Every woman has an “Ideal Self,” that is, her own individual idea of her perfect figure. If you’re not satisfied with your current shape and desire a more curvaceous form, breast augmentation surgery can help you achieve your goal. In this surgery, saline or silicone implants are inserted into the breasts in order to increase volume. Alternately, in selected cases meeting strict criteria, fat transfer can be used instead. This procedure involves the transfer of fat from one area of the body into the breasts. Breast augmentation can:
During your consultation, Dr. Anous will carefully review your objectives and motivations. He will then guide you to the correct implant type and volume meant to meet your needs. You, however, will be in control of the choices.
Before having breast augmentation surgery, you’ll need to decide whether you prefer saline or silicone (gel) implants. Both of these options are safe, durable, and capable of producing a natural look and feel, but they have distinct properties.
Saline implants have a silicone shell. They are filled during surgery with pure saline (sterile salt water). They are inserted while deflated, then expanded once they’re inside the breast pocket. Saline implants have the advantage of being adjustable intra-operatively. This can help in cases with marked asymmetry. Some patients also find comfort in knowing that if these implants leak, the saline fluid inside them can be harmlessly absorbed by the body.
Saline implants may not be suitable for patients with thin skin. This implant type is more likely to create visible wrinkles or ripples. Saline implants also look less natural than silicone ones. Their main disadvantage is the presence of the valve used for filling. Because it is glued to the body of the implant the valve is the most frequent site of leakage. This thankfully remains an infrequent event.
Silicone implants have a silicone shell filled during manufacturing with compact silicone gel. This closely mimics the consistency of natural breasts making these implants the preferred choice for most women. Current silicone implants are called “Gummy Bear” or “Cohesive Gel Implants” because their content is no longer fluid. These implants are highly durable and don’t typically display visible rippling or wrinkling. Contrary to popular belief, silicone is in many respects the safer implant type.
There are four different ways to create the retro-Pectoral (behind the muscle) pocket and introduce the implant. Every surgeon has his/her chosen method and should be able to explain her/his reasons. Dr. Anous will methodically and scientifically discuss his preferences. The access incision may however vary depending on the patient’s anatomy.
To view the results of breast augmentation surgery in different body types please view our gallery of “Before and After” pictures.
Fat transfer breast augmentation is ideal for patients with small firm breasts and no droopiness (ptosis). To perform fat transfer breast augmentation, Dr. Anous uses liposuction to remove fatty tissue from a chosen donor location (e.g., the abdomen, thighs, or back). He then purifies the harvested fat cells and injects them into the breasts. This procedure allows patients to achieve multiple body contouring goals (slimming areas of fat deposits while increasing breast size), but it offers a subtler increase in breast volume as compared to implants. Patients who have a fat transfer breast augmentation can expect to go up about one cup size and rarely two.
Breast augmentation is suitable for all women who desire bigger breasts. While the FDA recommends the restriction of silicone implants to women over the age of 22 (for consent reasons), the final decision is left to the patient and her surgeon. Young women between the ages of 18 to 21 who are candidates for Silicone augmentation (either by anatomy or choice) should preferably also have the support of their families or loved ones.
Patients who are interested in having a fat transfer must have a sufficient amount of body fat to permit fat harvesting. As such, this procedure may not be suitable for very thin individuals.
When you come in for a consultation, Dr. Anous will review your medical history in order to verify that you’re a good candidate for surgery. You’ll be asked to provide details about any current health conditions you have and what medications and supplements you use regularly. You’ll then be given instructions on how you should prepare for your operation.
Immediately after having surgery, due to the lingering effects of anesthesia, you will be unable to drive. You will therefore need to have someone with you. Because in most experienced surgeons’ hands this surgery rarely takes more than 20 minutes to complete and because Dr. Anous uses a “No Touch” technique with minimal tissue trauma, swelling, bruising and pain are usually not an issue. In fact, going for an outing the same night of the operation is possible. Motivated patients are able to resume gym activities, exclusive of bench-pressing, within 48 hours.
Dr. Anous will provide you with specific recovery instructions and a special post-surgical bra designed to minimize soreness and speed healing. You will also be given a prescription for oral pain medication although you might opt not to take it. Return to work is dependent on patient’s progress but is usually possible two to three days after surgery.
The same way you pick the left implants: Trust the choice you make during the fitting session! Only you know what you want and when you see it in the mirror you will immediately recognize it.
Yes, there is ALWAYS a scar. The real question is: Will it be visible? All scars fade away after an appropriate interval (6 months) and most scars used for implant placement are properly concealed.
Yes, implants can break but they rarely do. Ruptured Saline implants deflate quite quickly unless they have a slow leak from a defective valve. Silicone implant rupture is almost impossible to detect clinically although the patient herself would have a high suspicion rate due to the events surrounding the suspicion (trauma). Ruptured Silicone implants can only be detected by radiological methods or by re-exploration.
We have no evidence that smooth-walled implants, whether Saline or Silicone, are associated with an increased risk of breast cancer. Long-standing (many years) Textured implants, while not causing mammary gland cancer, are associated with a rare form of lymphoid cancer appearing in the capsule surrounding the implant.
Cleavage is one of the goals of this surgery. There are however chest wall conditions, that your physician will have to discuss with you should you happen to have them, that might interfere with the process of creating cleavage. With the settling of the implants, a process that is never complete before three months following surgery, the nipple position should be higher than before the surgery.
I have never myself had this surgery so I can only report what my patients tell me. With “gentle” surgery comes gentle recovery. The degree of post-operative discomfort is directly proportionate to the amount of tissue damage inflicted during the operation. Thus, there are techniques of dissection that are more painful than others. The surgeon has the duty of discussing this with the patient. Of course, there is also what I call “The Woos Factor” when a patient uses theatrical gestures to illicit sympathetic responses from her entourage.
This is the technique I personally use. There is minimal manipulation of tissues during the creation of the pockets and thus, minimal bleeding, pain or swelling. My fingers almost never touch the implants (they are introduced by what is called the “Keller Funnel”) and the implants never touch the patient’s skin during introduction. This minimizes the possibility of contamination.
Silicone (gel) implants always feel more natural as the gel consistency closely approximates that of normal breast tissues. As far as looks are concerned and although weight-for-weight Silicone implants can better mimic breast shape, it is the location of the implant (above or below the muscle) and the balance between implant volume and chest measurements that decide on the final “natural” appearance.
As a general rule, the answer is: Most likely not, even if there are approaches (peri-areolar) that THEORETICALLY increase that risk. The gentleness of the dissection (“No Touch Technique”) plays a major role in avoiding loss of nipple sensation.
NO! Unless you are a hemophiliac on Aspirin and blood thinners and with uncontrolled high blood pressure (in which case I will not do the surgery).
You can have your surgery on Friday and be back to work the following Monday (that is, unless the “Woos Factor” mentioned above is at play). However, human physical and psychological variations being at play, you can request for one week off without raising (my) eyebrows; two weeks would be a stretch (unless you are a professional volleyball player) and three weeks will be a definite no-no.
You can exercise other parts of your body immediately. You can even resume jogging right away but with a tight sports bra to prevent jiggling. Because of the need to protect incisions, arm lifting will be curtailed for two weeks.
Complications are exceedingly rare with this procedure. The one that we surgeons fear the most (and is fortunately quite uncommon) is for the patient not liking her outcome.
My general philosophy regarding breast augmentation can be judged “in reverse”, that is, by the time it typically takes me to complete this operation: Less than twenty minutes (from start to finish)! Contrary to those saying that speed in surgery denotes recklessness, I would argue that the safest surgeons are the fast ones: they know where they are going and how to get there without risks. Because Breast Augmentation is a Patient-Oriented operation where all decisions are made prior to setting foot in the operating room, pocket development, cleavage creation and implant placement become technicalities that an experienced surgeon has mastered cold. A short exposure to anesthesia insures a speedy and almost painless recovery.
Trust yourself! The surgeon is here for guidance and fine adjustments but never to make the decision for you. Measurements and sizing during consultation should lead to an implant size fitting your perception of yourself. Trying implants in a bra, in front of a mirror, should help you pinpoint exactly what you want.
No. Trust your body to tell you when to stop before you harm yourself.
Yes, a supportive medical bra goes a long way in making you comfortable. The wear of wireless bras is recommended for the first three weeks after surgery. Sports bras should be worn during exercising.
Preferably, for your comfort and safety.
Someone will have to pick you up after the operation and take you home. It is always safer for those receiving general anesthesia to have someone stay with them overnight on the day of the surgery.
As long as you are happy with your result and experience no problems with your implants, replacing them, regardless of the duration after the initial surgery, is not necessary. I understand that this goes against the “Every Ten Years Rule” and everything else you have heard so far, but surgeons operate based on the “Risk/Benefit (ratio) Rule”: As long as there exist no overwhelming reasons mandating surgery, the risks of operating are higher than the derived benefits (for the patient). Regular follow-ups and occasional radiographic examinations are all that is needed for continued safety.
The best way to learn about breast augmentation surgery in detail is to visit a board-certified plastic surgeon for a personal consultation. If you’re ready to pursue this procedure, contact experienced Beverly Hills plastic surgeon Dr. Maher Anous. We look forward to welcoming you to our practice and providing you with personalized, attentive care.