Indications

Breast enlargement is a cosmetic operation performed to increase breast size for patients who are dissatisfied with their natural breast size or shape.

Many patients feel their breasts were too small and in most cases this is determined by genetic factors. This group may seek enlargement at any age once their full natural growth potential is reached.

A second large group of women experience some atrophy of their natural breast tissue following child birth, breast feeding, weight loss, or they may experience a natural reduction in breast size as they age. These patients often wish to return to their normal size prior to the loss of breast tissue.

There is a third smaller group of women who have breasts that most consider normal in size, but who personally prefer a larger breast. If their general health is satisfactory, any of these groups of patients can be evaluated for breast augmentation.

Notice: This section contains graphic medical images.

Implants - Anesthesia - Operation - Recovery - Results - Cost

Implants

Iowa City Plastic Surgery Now Offers both Saline and Silicone Breast Implants

"Silicone Breast Implants are Making a Comeback"

Silicone breast implants have never been without controversy. Amid patient complaints of connective tissue disorders, immune and other diseases due to silicone, the FDA banned their use as a aesthetic option for women considering breast augmentation in the mid-1990s. Following extensive clinical, scientific and patient studies, silicone gel-filled implants have once again been approved for breast reconstruction in women of all ages and breast augmentation in women ages 22 and older. With the FDA's recent approval, silicone gel-filled implants are back.

Current statistics show that silicone implants account for roughly 20% of implant procedures and following the new FDA approval, physicians predict an increase in silicone implants.

Every patient is unique. Many of our patients desire the very soft and more natural feeling of the silicone breast implant. Silicone is recommended for certain types of reconstruction patients and preferred by women who are looking for a gently sloping breast silhouette. However, we will always have patients who believe and trust in saline. "Now, they have a choice", explains Dr. Cram. If you are in need of reconstructive surgery following breast cancer, or if you would like to speak to us about breast augmentation, please call to schedule an initial consultation today.

All implants currently available have a silicone elastomer that forms the outer shell. Some are smooth and others have a textured surface. The outer shell may have a variety of shapes and can come in a number of different sizes. The choice of outer surface, shape, and size is a matter for discussion in every case, and will be influenced by the patient's needs, and the experience of the surgeons. As a general rule we favor smooth surface round implants for the majority of breast augmentation cases.

Anesthesia

Breast augmentation can be done under local anesthesia with sedation, or can be done under general anesthesia. In either case the procedure is done on an outpatient basis. The choice of anesthetic technique will be discussed during your consultation. Patient safety and comfort are our primary concern, and the anesthetic choice will be chosen with these two parameters in mind.

Operation

There must be a skin incision somewhere on the body in order to insert the implant. There are several options for placement of the incision. Dr. Aly and Dr. Cram use a personalized approach and speak with each patient prior to deciding there the incision will be placed. The choice of the incision will be based on factors which Dr. Aly or Dr. Cram will discuss in detail with the patient and may be influenced by the patient's anatomy and the size of the implant chosen.

Recovery

On the day of surgery and for a few days thereafter there will be some discomfort due to the incisions and the creation of the pocket to hold the implant. This is usually well controlled by the use of a variety of narcotic and non-narcotic medications. Often by the third to fourth post operative day the patient is able to provide adequate comfort with over-the-counter types of medication such as Tylenol. We encourage early general activities but restrict weight lifting and heavy upper body work outs. The surgeon will discuss activity levels at each visit.

Results

With any surgical procedure there are risks and potential complications. Bleeding and infection are two risks of any operation and could occur in breast augmentation as well. There is a possibility of loss of sensation of the nipple though this is not common. The body forms a capsule around any material that is placed within it, whether it is a heart pacemaker or a breast implant. The capsule usually stays soft, but can become firm in some cases and may, in rare cases, change the position of the implant and/or change the shape of the breast mound. This is called capsular contracture and it is possible for it to occur early on after surgery or many years later. Implant deflation can occur spontaneously or due to some form of trauma, but this occurs infrequently. As surgeons, we are aware of all of these possible complications and will always do all that we can to prevent their occurrence. However, despite our best efforts there is always the possibility that one of these complications could occur. In that event, the patient and the surgeon must remain a team, and work together to obtain the best outcome possible under the circumstances.

Chest wall shape and size, and breast tissue quality will all have a bearing on the outcome of the procedure. In some cases the chest wall has what is often called a "pigeon" shape. This will point the implants out to the side more than if there is a flat or inverted central chest contour. If there is very little breast tissue then the implant edges may be visible even with small implants.

If the breasts drop in their position, as can occur with natural aging and after child rearing, this is referred to as ptosis (the p is silent) and then a procedure called mastopexy, or breast lift, may be necessary to achieve the desired result. The surgeon will discuss this, along with all other aspects of the evaluation and operation at consultation.

Cost

The cost of the procedure will depend on the cost of implants as well as the cost of the operating room and the anesthesiologist fees. The patient is usually given the information on cost at the time of the first consultation. It is important to understand what the price quote includes so that the total cost of surgery is determined.

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