Plastic Surgery

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Video on Surgery After Breast Implants

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Surgery After Breast Implants
Dave Stringham
For women who are physically healthy as well as realistic in their goals, breast augmentation can provide an effective cosmetic enhancement.
Breast implants are filled with either saline or silicone.
Breast augmentation offers a unique opportunity to scientifically "customize" the shape of the breast rather than just bra size. You may want to wear an outfit that reveals more cleavage, change your wardrobe style, or simply create the proper balance between your breasts and hips.
Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for breast augmentation are women who are looking for improvement and realistic in the way they look. If you're physically healthy, 18 years of age or older, not currently pregnant or nursing, you may be a good candidate.
Implants are not to be used for: Women with existing malignant or pre-malignant cancer of the breast without adequate treatment. Women with an active infection anywhere in her body. Augmentation in women who are currently pregnant or nursing.
To permit the smallest possible incision, the breast implant is typically inserted empty, and then filled with saline. You should discuss with your plastic surgeon, the pros and cons for the incision site specifically recommended for you. There are three common incision sites: under the arm (axillary), around the nipple (periareolar), or within the breast fold (inframammary).
Periareolar - Areola - Nipple Incision
This incision is most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites. This incision is a half-circle at the outer edge of the areola, the colored area around the nipple. The scar is extremely favorable and blends well with the areola. It grants the plastic surgeon with the best access for precise placement of the implant, resulting in a strong cleavage and better symmetry. There is also better control of any bleeding during surgery, which ultimately affects the chance of scar formation or capsular contraction.
Inframammary - Breast Fold Incision
This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breast feeding. This is a one to two incision made by your cosmetic surgeon near the under-breast fold. Like the peri-areolar incision, this approach affords the plastic surgeon the greatest control over the position of the implant, giving the patient more attractive cleavage. The final scar is very favorable.
TransAxillary - Under Arm Incision
This incision is less concealed than periareolar and associated with less difficulty than the periareolar incision site when breast feeding. An incision placed in the arm pit is also known as a Trans-Axillary incision. Despite the myth that this scar is usually unnoticeable, it can be more prominent than other scars, especially when a woman is wearing sleeveless cloths. This access point is very far from the central location of the implant making it very difficult to precisely position the implants, thus causing the implants to sit away from each other, creating a wide cleavage. It is associated with a higher risk of bleeding and less control, often forcing the surgeons to use drains which can increase the risk of infection.
If the incision is made under the arm, the surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a pocket for the breast implant.
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