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To learn more about Breast Augmentation/ Mammoplasty the
American Society of Plastic Surgeons has an in depth article
answering many of your questions.
To assist those visiting this web site, Dr. Eng supplements the
American Society of Plastic Surgeons article with the discussion
below of commonly asked questions and general information. Dr. Eng
consults with patients on specific issues prior to any surgical
procedures.
An open discussion on Breast Augmentation
by Dr. Eng:
Having larger, firmer and attractive breasts is an ideal that appeals
to women of all ages. With the availability of breast implants,
be they silicone or saline, the wishes of many women can readily
be fulfilled with one simple operation. However, as the ones wearing
these implants, patients need to ask questions regarding:
1. The safety of the implants.
2. The longevity of the implants.
3. The need for future surgery.
4. How is the surgery performed?
5. How does one decide on the size of the implant?
6. What is involved in the post op care?
The answers to these questions are quite varied depending on the
source of the information. The best and most reliable and unbiased
source can be found in the Plastic Surgery Society website at: www.plasticsurgery.org.
Etc...
My personal approach to this operation focuses on two major concerns:
1. Many women received implants that are too large for their bodies,
giving them the quintessential Barbie Doll look. The heavier and
larger implants are more frequently visible and palpable (one can
feel the edge of the implant) and form folds inside the breast pockets.
After a few years, they are more prone to “bottom out”
by sagging and stretching the bottom halves of the breasts, making
the nipples to point skyward.
2. Many incisions go through breast tissue, i.e. the nipple incisions.
If a woman has breast implants in her 20’s, 30’s or
40’s, it is very likely that she will have another operation
to deal with the implants till she lives out her projected life
expectancy onto the 80’s or 90’s. The repeated surgical
visits to the breast pockets via the nipple incisions and through
the breast tissue for implant removal, or exchange due to complications,
are undesirable.
My solutions to these concerns are:
1. I select the largest implants that will sit comfortably on a
particular patient’s rib cage so that the breasts will move
when the patient is lying down. I also want to make sure that the
size of the implant will augment the breasts to match the size of
the patient’s hips and buttocks. These 2 simple rules consistently
result in natural, soft and attractive looking breasts.
2. My favorite incision is a 1 inch incision in the breast crease
for saline implants (which is rolled up like a cigar and inserted
through this incision before it is inflated). This incision allows
the surgeon to quickly go under the muscle without touching the
breast tissue, and dissect a very accurate pocket for the implant.
The axillary incision has the same benefit for not touching the
breast tissue, but it may interfere with the lymphatic drainage
of the breast to the axilla, and furthermore, it is more difficult
to dissect an accurate pocket for the implant from above. Lastly,
if a patient is not a scar former, it does not matter where the
scar is selected. But, if she is a bad scar former, I think it is
easier for her to hide the scar under the breast crease.
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Patient #4,
