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Breast Augmentation

Breast Augmentation Surgery (Saline/Silicone Implants or Fat Transfer) – Scottsdale, AZ

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Breast Augmentation Video

Breast Augmentation - Dr. James Nachbar

About Breast Augmentation

Breast enhancement surgery is a procedure that resizes the breasts for a fuller appearance. It is one of the best cosmetic surgeries in terms of patient satisfaction, granting women who are unhappy with their breast look numerous options for improvement. Using breast implants or fat grafting, this cosmetic treatment improves breast size and shape, and produces an attractive and balanced outcome. However, most patients desiring breast augmentation would not be satisfied with the limited enlargement available with fat transfer.

Scottsdale, AZ plastic surgeon Dr. James Nachbar is highly trained in executing this procedure and performs many breast augmentations year round. During your consultation at Scottsdale Plastic Surgery, Dr. Nachbar will address your concerns and desires and provide you with all of the options available, while also tailoring a surgical plan to reach your goals.

Also at your consultation, we can do a 3-D Surgical Simulation, so you can see what you might look like with the breast implants you have selected.

Ideal Candidates

The ideal candidate for breast enlargement surgery is usually a woman whose breasts have developed, but she is dissatisfied with the size.  A moderate amount of drooping of the breasts can also be improved with breast augmentation, but if there is a significant amount of drooping, or if drooping is the primary concern, often a mastopexy, or breast lift, will be required to produce the result you are looking for.

About Breast Implants

At your consultation with Dr. Nachbar, we will look at the various types of implants that can be used, and help you select the implant that will give you the result you are looking for.

Factors that we will consider include how thin or thick the tissues are, how much enlargement is desired, the width of the breast, any specific preferences for shape (e.g., more roundness or less roundness apparent).

Breast implants come in varying sizes and profiles, as well as shapes and textures — all of which are taken into consideration in order to achieve the desired look. Both saline and silicone breast implants have been approved by the FDA, and are available for use.  The FDA has recommended that silicone breast implants not be used in patients under 22 years of age, but patients between 18 and 22 years of age may have silicone breast implants, as long as they have acknowledged having been told of the FDA recommendation.

Generally, women considering breast augmentation must be 18 years of age, although an exception can be made for those women whose breasts either failed to develop or developed with a deformity, or who have significant differences between the right and left sides.

Modern silicone breast implants are of the "gummy bear" type, in that they are not liquid inside, and can be cut in half.

It is also possible to do minor breast augmentation using fat grafting, but the amount of enlargement is limited.  I am aware that some surgeons recommend fat grafting, and may quote high success rates, but if you decide to do breast augmentation with fat grafting, I would encourage you to come to our office for a 3-D breast photograph.  Then, after you have healed from your fat grafting, we can actually measure how much of the fat survived and how much enlargement you actually achieved.

Aside from the type of augmentation chosen, other factors we will consider include:

  • Size
    Implant size is chosen measured by volume, expressed as the number of CCs of silicone or saline used, where a fluid ounce is about 30 cc. We have several techniques to help you decide on the implant size you want to use, including our 3-D Breast Surgery Simulator.  We can adjust the amount used on each side to account for differences in the size of the breasts.  While it is sometimes necessary to try various sizes in surgery, I will not put in a different size than we agreed to unless we clearly discuss and plan that before surgery.
  • Shape
    Breast implants are produced in either a round or teardrop shape. Both shapes are commonly used; however, the majority of our patients select a round shape. However, for patients who want a more subtle and less "round" upper breast, the teardrop implants work very well.
  • Profile
    Breast implant profile refers to the relationship between the volume of the implant and the width of the implant.  A higher profile implant will be less wide than a lower profile implant for the same size.  Of course, there will be more separation between the breasts with a higher profile implant than with a lower profile implant.
  • Textured vs. Smooth
    Both textured (rough surface) and smooth breast implants can be used.  All implants other than round implants must be textured, because otherwise they will tend to turn within the breast pocket.  While both types are safe, there is a very rare type of lymphoma, ALCL, which appears only to occur when textured breast implants are used, so unless there is a good reason, we usually recommend the smooth breast implants.

These options may seem overwhelming, but we are here to help you select the right implant to meet your goals.

Surgical Technique

Dr. Nachbar performs breast augmentation under general anesthesia, for the best comfort and safety. 

There are several choices for making the incision to place the implants, including inframmamary (near the bottom of the breast, but not directly in the crease), peri-areolar (along the edge of the areola, the darker skin around the nipple), and trans-axillary (through the armpit).  If a breast lift is being done at the same time, the breast implants can be placed through the breast lift, and additional incisions are not necessary.

Any of the incisions can work well, and Dr. Nachbar uses all of them.  However, you should be aware that the peri-areolar incision passes through the breast tissue, and may have a higher risk of getting bacteria from the breast on the implant, which may increase the risk of later capsular contraction.

The trans-axillary incision works well for saline breast implants, which go in empty, and for smaller silicone breast implants.  However, while even a larger silicone implant can be inserted through the trans-axillary approach using a Keller Funnel, it has been reported that there can be permanent nerve injury to the nerves to your arm caused by placing a large silicone breast implant through the armpit. In fact, that has actually happened in Scottsdale and elsewhere.  If you are thinking about placing a silicone breast implant through your armpit, you might want to ask your surgeon if they have ever seen nerve injury from that procedure.

Regardless of the approach, unless the breast implant is being placed in conjunction with a breast lift, for silicone breast implants not being placed via a breast lift, Dr. Nachbar uses the Keller Funnel to allow the implant to be placed with less force and through as small an incision as possible.

Once the incision is made, the implant is generally placed under the pectoralis major muscle under the breast, unless there is already an implant in place above the muscle.

What to Expect

Dr. Nachbar performs breast augmentation as an outpatient procedure using general anesthesia. Some discomfort is expected for the first few days after a first-time breast augmentation, although very little discomfort is typically experienced after a second or subsequent breast procedure.

When making the initial breast implant pocket, Dr. Nachbar injects long-lasting local anesthetic directly into the muscle, to provide pain relief in the hours after surgery.

After surgery, all patients are taken to the recovery area and carefully monitored before being released. Dr. Nachbar uses a light dressing on the chest, which you can remove whenever you want.  For first-time breast augmentation, the breast implants will be quite high immediately after surgery, but will eventually move into the pocket that Dr. Nachbar created over the subsequent weeks and months.

Dr. Nachbar asks you to avoid vigorous exercise, bouncing, and shoulder exercises for six weeks after surgery.  However, you may resume lower-impact exercise, including cardio, as well as lower body, biceps, and triceps resistance exercise, within a few days after surgery to maintain your fitness.

You should not drive an automobile after surgery until you are off all narcotic pain medication, and are in complete control of the vehicle.  Imagine that a child runs in front of your car.  When you feel confident that you would be able to safely handle the vehicle in that circumstance, you may drive again.  Most patients feel that they can drive within four to five days after breast augmentation.

There is one small suture that Dr. Nachbar leaves on each side, under skin strips.  You may take off the dressing, leaving the skin strips, and shower as early as the day of surgery.  However, please avoid submerging the incision in a bathtub or pool until Dr. Nachbar has told you that the incision is completely closed.

Breast enhancement surgery produces beautiful outcomes that look and feel normal. This treatment in most cases can be life changing for many individuals, allowing them the chance to feel more confident.

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Get the Look You Want

Cosmetic breast surgery is popular for so many reasons. This treatment is FDA approved for safety and effectiveness, and produces beautiful outcomes. With an abundance of enhancement options, you can get the appearance you have always dreamed of. Scottsdale Plastic Surgery is proud to provide this proven treatment and we invite you to learn more. Contact our team in Scottsdale, AZ to schedule your first office visit with Dr. James Nachbar.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.