COSMETIC PLASTIC SURGERY CENTER

of San Diego

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Breast Augmentation

Saline and Silicone implants

Breast augmentation is a surgical procedure that uses implants to refine the shape and size of the breasts. Recently, the FDA has lifted the restriction on the use of silicone implants allowing patients the choice between silicone and saline breast augmentation. Breast augmentation has seen a dramatic increase in popularity over the past three years, a testimony to the high satisfaction rate that most women give to the results.

There is considerable controversy among surgeons over breast implants, particularly those related to decisions about size and shape. The size and shape are decisions that are mostly subjective and are governed by prevailing taste. Adding to the confusion is the fact that nobody really agrees about what the appropriate size of the ideal breast actually is.

To resolve these issues in my office, we first perform detailed measurements and estimate a reasonable implant volume, based upon the tissue characteristics that we measure. This size becomes our starting point for the next step of our process.

To help our patients better visualize the suggested volume, we have them use "sizer" bras with different sized sizer implants to demonstrate the effects on them. By standing in front of a mirror with these sizers in their own clothes, patients can more appropriately appreciate what is ideal for them. Within reason, we let our patients pick their own size implants. If the patient's choice differs dramatically from what I think tissues will accept, we then try to compromise. It is paternalistic of me to choose the "correct" implant size for a patient. What I think is the right size may have nothing to do with what women think is the right size. It is far more important to please the patient's body image than my sense of beauty.

By combining the biodimensional measurements with the patient trial sizers, we are now able to have uniformly happy patients and have greatly reduced implant size exchanges.

Recovery time depends on the type of procedure and ranges from two days to one week. The discomfort ranges from mild, when the implant is placed above the muscle, to moderate, when the implant is placed below the muscle.

47 y/o - 360 cc Inamed Saline Implants placed above the muscle

31 yrs 450 cc saline implants placed in sub glandular pocket...nice natural result 4 years later

23 y/o – 390 cc Inamed Saline Implants placed Submuscularly. Note this young lady is a body builder/runner/athlete. Most of us will never be this perfect. I was very happy with her results, and I can't do any better, but she fussed incessantly about her scars (which are 4 mo old in this picture) and will continue to improve with time. Incidentally, I do not control the healing process. I can cut – but only GOD heals! For a discussion on scars and healing.

35 y/o - 390 cc Inamed Saline Implants

38 y/o - 650 cc Inamed Saline Implants placed Subglandular. Refused breast Lift and opted to just fill her breast volume loss with implants. I would have opted for a breast lift without implants.

27 y/o - 420 cc Inamed Saline
Implants placed Subglandular

38 y/o - 540 cc Inamed Saline
Implants placed Subglandular

35 y/o - 450 cc Inamed Saline Implants placed Subglandular

45 y/o - 390 cc Inamed Saline Implants placed Subglandular

37 y/o - 390 cc Inamed Saline
Implants placed Submuscular

26 y/o - 390 cc Inamed Implants
placed Submuscular

30 y/o - 360 cc Inamed Saline Implants

26 y/o - 330 cc Inamed Saline Implants placed Submuscular. Note that she weighs 95 lbs, has very thin coverage, and has very laterally placed breasts. It is difficult to get natural results on these patients; and to me, they are artificial looking; suprisingly many young patients like this look and actually ask me to create this shape.

B B - 22 year old nuliperous unmarried female who wanted everyone to know she had implants. 330cc saline implants in a submuscular placement via periaureolar incision.

Dr Splinters comment: a bit too large and too obvious to me, but patient was very happy with her choice...with time and pregnancy they will soften and become more natural..

24 yrs and 2 children, very thin coverage. desired more feminine shape... 375cc silicone high profile implants, total submuscular placement thru an inflammatory incision... a nice natural result

32 y/o - 270 cc Silicone Implants (very thin ~95 lbs). Note that her right nipple points down and out, and her right breast and right hemi thorax and right shoulder are smaller and sits lower than the cooresponding left side. These differences remain post operatively. The larger the implant, the larger the differences are magnified. Too make matters worse small breasted ladies often want larger implants to make up for what nature shorted them. Doctors and patients are always compromising on what size implant their body will accommodate naturally, and what they want to look good in their clothes.

This patient had a deflation of her left saline implant 5 yrs after original augmentation. She opted for silicone replacements and also wanted to dramatically increase the size; I advised against this, but it is neither immoral nor illegal to have giant breasts. Her 420 cc Inamed saline implants were exchanged for 650 cc Inamed silicone implants. Incidentally she is tiny; weighing 105 lbs.

38 YR Breast Augmentation with 460 cc silicone implants

32 y/o - 420 cc Inamed Style 40 Silicone Implants

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