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27 Nov 2012

Breast Augmentation: Implants vs. Fat Grafting (part 7 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is whether to pursue augmentation through implants or Fat grafting.  Fat grafting was not a serious consideration until the past few years, and it still doesn’t have the capabilities of a silicone implant.  Still, for someone seeking a modest augmentation (1 cup) and possessing “good??? fat donor sites, and willing to accept unknown risks, and the possibility of lumpiness and inconsistent results, it is a consideration.  Much is written about how to make the operation more predictable, but at present it remains that breast implants are…

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18 Nov 2012

Breast Augmentation: “Too Big vs. Too Small??? (part 6 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is the choice of implant size. Size is an easy concept, and many patients feel comfortable making decisions on size. Patients often reflect at great length on size, sometimes calling the day before surgery to change implant size Much of the deliberation is unproductive, as the difference between a 300 and 360 cc implant is only a 20% increase in implant size, and probably a 10% increase in overall breast size. Your surgeon should recommend a size at consultation that factors in your chest…

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3 Nov 2012

Breast Augmentation: Round vs. Anatomic Implants (part 5 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is whether to choose round or anatomic (breast-shaped) implants. Round implants can be smooth or textured, because a round implant can rotate without changing the breast appearance.  An anatomic implant must be textured to prevent rotation (e.g. upside-down breast!).  A common misconception among patients with some drooping of the areola and a hollow upper breast is that they need a round implant to fill the upper pole and correct this appearance.  In our experience, a better appearance is achieved by using an anatomic implant that…

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21 Oct 2012

Breast Augmentation: Incision location (part 4 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is the location of the incision for insertion of the implant. Incisions on the edge of the areola or across the areola (Pitanguy) are worth of consideration, but have the disadvantage of damaging milk ducts, exposing the implant to duct bacteria, and compromising nipple sensation.  Also, a bad scar here is a rare but conspicuous problem. Patients with very small breasts and no infra-mammary fold are good candidates for an armpit (axillary) incision.  The scar from this surgery is invisible, but does not allow…

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21 Oct 2012

Breast Augmentation: Under vs. Over (part 3 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is whether to go under (sub-pectoral) or over (sub-mammary) the pectoral muscle. Implants put under muscle will cause more discomfort for the first few days, as the muscle is partially divided and must stretch over the implant. The implant is also pushed away from the midline by the pectoral muscle as it attaches to the sternum (breastbone), and this appearance will be exaggerated by exercise. This is a problem for patients who are looking for ‘lots of cleavage’, or are concerned with their appearance…

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14 Oct 2012

Breast Augmentation: Textured vs. Smooth (part 2 of 7)

Consultation for breast implant surgery (augmentation) is a challenging process, as there are many options to be considered. This 7-part series is intended for those of you interested in the surgery but confused by the choices involved. Breast Augmentation: Textured vs. Smooth (part 2 of 7) Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is Textured vs. Smooth implants. Smooth implants require smaller incisions and can be inserted through an armpit incision. They may be more prone to shifting over time, or capsular contracture. Capsular contracture is the process in which the…

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