Breast Implant and Augmentation Information

Breast Augmentation adds volume to the breasts with a breast implant to increase fullness and create better balance with the rest of your figure. Your clothing options will expand tremendously, and you’ll be comfortable wearing many types of clothing you’d be uncomfortable wearing before.
There are different types of breast implants available, and three different approaches for augmentation. The small incision can be placed under the breast, at the edge of the nipple-areola, or in a skin fold in the armpit.
There is no single best type of implant and approach for every augmentation. Breasts are extremely different, and different approaches give the best results in certain breasts.

Why Are Breasts Small?
Small breast sizes usually results from one of two causes:
  • Lack of development of breast size during puberty.

  • Loss of breast fullness following pregnancy.

How Pregnancy Affects The Breast
During pregnancy, breast enlargement occurs and stretches the skin envelope of the breast. When pregnancy and nursing are over, the tissue within the breast involutes or shrinks, usually to a size smaller than it was originally. The skin, however, remains slightly stretched, and the smaller fill tissue falls to the bottom of the stretched skin envelope. The result is usually a breast with somewhat loose skin, with the breast tissue in the lower part of the breast, and an empty upper breast.

How Much Can The Breast Be Enlarged?
How much a breast can be enlarged depends on the degree of stretching of the skin envelope and your desires regarding breast size. For example, if you have never been pregnant, and have very small A cup breasts, your skin may be very tight. Dr. Gold can expand the skin during surgery if necessary to allow you to have virtually any size breast you’d like, without the breast appearing too large or unnatural.
New techniques allow very precise filling of specific areas of your breasts, which you might want to be fuller. For example, Dr. Gold can narrow the distance between the breasts and produce more fullness or cleavage, and can increase fullness in the upper breast, in the outside of the breast, or all three, depending on your preferences.

Understanding Desires And Making Choices
At your consultation, Dr. Gold will discuss your preferences regarding breast size, incision location, and most importantly exactly how you’d like your breast to look. After examining you, he will recommend a range of options for implant type and size, and incision location that will be best for your breast and balance with the rest of your figure. He will always honor your choices of alternatives if he can achieve an aesthetic breast using your choices.
In order to help you make an informed choice Dr Gold recommends that you read
"Picking The Right Implant." (click to go to that article)

Breast Implants and Breast Cancer
Breast implants do not cause breast cancer.
Excellent scientific studies indicate that breast cancer occurs in about ten percent of women, regardless of whether they have had breast augmentation.

Breast Implants And Mammography
Breast implants may make a mammogram somewhat more difficult to read. This does not mean that a mammogram can’t be adequately read, simply that the mammograms must be performed and read by someone experienced in the proper techniques. When a breast implant is present, the breast tissue should be pulled forward in front of the implant before compressing the breast for a mammogram. This maneuver, combined with additional views of the breasts if necessary, allows optimal visualization of the breast tissue if you have implants.

Differences Between Breasts
Differences always exist in the appearance of your breasts. The sizes, and the nipple locations
are different. After breast augmentation these differences will be less, but will exists to some degree.

Reliability Of Implants
Breast implants are mechanical devices, which are manufactured to extremely high standards. We use only implants that Dr. Gold feels are thoroughly tested. Some patients have had breast implants in place for over 30 years, but no one can specify the life of a breast implant. At some point you may choose or need to have it replaced.

Choosing Between Saline versus Silicone Gel Filled implants is basically choosing between two good options. Read this article and discuss it with Dr. Gold.

How The Body Responds To Implants
When any implant is placed in your body, the body forms a lining or capsule around it. This capsule is similar in some ways to scar tissue and can shrink or contract. If it contracts markedly and squeezes on your implant, it can distort the implant or make the breasts feel too firm. There are several techniques to decrease the likelihood of developing hardness, but so far the risk cannot be totally eliminated since it is the result of your normal healing mechanisms.

Can Implants Break? What Happens?
Very rarely, the outer shell of a breast implant can break. Usually, this is due to folds occurring with abrasion of the outer shell, and is more likely to occur following development of hardness due to capsule contracture. Your breast should never be squeezed in an attempt to correct hardness, as this risks breaking the implant. If an implant is ruptured, saline contained in the implant will drain from the implant and this poses no problem. If this occurs, we would do a mammogram, and if implant rupture can be confirmed, remove the implant and replace it with a new implant.

Other risks common to all surgical procedures such as bleeding, infection and scar tissue formation occur in a very small percentage of cases. Bleeding or infection occur in only 1-3% of cases, but may require another procedure for correction. Infection may necessitate temporary implant removal and subsequent replacement. We encourage you to discuss any concerns that you have during your consultation.

The Operation
The incision for breast augmentation may be placed in the fold beneath the breast, around the areola, or in the hollow of the armpit, depending on the type and size of implant to be used and your preferences. In any of these locations, very meticulous closure of the incision minimizes the visibility of the scar and maximizes its quality. Dr. Gold will discuss your preferences about incision location with you.
Breast implants are placed behind the breast tissue, not within it. In most cases,. the implant will also be placed behind the pectoralis muscle on the chest wall. Dr. Gold will discuss the best option depending on your preferences and the best option for your specific breast type. In either case, your breast tissue is located in front of the implant where it can be readily examined.
A pocket is created behind the breast to receive the breast implant. After final implant placement and position is achieved, Dr. Gold will spend considerable time precisely closing your incisions to achieve the best possible scar result.

All of your incisions will be carefully closed with stitches placed beneath the skin, so there’s no chance of your having “railroad track” type marks but rather very fine line scars. You’ll be able to shower or bathe immediately.
Following breast augmentation procedures, most patients have very little pain, but rather experience nuisances such as tightness or fullness.
Your breasts will feel very tight to you for 48/72 hours, and the tightness will gradually resolve over the next several days as the swelling decreases. You may develop slight bruising beneath the breasts a day or two after surgery, which will resolve in about a week.
You may have a moderate feeling of soreness. We will prescribe medication for that soreness. Most patients require medication for only 2-3 days.

The Stages Of Recovery
Our patient’s usually want to know about four stages of recovery: surgery time, when swelling or bruising will be resolved, when they’ll be able to return to work or social activity, and when they can return to full aerobic or strenuous exercise.

Surgery: Breast Augmentation is usually performed as a day surgery procedure. Dr. Gold has a fully accredited surgical suite in his office for your convenience.
Bruising and swelling resolve: 10-21 days
Return to work, social activity: 7-10 days
Aerobic or strenuous activity: 14 days

We encourage returning to full normal activity immediately. Don’t do any type of strenuous exercise that would push your pulse over 100 for about two to three weeks. Any aerobic activity that increases your pulse over 100 also increases your blood pressure, and could make you bleed.