Breast augmentation has not only changed appearances but has positively affected how our patients feel about themselves.
Our goal is to choose the best approach and implant for your breast and body. During your consultation with Dr. Cenedese, options of size, shape and implant type will be reviewed. Implants may be inserted around the areola (nipple), below the breast or through the axilla (armpit). Saline implants can be inserted through the umbilicus resulting in a scarless breast. This procedure although somewhat more technically demanding results in a very natural appearance. Implant placement behind the muscle is preferred by most patients. A more natural, sloping upper and outer breast shape is achieved.
Obtaining maximum cleavage is an important goal. The amount of cleavage that we can obtain is determined by the original distance between the breasts and pectoral muscle insertions. The larger the implants and the closer together they are placed increase the resulting amount of cleavage.
The procedure lasts under two hours. You can go home within two hours. Most patients experience some pain but can start their new lifestyle in a few days.
Saline implants
The safety of breast augmentation has become possible after 40 years of refining the technique and extensive product research. Saline filled implants are placed through smaller incisions surrounding the areola or through the armpit or umbilicus. They are then filled with a special fill tube through a self sealing valve built into the silastic shell of the implant. Dr. Cenedese prefers smooth implants as apposed to textured implants as they feel softer. There are fewer infectious complications as apposed to textured implants. The saline implant results in a very soft breast. They are ideally suited for the women who begin with adequate breast tissues and desire a 1-2 cup increase in size.
Patients requesting a more natural appearance will realize this as time passes. The umbilical or axillary approaches may necessitate an additional incision in another area if repositioning becomes necessary. High profile saline implants appear to ripple less. Unless your breast and chest are broad these are Dr. Cenedese's preferred implant style. If there is inadequate tissue to cover the implant or you desire to increase more than two cup sizes he suggests the use of gel filled implants. When saline implants leak there is no pain but the breast will decrease in size over a few weeks. Replacement of a leaking saline implant, if addressed within a month, is straightforward and nearly painless.
A new subfascial technique allows placement of implants below a thin firm layer of tissue overlying the muscle. This produces more cleavage a natural appearance and less pain avoiding manipulation of the pectoral muscles.
Silicone implants
Silicone gel implants, on the other hand, feel slightly firmer but more natural. The majority of our patients have been selecting silicone gel implants. This follows the European and South American trends where saline implants are rarely used. Since it is difficult to properly place a good sized gel implant from the axilla Dr. Cenedese has been using a new technique which makes the periareolar incision even less prominent than in the past. The Leak rate statistics collected by the manufacturers indicate these to leak less often than saline filled implants. For more information visit www.breastimplantsafety.org.
Silicone gel implants have become accepted as patients are becoming more aware of their safety, natural feel and appearance. Gel implants have recently been approved by the FDA as safe for the average patient. Silicone gel implants have been used for 30 years. Advances in design and manufacturing have made the latest implants more resistant to leaking yet maintaining a natural feel. A leaking gel implant can be replaced without complicated surgery if addressed within a few months of leakage. Failure of a silicone implant is usually detected by a change in shape or firmness of the affected breast. Mammography, sonogram and MRI are helpful in confirming a suspected leak. Please refer to www.siliconegelimplant.com for more information.
Breast Lift
When breast skin has stretched causing drooping, a lift may be of benefit. A breast lift is performed by removing the skin above and below the areola which surrounds the nipple. The nipple/areola are left attached to the breast tissue thus preserving sensation and the ducts necessary for breast feeding. The breast and nipple become higher, perkier and fuller in appearance. Improvements are long lasting unless you undergo large changes in breast size from weight changes or breast feeding. Thin scars around the areola extending to the bottom of the breast must be accepted.
Nipple Enlargement
Girls now you have gone and done it! We can now accommodate your requests for bigger, more projecting nipples. As clients' demands become more sophisticated we develop techniques to accomplish them. For many years nipple enlargement was part of total breast reconstruction. The very same techniques can be used for cosmetic enhancement. The procedures involve minimal incisions and buried sutures. The risks however include difficulties with milk ejection, diminished sensation and rarely cyst development deep to the nipple areola. The areola can be decreased in size by excision or increased with medical tattooing. Demonstrative photos are on the way.
Breast Revision Surgery
Modifications in implant position are the most frequent reason for revision surgery. The axillary incision and approach requires more cutting of the central pectoral muscles to prevent the implant from being pushed back and out towards the axilla. We have seen several patients with implants which have been placed or forced up or out resulting in too wide a space between or high lying breasts. Implants tend to settle from one half to an inch over the first two years.
Contact us to set up a consultation to help to decide which option is best for you.
