guide to breast augmentation - nsps · 2019-01-08 · guide to breast augmentation: everything you...

Guide to Breast Augmentation: Everything You Need to Know

Northwestern Specialists in Plastic Surgery

Dr. Neil Fine, MD, FACS Dr. Clark Schierle, MD, PhD, FACS


Contents

3 Introduction

4 Implant Shell

5 Implant Fill

6 Ideal Implant

7 Implant Shape

8 Implant Placement

9 Incision Site

10 Risks

11 General Surgery Information

12 Choosing Size

14 Patient 1 Case Study

15 Patient 2 Case Study

16 About Our Practice

17 Why Choose Us?


Introduction

Breast augmentation is a very popular and common procedure

that can increase your breast size by one or more sizes. By

surgically inserting breast implants beneath the breast tissue or

the chest muscle during breast augmentation, women can

achieve larger, shapelier breasts. For some women, breast

augmentation is a way to enhance self-image and self-

confidence. For others, breast augmentation is part of breast

reconstruction after surgery for breast cancer or other

conditions affecting the breast.

During your breast augmentation consultation, you’ll learn

more about your options for creating your ideal breast

appearance. In order to be prepared, we have put together this

Ebook that details all of the information you need to know

about breast augmentation.


Implant Shell

The first thing to consider when discussing breast

augmentation is the type of implant. There are different types

of shells, which are shown and described below.

Smooth Round Implant Textured Round Implant

**In our practice, smooth round implants are used most often**

This is a softer implant

with more natural

movement. It is typically

described as the most

comfortable implant, as it

feels closest to your

natural breast tissue.

This implant feels slightly

more firm. It is also less

mobile, as its texturing is

designed to incorporate

with your tissues and stay

in one place.


Implant Fill

Silicone Fill

Silicone provides a softer, more natural feel

There can be less visible rippling, which occurs when you can see the implant rippling under the skin

These implants are less likely to rupture

There is a possibility for a longer incision, depending on the incision site and size of implant

Although controversial in the past, silicone implants are now considered to be very safe, even if they were to leak or rupture

Saline Fill

Saline has a firmer,

less natural feel

There is potentially

more visible rippling

Saline implants have a higher rupture rate

There is a possibility for a shorter incision, depending

on the incision site and size of implant

**In our practice, silicone implants are used most often**


Ideal Implant

Although our research shows us that silicone implants are safe, some

women still feel more comfortable with a saline implant fill. With the

invention of the Ideal Implant, women now have the choice to have a

saline implant that feels more natural and soft. The Ideal Implant

combines a natural feel with the safety of only saline inside. The design

itself consists of an inner and outer shell, which can be filled to

different amounts of saline in order to achieve a desired look. The

internal structure controls the movement of saline, which is often

thought to be the cause of visible rippling, implant folding and

wrinkling. These things can contribute to implant rupture and deflation,

so this implant offers a decreased chance of rupture and deflation.

While silicone leaks may be silent ruptures, saline is harmlessly

absorbed by the body so imaging is not necessarily needed to detect a

rupture. This implant is FDA approved, and only offered by a limited

number of surgeons as it is newer to the market. We offer this implant

and feel that it is an excellent choice for some patients.


Implant Shape

Shaped Implant

These implants are slightly more firm

They have the potential to show less rippling

They have a more natural shape, which means less fullness at the top. This can also be referred to as a tear drop shape

These implants are textured, which means less natural movement

There is a risk for rotation, as these implants are designed to sit in a certain position on the chest

Round Implant

This is a softer implant with a more natural feel

There is the potential to show more rippling

This implant provides more upper pole fullness, creating a rounder appearance at the top

If this implant is also smooth, there is more natural movement

There is no risk for rotation, as this implant is round and able to move on the chest

**In our practice, smooth round silicone implants are used most often**


Implant Placement

Implants can be placed above or below the muscle. The

techniques are described below.

Subpectoral- Under the Muscle This provides for a more natural appearance

There is less chance for visible rippling

There is less risk for capsular contracture, which is a hardening of the breast capsule (described below in "Risks" section)

This is easier for mammographic imaging of the breast tissue

Subglandular- Under the Breast Tissue This provides a less

natural appearance

There is a greater probability for visible rippling under the skin

There is a higher risk for capsular contracture, possibly leading to revision surgery

**In our practice, the subpectoral approach is used most often**


Incision Site

There are different options for inserting breast implants. They

are described below in detail.

Inframammary Incision (IMF)

This is the simplest approach, where an incision is made underneath the breast

This can be ideal if there is a natural fold underneath the breast, so the incision is hidden in the fold

Transaxillary Incision

This approach is more technically challenging, but provides equally excellent results

This can be ideal because the incision is concealed under the arm, which avoids scarring on the breast

Because we have expertise in this type of incision, we feel comfortable using a larger size implant with the transaxillary approach

Periareolar Incision

This incision can be less noticeable due to a natural contrast between the skin and areola color

However, there is a higher risk of breast feeding difficulty and change in nipple sensation

This incision is more often used in conjunction with a breast lift procedure

**In our practice, the IMF and transaxillary approach are used most often**


Risks

Surgical Risks

There can be a change in nipple sensation. Most

commonly, changes are temporary and will return back to

normal after healing occurs

Breast feeding can be affected. However, this is often not

the case and there is no evidence to prove that breast

feeding ability is reduced after a breast augmentation

Like any surgery, there is a risk of bleeding and infection.

These risks are low. There is also a risk of implant

malposition, but this is very unlikely with smooth, round

implants.

Long Term Risks

The most common long term risk is capsular contracture.

This relates to tightening of scar tissue which can make the

breasts feel hard and distort the shape of the implant.

Sometimes, this requires revision surgery.

Implant leakage or rupture is also a long term risk. This is

rare, and occurs less with silicone implants (the rupture

rate for silicone implants is about one percent per year).


General Surgery Information

Anesthesia options can differ depending on the surgery

location

- Most commonly, a general anesthesia is used

- Monitored Anesthesia Care (MAC) can also be an

option, where local anesthesia is used along with

sedation and analgesia (treatment of pain)

There is an option for a local anesthetic pain pump, which

is a small catheter placed at the time of surgery that

delivers local anesthesia to the breast tissue for 2-3 days

after surgery. This is used in addition to pain medication

after surgery

The surgery generally takes about 1.5 hours

Downtime after surgery is subjective and can be different

for each individual patient. Typically, return to work time is

about one week after surgery.


Choosing Size

Choosing implant size for augmentation can be a

challenging decision. During the consultation, we will

give you a suggested range to start exploring the size

that works best for you.

It is best to aim for the "perfect" range.

Size is subjective, so bra cup size does not always

correlate to the size of the implant.

We use a 3D Vectra

system to perform

imaging when

helping patients to

choose a size. This

technology creates

a 3D image of the

patient with

different size implants as a simulation.

Gel implant sizers can be used in the office. This

process allows patients to try on different size

implants to see what size feels right.


Choosing Size

Rice test- this is a test that can be performed at home to help patients choose the correct size

-- Use a measuring cup with milliliters (mL) on it to measure the appropriate amount of rice

-- Place the rice in a knee high stocking, and place the stocking inside your bra. You may also want to purchase a bra that you would like to fill

-- Add rice to the stocking until you reach your desired look

Choosing a size is a very individualized process, and varies from one patient to the next depending on desired outcome. For this reason, we recommend you spend time exploring different sizes at home.

Try on different clothes and different bras to see what works best on your body.


Patient 1 Case Study

Patient demographics: 25 year old female with no children

Implant: smooth, round, silicone implant

Implant placement: subpectoral (under the muscle)

Incision site: inframammary incision (under the breast)

Size: 300cc

Before After (3 months post-op)


Patient 2 Case Study

Patient demographics: 34 year old female with three children

Implant: smooth, round, silicone implant

Implant placement: subpectoral (under the muscle)

Incision site: transaxillary incision (under the arm)

Size: 375cc

Before After (3 months post-op)


About Our Practice

With expertise in both cosmetic and reconstructive breast surgery, our

practice's exceptional strength lies in our mastery of anatomy and

surgical technique and also attention to aesthetic detail. We believe in

providing our patients with the understanding they need to make

informed and empowered decisions. By focusing on individual needs,

our staff provides the highest level of personalized and compassionate

care.

Dr. Neil Fine is a board-certified plastic surgeon affiliated with

Northwestern Memorial Hospital and an associate professor of

clinical surgery at Northwestern University. He received his

medical degree from the University of California, Los Angeles

(UCLA), and completed residencies in general surgery and

plastic surgery at the combined Brigham & Women's Hospital-

Children's Hospital- Harvard Medical School program in Boston,

Massachusetts. His focus is on reconstructive and cosmetic

surgery of the breast and face. Dr. Fine's expertise has been

recognized in "Top Doctors" in Chicago magazine and in the

Castle Connolly Guide since 2001.

Dr. Clark Schierle completed the prestigious integrated plastic

surgery residency program at Northwestern University, where

he received extensive training in cosmetic and reconstructive

surgery of the face, breast and body. He also completed a six-

year PhD and four-year MD at Harvard University after

graduating from UCLA at the early age of 16. Dr. Schierle’s

excellence in both cosmetic and reconstructive plastic surgery

has been nationally recognized with awards from the American

Society for Aesthetic Plastic Surgery. He specializes in

reconstructive and cosmetic surgery of the breast with

expertise in transaxillary breast augmentation.


Why Choose Us?

For many women, breasts are an integral part of their body image and

can be an important factor in feeling confident and attractive. Every

woman deserves to feel good about herself, and to be self-assured in

her femininity and sensuality.

At NSPS, we understand that breast enhancement requires both master

of technical details and an aesthetic eye. Our surgeons make extensive

use of many technical innovations to improve your results.

What makes us different at NSPS?

We use advanced three-dimensional (3D) surgical planning. Our

Vectra imaging system allows us to take 3D images of the breast

and simulate changes based on desired size of your breast

augmentation. We can then compare how sizes may look on your

body. We continue to use this system after surgery, so we can

view your journey from beginning to end.

At NSPS, we specialize in endoscopic techniques to minimize

scarring. With a great deal of experience in using the transaxillary

approach, our surgeons feel comfortable using larger size


implants. This is an excellent way to conceal your scar, and does

not limit you to a smaller size implant than you would like.

We offer pain pump technology to speed your recovery. Utilizing a

pain pump that delivers local anesthesia to the breast tissue after

surgery can minimize pain, as well as allow patients to take less

narcotic pain medication. Pain medication can have negative side

effects, and using the pain pump for local anesthesia does not

offer any negative systemic side effects after surgery. This helps

to provide an easier recovery.

Another innovative addition to our practice has been the use of

the Ideal Implant. This implant offers a natural feeling saline

implant option, which has previously been unavailable to patients

who want saline implants, but do not want to sacrifice the natural

feel.

Through years of refinement and expertise, we have developed innovative

techniques to assure that patients have improved comfort and outcomes after

surgery. If you would like to meet with Chicago plastic surgeons Neil Fine or

Clark Schierle, click here to request a consultation online at our downtown

Chicago plastic surgery office. Or you can call our practice at (312) 266-6240 and

one of our helpful staff members will schedule your appointment. Call us today,

and let us help you to achieve the aesthetic appearance you have always

dreamed of.

http://www.northwesternplastics.com/contact-plastic-surgery-office-chicago/

guide to breast augmentation - nsps · 2019-01-08 · guide to breast augmentation: everything you...

Documents