WHAT IS A BREAST AUGMENTATION?

A Breast Augmentation is a surgical procedure by Plastic Surgeons to place a breast implant underneath the breast tissue in order to enhance or ‘augment’ the natural volume of the breast. It is one of the most popular cosmetic procedures performed by Plastic Surgeons in the United States . There are a number of reasons why women seek out a Breast Augmentation-- to restore breast volume after children, breast feeding, weight loss or natural aging-- or to create a more proportional breast volume in relation to the rest of the body. Whatever the reason, the ultimate goal of a Breast Augmentation is to restore and boost a woman's self-confidence by providing her with a natural, aesthetically pleasing result. As a female plastic surgeon, Dr. Megan understands the importance of our physical appearance on our self-confidence and body-image and strives to provide each and every patient with the comfort and validation they deserve throughout this process.  By balancing the unique characteristics of each patient's anatomy with each patient's individual goals and expectations, Dr. Megan is able to use her Plastic Surgery expertise to create natural, feminine results. 

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AM I A GOOD CANDIDATE? 

An ideal candidate for a Breast Augmentation is healthy, has a stable weight, and is in overall good health. Most importantly, an ideal candidate seeks natural results and has realistic expectations. Often, a Breast Augmentation can be combined with other procedures such as a Breast Lift, or as part of a “Mommy Makeover.” 

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BEFORE YOUR CONSULTATION: 

To best prepare for your seattle breast augmentation consultation, Dr. Megan recommends that patients take some time to do a little background homework. While not required for consultation, having a bit of knowledge about breast implants and the surgery itself can greatly facilitate a more thorough and effective consultation. Some patients find it helpful to gather “wish pics” for their consultation, which can be reviewed in order to help establish a patient’s plastic surgery goals. In addition, patients will be given the option to try on implant sizers during their seattle plastic surgery consultation. For best results, we recommend patients wear a non-underwire, non-padded bra and bring a solid-color fitted shirt. These help us to best simulate implant size and shape.

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THE CONSULTATION: 

A Breast Augmentation consultation is usually performed in 2 parts. The initial consultation is where we will review your medical history, surgical goals and do a thorough physical examination. From this, a rough draft surgical plan will be devised. There is a LOT to cover in a Breast Augmentation consultation because not only does the surgical plan have to be created and reviewed but also the surgical devices themselves (i.e the breast implants). For this reason, Dr. Megan likes to treat these consultations in a two step approach. The second consultation, closer to the date of your plastic surgery surgical procedure, will include finalizing the details of your procedure and the details of the breast implants.  During both of these visits, patients will have the opportunity to try on implant sizers. These are shaped silicone devices that a woman can place in her bra over her native breast tissue in order to simulate enhancement with different sized breast implants. 

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THE PROCEDURE: 

A Breast Augmentation is a relatively short, outpatient procedure that can be done in less than an hour and will take place in our State-of-the Art Surgical Suites. Most patients will undergo a General Anesthesia (completely asleep) administered by our outstanding Anesthesia Team. 

 

First, a carefully placed incision is made at one of two locations-- under the breast (Inframammary fold) or around the areola (periareolar).Then a pocket either above the Pectoralis Major muscle or below it is created for eventual implant placement. Once the pocket has been created and each side of the chest has been evaluated for symmetry, the implant is placed through the incision using a funneling device that resembles a pastry bag. The purpose of the funnel is to avoid contamination as part of a "No Touch" technique  and allow us to place implants through smaller incisions. 

 

Following implant placement, the patient is placed in a sitting position so that position and symmetry can be evaluated. Once Dr. Megan feels she has achieved her optimal results, the incisions are closed with multiple layers of dissolvable stitches all placed underneath the skin. A small strip of tape is placed over the incision and a soft, non-underwire bra is then placed on the patient. Once awoken from anesthesia and ready for discharge, the patient can then go home to recover. 

 

AFTER SURGERY:  

Patients generally note a couple days of downtime after a Breast Augmentation procedure during which they will have soreness and possible muscle spasms that may require some stronger pain medications to control. Patients will not be able to shower until after the first postoperative appointment with Dr. Megan. Most patients will take approximately one week off of work to recover, though this can vary depending on the nature of work. We ask that a patient refrain from lifting any objects heavier than 10lbs for the first 4 weeks after surgery to allow for everything to heal. Swelling is normal over the first couple of weeks and tends to be most prominent at the upper pole of the breast. By three months, most implants have settled into their pocket and the breasts have reached their new baseline. 

 

BREAST IMPLANTS: 

Breast Implants come in all shapes and sizes, and this can often be overwhelming for patients to choose what they feel is the “perfect implant.” There are multiple factors to consider: 

• Saline Implants vs Silicone Implants

• Textured vs Smooth

• Shaped vs Round

• Profile-- High, Moderate or Low

• Size

 

Ultimately, how Dr. Megan will help her patients find the “perfect” implant is a delicate balance between patient goals, patient lifestyle and patient anatomy. Dr. Megan will perform careful measurements at your appointment to better understand your anatomy and also help you to understand how your anatomy affects the type of implant she might recommend. 

 

WHERE WILL MY INCISION BE? 

There are 3 common incisions used to perform a Breast Augmentation and place the breast implant. The most common is through the Inframammary Fold, or at the lower breast crease. This incision usually measures around 3cm in length and is made to be hidden in the natural crease of the breast so as to not be visible when a patient is wearing a bra or a bikini. An incision around the Areola, or a periareolar incision, is another popular option for women. This incision is carefully placed at the junction between the darker areolar skin and the lighter breast skin in order to camouflage its location. Lastly, an incision in the armpit can be used in order to place a Breast Implant. This option is very appealing to patients because of its lack of scar placement on the breast itself but is not always the best choice.  All scars will flatten, soften and fade over time but the healing process can take upwards of a year.

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HOW DO I PICK AN IMPLANT SIZE? 

Implant size can be a very overwhelming choice for patients. Dr. Megan does not believe in “choosing” a size for her patients. The “perfect” size of an implant is an individualized and multifactorial decision involving a number of factors that must be considered-- lifestyle, age, skin quality, height, weight, chest circumference, breast width, existing breast tissue and patient goals. Dr. Megan’s goal is to walk her patients through each of these considerations so that, together, they can agree on the best size for the patient. 

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WHAT POCKET WILL DR. MEGAN USE? 

There are 4 potential anatomic positions that a Breast Implant can be placed in. The two most straightforward are either completely above the Pectoralis Major muscle (subglandular), or underneath the Muscle (submuscular). To place the implants in a pocket under the muscle, the muscle is released from its rib attachments to the midline of the chest to allow for an appropriately positioned pocket for the implant. Less straightforward are a Subfascial Pocket and a Dual Plane Pocket. A Subfascial pocket is where the implant is placed above the Pectoralis muscle and directly underneath the fascial layer covering the muscle. The idea behind a Subfascial pocket is to leave the muscle undisturbed and utilize the strength of the fascial layer to help hold the implant in its position over time. 

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A Dual Plane pocket is in essence a hybrid between a Submuscular Pocket and a Subglandular pocket where the implant is covered superiorly by the muscle and inferiorly by the glandular tissue. This is Dr. Megan’s preferred method of Augmentation when she has a patient with a lower nipple position or some glandular tissue that hangs below the breast base. 

Ultimately, patient anatomy combine with patient goals will best help us decide which pocket is correct for each patient.