Breast augmentationis consistently rated one of the most satisfying cosmetic procedures by patients and cosmetic surgeons alike. With proper training and experience, the procedure is straightforward. Patients will oftentimes undergo a noticeable emotional change along with their physical one. A shy, reserved woman may become outgoing and self-assured almost overnight. It is no wonder that breast augmentation is also one the most often performed cosmetic procedures.
The second most important consideration is the placement of the implant. The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or on top of the muscle and under the breast glands (subglandular) depending on the thickness of your breast tissue and its ability to adequately cover the breast implant. The submuscular placement may make surgery last longer, may make recovery longer, may be more painful, and may make it more difficult to have some reoperation procedures than the subglandular placement. The possible benefits of this placement are that it may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography. The subglandular placement may make surgery and recovery shorter, may be less painful, and may be easier to access for reoperation than the submuscular placement. However, this placement may result in more palpable implants, more capsular contracture, and more difficult imaging of the breast with mammography.
A third option has recently gained attention. A thick layer of tissue called fascia overlies the pectoralis muscle. Using this subfascial plane often combines the advantages of both traditional planes. It is extremely rare for Dr. Ferguson to place implants in a subglandular fashion.
The inframammary approach has been around the longest and is still the preferred approach by many surgeons, as it allows excellent visibility and minimal disruption of the glandular tissue of the breast. Although the incision usually heals very well, any slight irregularity is apparent in the exposed breast or small bikini tops. This is the preferred route for re-operation.
Currently, the most popular incision among surgeons is the peri-areolar incision. This allows easy access to the appropriate planes, and the scar is usually well-camouflaged in the nipple-areola complex. There are two disadvantages to this route since it traverses the milk-producing glands of the breast. There is an increased incidence of infection (the glands harbor bacteria) and nursing problems.
Transumbilical breast augmentation, or TUBA, involves making an incision within the navel and using specialized instruments to place the implants. The limiting factor involves the technical demands placed on the surgeon. Dr. Ferguson is well-experienced in this approach and will use it in the patient with favorable anatomy.
The final incision, transaxillary, has also seen limited utilization due to its technical demands. This is Dr. Ferguson's preferred approach. Endoscopes allow complete visualization of the area, and the incision is away from the breast. Its primary complaint among surgeons is that the incision is not covered by bikini or sleeveless tops. With proper placement, closure, and postoperative care the incision is as well camouflaged as any of the other approaches. Under close inspection all scars are visible. Dr. Ferguson, again: "Which gets closer scrutiny, the armpit or the exposed breast?"
Then, on the morning of your operation, Dr Ferguson will then meet with you and the responsible person who will be taking care of your postoperatively. Dr. Ferguson will make a few marks on you, then it is off to the procedure room. You will be given a mild sedative followed by local anesthetics. The procedure usually takes about an hour to an hour and a half. The incisions are closed with absorbable, dissolving sutures and drains are rarely used. A support garment is placed, and you will be discharged to the responsible adult within one to two hours. Within an hour most patients are ready to go home.
There is usually little pain the first few days, mostly just a mild to moderate aches. We will see you the next day in the office and remove your support garment. Bring a sports bra to wear home. At that point you can go home and shower, but you will need to avoid raising your arms above your shoulders for two (2) weeks. Other than that, you can resume most other activities the day after the procedure. You will then return 7- 14 days later depending on the approach used, and the small tape that covers the incisions is removed. You will usually be instructed in breast massage. The timing of the next visit varies from patient to patient, but is usually within a month.
For more information about having breast augmentation in Honolulu Hawaii contact Dr Ferguson today.