What to Expect from Your Breast Augmentation Procedure
One to two weeks before the procedure you will have a preoperative visit where we will go over the plan with you one more time, give you your prescriptions, make sure no new issues have arisen, and discuss what to do and what to expect before, during, and after your procedure.
Day of the Procedure
You will be given a Valium to take before you come to the office the day of your procedure. There are two things we do not believe in at The Ferguson Clinic: pain and anxiety. We want to you to have a good experience. On the morning of your operation, Dr Ferguson will 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 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.
Allergan offers two lines of round silicone-filled breast implants: NATRELLE ® Silicone-Filled Breast Implants and NATRELLE INSPIRA® Breast Implants. NATRELLE ® Silicone-Filled Breast Implants are filled with Responsive silicone gel. NATRELLE INSPIRA® Breast Implants are filled with Responsive silicone gel (NATRELLE INSPIRA® Responsive Breast Implants), SoftTouch silicone gel (NATRELLE INSPIRA® SoftTouch Breast Implants), and Highly…Read More...
A breast implant is NOT a lifetime device. The longer you have your implants, the more likely you’ll experience a complication and need a reoperation requiring the replacement or removal of the breast implant. As many as 32.4% of women who received breast implants for augmentation had their implants removed within 10 years, but your…Read More...
Patient Overview: To address the patient’s concerns with asymmetry, a crescent lift was recommended. The patient is unhappy with the size and positioning of their breasts. The right breast is 1cm lower than the left with the nipple areolar complex 2 cm lower. There is a 4 cm pinch on the left. The parenchyma is…Read More...
Nipple repair is a cosmetic surgical procedure designed to restore or reconstruct the nipple, which may have been lost or damaged due to various reasons. This procedure can help individuals who are self-conscious about the appearance of their nipples or have lost sensation in the nipple area. At The Ferguson Clinic, we want you to…Read More...
Welcome to the Ferguson Clinic of Honolulu, Hawaii. Our cosmetic surgery clinic provides the highest standard of care to our patients. In our clinic, we perform a broad range of procedures to deliver the results you want. Our slogan has always been “beauty defined,” and whatever that definition means to you, we can make it…Read More...
Have you recently had a plastic surgery procedure? If so, there are some things to keep in mind during the recovery process. Here at The Ferguson Clinic, we specialize in plastic surgery in Honolulu. Today, we’ll go over four general tips for recovering after plastic surgery. Learn more below and contact us if you…Read More...
If you are considering breast augmentation surgery, The Ferguson Clinic in Honolulu is the best place to go. We have years of experience performing this procedure, and our team of experts will make sure you are fully informed about everything related to breast augmentation. In this blog post, we will discuss the basics of breast…Read More...
How to Pick the Right Breast Augmentation for You
Sizing & Profile
The first decision you need to make is what size implant is right for you. At home, you can try this easy DIY trick for getting use to different sizes and their weights. Most patients already have a cup size in mind, but they are encouraged to find a bra in their desired size, put it on, and fill the cups with rice inside hosiery. earing this around all day will give an accurate idea of the size and feel you can expect after surgery.
Today's implants are available in different widths/profiles to fit your torso whether narrow or wide. During your consultation you will be able to try on silicone implant sizers for a better idea of the final shape/look. Implants do not change the shape of your breasts, they enhance what is already there. If your breasts are naturally far apart on your chest, larger implants will not necessarily create cleavage without the aid of a bra.
Choosing the material is important as well, as both silicone and saline are available. Saline breast implants contain an outer shell of silicone within which the saline solution is placed. This allows for a very small incision since the implant can be filled after insertion. They can also be overfilled and are the kind you see on world-record holders and extreme body modification enthusiasts. The downsides to saline are they are more likely to rupture/leak and deflate like a popped water balloon. They also feel less natural, and the water ripples can be seen underneath your skin.
The new and improved silicone gel implants have the same outer silicone shell within which is a new cohesive silicone gel. Unlike the old silicone implants, which were more like a liquid, the new cohesive gel implants act more like a solid and holds together uniformly while retaining the give and feel of natural breast tissue. This gelatin – like cohesive silicone gel is much less likely to leak, rupture or tear as compared to the older traditional silicone implants, and the implant does not leak even when cut in half.
Dr. Ferguson is certified by Mentor and Allergan to use their newest silicone implants. These new cohesive silicone gel implants have a more natural feel and are less likely to produce rippling than saline breast implants. The cohesive gel implant goes up to a size 800cc and thus requires a slightly larger incision to allow placement. Choosing silicone vs. saline is entirely up to you and Dr. Ferguson can help you decide if you need further guidance.
The final decision concerns the placement of the incision and, therefore, the scar. There are pros and cons to each option. Dr. Ferguson is well-trained and experienced in each approach, so the final option is up to you.
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. This is the preferred route for re-operation.
For Silicone & Saline, 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. A new disadvantage is being seen recently. The scarring that occurs in the breast tissue may calcify over time and lead to false positive mammograms in the future.
Transumbilical breast augmentation, or TUBA, involves making an incision within the navel and using specialized instruments to place the implants, typically saline. 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, says of this option: “Which gets closer scrutiny, the armpit or the exposed breast?”
Another important consideration is the placement of the implant. The breast implant can be placed either partially under the pectoralis major muscle (submuscular & dualplane) 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. There is a third placement option as well where 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.
For patients with much of their own breast tissue or have moderate drooping of the breast tissue with most of the bottom have of the breast facing the chest the usual treatment is to combine placement of an implant and a breast reduction/lift. However, there is an alternative technique that Dr. Ferguson has mastered, the dual-plane approach. Through a small incision just above the lower crease of the breast, the lower half of the breast that is facing the chest wall is disarticulated off the pectoralis muscle before the muscle is elevated. This allows the implant to support and expose the lower half of the breast with upper half of the implant below the muscle filling in the often-depleted upper pole of the breast. The back of the implant is against the chest wall, so once the breast heals there is no long-term inferior displacement of the implant, the breast gets a nice lift, and it is all done through a small incision. This approach has relatively less discomfort than even traditional breast augmentations, and patients are back to normal activities within one week.