Welcome to the Center for Plastic Surgery Guide to breast enhancement. This information will educate you about breast implants and the breast augmentation/enhancement procedure. Breast enhancement with implants remains the safest and most effective way to improve the size and shape of your breast. In our office we regard each woman’s body and breast shape as unique. We want to understand your desires and concerns in order to help you achieve your individual aesthetic goals. The following information is not a substitute for a consultation with a Board Certified Plastic Surgeon, such as Dr. Stephens. A consultation will better assure that you will have results to enjoy for years to come.
Women considering breast enhancement express a variety of personal concerns about their breast shape and fullness. We recognize that each woman has a unique body type as well as chest, torso and breast shape. There are many reasons why you may choose to have breast augmentation surgery. Some of the more common being to enlarge small breasts, to replace volume lost after weight loss and pregnancy or to balance a natural asymmetry. Most women have the breast augmentation/enhancement procedure to better balance their upper torso with their waist, hips and legs fulfilling their desire to look better in clothes and swimsuits. Women who are otherwise happy about themselves may have breast enhancement to improve their self image and to enhance their sense of femininity. Most find themselves more confident following the procedure.
During the consultation, we want you to take the time to share your unique goals and personal considerations for breast enhancement with us. Our goal is not only to increase your breast size but to create a breast that enhances and balances your silhouette while providing a natural breast shape that looks as though there is no breast implant present. We want you to know the risks of breast implant surgery as well as the long-term considerations and safety of the implants so you can make an informed decision. You will undergo a comprehensive dimensional analysis of your breasts and body type along with discussion of your breast and chest shape, providing an opportunity for you to understand the tradeoffs as well as compare the different breast implant types, styles, shapes and sizes. While discussing the surgical techniques and their considerations we will work with you to recommend the best implant type and size to achieve your goals. Throughout the consultation please feel free to ask questions. We are here to listen to you as well as inform you about the procedure so that you are able to make the best choice for you. While breast size is important, a natural looking proportionate breast with a pleasing shape that best suits your figure, lifestyle and unique goals are what defines a desirable result.
Breast enhancement procedures in our office are performed in our state of the art surgery center, which is state licensed and meets the highest standards of accreditation. Our board certified anesthesiologists use a light, fast acting general anesthetic to ensure your safety and comfort. Most procedures last between 1 ~ to 2 hours.
Breast implants have traditionally been placed using inframammary incisions. A lot of surgeons use this incision because it provides simple and straight forward access to the breast pocket. While the incision can sometimes be hidden within the crease beneath the breast (the inframammary fold) it often leaves obvious and unsightly scars, especially in young women. The infra-areolar incision is favored by many plastic surgeons due to its reduced scar visibility, as the incision is placed along the bottom of the areola where the texture and color are changing between the areola and the skin of the breast.
Due to concerns Dr. Stephens had about the aesthetic result he focused on the trans-axillary approach because it truly hides the incision in the hollow of the armpit. However, the traditional trans-axillary approach had a problem. Because it utilized a blunt and traumatic dissection of the breast pocket, it was difficult to make an accurate dissection using this technique. This is also the problem with the transumbilical breast augmentation technique (TUBA) which utilizes a blunt probe and temporary spacer to make the breast pocket from the belly button incision. With the development of laparoscopic and arthroscopic techniques in surgery, Dr. Stephens along with a group of plastic surgeons in 1990 were able to solve this problem by incorporating minimal incision endoscopic approaches in plastic surgery. An obvious solution for breast augmentation would be to place a hidden incision in the hollow of the arm pit and use an endoscope to provide a precise pocket under direct vision which would optimize the pocket dissection and accuracy. The Trans-axillary Endoscopic Assisted Breast Augmentation (T AEBA) procedure was the result, giving us the ability to precisely dissect the breast pocket with the assistance of specialized instruments and a video camera utilizing a television monitor. While Dr. Stephens still performs the infra-areolar and inframammary incision placement, he prefers to perform the TAEBA technique when appropriate.
Dr. Stephens is one of the few surgeons using this technique around the country because of the difficulty in mastering the technique. “I’ve utilized this approach for eighteen years because of its ability to hide the incision away from the breast and give accurate and reproducible results, thus giving it a clear advantage over all other techniques.” While the Bellevue Hidden Scar (TEABA) technique is not for every woman, it produces an optimal approach to breast augmentation.
The implants are placed in the submuscular position in most cases to provide a smooth, natural shape to the breast. This also preserves ideal nipple and breast sensation and maximizes the ability to breast feed. This technique provides a natural un-operated look. By taking into consideration the breast implant size and shape based on a dimensional assessment, we are able to provide women their desired breast shape and proportion. We utilize both saline and silicone implants with this approach.
As one of the pioneers of this technique, Dr. Stephens is one of the most experienced surgeons in the northwest, if not the country of the TEABA. Dr. Stephens uses his training and experience to teach other surgeons this technique. “My patients and I have been very pleased with the results of this procedure over the years.”
On November 17, 2006, after careful review of research done by independent groups, the United States Food and Drug Administration lifted a 14 year moratorium on silicone breast implants making them available for cosmetic use in patients 22 years or older. There have been no proven links found between silicone breast implants and any systemic diseases in women. We are sure that you still have many questions relating to implants and assure you that we are here to answer them and alleviate any concerns you may have.
You may know that both silicone and saline implants come in a wide variety of sizes. There are also different shapes of implants. “We now have implants that are low, moderate, and high profile which provides us the ability to individualize the amount the breast projects (stands away from the chest in the side view). With a moderate projection breast implant style the implant does not increase in projection very much as it gets bigger.” What happens is the width of the implant gets bigger as the size increases.
Therefore a moderate profile 360cc implant is wider than a 300cc implant. For a woman whose breast is a given width we can consider a low, moderate or high profile implant which has the same diameter, but will provide her with an increasingly full breast. “In this way we can optimize a woman’s proportional desires.”
Both silicone and saline implants are produced this way. In addition implants come with smooth or textured surfaces. There is also a tear-drop shaped biodimensional textured saline implant. Understanding your goals and utilizing an anatomical-dimensional analysis of your breast will determine the type, size and shape of implant that will give you the most desirable result.
We provide a comprehensive post-operative recovery program which provides effective pain management. This includes The Accufuser pain pump combined with prescription medications, along with gradual activity and exercise to minimize your discomfort and speed up your recovery.
You are seen frequently during the first month after your procedure to assess your progress and provide you with instructions, feedback, encouragement and care. Initially after the procedure you may have swelling, minor asymmetries and your implants may be high and tight on your breasts. Our experienced and caring staff is here to help you throughout every step of your recovery. In fact, we prefer to follow our patients for at least one year after their procedure so that we can assess their long term results.
Our mission is to educate you about the long term care of your breasts. It is important that you know that your implants will not likely last a lifetime and that you will need mammograms and/or MRI studies when appropriate. We want you to return to our office if you have any questions or concerns about your breasts.