What is Breast Augmentation

A breast augmentation is a cosmetic surgery that increases the size of the breasts using either implants or fat transfer. This procedure can be done to help restore lost volume, restore balance and enhance their overall figure. Patients can choose from saline, silicone, cohesive gel or autologous fat transfer.

Tubular Breast Augmentation Mammaplasty

Tubular breasts are so called due to their “tube-like” appearance. The breasts have a narrow, constricted base at the origin of the chest wall, with a tight skin envelope and sagging, overhanging nipple-areolar complex. The breast tissues appear to be pushed forward and protrude into the nipple-areolar complex. As a result, the areolae are often enlarged and asymmetric. The net effect is a drooping and limp, barbell-shaped breast that sags and overhangs the natural breast folds with overhanging and downward-projecting nipples. Correction requires expansion of the narrow base, with the insertion of a wide-based implant. A release of the prolapsed areolar breast tissue is performed by incisions to relax and drop the breast. This facilitates reduction of the enlarged areola and asymmetrical correction via periareolar or donut type mastopexy repair.

Before & After

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Incision Options

Periareolar Breast Augmentation

Breast implants can be placed through an incision around the complex nipple margin. Areolae with full coloration and texture offer a distinct border to conceal potential incisions. This approach is commonly used with sagging breasts.

Inframammary Breast Augmentation

For an inframammary breast augmentation, the incision is made under the breast just above the crease. Inframammary augmentations create an incision on the underside of the breast, where implants can be placed directly behind the nipple either on top or underneath the chest muscle. This type of incision leaves an inconspicuous scar that isn’t readily visible.

Transumbilical Breast Augmentation

Transumbilical breast augmentation is completed by making an incision in the inner creases of the belly button. A slim device is then guided under the skin from the navel, up to the area above or behind the chest muscle. Once the incision is made, a tissue expander is then placed in order to create a pocket where the implant would be placed and injected with the required amount of saline to achieve the desired size.

Trans-Axillary Breast Augmentation

Either saline or moderately-sized silicone implants can be placed through a small underarm incision into a submuscular pocket. This type of augmentation mammoplasty avoids any breast scars and allows for earlier breast message and activity.

The implants are situated beneath the muscle, which helps to minimize any palpable or visible implant wrinkling and affords a natural contour and breast shape. Breast enhancement via a concealed underarm incision is particularly well-suited for the women with little or no breast tissue and small or faintly colored areolae. The lack of a natural breast fold or strong areola contrast makes incisions either beneath the breast or around the nipple complex difficult to conceal.

Typically there are two or three natural underarm creases or folds that can be utilized for trans-axillary breast augmentation. These incisions allow the breast implants to slide directly beneath the chest muscles without violating the breast gland. Often the musculature can be elevated and stretched to accommodate the implants, limiting the need for muscular alteration.

Dr. Shienbaum and his staff are amazing and so caring! I was so pleased with my results and how quickly I felt back to normal! Would recommend to anyone!”

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Breast Implant Recovery

Immediately after surgery your breasts will most likely feel very sensitive and have some bruising and swelling. Soreness in the chest area is common for the first several days but getting up to walk every couple of hours in order to promote blood flow. The only major limitations after breast surgery involve lifting of any kind, otherwise returning to light daily activity should be fine as long as it is well tolerated.

 

Massaging breasts after Breast Augmentation

Massaging breast implants is thought to reduce the risk of capsular contracture by maintaining the implant pocket. This allows additional space for the implant and, hopefully, a more supple result.

Be certain to massage the implant and not the breast skin. The implant itself should be gently moved in all directions– up, down and sideways in a circular motion. This displaces the implant and will resist the potential for the breast tissue to tighten down around the implant. Massage is not recommended for textured implants and its long-term value has been questioned by many experienced plastic surgeons.

 

Recommended arm exercises following breast augmentation

Many plastic surgeons feel that it is important to gently and progressively stretch the pectoral chest muscles after surgery. These exercises can aid in relaxing any spasms or abnormal muscular tightness, as well as reducing pain and tenderness, However, be certain to proceed cautiously, without sudden or forceful lifting or pushing. These exercises can include alternating rolling and circular movements of the shoulders and arms, as well as stretching backward with the hands cupped behind the head.

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Risks

Any surgical procedure involves some risk. Luckily, breast augmentation has a long and successful record in which serious complications are infrequent. Since anesthesia is used, there is the potential for an adverse reaction though it is uncommon.

Leaking Breast Implants

Saline Implants
Leaking, saltwater-filled, saline implants will typically show a sudden, rapid decrease in size as the saline is harmlessly absorbed by the body. Sometimes there may be a slow leak with a gradual decline in size but this is the exception. The deflated implant bag can often be felt within the breast tissues.

Silicone Implants

Signs and symptoms of Silicone implant leakage may include a sudden firmness or soreness, a misshapen contour, palpable lumps, or surface irregularities. The leaking silicone material may induce an inflammatory response, which can cause a tight capsular contracture.

A leaking silicone implant is difficult to detect because there is no loss of volume. This is especially true of modern Cohesive “Gummy Bear” implants which are highly viscous and maintain their shape. Older silicone implants are more liquid and silicone droplets may migrate into the surrounding tissues. Learn more about all three types of breast implants.

Studies & Tests

Even if the implant shell integrity has been compromised, the silicone contents will be contained by an intact breast capsule. This intracapsular leak is often “hidden” and difficult to diagnose.

Your routine mammogram will often provide the first clue. An additional ultrasound study will demonstrate frank rupture, while an MRI is typically needed to detect small and intracapsular silicone leakage. Remember that your MRI report includes a certain percentage of false positives and negatives. In the Tampa, Lakeland, and Brandon areas, your physician may be able to detect any problems as they occur.

Breast Lift Vs. Breast Augmentation

Breast Implant

A breast implant will plump up and restore the volume lost in an empty, deflated breast. If the associated breast sag is mild, meaning the nipples point forward and not down, and the areolae are still in the center of the breast, then the selected implant can fill the loose skin and a breast implant alone may work. In the Lakeland, Brandon, and Riverview areas, Dr. Shienbaum can help you determine if breast implants would suit your desires.

Breast Lift

breast lift procedure is usually necessary for large and pendulous breasts if the nipple points down, or if the areola is at the bottom of the breast and the nipple sits below the inframammary breast fold. An aesthetically pleasing breast shape is possible if there is a satisfactory breast volume.

Breast Lift with an Augmentation

Top Tampa plastic surgeons can also combine an implant placement with a breast lift. This procedure, called an augmentation mastopexy, may be necessary if there is insufficient existing breast volume to construct a full, round, well-shaped breast.

Breast Implant Alternatives

  • Tampa plastic surgery has many alternatives, and here are four the main options:
    Brava breast enlargement systemutilizes a special external vacuum pump bra which is worn continually for several weeks. About a one cup enlargement is possible, however, following completion of the treatment, there is a potential for the enlargement to diminish.
  • Natural fat transfer breast enhancement– while fat transfer is now widely used for breast reconstruction following mastectomy, it still has limitations and risks which have prevented more widespread acceptance and use.
  • Creams, Hormones, and Pills–There exists a huge variety of generic and hormonal ointments and pills to promote breast enlargement. However, there is no convincing verifiable proof of their long-term efficacy.
  • Push up Bras– There is a huge assortment of this longstanding option.

Is Fat Transfer with a breast augmentation an option in Tampa, FL?

Is a natural breast augmentation using fat better than breast implants? Having your own natural tissue injected for breast enlargement sounds so intuitively appropriate. A one or two cup size increase may be possible without the worry of implant rupture or capsular contracture. Fat transfer is already widely used for breast reconstruction, so why not breast augmentation?

Well, there are risks. Only a certain percentage of the fat cells ultimately survive. The remaining cells may cause inflammation, lumpiness, fatty cysts or calcium granulomas. Calcium deposits in the breast raise the suspicion of breast cancer and may lead to unnecessary biopsy. Think twice if you have a family history of breast cancer.

FAQ

Most of the pain following breast augmentation arises from detaching and elevating the pectoral muscles. This allows a space for insertion of the implants. The discomfort can be minimized by a gentle surgical technique which avoids trauma to the underlying rib peritoneum.

Dr. Shienbaum administers a long-acting block of local bupivacaine (Marcaine) anesthetic which will last for several hours and minimize the need for post-op pain medications. Your degree of pain, both in duration and severity, will vary with your individual tolerance and perception.

Having performed thousands of breast augmentations for over a 30 year period, Dr. Shienbaum has developed his technique to allow the most comfortable experience possible. He can inform you about what you can expect during your procedure in the Tampa, FL area.

Most doctors in the Tampa area now agree that breast implants neither cause autoimmune disease nor make the condition worse. However, the medications taken to suppress the autoimmune disease symptoms may increase the risk of infection and delay healing.

The FDA found that women with breast implants had no greater incidence of immune disorders than women without implants. It is highly questionable that removal of breast implants will make your existing autoimmune disease disappear. There is simply no convincing evidence that associates breast implants with autoimmune disease.

Pregnancy will not damage the shape or integrity of your breast implants. However, the rapid expansion and stretching of breast tissues, lactation, breastfeeding, and hormonal influences may change the surrounding breast tissue characteristics.

Stretch marks and ptosis (sagging), areola discoloration, and breast atrophy (volume loss) are the most frequent concerns following pregnancy. One side may be affected more and result in uneven and asymmetrical breasts.

Breast ptosis can be readily corrected by a breast lift, which elevates the breast tissue back to its normal position. Stretch marks (striae) are more difficult to address. Ultimately, your individual genetics play the dominant role in determining the appearance of your breasts following pregnancy.

There is no specific age that prohibits breast augmentation. Rather, it is your medical health and ability to safely undergo surgery which are the most important considerations. Serious medical issues, such as labile hypertension, advanced diabetes, lung compromise, and coronary artery disease require careful evaluation of the potential risks.

According to The American Society for Aesthetic Surgery, nearly 11 % of women undergoing breast enlargements are over 50 years of age. And many older women will want their aging implants replaced rather than removed.

Your chronological age should not be the deciding factor in cosmetic surgery. It is a highly personal decision, and your health, safety, and self-perception are ultimately what matters most. In Tampa, FL, patients of many different ages opt for breast augmentation.

Select a surgeon who has lots of experience with breast augmentation, and performs precise and delicate surgery, avoiding trauma to the underlying ribs and surrounding tissues. Going under the muscle is always more painful, as well as selecting large implants that push against and irritate the adjacent nerves. Ask your surgeon about instilling long-acting local anesthetics during surgery and the use of anti-inflammatory and muscle relaxants. An early return to normal arm movements and exercise helps relieve tightness and discomfort.

Bras are measured in two dimensions– the cup size and the body circumference around the rib cage. Implants are volumetrically sized in CCs, or cubic centimeters. It takes approximately 200 CCs to create one full cup bra size increase. Because of differing bra styles and manufacturer patterns, the dimensions of a particular cup size are not necessarily uniform. Some women may prefer a tight and revealing cup while others desire full cup coverage. Plastic surgeons are therefore reluctant to predict a particular cup size after augmentation.