Breast Augmentation has become one of the most common surgical procedures performed today. It is usually performed to enlarge small, underdeveloped breasts or some that have decreased in size after pregnancy, or asymmetrical or unusually shaped breasts. When a breast is lost due to breast cancer, breast reconstruction by simple augmentation may also be possible. There are several types of approaches or incisions for breast augmentation. The incision choice generally depends on the work to be done to improve the gland shape or position. Once the incision is made, the surgeon will lift breast tissue to create a pocket. This pocket will either be under the breast tissue (subglandular), or underneath the pectoral muscle cover (subfascial), or under the muscle itself (submuscular). After the pocket is created, the surgeon will place a breast implant inside. One of our favorite approaches to create well-shaped breasts is the armpit incision, which leaves a virtually invisible scar. Additionally, there are several choices for implants which our doctors will discuss in a formal consultation. Different types of implants are available to fit your specific needs, your budget, as well as the ultimate shape you would like to obtain.
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| Jenny is one our many cover girls. The after picture was taken 1 month post op. Please see the bottom of this section to see what she looks like now. |
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| Jenny is one our many cover girls. The after picture was taken 1 month post op. Please see the bottom of this section to see what she looks like now. |
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After
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| Jenny is one our many cover girls. The after picture was taken 1 month post op. Please see the bottom of this section to see what she looks like now. |
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| 25 years old, 450cc Silicone Implant on Right & 425cc Silicone implant, on left to correct Asymmetry, Transaxillary “Armpit” Submuscular Breast Augmentation, post op picture taken 6 month(s) after procedure |
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| 30 years old, 450cc Silicone Implant on Right & 425cc Silicone implant, on Left to correct Asymmetry, Transaxillary “Armpit” Submuscular Breast Augmentation, post op picture taken 3 month(s) after procedure |
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| 50 years old, 325cc Silicone implant, Transaxillary “Armpit” Submuscular Breast Augmentation, post op picture taken 3 month(s) after procedure |
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| 28 years old, 475cc Silicone implant, Subfascial Breast Augmentation, post op picture taken 2 month(s) after procedure |
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| 28 years old, 475cc Silicone implant, Subfascial Breast Augmentation, post op picture taken 2 month(s) after procedure |
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See Subfascial Breast Augmentations (Inner Bra)
Indications for Breast Augmentation Procedures
- Cosmetic breast augmentation of underdeveloped breasts.
- Asymmetrical breasts.
- Abnormal breast shape such as conical deformity.
- Post delivery, weight loss, tissue sagging, and loss of volume.
- Breast reconstruction after surgical removal. (Total or partial).
Choice of Breast Implant position
Classically, patients have been left with two choices; a submuscular placement, which was widespread with saline implants, and the subglandular one. Unfortunately, these two choices present some significant flaws. The constant muscle activity over the implant inherent to a submuscular placement has often led, in the late follow up (1-2 years), to implant displacement (with loss of medial cleavage), inferiorly (bottoming), or superiorly (wide chest look or snoopy breast) . These late displacements are, unfortunately, not totally predictable or preventable and more likely to happen in people with large implants, loose tissue, or intense physical activity. The subglandular approach, on the other hand, appears to maintain the cleavage better, however, in some cases of loose tissue, may show more secondary sagging and rippling.
A new third placement, which has become a favorite of the Clinique's, is the subfascial placement. In this approach, the fibrous layer covering the outer surface of the muscle is elevated from the muscle, allowing support of the implant by a stronger fibrous sheath. This, in our doctors' experiences, reduces implant displacement since the muscle activity does not affect the implant placed in front of it and also reduces wrinkling and sagging due to the presence of this stronger supporting fibrous sheath. The procedure is slightly longer due to the tedious nature of the creation of a subfascial pocket.
NOTE: The subfascial placement can only be done through an inframammary approach. The key to making the scar inconspicuous is placing the incision in the projected new fold, not in the existing one.. This subfascial approach eliminates many of the problems described below and also maintains the new cleavage more effectively than submuscular or dual plane placement.
As and alternative, a Dual Plane Placement is sometimes performed to avoid post surgical deformities such as "double bubble" deformity (original breast shape visible on top of the implant) or "snoopy breasts" (submuscular implant placed too high under the muscle), or to help correct nipple position asymmetry and early sagging. The procedure involves working under the muscle (totally or partially to position the implant) and under the gland to help correct shape or position problems.
For a personal and confidential consultation with one of our Board Certified Plastic Surgeons, call the Clinique of Plastic Surgery at 800-942-1606 to schedule your appointment today!
As with any medical procedure, there are certain inherent risks that should be discussed. Costs vary depending upon the extent of the surgery and areas treated.