Breast augmentation continues to be one of the most requested cosmetic procedures in the United States. Through the placement of silicone or saline implants, breast enlargement can provide balance and proportion to the body. Dr. Hlavacek specializes in a multitude of surgeries, including breast augmentation, in Kansas City.

Who Can Benefit from Breast Augmentation?

Breast enlargement, or augmentation mammoplasty, enhances the body contours of a woman who is unhappy with her breast size. It may also be used to correct volume loss after pregnancy, to help balance breast size asymmetries, or to reconstruct following other breast surgeries.

Patients who are in good health but dissatisfied with the size and shape of their breasts are excellent candidates. Breast augmentation may be used to:

• Increase breast volume
• Create a more balanced appearance
• Improve body proportion
• Restore the breasts after weight loss or pregnancy
• Reconstruct the breasts following mastectomy

After breast augmentation, your breasts will appear more proportionate to the rest of your body. They will be fuller and more prominent, but retain their sensitivity and ability to breastfeed.

While breast augmentation will enlarge the breasts, it will not alter basic defects in breast shape or form. Major asymmetries may be improved but will not be completely corrected. A slight difference in the size or shape of the two breasts is considered normal and should not be a cause for concern. If breast size or nipple position asymmetries are severe then additional procedures to further improve symmetry may be necessary.

Despite its many advantages, breast augmentation may not be for everyone. The best way to determine if you are an ideal candidate is to schedule a consultation with a board-certified cosmetic surgeon like Dr. Hlavacek. To develop realistic expectations regarding results, it’s best to look over our breast augmentation before-and-after photos.

Types of Breast Implants

A breast implant is composed of an outer silicone shell filled with saline or silicone gel. The outer surface may be smooth or textured, and implants come in various shapes to meet the individual woman’s needs.

Additionally, high profile breast implants are available, along with implants in other profiles. The profile describes the implant’s projection from the chest wall. Textured implants, profile options, and shape options can further be discussed with Dr. Hlavacek upon consultation.

The two main types of breast implants are silicone and saline breast implants, each of which present their own set of benefits and considerations. Your surgeon will help you determine the best breast implants for you.

The FDA re-approved silicone breast implants in November of 2006. These are now silicone gel versus the “old” liquid silicone implants. Women must be at least 22 years old to select this option as directed by the FDA to ensure their emotional maturity in accepting the possible risks of having these newer implants placed.

There is no perfect breast implant, and both the saline and silicone gel implants have advantages and disadvantages. The silicone gel implants feel softer and more natural, have less chance of rippling, but are more expensive and have a higher chance of developing tightening of the scar tissue around the implant known as capsule contracture.

Saline implants are very safe, and if they deflate, your body will absorb the water. Saline implants are more prone to rippling and feel less natural than silicone.

Breast Implant Size

In selecting the size of the implant, the general choice should be jointly made by the patient and the surgeon prior to surgery. While ultimately the choice of size is made by the patient, she should recognize that there are advantages to a conservative selection. In many cases, small breast implants may be ideal. Capsular contracture and rippling are more common with larger implants. Postoperative numbness and long-term sagging are also more common with large breast implants.

The shape of your augmented breasts depends on the implant size and shape, along with how your breasts appear prior to surgery. Many patients desire fuller cleavage. Although larger implants will give more cleavage, the patient’s nipple position, chest shape and breast shape largely determine the amount of cleavage that can be achieved.

Also, 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. A thorough consultation and pre-operative screening with your surgeon is critical to determine your options and ideal treatment plan.

Breast Augmentation Incision Patterns

There are several ways in which the breast implant can be inserted. The size and position of the incisions will vary based on factors such as the type and size of implant used. An incision can be made under the breast (inframammary), around the bottom of the areola (periareolar) or in the armpit (transaxillary). All of the incisions have benefits and drawbacks.

The incision under the breast (inframammary) is the most common. Unfortunately, it is the incision that most people relate to breast enlargement surgery should anyone see it. Also, it may not always end up in the new inframammary fold, where it would be hidden the most.

This approach places the scar very close to the implant. If the incision should get infected, it may be more likely that the infection could reach the implant. Finally, although inframammary scars usually heal well, there are some instances of scar thickening that are very difficult to improve. However, the incision has been used for decades and remains a good option that usually has no major problems.

The periareolar incision is made in a semicircular fashion around the lower half of the areola approximately 4-5 centimeters in length. It offers the advantage of keeping the incision far away from the implant and allowing good surgical exposure of the entire pocket. The incision has a higher risk for loss of nipple sensation and difficulty with lactation as compared to the other incisions, but it also remains a good incision option.

The endoscopic transaxillary incision offers several advantages. The incision is approximately four centimeters in length placed high in the armpit. The incision usually heals very well, leaving no visible scar on the breast itself.

The use of endoscopic surgery allows Dr. Hlavacek to carry out breast augmentation with more precision and less bleeding. Special instruments designed for this purpose allow working through the small incisions, monitoring the operation on a video screen.

The pocket is tailored under direct vision rather than the traditional blind dissection. The improvement is obvious, since it is always better to see clearly what one is cutting.

Breast Implant Placement

The breast normally covers a muscle on the chest wall called 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 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. Submammary or submuscular placement is dictated by the existing breast form including the amount of existing tissue and also the patient’s goals regarding augmentation.

The Breast Augmentation Procedure

The breast enlargement operation is an outpatient procedure, meaning you may go home after the surgery and will follow up on the first post-operative day. It is carried out under general anesthesia, or in some cases, local anesthesia combined with sedation may be administered.

The selected incision is made. Through the incision, a pocket is made behind or in front of the pectoral muscles. The implant is then placed into the pocket through the incision. Symmetry and form are evaluated, and after only excellent results, the incisions are closed with dissolvable sutures. The incisions are dressed with cloth tape, and a compression bra is placed.

Breast Augmentation Recovery

After surgery, your chest will be wrapped with surgical dressings and a surgical bra. Temporary drains may be used to collect accumulating fluids. You will be able to walk around immediately following the surgery but should rest for at least a day or two.

Your breasts will be bruised and swollen, and you may experience some mild discomfort for a couple of days. The pain is generally well controlled with oral pain medication. In the recovery stage, you will need to wear a compression garment or support bra for several weeks. It is important to wear the bra at all times until otherwise directed.

Patients follow up on post-operative day one for general re-evaluation and then at one week. At that post-operative visit, the cloth tape is removed and replaced with flesh-colored dressing tape, which falls off on its own within the following week. Stitches will also be removed during the one-week follow-up.

Your incisions will be noticeable immediately following surgery, but they will gradually fade and flatten for up to a year after surgery. Massage exercises may be started, and the compression garment wear will be tailored.

Recovery times vary; recovery is generally one to two weeks. It is important to limit lifting weight to less than five pounds the first week and ten pounds the second week. It is also important to limit lifting your arms above your shoulders as much as possible the first two weeks.

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) are recommended for 6 weeks. The chest should be protected from accidental impact and sun exposure for several months.

Although the breasts usually look good almost immediately after surgery, some swelling and bruising may obscure the final results for a few weeks, and there is an improvement in the shape over the following several months.

Following breast augmentation, routine examination and imaging as indicated by the AMA/your primary care physician, the FDA, or the implant manufacturers is important.

As with other surgeries, breast augmentation surgery carries the risk of complications. Possible complications include discomfort, bruising, infection, asymmetry and changes to sensitivity. These risks will be discussed in depth during your consultation.

Breast Augmentation Cost

The cost of a breast augmentation depends on a variety of factors, including the amount of time the procedure takes, what kind of implants you are getting, and more. Be sure to discuss the price of this procedure during your consultation with Dr. Hlavacek, and if you have any questions, be sure to check out our financing options.

Schedule Your Breast Augmentation Consultation

If you’re interested in learning more about breast augmentation in Kansas City, contact our office to schedule a consultation. Your consultation with Dr. Hlavacek is an excellent time to address any questions or concerns you may have about the procedure, view our archive of patient photos, and discuss other important details.

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