Breast Lift, Augmentation, Implants

We’ll help you get your
pre-baby body back!

Breast Augmentation Surgery

Breast augmentation is a cosmetic surgery procedure designed to enhance the body contour of a woman unhappy with her breast size. It may also be used to correct volume loss after pregnancy, or to help balance breast size asymmetries, as well as a reconstructive technique following another breast surgery procedure such as mastectomy.

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Breast Augmentation Incisions

At Chugay Cosmetic Surgery, we offer three primary incisions for breast augmentation:

Nipple areolar complex (at the border of the areola)
Inframammary fold (in the crease of the breast)
Axillary (in the armpit)

At the time of your consultation, your surgeon will discuss which options are best suited for your skin type and will offer some advice as to which incision best suits your needs.

Silicone Breast Implants

Silicone implants tend to feel more natural and have a lesser chance of rippling. However, on the other side of the coin they are a bit more costly and have a higher chance of producing a thickening of scar tissue around the implant known as capsular contracture.

Saline Breast Implants

Saline implants are implants that are filled with sterile salt water. They are very safe and if they become damaged or deflate, your body will absorb the water. Saline implants are more prone to rippling and feel less natural than silicone.

Possible Complications:

Capsular contracture
Implant rupture
Hematoma
Wound infection

Brief History of Breast Augmentation

History

2007

Stem cells

Stem cells and fat derived from liposuction used to grow breast tissue in clinical trials in Europe.

2005

Silicone Back Again

FDA allows silicone breast implants back on market (with registry).

1992

Silicone Implants Banned

FDA bans silicone breast implants. Saline implants used much more frequently.

1962

First US Breast Implant

First US woman to receive encapsulated silicone breast implants.

1950

Silicone Injections

Early 1950’s – Liquid silicone injections used

1903

Interesting Injectables

1903-1950’s – Petroleum jelly, beeswax, shellac, and epoxy resins used.

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Let us help you get your
pre-baby body back!

Breast Lift & Reduction Surgery

Many women, over the years, develop sagging and aesthetically displeasing breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast Lift, medically known as mastopexy, is a surgical procedure to lift up and restructure sagging breasts. This procedure raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Loss of skin elasticity can result from:

Pregnancy
Breastfeeding
Weight fluctuations
Aging
Gravity
Heredity
Breast reduction

A woman’s breasts often change over time, losing their youthful shape and firmness. A breast lift/reduction procedure can help to alleviate these symptoms and give new support and contour to your breasts.

Postop - What to expect:

One should expect severe swelling and bruising for about 2 weeks after the procedure.
A compression bra should be worn for 4-6 weeks to help with the healing.
Final results may not be evident for 3-6 months as swelling continues to resolve and incisions mature.

Breast Lift With Augmentation Surgery

Gravity, aging, and pregnancy take a toll on the female breast. It is the cosmetic surgeon’s job to then bring a sagging and flattened breast back to a more youthful, perky, and full appearing breast. In many instances, a simple lift will reposition a nipple and possibly reduce the size of the breast depending on the amount of tissue. However, a breast lift does not increase the fullness of the upper portion of the breast. For this reason, the breast lift can be combined with an augmentation (breast implants) to increase the fullness and shape of the breasts.

A breast lift with augmentation is great for the female that wants to maintain her full shape and size while getting a lifted appearance to a breast. It is also ideal for the female that has lost significant breast volume either due to massive weight loss or after child birth and now has drooping/floppy breasts. These breasts can be lifted and repositioned in a more aestheically pleasing position while also augmenting the breast and making it more shapely.

Risks Associated with Simultaneous Lift and Augmentation

The risks for this procedure are similar to those seen with breast lift and breast augmentation surgeries independently. A patient may suffer an adverse reaction to anesthesia, experience bleeding, or suffer an infection. Infection may cause a widening of the scar. Smokers are at a much greater risk and may benefit from a lift and staged augmentation procedure. Smokers are prone to delayed wound healing, wound breakdown, and possible loss of skin of the nipple and areola. For those patients that are smokers, we recommend cessation of smoking for 3 weeks before surgery and 3 weeks after surgery to minimize risks and maximize results.

After your Surgery

After your procedure, you’ll wear an elastic compression bra over surgical dressings. Some bruising and discomfort in the breast area is normal. Any pain and discomfort you feel can be relieved with medications prescribed. Healing is gradual. You should be up and about in a day or two. You can return to work within several days (depending on what you do). Patients are asked to avoid heavy lifting or vigorous physical activity for 6 weeks after surgery to maximize results. Light aerobic activity can begin at week 2 after surgery.

Common Questions & Concerns

How will I Care for My Implants After Surgery?

Patients are asked to wear a compression bra after surgery to help limit swelling and lock the implants in the desired position. We ask all patients to begin laying on their chest at 2 weeks to help stretch out the capsule that is forming around the implant. This will help to possibly prevent a case of capsular contracture.

Following breast augmentation patients will need to continue routine breast screening with their primary care physician or OB/GYN. Some studies have suggested that it may be more difficult to detect early breast cancer on routine mammography, and for this reason an MRI (magnetic resonance imaging) may be recommended by your physician when there is any doubt about the results of your mammographic evaluation.

What are the Risks of Breast Augmentation?

As is the case in all surgery, there are certain risks that are inherent with this operation. Although the scars are usually well hidden, irregularity or thickening of scars can occur which might require revision.

Rarely, bleeding (hemorrhage) may result due to the trauma of the surgery. Small amounts of blood can be easily managed and broken down by the body; however, a large amount of blood or persistent bleeding often requires a return to the operating room for achievement of hemostasis (stopping bleeding) and wash out of the implant space.

Infection is also a risk with breast augmentation surgery. If an infection occurs, antibiotics may used for a superficial skin infection. However, deeper infections and ones that may be in communication with the implant space may require implant removal. While implant salvage has been described in the literature, there is a reported failure rate of 20-40%. If the patient is a candidate for salvage of the existing implant, this will be discussed with you by your surgeon. If the implant is removed, it will often be necessary to leave the implant out for a period of approximately 3-6 months. At that time a new implants can be placed back in the breast. The risk of infection during the first year, as reported by the manufacturer, is between 0.5 and 1%. While infection is usually confined to the first few weeks after surgery, certain bacteria can show up later and produce infection at a date further removed from surgery.

Another potentially serious complication is implant rejection. Silicone is the least reactive material used for implant construction. Most patients tolerate the material without difficulty. Nevertheless, a very small percentage will react to the implant and require removal to avoid long term sequelae.

Will I Lose Sensation In My Breasts After Augmentation?

Sensory changes can occur resulting in numbness or discomfort, and while these symptoms are usually not long-standing or severe, they can be in some cases. Temporary sensory changes are common and usually last 3 to 6 months. Risk of permanent sensory loss increases with increased implant size since larger implants stretch the sensory nerves further. Implants could possibly interfere with nursing although many patients nurse after the operation without difficulty.

What is Capsular Contracture and how is it treated?

One problem that can occur with any implant placed is the formation of a scar tissue capsule around the implant. As the body recognizes that the implant is not yours, it will naturally try to wall off the implant using scar tissue. In some people, this formation of scar tissue is exaggerated and can form thick scar tissue/capsule within the body. If this occurs, it can cause an unnatural firming of the breast and can even cause breast distortion and pain. This condition is referred to as “capsular contracture.”

In mild cases, breast compression exercises may allow the capsule to stretch and soften. Also, your surgeon may prescribe medications to retard the process of capsular contracture and help to soften the breast. While use of mediations for this purpose (such as Accolate), may be helpful, there is not a guarantee of 100% that the capsule will be softened. Furthermore, there are risks associated with this and similar medications. Your doctor will go over these risks if you are prescribed leukotriene inhibitors such as Accolate for your capsular contracture. More advanced cases, or those that are recalcitrant to treatment, may require further surgery and possible replacement of the implant.

Studies presented to the FDA indicate that the overall risk of requiring further surgery in cases of capsular contracture can be as high as 15 to 20% within the first three years following surgery. If surgery is needed, there are two primary options available: capsulotomy and capsulectomy. Capsulotomy is a simple procedure that works well for mild capsular contracture, but may be inadequate for more severe scar thickening. For more severe capsular contracture a complete capsulectomy (removal of all scar tissue) and replacement of the implant may be required. Unfortunately, there is no certainty that the scar tissue will not reform.

What Causes Rippling after Breast Augmentation?

Rippling, or surface irregularities over the implant that can be seen or felt, is a potential problem with any type of breast implant. It occurs more frequently with saline filled implants because the water in the implant is less viscous than silicone gel. Because of the potential problem, placement of the saline filled implant under the muscle may be indicated to help decrease the risk of rippling. This is because it gives more soft tissue coverage over the implant. This may be particularly true for patients who have very little breast tissue. Since the pectoralis muscle only covers the upper portion of the implant, rippling can still occur where there is not muscle coverage. The bulk and size of the pectoralis muscle varies from individual to individual, and so there is no set rule as to how much of the implant will be protected. A major factor influencing the possibility of rippling is implant size. Larger breast implants tend to stretch and thin out the overlying tissue resulting in less natural coverage over the implant. For that reason, rippling is more common in patients who select very large implants. This is a factor to be taken into consideration when selecting implant size. Implant texturing may also increase the chance and severity of rippling. Smooth surface implants seem to have less of a chance for rippling than textured surface implants. In the event that rippling is noted, an implant can be moved to a deeper position with more tissue coverage. If inadequate tissue coverage exists, the use of dermal matrix (skin substitute) can be used to create coverage of an implant.

How Do I know what size is best for me?

The shape of your augmented breasts depends on the implant size and shape chosen along with how your breast appears prior to surgery. The same size and shaped implant on one patient can look completely different on someone else. Therefore, one should avoid picking a size or shape solely on what ‘looks good’ on someone else.

Implants may be round or teardrop-shaped (anatomical). While teardrop (anatomical implants) may seem like a good idea they have some drawbacks. Teardrop implant widths are different than their length and any rotation may produce an unwanted asymmetry. Round breast implants are the same diameter all around but not ball shaped. Our preference is to use round shaped gel and saline filled implants as they provide excellent aesthetic results without the risk of rotation.

During your consultation our surgeons and nurses will with help you determine the implant size by placing actual filled implants of various sizes in special surgical bras to help estimate the size you desire. You may want to bring different shirts to see how your new look appears in different clothing. Some women find it effective to pad a bra by using baggies filled with birdseed or rice to estimate the approximate additional volume they desire. The final decision is yours but we are always ready to discuss concerns of implant style, shape, and size.

Submuscular or Subglandular Implant Placement?

The breast normally sits on top of the pectoralis muscle. Breast implants can be placed above or below this muscle. When implants are placed below the muscle, it is called a submuscular placement or a subpectoral placement. When the breast implant is placed above the muscle, it is called a subglandular or submammary placement, meaning that it’s below the mammary gland.

We generally prefer to place breast implants below the pectoral muscle. A possible advantage of submuscular placement is that it may allow better mammography and thus less chance of missing a breast lesion. Another advantage of submuscular placement is that the implant is entirely beneath the breast tissue, decreasing the possibility of interference with breast function. Research indicates that implants placed below the muscle are less likely to develop firmness (capsular contracture). This may be the result of pressure or internal massage of the implant by muscle movement. Lastly, placement of the implant below the muscle allows for better camouflage of the implant as there is more tissue covering it.

The primary disadvantage of submuscular implant placement is a slightly more painful and prolonged recovery compared to subglandular placement. The most severe pain lasts for one week on average due to the stretching of the muscle. Another disadvantage is the so called “flexion deformity.” Placement of an implant under the muscle can at times result in a temporary crease along the edge of the muscle over the lower portion of the implant. While noticeable briefly it is of no major concern and the breast appears normal at all other times.

What can I expect for my recovery after breast augmentation?

Anesthesia is provided by a registered nurse if having a procedure under sedation or by an anesthesiologist. Immediately after the surgery, a nurse will monitor you and ensure that you are doing well after anesthesia prior to discharge home on the day of surgery. A layer of elastic tape will be used for 7 days to help support the breast along with a light compression bra. Patients usually return to light activity within two to three days after surgery. Full activity is resumed within two or three weeks but no vigorous bouncing type activities (jogging or horseback riding) is recommended for 4-6 weeks. Although the breasts usually look good almost immediately after surgery, there is an improvement in the shape over the following several months as the inflammation goes down and the implants settle into position.

What is my next step?

For your free consultation to get the best idea of what breast implants best suit your body shape and size, simply call (562) 595-8507 or click the Contact us button below to request an appointment date and time.

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Come visit us and see the difference in our medical philosophy, see the difference in how we treat our patients, see the difference in your skin, face, and body. Together we will defy gravity and achieve a more beautiful you.

We’ll help you get your
pre-baby body back!

Breast Augmentation Surgery

Breast Augmentation Incisions

Silicone Breast Implants

Saline Breast Implants

Possible Complications:

Brief History of Breast Augmentation

History

Let us help you get your
pre-baby body back!

Breast Lift & Reduction Surgery

Loss of skin elasticity can result from:

Postop - What to expect:

Breast Lift With Augmentation Surgery

Risks Associated with Simultaneous Lift and Augmentation

After your Surgery

Common Questions & Concerns

Office Hours

Long Beach Office

Long Beach Social

Quick Links

We’ll help you get your pre-baby body back!

Breast Augmentation Surgery

Breast Augmentation Incisions

Silicone Breast Implants

Saline Breast Implants

Brief History of Breast Augmentation

History

Let us help you get your pre-baby body back!

Breast Lift & Reduction Surgery

Loss of skin elasticity can result from:

Breast Lift With Augmentation Surgery

Risks Associated with Simultaneous Lift and Augmentation

After your Surgery

Common Questions & Concerns

Office Hours

Long Beach Office

Long Beach Social

Quick Links

We’ll help you get your
pre-baby body back!

Let us help you get your
pre-baby body back!