Breast Augmentation

The object of breast augmentation is to create a prettier but still natural breast shape. There are two main categories of women who request breast augmentation. The first are those who lost their prior breast volume because of weight loss or breast feeding, and the second are those women who feel that their natural breast size is inadequate. While fat injections harvested from an expendable site on a woman’s body and used like a “sterile paste” may be a good supplement in such women, the mainstay of the management remains placement of breast implants. There has been a great deal written and reported about breast implants. The fact is that they are the most widely studied medical devices in history and have been deemed definitively safe by our FDA (Food and Drug Administration). There are two main types of implants. The outside shell of both is a smooth sheet of silicone. (We only use smooth and not textured or roughened surface implants because the latter are associated in rare instances with the development of a lymphatic reaction). Silicone is the material of choice because it is inserted in the human body. The same substance used for breast implants is also used in many other medical devices such as heart valves or artificial joints. The silicone shell is filled with one of two substances, sterile saline or a silicone gel. The majority of our patients choose silicone implants because they tend to look and feel more natural, we continue to use saline implants successfully as well. The advantages and disadvantages, of both types of implants will be discussed with each of our prospective patients in detail at the first consultation.

Dr. Sultan has vast experience with cosmetic and reconstructive breast surgery of all types. For breast augmentation this is manifested in his ability to identify subtleties in a woman’s anatomy such as the quality of her breast skin, or differences in her ribcage or breasts, themselves. These may mandate modification in the techniques used at surgery to achieve the best, most symmetric results possible. He will individualize the plan based on the patient’s anatomy and goals.

In the vast majority of cases we recommend placing the implants below chest muscles (submuscular) as opposed to above muscles (subglandular) because the breasts then look and feel more natural, mammograms are more accurate, and there is a lower risk of contractures, which is hardening of the scar tissue around the implant. Prior to surgery we spend a great deal of time with our patients discussing their goals for the size and shape of their breasts and the options for implants and incisions. “Sizing” sessions with our staff, and a review of breast photos are invaluable to hone in on patient preferences for the end result. On occasion a breast lift will be offered on one or both sides to further improve the shape or symmetry of the breasts. Fat injections to the chest may also be recommended to further enhance the natural appearance of the breasts. Fat injections involve the harvesting of a small amount of expendable fat from the patient’s body and using it like a “sterile paste” to thicken the skin in certain areas.

Pre-operative mammograms are needed in those patients over 30 years of age. The surgery is done under a light general anesthetic called an LMA. It generally takes one and a half hours to complete and requires approximately one week to recuperate.