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Breast augmentation was the most popular cosmetic surgery procedure that women underwent in 2012. Over 330,000 women underwent breast augmentation procedures according to data released from ASAPS (The American Society for Aesthetic Plastic Surgery).
There are many reasons women undergo breast augmentation. Women may choose to undergo breast augmentation to improve their proportions and to make them feel shapelier and have normal proportions so that they will fit better in clothes. Many women undergo breast augmentation following childbirth and nursing, as the breasts change following the increased size with pregnancy as well as the atrophy or deflation that follows nursing.
There are several different types of implants that can be used for breast augmentation. These include saline implants as well as silicone implants. Silicone implants have become much more popular over the past 7 years with the FDA approval of silicone implants for all women 22 and older. There still are some women who undergo saline breast augmentation, however, silicone breast implants provide a much more natural feel to the breasts and may even give an improved more natural shape.
Breast implants can be placed in different positions to achieve different types of results. Breast implants may be placed on top of the muscle (subglandular position) or they may also be placed under the muscle (submuscular or subpectoral position). There are also different ways of putting implants under the muscle as well. Some surgeons like to place the implant entirely under the pectoralis major muscle, whereas others may place it partially under the muscle in what is called a subpectoral or dual plane approach. I prefer a dual plane approach for most of my patients as I feel it provides a more natural looking, sloped breast appearance, and that is what my patients desire.
There are several approaches to placing the implants. Implants can be placed by the nipple approach (the periareolar approach). They can also be placed underneath the breast in the fold or crease, which is called the inframammary approach, or via an underarm incision through the transaxillary approach. I perform all of these techniques depending on the patient’s anatomy and desire. There are advantages and disadvantages of each technique.
The periareolar approach is a nice approach for women to hide the scar, given that they have an adequate sized areola. Additionally there are times when one is undergoing a breast lift or mastopexy and we may choose to proceed via the periareolar approach as we will be making other incisions around the nipple areolar complex as well. The inframammary approach is also an optimal approach for many patients as the scar will be placed in the fold under the breast and will be difficult to visualize. The transaxillary approach is also an option. However, I prefer the transaxillary apporoach for a select group of women. I will utilize the transaxillary approach for both saline and silicone implants. With the transaxillary approach, I perform it with endoscopic visualization or assistance; that way, I am able to look on a television monitor to see the extent of the dissection directly, and to make sure that there is excellent hemostasis or minimal bleeding throughout the procedure, and is performed in a clean manner. The incision for saline implants is only an inch long. With a silicone implant, the incision needs to be 1-1/2 to 2 inches long in the axillary approach.
Breast implants come in different profiles as well. There are several different companies that offer breast implants in the United States that include Allergan, Mentor, and Sientra; Allergan and Mentor offer both silicone and saline implants, and Sientra only offers silicone implants. All 3 of them have FDA approval to provide implants to the United States for different types of implants. Saline implants were more popular back in the 1990’s and 2000’s as there was a temporary ban on silicone implants in 1992. However, over 7 years ago, the FDA approved silicone implants for use by all women 22 and older, and for some women under 22 given reconstructive purposes, and since that time, more and more women are undergoing silicone breast augmentation. In my practice, over 95% of my patients elect to have breast augmentation utilizing a silicone implant as it gives them a much more natural feel and appearance.
All implants are warranteed by the US manufacturers for their lifetime, so that if there is ever a failure or a rupture or a deflation of an implant, the company will replace the implant at no charge. Additionally, if there is a failure within the first 10 years of a silicone implant being placed, the implant manufacturer will provide them with additional money to assist with operating room and anesthesia expenses as well, up to $3,500.00. With saline implants, this is available up to $2,400.00 if one purchases an extended warrantee for $100.00 at the time of implantation. There is no set rule as to when somebody needs to change their breast implants. With earlier generations of silicone implants, it was noted that there was a high rupture rate by 10 years, and in the past, it was recommended that women undergo a change of their silicone implants within the first 10 years of augmentation. Today, that is not necessarily the case as we know that breast implants are much sturdier and after 10 years have a 5 to 15% rate of rupture. Thus, one may choose to wait a little bit longer and undergo radiographic evaluation of the implant to determine if an implant exchange is required.
Breast implants come in different profiles. There are low profile, moderate profile, moderate plus profile, high profile, and extra high or ultra high profile implants. What varies, is the width and the projection of these implants. A low profile implant is much flatter and wider whereas an extra high profile implant is much narrower and has more projection. I will select a certain type of implant for a patient depending on the width of their chest and the width of their breasts as well as the desired appearance that they hope to achieve, as well as the amount of breast tissue they may have. Saline implants are more prone to rippling especially in a thin patient and in the lower profile implants. Silicone implants have much less rippling. However, in certain patients, one can still notice rippling in the lower part, or the lateral part, or the outer part of the breast with a silicone implant, and this is more common in the low profile implants than in the high or ultra high profile implants.
A new addition or option for women is the Gummy Bear breast implants or the cohesive gel shaped silicone breast implants. There are multiple names for this including Gummy Bear, form-stable shaped implants, cohesive gel implants, etc. This implant has been newly approved by the FDA over the past 1 year. The first company to receive its approval of their shaped implant was Sientra, approximately 1 year ago (2012), and Allergan recently (2013) obtained their approval for their shaped 410 cohesive gel shaped implant. Both of these companies provide different shapes and profiles of their shaped implants which allow for a “more natural” or tear-drop shape. This type of implant may be more suitable for women who hope to achieve a more “natural appearance” and who do not have much breast tissue to begin with. The implant is placed via the inframammary approach as it does require a slightly larger incision. It has been touted to maintain its shape over a longer period of time over multiple years versus the other round type of silicone implants. It does require more precision in the pocket dissection and in the determination of the sizing. It is important that you have a surgeon who is comfortable utilizing these implants to achieve the best results possible. These implants have a much lower rupture rate than the other round silicone implants and have also been shown to have a lower capsular contracture rate.
When I see a patient for an initial consultation, I like to get an idea of what size they hope to achieve, just what they have in their mind, whether they would like to be a B cup, C cup, D cup, or DD, it gives me an idea as to what they are thinking beforehand. I also like to see photos of other patients that they may think have a desirable appearance or look and they can show me photos from another website, my website, or even from a magazine. I try to have patients not tell me exactly what size implant or cc’s (or ml) they want as they may be looking at somebody else’s photo with a similar height and weight and think that that person has a similar look and they want to have the same size cc implants. However, there are many factors that are considered when selecting a breast implant for somebody and that is difficult to note just by height and weight and looking at a picture. It is important to look at the width of the breast, the amount of tissue that one has, the compliance of their tissue or how thin the tissue is (the skin is); also whether they have nursed or not may play a factor and also depending on the size that they hope to achieve.
There are certain tools that one can use to help determine sizing including a sizing kit developed my Mentor where one can place these silicone forms or implants in a bra to help determine the size that they feel comfortable with. However, ultimately, what I prefer to do is once I take the patient to surgery, I have multiple options or sizes available for me, and then during surgery, once I have created the pocket and the patient is asleep, I will place a temporary silicone implant sizer in the patient in each breast, sit the patient up and take a look from the foot of the bed to see what is the best size that I feel the patient hopes to achieve and has the most appropriate look as well as the most symmetry. Many patients have underlying asymmetries that they are not aware of. They may have a different amount of breast tissue on each side. Additionally, many women have some sort of chest asymmetry or chest deformity that most women do not realize until I point it out at their initial consultation. By using temporary silicone implant sizers, it helps me see exactly what I am going to be getting before selecting the final implants and this gives me the best opportunity to get the most symmetric result.
Breast augmentation, or breast enlargement, enhances the size and shape of a woman’s breast using either saline (salt water) or silicone gel implants.
The incision may be placed in the axilla (armpit), beneath the areola (colored area), or the fold beneath the breast. Dr. Grover utilizes the endoscopic (camera-assisted) transaxillary (armpit) approach for more than half of his patients requesting breast augmentation. This technique avoids placing any incisions on the breast and provides a pleasing aesthetic result with an inconspicuous scar that is hidden within the patient’s own skin crease. A periarealor technique is also utilized for many patients.
Click to Hear Dr. Grover Discuss Silicone Breast Implants!
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The procedure is performed using general anesthesia in an outpatient setting.
“My entire experience with Dr. Grover was impeccable. The post-surgery care was by far the best I have ever received…My augmentation was the best investment that I’ve ever made!!!”
L.R., breast augmentation patient
“Words could never express my feelings & gratitude for the “miracle” that you have performed on me. I knew from the moment I had my first visit that I was in good hands…You are a master in your profession, a miracle worker and a wonderful man! Thank you very much.”
L.S., breast augmentation patient
“I am enjoying being a woman every day. You are a great doctor. Thank you. You changed my life…”
M.U., breast augmentation patient
“I have nothing but great things to say about Dr. Grover and his staff. I feel I received excellent care and the entire staff is outstanding!…I am nothing but amazed and very satisfied with my results. I would highly recommend the practice to others and look forward to coming back to you in the future.”
E.C., breast augmentation patient
“I could never thank Dr. Grover enough for what he has done for me and given me. He has given me the perfect shape that I have always wanted and a beautiful, hard, flat, stomach that so many people dream of having…I have had two children, and I thought that after pregnancy my breasts and stomach would never look the same. I was right. Thanks to Dr. Grover my breasts and stomach look better than they have ever looked before. Dr. Grover has given me a type of self confidence that I had never had before. I have never met such a kind, caring, respectful physician/surgeon who is not only a perfectionist, he believes in the natural look. Thanks Dr. Grover!”
S.M., breast augmentation and abdominoplasty patient
Getting breast augmentation is a big decision and it’s important to become fully informed. Dr. Sanjay Grover, a Breast Implants Newport Beach specialist, will answer any questions you may have about Breast Augmentation surgery. Click here to contact Dr. Grover and setup a consultation today!
– by Sanjay Grover
One of the most popular procedures done in the United States is Breast Augmentation. Many women in Newport Beach desire to increase the size of their breasts for many personal reasons. Some women are born with naturally small breasts that are out of proportion with the rest of their body. Some women may experience a decrease in breast size after weight loss or nursing. Sometimes breast augmentation procedures may even be done to bring symmetry to asymmetrical breasts in which one breast is notably smaller than the other. For all of these reasons and many more, breast augmentation has become one of the most popular procedures in the United States today. Dr. Grover is a board certified plastic surgeon and serves patients in both Los Angeles and Orange County. Dr. Grover is very well known for his beautiful breast augmentation results – view them here: Newport Beach Breast Augmentation Photos.
Ideal candidates for this procedure are in good health both physically and mentally, and they should have realistic expectations for the procedure and the procedures potential outcome. Breast implants may be able to help women who have long been bothered by the naturally small size of their breasts, women whose breasts are disproportionately small compared to the rest of their body, women who have difficulty finding clothes or swimsuits that fit on top, women whose breasts have decreased in size and/or firmness after weight loss of having children, and women with one breast significantly smaller than the other.
The most important step in your breast augmentation journey is finding the right board certified plastic surgeon. We encourage you to have a one on one consultation with Dr. Grover.
We also suggest visiting Dr. Grover’s extensive before and after gallery and also the testimonials page of happy plastic surgery patients from Newport Beach and Los Angeles and throughout the world.