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Breast Augmentation New Orleans

Breast augmentation is one of the most popular cosmetic procedures. Breast augmentation can significantly or subtly enhance the appearance of the breasts. Modern-day procedures are not only capable of adding size, but various techniques can change the shape and feel of the breasts as well. There are many reasons that women choose to undergo breast augmentation, such as reconstructing the breasts after a mastectomy for breast cancer, fixing congenital asymmetry of the breasts, or boosting self-confidence. What breast augmentation will not do is correct breasts that are already sagging, which is an issue fit for a breast lift.

There are many kinds of breast augmentation. The idea of breast augmentation has been around since the 1890s, but the modern methods as we know them came about in 1961, when the first silicone implants were developed. Today, patients have a wide variety of choices between silicone-filled or saline-filled implants of various sizes, textures and shapes. Both have silicone shells (outer casings), but saline implants are filled with saline — a sterile saltwater solution. Saline and silicone implants offer different benefits for different patients’ needs.

One of the most modern types of breast implant is the recently FDA-approved “gummy bear” breast implant. This implant is said to have the most natural feel and appearance and poses little risk if it is ruptured. However, saline implants still account for a large portion of implants selected, as they can be inserted empty and filled afterwards. This is beneficial because surgical incisions can be smaller and the implant size can be adjusted. Saline implants are available to women 18 and older, but if you are interested in silicone-filled implants, you will have to wait until you’re at least 21 years of age.

One of the major considerations is the surgical technique involved. For many patients who are undergoing augmentation for cosmetic purposes, scarring is a significant concern. Breast augmentation is an invasive surgical procedure, which means that incisions will be necessary, and you will need to undergo local or general anesthesia. There are four main surgical techniques, and they are classified by the location where the incision is made.

The incision types are inframammary, transaxillary, transumbilical and periareolar. The inframammary technique is the most common procedure, and it is characterized with an incision along the inframammary fold — the underside of the breast where it meets the chest cavity. The transaxillary technique is an incision that minimizes the appearance of scarring with an incision in the upper area of the armpit. Transumbilical breast augmentation, also known as TUBA, requires an incision around the belly button; it has minimal impact on milk production but is considerably more difficult. The periareolar incision is a technique that has an incision around the areola; scarring is hidden, but there is some risk to milk production and tissue sensation.

There are other considerations to make, especially if you are considering augmentation as a result of a mastectomy. The timing of the procedure and the need for tissue expanders may come into play depending on your particular case.

Feel free to contact Dr. Pelias if you have additional questions about breast augmentation or would like to schedule a consultation or examination.

Hidden, Underarm Breast Augmentation Scar

If you desire beautiful breasts, but are concerned about the scars created by the traditional methods of breast augmentation, an axillary endoscopic breast augmentation is a wonderful choice.

With this technique, an approximately 1.5 inch incision is made in the most hidden and hollow area of the underarm. (The incision is about 2 inches if silicone gel implants are used).

The incision is placed in a skin crease, so that the scar is usually well hidden and hard to find after healing has occurred.
A small tunnel is then made to the border of the pectoralis major muscle. The tunnel is continued under the pectoralis major to allow dissection of a sub-pectoral “pocket” for placement of the implant.

Breast Implant Placement

After the space for the implant is opened, the pectoralis major muscle is cut (or “released”) along the base of the breast. The implant is then soaked in an antibiotic and saline solution and then the implant is placed in the pocket. If a saline implant is used, the implant is then filled. (Silicone gel implants come pre-filled and sealed from the manufacturer.) The size, symmetry and appropriateness of the pocket dissection are then assessed. If needed, the patient’s back will be raised as in the sitting position and the results will be assessed with the patient “sitting up” (while still under general anesthesia). Silicone gel implants can also be placed with this approach, but the incision is slightly longer to allow placement of the pre-filled silicone gel implant. The incisions are then closed with hidden, dissolvable sutures. Tissue glue or tape, gauze and a clear bandage are then placed over the wounds. Finally, a post-surgical sports bra is placed.

Endoscopic Breast Augmentation Recovery

The recovery very similar for all three of the approaches to breast augmentation. The post-surgical pain is similar for all three approaches, as well. This is true because the majority of the pain after breast augmentation is from the manipulation of the muscle and creation of the space for the implant. These maneuvers for creating the space for the breast implant are nearly identical with all three approaches to breast augmentation. With the axillary approach there is additional pain under the arm, of course. But this is not severe and overall does not affect the recovery much compared to the breast fold and areolar augmentation approaches. So, we do not think post-op underarm pain should be a deterrent for women desiring axillary breast augmentation.

After breast augmentation, no drains, pain pumps, or chest wraps are used—you simply wear a post-op bra, which is similar to a sports bra. You go home a couple of hours after surgery to rest. The day after surgery, you start feeling well and can shower and shampoo and blow-dry your hair. Most patients can return to most of their home and work activities within 5 to 7 days. Some patients return to work in 3 to 4 days after surgery, but this is not recommended. You can perform some exercises three weeks after surgery and you can resume full activity six weeks after surgery. For more information about the surgical experience please see our sections on day of surgery and your recovery.

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