patient is returned to surgery to stop the bleeding and remove the blood and replace the implants.
Sensation of the nipple may change due to stretching of the nerves during surgery; it may become sensitive for a short time, but normal sensation will likely return. It is also possible for a patient to lose nipple sensation altogether.
Although it is a rare occurrence, the implant can deflate due to malfunction of the fill valve in saline implant, or rupture of the saline or silicone implant itself. In these cases, the damaged implant must be replaced.
The surgical incision can be made either in the crease below the breast, or in the outline of the lower half of the areola. Dr. Nezami does not recommend axillary or umbilical incisions. Most of our patients prefer to have the incision made in the crease below the breast. A breast surgery incision is meticulously repaired to leave the least visible scar. There are a number of available products, such as vitamin E, Mederma®, cortisone cream, and silicone sheets, that can assist healing and help ensure smoother, faster results.
The patient should arrange for a driver both to transport her home on the day of the surgery, and to drive her back to our center for her first post-operative visit. In addition, a caregiver should stay with the patient during the first 48 hours of recovery at home. To minimize the risk of blood clot, we ask patients to walk several times a day following their surgery. The stitches will be removed within five days at the first post-operative visit.
The patient may shower five days after her breast augmentation procedure, but should avoid hot tubs and baths. Five days after the surgery, she is advised to begin massaging her breasts as instructed by Dr. Nezami; this massage technique will relax the tissue and help to prevent capsular contracture.
Post-surgical swelling may make the patient's breasts feel unnaturally tight. This condition is temporary, and the breasts will gradually soften and develop a more natural feel.
Patients can return to work after one week of recovery, but must avoid lifting heavy objects. After three weeks of recovery, the patient can gradually reintroduce exercise.
Breast augmentation stretches the surrounding tissues. While this stretching can be painful, it is most felt during the first two days after surgery, and can be managed through medication. Occasionally, patients experience sudden, sharp pains, a burning sensation or sensitivity of the breast and nipple area up to several weeks after surgery. Some nerves may become stretched during surgery; these symptoms signal the return of sensation and will subside.
Dr. Nezami is available by telephone at all times, and our practice maintains a 24-hour service number: 904-399-5061. If a patient experiences any of the following symptoms, she should call Dr. Nezami immediately:
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