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AUGUSTA

PLASTIC SURGERY

BY AUGUSTA PLASTIC SURGERY

MAKEOVER YOUR BREASTS

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MOST COMMON CONCERNS

  1. My breast are too small
  2. I want more fullness
  3. I've lost weight and my breasts have no shape
  4. My breasts sag and my nipples point downward
  5. My breasts aren't symmetrical
  6. I don't have enough cleavage
  7. I want a more appealing figure
Image of Woman with a Breast Augmentation

BREAST AUGMENTATION

WHAT YOU NEED TO KNOW

Procedure Time:

 

1 hr

Recovery Time:

 

1 Day Basic

2-4 Weeks Full

 

1 Day Recovery Info

Approx. Cost:

 

$5700 saline

$6300 silicone

 

Payment options

HOW DO I CHOOSE MY CUP SIZE?

VECTRA 3D IMAGING SLIDESHOW

Vectra 3D Imaging

 

See your results before surgery by having the machine take your photo then instantly see your 3D image on the screen. The implants for every company are built into the software so you can virtually try on every implant size on your body. Go from an A to a B, C, D, or even DD on the screen.

 

The benefits of the Vectra 3D imaging:

 

  1. Easier than trying on implants
  2. 90% accuracy based on studies
  3. Better visualization
  4. Can try with and without a bra
  5. Print you images and take home
  6. View from every angle

VECTRA 3D IMAGING VIDEO FOR BREAST AUGMENTATION

OTHER BREAST SIZING OPTIONS

 

Try on implants beneath a sports bra

 

We can let you feel and see the different implants and you can try different sizes beneath a sports bra. By trying on different sizes in each breast, you may be able to determine which size looks better on your frame. Be sure to bring a fitted shirt for better accuracy.

 

Try the Rice Test at home

 

The rice test is a quick and easy way to get an idea of how you would look with different sizes of breast implants. Just follow the instructions below to make rice implants. After making several sizes, place them inside of a sports bra to get an idea of how breast implants of different cc volumes would enhance your figure.

 

Rice Amount Estimated Implant Volumes

 

1 cup    =  236cc

3/4 cup = 177cc

2/3 cup = 156cc

1/2 cup = 118cc

1/3 cup = 78cc

1/4 cup = 59cc

1/8 cup = 30c

 

Instructions: Use some knee high or cut-off panty hose to fill with the rice to different sizes. This will give you an approximate size and be very useful when discussing your size options with Dr. Ewart or Dr Smith.  This will get you in the right range and then you can narrow it down when using our 3D Vectra imaging.

 

Examples:

1 cup for 250 cc

1 1/4 cup for 300 cc

1 1/2 cup for 350 cc

1 2/3 cups for 400 cc

DO I NEED A BREAST LIFT OR JUST AN AUGMENTATION.....OR BOTH?

 

This is the most common question we receive and also the most important decision to address during your consultation. Let's make it simple by looking at these flow charts.

 

 

good, fills bra size I want

if sagging, then breast lift only

Breast Lift (Mastopexy) by Dr Ewart

Current Breast Size

too small, deflated, no fullness up top

minimal sagging then breast augmentation only

sagging (ptosis) then breast lift and implant

Breast Imlants by Dr Ewart
Mastopexy with Implants by Dr Ewart

HOW DO I KNOW HOW MUCH BREAST SAGGING I HAVE?

Look at you nipple position in relation to you inframammary fold (black line)

above fold

at fold

below fold

Possible Procedures

implant only

implant +/- lift

implant and lift

ARE THEY GOING UNDER THE MUSCLE OR ABOVE THE MUSCLE?

Submuscular (below the muscle) Breast Augmentation

 

In 95% of the cases, the breast  implants will be placed in a submuscular position for 2 main reasons:

 

  1. More natural appearance
  2. Less risk of capsular contracture (scarring around the breast implant)

 

 

 

Dual Plane Breast Augmentation

 

This occurs when the implant is placed behind the muscle in the top 2/3 of the implant and behind the gland in the lower 1/3 of the implant. This is performed by surgeons who have experience in this technique in those patients who do not wants the scars from a breast lift but still want implants and they have some mild sagging to the breasts. The dual place creates a lifting and rotation of the breast tissue.

 

 

 

Subglandular (above the muscle) Breast Augmentation

 

This is performed infrequently due to the higher risk of capsular contracture. There are some patients who do benefit from this type of placement:

 

  1. Constricted or tubular breasts (better expansion with this technique)
  2. Sagging of the breasts but not interested in a lift
    1. these patients can have too much sagging
    2. they need to have ticker breast tissue to cover the implant

WHAT TYPE OF BREAST IMPLANT IS THE BEST?

Saline Silicone Highly Cohesive Silicone
Fill Sterile Salt Water Cohesive silicone gel Firm highly cohesive silicone gel
Company Natrelle® Saline
Mentor® Saline
Natrelle® Silicone
Mentor® MemoryGel
Natrelle® 410
Mentor® MemoryShape
Sientra® Silimed
Covering/ Shell Smooth or textured silicone Smooth or textured silicone Textured silicone
Shape Round or teardrop Round Anatomical/ Teardrop
Feel Water ballon
Firmer than silicone gel
Similar to natural breast tissue Gummy bear
Firmer than regular silicone
Positives They’re less expensive
They can be filled to an exact amount during surgery
Small incision
They look very natural
They feel the most like real breast tissue
Numerous studies to confirm safety
Less rippling
Less shifting
They look natural
Less contracture
Negatives Less natural feel
Higher risk of rippling in thin patients
Higher cost
Slightly longer incision
Firmer than the other implants
Larger incision
Even higher cost

BREAST IMPLANT INCISIONS

Inframammary Fold Incision

 

This is the most common incision for breast augmentation because the scar is essentially hidden underneath the breast near the crease. You do not see it when looking in the mirror and it is hidden underneath all clothes, bras and bikinis. Great access and results from this incisions.

 

Infraareolar incision

 

Hidden along the color change and curve of the lower areola. Can be a very discreet scar in some patients. If it doesn't heal well, then can be visible in a mirror. Slightly higher risk of infection and capsular contracture since dissecting near the breast ducts.

 

Umbilical Incision

 

Well hidden along the curve of the upper belly button. Also called the Scarless Breast Augmentation since there are no breast incisions. Can only be performed with saline implants.

 

Axillary Incision

 

Potentially the most visible incision if it doesn't heal well since can be seen with tank tops.

 

 

Incision Locations for Breast Augmentation

SURGERY DETAILS

 

Anesthesia: General

 

Location: Augusta Plastic Surgery Center located in the Women's Center at University Hospital. The top ranked and best hospital in Augusta, GA.

 

ASC Certification: AAAASF

 

Surgeons: Dr. Randolph Smith and Dr. Christopher Ewart

 

BREAST FAQ

How long before my breast implants drop?

When breast implants are placed into a submuscular position, the normal reaction of the body is to contract the muscles and abnormally elevate the breast implants. In addition the skin is tighter and needs to relax as well. Over the course of a few weeks to a few months, the implants will continue to drop into a more natural position. They will continue to look more natural over the course of 9-12 months but most of the dropping occurs in the first 3 months.

This is a 28 year old female who wanted breast implants but not a lift. She was on the borderline for needing a lift but using a technique called Dual Plane Augmentation combined with the use of anatomically shaped highly cohesive (Gummy Bear) silicone implants, we were able to achieve an excellent result. She went from a 34 B cup to a 34 D cup.

Breast Implants Dropping Over the Months

How can I fix my uneven breasts (asymmetry)?

Uneven breasts or breast asymmetry is very common. In fact, almost every women if they look close enough will see that they have some difference between their breasts. For some women however, the difference can be very dramatic or noticeable. One side may be only an A cup while the other side could be a C cup. There are several reasons for this such as chest wall deformities which limit the growth and size of the breast or developmental abnormalities in which the breast does not develop properly or even at all.

 

For chest wall deformities, the chest wall is more sunken in on that side and the breast may look normal but is smaller and does not project out as far. This is why 3D imaging with the Vectra is so important. It can detect chest wall asymmetries and allow us to chose a larger and high profile implant on the smaller side to provide the best result.

This patient was an A cup on the right and a small B on the left. Her chest wall was depressed on the right side.  A High Profile 400cc Silicone Implant was placed on the right and a Moderate+ Profile  339cc Silicone Implant was placed on the left. She is now a full C cup on both sides.

Uneven Breasts Corrected with Breast Implants

This patient was an B cup on the right and a C cup on the left. She also had a developmental deformity of her breasts.  A breast lift with 405 cc and 360 cc saline implants were used to correct her deformity.  She is now a D cup on both sides.

Will I lose too much upper pole fullness if I get anatomical shaped implants?

We use highly cohesive shaped silicone implants from both Natrelle and Sientra here at Augusta Plastic Surgery for those patients who desire a slightly more natural appearance. There will be only a subtle decrease in the upper pole fullness for most patients because even in round implants there is some natural sagging and decrease in upper pole fullness over time.

This patient was an A cup on the right and a full C on the left. Shaped highly cohesive silicone implants were placed underneath muscle. 375 cc.

 A to a full C Cup.

Breast Augmentation with Style 410 375 cc Shaped Gummy Bear Silicone Implants

Can bottoming out or implants falling to the side be fixed?

Breast Implant Malposition Correction: Breast implants can fall underneath the inframmamary fold (bottoming out) or fall to the side when lying down (lateral displacement). This usually can be corrected with tightening the pocket so that the implant cannot fall down or out. Sometimes extra material (such as Alloderm, Strattice, or other Acellular dermal Matrices) is needed to provide additional support especially in thin patients.

This patient had a breast augmentation by a different surgeon and was unhappy with the bottoming out and lack of cleavage. Dr. Ewart corrected the problem by placing a wider implant that better fit the patients frame, reelevating the pectoralis muscle, and tightening the lower pocket. The patient was extremely happy with the results.

Copyright © 2015 - All Rights Reserved

Aesthetic and Reconstructive Surgery of the face, breast, body and hand provided by Dr. Randolph R. Smith and Dr. Christopher J. Ewart at Augusta Plastic Surgery. Proudly serving the CSRA and surrounding areas including Augusta, GA , North Augusta, SC,  Evans, GA, Martinez, GA, Grovetown, GA Aiken, SC and Columbia, SC

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