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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
Guide to Breast Augmentation: Everything You Need to Know
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?
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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**
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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**
Guide to Breast Augmentation: Everything You Need to Know
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**
Guide to Breast Augmentation: Everything You Need to Know
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**
Guide to Breast Augmentation: Everything You Need to Know
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).
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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)
Guide to Breast Augmentation: Everything You Need to Know
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)
Guide to Breast Augmentation: Everything You Need to Know
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.
Guide to Breast Augmentation: Everything You Need to Know
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
Guide to Breast Augmentation: Everything You Need to Know
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.