Breast Augmentation Surgery in McAllen and Brownsville
What Is Breast Augmentation Surgery?
One of the defining representations of beauty, vitality, and sexuality in the human form is the female breast. It is therefore understandable that many women desire a bust line that is larger, fuller, and shapelier. In a Breast Enlargement, or Augmentation Mammaplasty, an implant is placed behind the breast or the chest wall muscle in order to enhance the size, shape and fullness of the breast. The proportions of the body are also improved.
Visualize the new you now! Click here to instantly see how great you could look with Breast Implants.
Breast Augmentations have been performed for over 30 years in over 3 million women. Throughout this time, the surgical techniques and breast implants themselves have been continuously refined to increase the safety and reliability of the procedure. The primary factors that contribute to a successful Breast Augmentation procedure are thorough attention to detail during the pre-operative planning stage, meticulous attention to technique and implant positioning in surgery, and careful patient compliance during the recovery process. It is also of utmost importance that the procedure by performed by a highly trained and expert surgeon.
Am I A Candidate?
You are a good candidate for cosmetic Breast Augmentation surgery if you have at least one of the following conditions or characteristics:
• You have always considered your breasts to be too small or under-developed
• You feel that your figure is out of proportion because your small breasts make your hips appear wider
• You feel that your small breasts limit your choices of flattering clothing or swim wear styles
• Your breasts have lost volume after pregnancy, weight loss, or with aging
• The upper part of the breast appears “empty”
• Your breasts have a different size or shape from one another
• You have previously had breast implants and are experiencing problems with them
• One or both breasts failed to develop normally, or have an unnatural, elongated shape
Your Consultation
Only you can decide if Breast Augmentation surgery is a good option for you, and each patient has her own preferences regarding what is “normal” and “beautiful” in a breast. I will discuss your individual wishes regarding the change you seek in the shape and size of your breast, and I will individually design my surgical approach to incorporate your desires with my surgical expertise. I will assess the quality and quantity of your existing breast tissue in order to determine the proper choice of breast implant and technique.
Prior to making the decision to perform your breast augmentation surgery, I will thoroughly evaluate your general health status and any pre-existing health conditions or risk factors, which could compromise your surgical outcome or jeopardize your health. Detailed measurements of multiple physical parameters of your breasts will be obtained in order to define all pre-existing breast asymmetry. If significant nipple asymmetry exists, I might suggest adding a Crescent Lift via the peri-areolar approach for Breast Augmentation in order to optimize nipple-areolar symmetry.
Photographs will be taken before and after surgery. As a baseline precaution, most women older than 30 will be required to have had a normal mammogram within 6 months prior to the procedure. If one has not been done, we will arrange for a screening mammogram to be done prior to surgery.
Our Breast Augmentations take less than one hour in our certified outpatient surgery center and are performed under light general anesthesia. There is a quick 24 hour recovery period.
Incision Placement Options
There are many factors to be weighed when considering incision types, such as the degree of enlargement desired, your existing breast anatomy, and the type of breast implant desired. I always strive to minimize scarring, and will work with you to determine which incision approach is right for you. Some procedures even leave no breast scars. The four most common incision options are transaxillary, periareolar, inframammary and transumbilical.
- For extremely discreet scars, the transaxillary approach utilizes a small incision in the armpit. Both saline and silicone gel implants can be placed using this approach, although silicone implants require a larger scar because they are pre-filled and cannot be rolled tightly for insertion.
- The periareolar incision is made around either the top, or bottom half of the areola, which is the dark circle of skin surrounding the nipple. This incision allows very direct access to the interior chest wall, and leaves little noticeable scarring. This incision site will be used if a Crescent Lift is added to the augmentation to optimize nipple symmetry, or if a full Breast Lift needs to be performed. Both saline and silicone implants gel can be placed using this approach.
- The inframammary approach utilizes a small incision along the underside of the breast where it meets the chest wall, and is typically hidden in the fold beneath the breast. This incision method allows for the best access to the interior breast anatomy for optimal implant placement and adjustment. Both saline and silicone gel implants can be placed using this approach, although silicone implants require a larger scar because they are pre-filled and cannot be rolled tightly for insertion.
- For NO breast scars, the transumbilical (TUBA) approach utilizes a very small incision concealed inside the belly button. This is a newer technique, and requires a highly skilled surgeon to properly place the implant through the umbilicis. Only saline implants can be placed via the transumbilical approach.
Implant Placement Options
After deciding on the incision site, we will select the appropriate implant placement. Breast implants can be placed either submuscular (beneath the chest muscle) or subglandular (over the chest muscle.) The choice of where to place the implant depends on a variety of factors, including the degree of augmentation desired, the type of implant selected, and your particular anatomy.
- Submuscular placement is the preferred and most commonly used method for implant placement due to its numerous important advantages. Both saline and silicone gel implants are regularly placed in the submuscular position, which provides optimal soft tissue coverage, tends to produce a more natural appearance for most body types, and reduces the appearance of implant rippling. In addition, recent studies suggest that submuscular placement decreases the risk of capsular contracture, a complication in which excess scar tissue tightens around the implants. Due to the stretching of the muscle tissue, submuscular placement results in mild-to-moderate muscle soreness in the early post-operative period (similar to a strenuous workout.) Please refer to my 24-Hour Recovery after Breast Augmentation protocol, which minimizes recovery time and discomfort.
- The subglandular method places the implant behind the breast tissue, but above the chest muscle. This method is recommended for women who plan to continue strenuous weight training to build the chest muscle because implants placed submuscularly will become laterally displaced as the chest muscle contracts and grows. Subglandular implant placement may result in a more comfortable recovery (since the muscle is not stretched), but it may be more likely to interfere with mammograms. In addition, less tissue over the implant means that the implants will be more visible and may look less natural. Rippling of the implant tends to be more evident in the subglandular position, and the rate of capsular contracture is increased. Women with thin skin or very small breasts are not good candidates for this option.
Determining Implant Size and Shape
In addition to deciding on incision location and implant placement, patients will need to select the type and size of implant that best suits their goals. Click here to learn more about choosing the right breast implants.
Visualize the new you now! Click here to instantly see how great you could look with Breast Implants.
The shape of your augmented breasts depends on three factors: 1) the amount of existing breast tissue; 2) the quality of the skin envelope of your breasts; and 3) the size and shape of the implant you choose. Implants come in Moderate Profile, Moderate Plus Profile, and High Profile shapes. The choice depends on the look you want to achieve, and not all patients are suitable candidates for certain types of implants. Additionally, it is possible that several different types of implants and surgical approaches can be appropriate, and therefore patients must retain a healthy degree of skepticism if a surgeon offers only one implant or one approach. I will carefully examine your breasts and obtain detailed measurements of your breast and chest wall. Based on these parameters and my extensive experience with the many available implant options, I will help you to determine the best style and size of implant to achieve the result you desire.
Patients must have realistic expectations of what the Breast Augmentation procedure can and cannot accomplish. There are limitations to the degree to which a breast implant can produce a natural appearance of the breast. Women often think of breast size in terms of bra cup size. If you are currently a size “A” and wish to be a size “D”, there must be adequate existing breast tissue coverage; otherwise you have a greater risk of palpable or visible implant edges. Additionally, in some cases, if there is too much loose skin or breast droop, a Breast lift may be recommended in addition to the Breast Augmentation in order to maximize the aesthetic appeal of the new breasts. Placement of an implant alone in such circumstances would not improve the appearance of the breast, and in fact may make the breast less attractive. Either a very large implant would need to be placed to take up the slack in the skin envelope, producing an excessively heavy, droopier breast, or the redundant and saggy breast skin will droop over the implant causing a “Snoopy-nose” appearance.
Risks
As with any type of surgery, there are potential risks and complications, such as adverse reactions to anesthesia, bleeding, infection, poor healing of the surgical scar, and pain. Post-operative bleeding or formation of a seroma (a collection of the watery fluid around the implant,) may require re-operation and drainage, and may be associated with an increased incidence of infection or capsular contracture.
Infection of a breast implant is extremely rare, but may require removal of the implant for up to several months until the infection can be completely cleared and the implant can be re-inserted.
Postoperative formation of a fibrous tissue capsule around the breast implant is a normal bodily response when a foreign object is placed in soft tissue. Capsular contracture, however, is a persistent and aggressive shrinkage of this tissue capsule surrounding the implant, causing the implant and breast to feel unnaturally firm and sometimes painful. Capsular contracture is usually progressive, worsening with time, over the course of several months to years. This may result in asymmetry, making the breasts appear misshapen or out of position. The occurrence or severity of this condition varies with each individual, and there are no reliable data as to why it occurs in some people. Submuscular implant placement has been shown to decreases the incidence of capsular contracture compared with subglandular placement.
Implant Asymmetry, which is different than underlying, natural and pre-existing breast asymmetry, may sometimes occur as a result of unexpected early healing after implant placement.
Deflation of a saline breast implant may occur when the saline solution leaks either through the valve, or through a puncture or defect of the outer shell of the implant. This requires surgical replacement. Rupture of a silicone implant is more difficult to diagnose, since the implant does not deflate. Special MRI studies are required to identify a ruptured silicone implant, and the FDA recommends an MRI study be performed every 3 years for surveillance after silicone implants. Insurance does not typically cover surveillance MRI for silicon implant rupture. Both saline and silicone implants are covered by a manufacturer’s warranty against rupture and deflation.
Sensory changes may occur in the nipples or outer breasts, and scars may be unsightly. Patients with very small breast volume or thin skin pre-operatively may note visible wrinkling or rippling of the implants, especially in the subglandular position, and more commonly when larger size implants are chosen. Delayed wound healing may occur in persons with diabetes, history of radiation, autoimmune disease, or in smokers. It is important to have a thorough medical evaluation beforehand to address these potential risks.
Breast Augmentation surgery may not be a one-time surgery. It is very likely that additional surgeries and doctor visits will be necessary over the course of your lifetime to maintain the appearance of the breasts after Breast Augmentation, either because of problems related to the implants themselves (deflation, capsular contracture, rupture, etc.) or because of changes affecting the appearance of the breasts over time (pregnancies, weight gain, loss of breast tissue as a function of age, etc.)
There is no evidence that breast implants affect fertility, pregnancy, or a woman’s ability to breast-feed. Even without implants, not all women may be able to breast-feed. Although there may be a slightly increased risk for scarring within the breast and a decreased ability to breast feed when the peri-areolar (nipple) incision is used as compared to the inframammary (breast fold), axillary (under-arm), or transumbilical (belly-button) incisions, this has not been scientifically proven.
Health insurance does not cover Breast Augmentations, and may not cover re-operation (additional future surgery) in the event of complications. Your premiums may increase, coverage may be dropped, or future coverage may be denied.
Most risks of Breast Augmentation surgery can be lessened and managed by carefully following the recommendations and instructions you will receive during your consultation. Any of your personal questions or concerns can be addressed at that time as well.
Moving Forward
Making the decision to have breast augmentation is the beginning of a journey to a new and improved you. Along the way, you will be faced with numerous choices and I will help you carefully weigh all of your options. My extensive training and experience performing breast augmentation allows me to customize each procedure to your individual needs. If you still have questions about breast augmentation surgery, please visit the Breast Augmentation FAQ page where I answer some common questions.
If you would like to find out more about breast augmentation, we encourage you to take the first step toward feeling more attractive, confident and desirable. Click here to request a consultation with Dr. Filiberto Rodriguez , a cosmetic fellowship-trained, board-certified surgeon and breast augmentation specialist. Or, you can call his office to schedule your appointment: 956-350-6561.
A Word About Breast Implants and the Risk of Cancer
There is no evidence that implants either cause or play a role in the development of breast cancer, and there is no statistical difference in the occurrence of breast cancer in women with implants as compared to women without implants. Similarly, if or when breast cancer is detected, there is no statistical difference in the stage of disease when comparing women with implants to those without implants. Women must be knowledgeable about their risk factors, such as family history of breast cancer in first-degree relatives before menopause. Women must be diligent about self-examination of the breast, as well as scheduling regular breast examinations by your gynecologist or plastic surgeon. However, regardless of the type of implant or or whether the implant is placed above or below the muscle, breast implants may make mammography somewhat more difficult and less reliable, especially in cases where capsular contracture develops. Approximately one in eight of all women will develop breast cancer, and breast implants may make cancer more difficult to detect by mammography in women with implants. However, modern mammography centers are equipped with the latest equipment and trained technologists and physicians who are accustomed to imaging the breasts of women with implants.
Additional radiographic views, or in some cases, ultrasound or MRI examinations of the breast, may be required to fully evaluate the breast or any suspicious area of the implant itself. In some cases, mammography may result in rupture or deflation of the implants.
Recent media attention has focused on the increased incidence of Anaplastic large cell lymphoma (ALCL) of the breast in women with breast implants. It is important to note that ALCL of the breast is actually ALCL of the breast implant capsule, and removal of the breast implant capsule (capsulectomy) completely cures the ALCL. ALCL is an extremely rare form of lymphoma, with an incidence of 1/500,000 per year as per the National Cancer Institute.1 Diagnosing ALCL in the breast is even more rare, with a yearly incidence of 3 in 100 million women. In 2011, the FDA reviewed data from a 13-year period, during which 60 cases of ALCL of the breast (34 definitely unique, and some of the 60 could be duplicate cases) occurred in women with breast implants. The number of women with breast implants worldwide is estimated to be between 5 and 10 million. Calculating for the worst-case scenario, assuming that all 60 cases were unique and that only 5 million women have implants worldwide, the expected yearly incidence of ALCL of the breast implant capsule would be 4.6 cases per year for the 5 million women who have breast implants. With these current data, the incidence of ALCL of the breast is less than 1 case per 1 million women with breast implants per year. Although this is less than the expected incidence of ALCL for all body sites (2 per 1 million women per year), it is higher than the expected incidence of ALCL of the breast without implants (3 per 100 million women per year). The incidence of ALCL of the breast with implants (in a 1-year period, for every 1 million women who already have breast implants, 1 woman will be diagnosed with ALCL) can be compared with the risk of being struck by lightning, which is higher (2 other women in this same group, according to current National Oceanic and Atmospheric Administration statistics.) Most women are not afraid of lightning strikes, and should view these new findings about breast implants similarly.
Although ALCL is not breast cancer, patients may rightfully wonder why they would consider an intervention that might increase their risk for any form of cancer. To place this in perspective, it is worth reviewing the association between alcoholic beverages and breast cancer. On the basis of the National Cancer Institute data, approximately 1 in 8 women will be diagnosed with breast cancer in her lifetime. With an average life expectancy of 80.8 years (US Census Bureau data), the average yearly risk for a woman to develop breast cancer is estimated to be 1 in 650 (an incidence of 1539 cases per 1 million women per year). Multiple studies have shown that even moderate consumption of alcohol significantly increases the chance of developing breast cancer. In a meta-analysis of 38 epidemiologic studies, Boyle and Boffetta found a pooled relative risk of 1.1 for the development of breast cancer in women who drank an average of 1 alcoholic drink per day. This means that approximately 154 new cases of breast cancer per 1 million women who drink alcohol are attributable to the lifestyle choice of drinking, much higher than the 1 case of ALCL per 1 million women who choose to have breast implants.
* This discussion regarding ALCL is adapted from: Bogdan, M. Keep Anaplastic Large Cell Lymphoma Breast Implant Risk in Perspective. Medscape Plastic Surgery & Aesthetic Medicine, 2011-02-24.
For further information on breast augmentation surgery, or if interested in another cosmetic surgery in Brownsville or McAllen, please call our offices to schedule a consultation today: 956-350-6561.
