Breast Plastic Surgery Procedures in Philadelphia

Breast Enlargement Cosmetic Surgery

Every woman having breast augmentation wants to make sure she has the best possible operation to achieve the best possible result. Though the basic idea of breast enlargement is simple, there are many factors to consider and a simple idea can become quite confusing. Obviously one wants to be bigger but by how much? Alteration in shape is another goal, but what shape? When considering breast augmentation with a patient, we try to limit confusion by defining a patient's goals. There is no one perfect breast. Every woman has preferences regarding size and shape and therefore each operation has to be tailored to meet an individual patient's need. There are a few basic variables we discuss with each woman as part of the preoperative planning: Implant size, implant type, implant position relative to the pectoralis major muscle and incisions.

Women naturally think about breast size in terms of cup size, while breast implants themselves come in discreet volumes measured in cubic centimeters. In other words, implant volumes do not directly relate to bra cup size. For instance, a 300 cc. implant might result in a C cup size in a small woman and only a B cup size in a larger woman. To circumvent this issue, we will have you try on implants with a bra and ask you to identify an ideal breast volume for you. By knowing your body size and your goals, we can use our experience to select the appropriate implant.

Your Implant Choices

Implants come in both round and tear drop shapes. After learning of your expectations, we will discuss with you, which type of implant we feel will best accomplish your goals. Breast implant surfaces can be textured or smooth. Textured implants are designed to ensure breast softness after augmentation. Texturing unfortunately comes at a cost. Texturing causes the implant to adhere to one's tissue, breast or muscle, and is more likely to result in rippling of the overlying skin. A texture implant is usually easier to feel than a smooth implant. Based on your breast size and shape, we will attempt to pick an implant type which will minimize problems and give you the most natural shape possible. Implants are proven to be safe and reliable. However, implants can cause rippling of the overlying skin in thin patients. To reduce or eliminate rippling, implants are frequently placed beneath the pectoralis major muscle. The main consequence of this is that the surgical procedure requires general anesthesia and results in more early postoperative pain. However in most patients, the long term results are better with a more natural breast shape.

Incision Placement Options

Implants are placed through an incision in one of three places: 1. Inframammary fold (under the breast). 2. Periareolar (beneath the nipple) or 3. The axilla (arm pit). Implants placed through the axilla obviously leave no scarring on the breast. The problem with this incision is that it is the most difficult to ensure proper placement of the implant. Periareolar incisions usually result in an excellent scar; however some patients are intimidated by the incision being so close to the nipple. The most common incision used in breast augmentation is an incision in the fold underneath the breast. While this incision is on the breast, it is extremely difficult for anyone to see once the breast is augmented because the breast covers the incision. There is a fourth way to do breast augmentation with involves an incision near the navel or belly button. While it is possible to do a breast augmentation through this incision, in general it has significant limitations and complications. A specific problem with this operation is that a silicone gel implant cannot be placed through this approach and no manufacturer recommends or will provide a warranty for a saline implant if it is placed this way. For this reason, this is not a procedure that we do and it simply does not efficiently accomplish the goal of breast augmentation. After explaining each of these choices to a patient, most will have one clear preference and that approach will be selected for them.

There are many choices to make regarding breast augmentation. We strongly encourage patients to take the time to define their goals and make choices which seem most right for them. Patients who are the happiest with their breast augmentation are those who felt they helped select their final result.

• Click here for breast enlargement post-op instructions.