Breast Augmentation

Breast enlargement or augmentation mammoplasty is one of the most popular cosmetic surgical procedures. Breast augmentation has become so popular because of the dramatic improvements patients can achieve. When breast augmentation is performed by a skilled plastic surgeon like Dr. Bray, Jr. the results can be outstanding.

Determining Breast Implant Size

Dr. Bray Jr. will make a number of measurements during your consultation. These measurements are critical in determining the implant size selected for your breast enlargement. For example, the base width measurement of the breast will help determine how wide the final implant should be. The patient’s soft tissue coverage is also important to evaluate prior to selecting an implant. If the patient has minimal breast tissue and skin laxity then a large breast implant may cause problems. Once an implant has been selected based on measurements and soft tissue coverage, the volume can be customized to the patient’s desires by selecting the profile of implant that will meet her breast augmentation goals.

Silicone vs Saline Breast Implants

There are two general types of breast implants, saline and silicone. Both types of implants are composed of an outer silicone shell. Inside the shell the implant may be composed of saline(salt water) or cohesive silicone gel. There are advantages and disadvantages when comparing the different types of implants. Dr. Bray, Jr. will spend time during your consultation explaining the differences between the two breast implant types in detail.

The saline breast implant has a high patient satisfaction rate. The breast implant may be placed through a smaller incision than a silicone implant because the implant is deflated at the time of insertion. A ruptured saline implant is easier to detect than a silicone implant. The saline will leak and the breast will become smaller. Silicone implants may require an MRI to determine if the implant has ruptured. Additionally, saline breast implants are less expensive than silicone breast implants.

The silicone breast implant also has a high patient satisfaction rate. The silicone implant has a more natural look and feel. This may be noticed in all breast augmentations, however, it is most noticeable in patients who start with very little breast tissue. The silicone implant tends to have less rippling. Rippling is the appearance of contour irregularity where there is minimal soft tissue coverage of the implant. The silicone breast implant has become the most popular implant in Dr. Bray, Jr.’s Torrance practice, and Dr. Bray, Jr.’s patients have been extremely satisfied with this breast implant.

Teardrop vs. Round Breast Implants

The teardrop implant was designed to have an anatomical shape with more volume distributed to the lower pole of the breast and less volume distributed to the upper pole.  This shape is intended to provide a natural appearance to the breast. Teardrop implants have a textured surface to prevent movement or rotation of the implant.  The teardrop implant contains a highly cohesive silicone gel that maintains the shape of the implant.  The highly cohesive gel is more firm than the cohesive gel in most round silicone implants.

The round implant may be textured or smooth.  The round implant will tend to take on a teardrop shape when the patient is standing and a round shape when the patient is lying flat.  This may result in a natural appearing breast.  The round silicone implant is usually softer than the highly cohesive teardrop shaped implant.

Choosing the right implant is an important decision, and Dr. David Bray, Jr. will help you make this choice.    Despite the obvious differences in the appearance of the teardrop and round implants both implants can provide excellent results when proper planning and surgical technique is employed.  Studies have shown that even plastic surgeons have difficulty differentiating between patients with teardrop implants and round implants.  This suggests that there may not be a significant difference in appearance between the two implants.  When selecting an implant it is important to discuss your options with a board certified plastic surgeon like Dr. David Bray, Jr.

Determining Incision Location

Breast implants may be placed through a few different incisions. The different incision locations include the periareolar, transaxillary (through the armpit), transumbilical (through the belly button), or inframammary fold (underneath the breast). The location of your incision is based on the type of implant selected, your breast anatomy, and your personal preference. Dr. Bray, Jr. will help advise you as to the incision that will work best for you.

The Breast Augmentation Procedure

The breast enlargement procedure is performed in an outpatient surgical facility. Dr. Bray, Jr. will perform meticulous preoperative markings the morning of the procedure. You will then have a chance to meet the anesthesiologist, the doctor who will put you to sleep during the procedure. During the procedure Dr. Bray, Jr. will make a small incision to allow dissection under the breast tissue and pectoralis muscle. In most cases, a pocket will be made partially under the muscle and partially under the breast tissue for placement of the implant. Careful and meticulous pocket dissection is critical to a well performed breast augmentation. Dr. Bray, Jr. will then place a sizer implant. This implant is used to determine the perfect size implant for the patient. The sizer implant can be filled to different volumes until the breast size is ideal. The final permanent breast implant is then selected and placed into the pocket. The incision is carefully closed.

After the Breast Augmentation Procedure

You must have someone drive you home and stay with you for 24 hours after breast augmentation surgery. Dr. Bray, Jr. will see you in the office on the following day. He will remove all dressings and change you into a comfortable sports bra. You will experience some pain the first day or two that is easily controlled with pain pills. Some tightness in the breast area is also normal as your body adjusts to the implants.

You will follow-up again one week after surgery. At this time the breasts will be evaluated for healing. The sutures (stitches) that Dr. Bray, Jr. places will dissolve and are all placed underneath the skin. He will not need to remove these sutures. You will then return one month, three months, six months, and one year after surgery.

Wear a sports bra during the first few weeks following surgery. Dr. Bray Jr. will advise you on exercise and physical activity after breast augmentation surgery. You will most likely be able to return to work within a few days, but you will need to avoid any strenuous activity for at least a few weeks.

Images are available in the breast enlargement photo gallery. These images may not be appropriate for minors or the workplace.

Keller Funnel for Breast Implant Placement

The “No Touch” Technique

Dr. David Bray, Jr.is able to perform a no touch technique by using a surgical funnel, the Keller Funnel, during most breast augmentation surgeries with silicone implants. The Keller Funnel is a sterile device used to deliver the silicone implant into the breast pocket. The advantages of the funnel include a smaller incision and a no touch technique. The no touch technique allows the implant to be placed directly into the funnel then into the breast without touching the surgeon’s gloves or the patient’s skin. Dr. Bray, Jr. believes that the no touch technique reduces the risk of contamination of the implant. The incision length may be made smaller because the funnel provides an improved method of inserting the implant. The funnel may also reduce the force placed on the implant during insertion which may reduce the risk of an implant rupture. At the time of your consultation Dr. Bray, Jr. will show you a sample of the funnel and explain the benefits of the device.