Before and after patient who underwent breast augmentation with silicone. She went from a B cup to a DD cup.
Dr. Lanzer recently attended the American Academy of Cosmetic Breast Surgery in Los Angeles. At the meeting, many specialists from around the world shared ideas on different approaches to breast augmentation. There are a number of considerations that need to be taken into account when performing breast implants.
SALINE VERSUS SILICONE
There are varied opinions as to which is preferable. Dr Lanzer’s favourite implant is the new cohesive smooth silicone gel placed under the muscle. There is varying opinions as to whether saline and silicone feel different when they are placed deep underneath the muscle.
POINT OF ENTRY
Implants can be placed under the breast via a small incision in the crease below the breast via the axilla, arm pit, or around the belly button, or under the areola nipple. The most direct and simple approach is through a cut in the fold below the breast called the inferior mammary fold.
WHERE TO PLACE THE IMPLANT?
Implants can be placed subglandular under the breast, on top of the muscle, or submuscular, deep under the muscle of the chest. Dr. Lanzer’s experience, based on those who he has worked with in America, is that the submuscular is the more natural appearance and perhaps has less long-term risks such as capsular contraction and has the added advantage of the support of the muscle. Once disadvantage of submuscular would be in an athletic gym trainer there may be some difficulty in performing sit-ups due to the effect on the underlying chest muscle.
WHAT SIZE IMPLANT SHOULD I HAVE?
Ultimately, the size is determined by the patient. The surgeon can give a patient a guide as to what volume would be appropriate. A simple test is the rice study where a patient weighs or measures a volume of rice from a cup and places it into a stocking and this is worn in the bra. Normally, the surgeon would add approximately 50 mL to the desired volume. That is, if the rice was 400 mL then an implant of 450 would be used.
Generally speaking 200-250 mL is approximately 1 cup size. There is a significant variation with measuring sizes and one can never be accurate. Also, the effect of a volume implant under the muscle may end up being different to the effect on the external surface as far as a cup size goes.
DO I NEED TO BE ASLEEP FOR AN IMPLANT?
Implants can be performed under a light sedation. However, one must be aware that there usually is some pain when the implant goes in and a light general anesthetic is certainly superior as far as comfort for the patient.
WHEN WILL THE IMPLANTS SETTLE INTO PLACE?
All implants sit high in the beginning and then settle down over the next few months. They gradually move into position. Extremely rarely, implants require further repositioning with surgery and release.
Dr. Lanzer warns that breast implants are not an exact science and often patients do come in because implants are not an exact area where the patient would like to see it. Since it is a large implant across the chest, it is not like putting a dermal implant in the face where one can be much more precise.
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Surgical Warning: Every form of surgery has a possibility of a complication and these are given to you in detail by Dr Lanzer. It is a good idea to understand your surgical procedure well, and to obtain further advice from another Specialist Cosmetic surgeon such as a Dermatologist like Dr Lanzer.
All photographs represent one person's experience, and results may vary for each patient. All photographs are of actual patients of Dr Lanzer. The visible change in these photographs has occurred as a result of the procedure/s undertaken.
Some before and after photos shown are not exact, in that they vary in light, contrast, clothing, background, distance from camera, hairstyle and make-up.