Breast Augmentation with Implants

The breasts are a defining feature of a woman’s body that signify femininity, sexuality and beauty. When their size and shape do not match the rest of the body or are too small, it can have a profound impact on a woman’s self-confidence. Fortunately, augmentation procedures are available in Beverly Hills to enhance the natural appearance of the breasts, creating fuller curves and a more aesthetically pleasing shape. Dr. Barrett and his staff at Barrett Plastic Surgery are dedicated to helping you find the best solutions for achieving your aesthetic goals for your breasts.

From Dr. Barrett: “Breast augmentation is one of the most common procedures I perform, as this procedure achieves dramatic and aesthetically beautiful results. It is a lifechanging operation for women who feel insecure about their breasts and that happiness drives my passion for this wonderful procedure.  My focus with each breast augmentation patient is to provide natural-looking results. I don’t want anyone to know you have had surgery.  A single operation can provide a natural, well-proportioned body profile while correcting breast unevenness, cleavage, and shape. There is no better confidence booster.”

What is Breast Augmentation?

Breast augmentation is a type of surgery that adds fullness to the breasts by placing silicone or saline implants into the breast pocket. Through the positioning of the pocket, Dr. Barrett can ensure breasts are more proportionate in size while also enhancing the overall look for his patients. With many options to choose from in implant types and size, as well as surgical techniques, this procedure offers customization that produces a look that is natural, balanced and beautiful.

Like any operation, breast augmentation surgery involves anesthesia, incisions and a recovery period afterward. However, the process is often quicker and more comfortable than patients expect. Most breast augmentation surgeries can be performed on an outpatient basis, which means the patient does will not have any overnights in the hospital after the procedure. Recovery time is usually three days before a patient is ready to return to most regular activities including work. When you consider that the results of breast augmentation may last for many years, it is easy to see that breast augmentation is well worth the investment to many women who are unhappy with the appearance of their breasts.

Is Breast Augmentation Right For You?

There are several different reasons why our patients choose to undergo breast augmentation. Some include balancing breast size, compensating for reduced breast size after pregnancy or correction of a congenital breast defect such as tubular breasts. No matter why you might be seeking this procedure, the following factors will be considered when determining whether you are a good candidate for breast augmentation surgery:

  • Good physical health (underlying medical conditions will be evaluated by Dr. Barrett to ensure they are not contraindicative to this procedure)
  • Understanding that too much skin laxity may require you to consider a lift in addition to a breast augmentation. This would be determined at your consultation.
  • Non-smoker (if you smoke, you will be asked to quit for a few weeks before and after surgery to prevent potential complications linked to nicotine)
  • Realistic in your expectations (Dr. Barrett will explain the results you can expect to achieve at your initial consultation)
  • Healthy reasons for wanting breast augmentation (the procedure should be done for you alone and not to please a partner or others in your life)
  • Willingness to take time off for recovery (by allowing yourself time to rest and recuperate after surgery, you can reduce the risk for many complications and encourage healthy healing)

Because your safety is a top priority for Dr. Barrett, he will take ample time to assess your medical history, general health and expectations for your procedure before recommending breast augmentation.

Choosing Your Plastic Surgeon

When you decide to undergo breast augmentation, your selection of a plastic surgeon will be critical for a safe and successful operation. Dr. Barrett is a board-certified plastic surgeon with extensive training and experience in the field of plastic and reconstructive surgery. His previous breast reconstruction work has qualified him to work with even the most challenging cases to tailor procedures to their precise needs and body proportions, ensuring natural results that they are happy with for years to come. Dr. Barrett takes time with each of his patients to meet their expectations and address concerns as they arise, so their surgical experience is a positive one. Patients have direct access to Dr. Barrett after surgery and see him at all their post-operative visits to make sure they are healing appropriately.

Benefits of Breast Augmentation

Breast augmentation is more than simply enlarging the breasts. Some of the benefits you can expect with this procedure include:

  • Breasts brought into proportion with the rest of your body profile
  • Creation of beautiful cleavage and fullness in the breasts
  • Restoration of breasts that have become deflated after pregnancy and breastfeeding
  • Symmetry between breasts that differ in size, shape or a combination of the two
  • Reversal of deformities or defects of the breasts, including tubular breasts
  • Minor lifting breasts that have experienced mild sagging over time
  • Better fit to clothing, which in turn increases self-confidence in your appearance – the best part

While there are numerous benefits of breast augmentation, the surgery is not right for everyone. Dr. Barrett will make a full assessment of your concerns, aesthetic goals and expectations to determine whether breast augmentation using implants is the best choice for you.

BEFORE AND AFTER PHOTOS

Case #2717

Keller Funnel used for minimal incision

Case #3463

Keller Funnel used for minimal incision

Breast Augmentation with Implants

Incision Techniques

Incision Choices

Incisions for breast augmentation can also differ, based on the type of implant used and the preference of the patient and surgeon. Locations for the incisions might include:

  • Inside the armpit (transaxillary) which eliminates all visible scarring on the breast. However, this approach can increase the risk of infection and may not provide the most precise positioning of the implants. Implants tend to fall laterally, and the scar is noticeable in the axilla. Sensitivity can be affected more often by this approach because many of the nerves enter the breast laterally.
  • In the crease on the underside of the breast (inframammary). This is a common incision position, allowing the surgeon ample access to place implants accurately and accommodating nearly any implant type and size. One drawback of this incision is that it may be seen in swimwear when raising the arms. It is also very likely to get hyperpigmented in Asian breast augmentation patients. Lastly, the rate of implant bottoming-out is higher with this incision. Some claim that there is a slightly decreased risks of capsular contracture with this approach.
  • Around the areola (periareolar). The areola is the pigmented skin surrounding the nipple. This placement may be used for both saline and silicone implants.  Combined with the use of a keller funnel, this incision is perhaps the most advantageous of all incisions. It is the most discreet location on the breast or body as one would have to be completely naked to see the incision. There is less risk of bottoming out for this incision. It is ideal for Asian and Hispanic breast augmentation because any hyperpigmentation that would occur would blend into the areola skin. New fashion trends that reveal the under-breast has increased the popularity of this choice.

No matter which incision you choose for your breast augmentation surgery, Dr. Barrett will take care to optimize your healing to help minimize the appearance of the scar. He closes all his incisions in five discreet layers to minimize the tension on the incisions and allow your body to heal more naturally. He also does not use absorbable sutures to decrease the inflammation in the healing incision. He only uses non-reactive sutures and removes them when they need to come out.

Breast Augmentation with Implants

Placement Options

Placement Choices

There are two locations in which to place breast implants. The first is beneath the chest (pectoralis) muscle, known as submuscular placement. With this technique, the implant may be placed under just a portion of the muscle or the muscle will be used to completely cover the implant. The second is above the chest muscle and underneath the natural breast tissue, known as subglandular placement.

Submuscular placement offers many advantages over subglandular placement, including a reduced risk of capsular contracture, a longer lasting result, and less interference during mammogram examinations. Possible disadvantages of submuscular placement might include increased pain during the first few days following surgery. Active women may also find the chest becomes distorted during strength training and other activities with this placement. However, some women do not have sufficient breast tissue for subglandular placement, making the submuscular position the only viable option.

Subglandular placement also features both benefits and drawbacks. This positioning may be more likely to lead to sagging breasts in the future. In women with less natural breast tissue, the edges of the implant may be visible on the outside of the breast as well. Dr. Barrett will discuss both options and help you decide which placement will be best for you.

Breast Augmentation with Implants

Creating Your Surgical Plan

Every woman is unique in both her desires and her body shape. Keeping this in mind, Dr. Barrett will take the time during the pre-operative consultation to discover your specific concerns and desires for breast augmentation surgery. The time taken at this appointment ensures you enjoy a completely customized treatment plan with your specific needs in mind.

During your consultation, you and Dr. Barrett will discuss the differences between the two options in implants. Both saline and silicone implants have a long track record of safety and each offer their own set of advantages. Numerous measurements are taken, and detailed discussions ensue to determine the right implant for you. Other decisions will also be made, such as implant placement and surgical technique. When your surgery is personally tailored in this fashion, you enjoy more natural results and a higher rate of satisfaction in your outcome.

Preparing for Your Surgery

What you do before your breast augmentation surgery is just as critical to the success of your procedure as the operation and recovery process afterward. Our goal is to make sure you go into your surgery confident of your choice and comfortable with the choices discussed for your personal breast augmentation. Dr. Barrett will ask you to bring 3 nude breast photos from the front that represents your goals in terms of size to your consultation. We will also give you list of pre-operative instructions to prepare you for your procedure and ensure your safety throughout. Those instructions might include:

  • Stop smoking six weeks or more before your surgery to prevent nicotine-related complications
  • Do not take medications or supplements that work as blood thinners, such as aspirin, anti-inflammatory medications, vitamin E and fish oil
  • Stay hydrated before and after surgery as this will ensure a safe recovery process
  • Line up someone to take you home from your procedure and stay with you for the first 24 to 48 hours
  • Schedule help with the house, children and pets for the first week so you can focus on resting and recovering after surgery
  • Fill prescriptions, stock up on food and quiet activities to make your recovery time more comfortable and pleasant

The better your preparation before surgery, the easier it will be to rest after the procedure without worry over fulfilling obligations or taking care of tasks.

Procedure Overview

Dr. Barrett recommends general anesthesia for your surgery, which will be done on an outpatient basis. He also injects long acting pain medication, similar to what one would get at the dentist office to numb the breast and performs local nerve blocks. You will be comfortable throughout the process and most importantly, when you wake up. Incisions will be placed as discussed during your consultation and through the incisions, Dr. Barrett will place the implants into the breast pocket using a Keller funnel. Use of a Keller funnel has been shown to decrease incision size and the rate of capsular contracture.

If the implants will be positioned underneath the muscle, an incision will be required internally as well to create a space for them. If you have chosen saline implants for your surgery, they will be filled once they are in the proper position in the breast pocket. Each pocket dissection is performed very carefully, making sure to avoid any bleeding. Each pocket is also irrigated three times with triple antibiotic solution to further reduce the risk of capsular contracture.

Dr. Barrett incorporates a no-touch technique and re-preps the surgical area before the permanent implants are opened. Dr. Barrett will take between one and two hours to complete your breast augmentation surgery. At the end of the procedure, Dr. Barrett will meticulously suture the incisions closed in five specific layers to minimize post-operative scarring. He will then place glue and external tapes to hold the surrounding skin in place to protect them as they begin to heal. Dr. Barrett does not recommend surgical bras or any tight fitting clothing on the breasts after augmentation. The new pressure from the implants on the inside may cause wound ischemia if the breasts are compressed additionally from the outside.

After Your Breast Augmentation

You will be swollen and sore for the first few days after breast augmentation. This is not your final look. It takes six weeks for your implants to drop and fluff. You will be provided with detailed post-operative instructions to make your recovery smooth and comfortable. Dr. Barrett will prescribe oral medication to manage pain and antibiotics to prevent infection. He also encourages the use of ibuprofen and arnica after surgery to provide the best swelling reduction and pain relief. Patients are pleased to find that this stage of recovery typically only lasts a few days and they begin to feel better much faster than they expect, typically within 3 days.

Most of our patients return to work within the week if their job is not overly strenuous. Pain, swelling and sensitivity will linger for a few weeks, but subside enough to allow you to return to most of your activities without significant discomfort. Rigorous exercise should be restricted for two weeks to give the breasts ample time to heal. Patients are encouraged to walk immediately after surgery and then 3 times daily to prevent blood clots and to improve circulation. Dr. Barrett will monitor your progress at your follow-up appointments and advise you as to when you can resume your workouts or other strenuous activities.

Patients typically return at one week, two weeks, three weeks, six weeks, three months, and six months for postoperative visits. Patients may resume cardio or lower body activity that does not involve bouncing up and down nor the upper body at two weeks. At four weeks they can do light jogging, and at six weeks they can resume upper body activity and heavy lifting (greater than eight pounds).

While you will begin to see your scars fade within a couple of months, it can take up to a year before you will see their final effect. Dr. Barrett starts all his patients on a 12-week silicone scar gel program. It is important to avoid direct sun exposure in the area during this time, since UV rays can make scars more prominent. With proper care and patience, you will likely find your scars are not very noticeable once healing is complete.


Results that Last

Breast implants are designed to last for many years, making them an excellent investment of time and money over the long run. The FDA and implant manufacturers recommend replacing implants after 10 years. Regular monitoring of breast implants after breast augmentation is also recommended.

Some women may decide to change up their implants years after their initial augmentation because they would like to modify their size or shape. Dr. Barrett performs revision breast surgery for patients that would like to exchange or remove previous implants. He also works with women that are unhappy with their initial breast augmentation due to the size of the implants or complications they experienced after surgery.

Taking the Next Step

Breast augmentation is a decision that should be made between a woman and her plastic surgeon. You are not one size fits all and you should not be treated that way. Find a surgeon that you connect with in terms of your goals and make sure he or she is giving you the look that you want. Ask plenty of questions, come prepared with photos, and do your research to make sure your plastic surgeon is a breast expert and board-certified by the American Board of Plastic Surgery.

This may be your first procedure or your tenth. You are making surgical changes to your body and you want to make sure you feel comfortable and not rushed. Dr. Barrett is known for spending as much time as you need to make sure you understand all the components of the process. His bedside manner is exemplary, and he truly cares about his patients. He prefers to do fewer surgeries so that he can focus on making each of his results the absolute best. He is an artist that truly loves what he does. To schedule your consultation with Dr. Barrett today, contact Barrett Plastic Surgery at 310-598-2648.

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