In 2006, the US Food and Drug Administration announced that, after intensive study, silicone breast implants are, in fact, safe for women. Now, women seeking breast augmentation can choose between silicone and saline implants. Dr. Cangello guides his patients through the selection process so they can choose the best option. Silicone is often preferred because it is considered to be softer and it more closely resembles the feeling of natural breasts. However, advances in saline implants have led to increased softness and natural resemblance, as well.
There are many valid reasons you may want to consider breast augmentation surgery. For example, one breast may be smaller than the other, or the breasts may be less firm and the breast skin may be sagging due to child bearing or aging. You may want to enhance your appearance and improve the proportion of your breasts in relationship to the rest of your body. Because of the complexity of the many procedures available and their implications, it is critical that your goals and desires are realistic. Whatever the reason for your surgery, your options will be analyzed and discussed thoroughly with Dr. Cangello, and the right procedure or procedures for you will be identified.
The aim is to insure that the results of breast augmentation surgery complement your natural beauty.
A pre-op plan will be carefully created for you, and may include changes in diet and other habits that impact your health. You will be asked to fast the night prior to surgery, and may be asked not to take certain medications, refrain from common activities, or stop certain habits. We will create a post-op plan specifically for you so you can minimize pain and quickly nurse your body back to health. Our Physician’s Assistant will educate you on the entire surgical plan. She will tell you what to expect the day of the operation and after. She is happy to address any questions that you have. We know having surgery can be very anxiety provoking and we do our best to make sure that you feel extremely comfortable and have left no question of yours unanswered.
Incisions for breast augmentation are usually made around the areola or in the breast fold, underneath the breast. Other options for incisions are in the axilla (armpit) or in the umbilicus (belly button). The latter two incision approaches are not used by Dr. Cangello. While there is no visible scar on the breast from either of these approaches, the overall rate for revision surgery is highest with both of these approaches because the pocket that is created for the implant is being created remotely (through an incision that is distant from where the actual pocket is). As a result, it is much more difficult to get the two pockets to be exactly alike. Not creating two identical implant pockets can result in malposition of one or both of the implants. Furthermore, if revision surgery is necessary for any reason, an incision often has to be made on the breast anyway.
The implant pocket is created almost always under the muscle (pectoralis major). This provides additional soft tissue coverage over the breast implant which has multiple benefits. First, having the muscle in addition to breast tissue cover the superior (upper) portion of the implant as opposed to breast tissue alone, as is the case with a subglandular implant pocket, gives the breast a more tear dropped shape. It makes the breast implant appear less round on the chest wall. Second, having more soft tissue to cover the implant means less of a chance of seeing visible ripples from the implant. Lastly, implants that are placed under the muscle are less likely to cause capsule formation which can make the breasts hard, painful or distort their shape.
Once the pocket is made, Dr. Cangello inserts temporary implants called “sizers” to make sure that he has the perfect size for your body. Once he has chosen the appopriate sized based on your desire discussed in preoperative consultation, the permanent implant is placed. The incisions are closed and a dressing is placed along with a supportive bra.
The procedure usually takes around an hour and a half to two hours, so you will able to return home the same day.
Incisions made around the areola are extremely well camouflaged and often barely visible—if not invisible—several months after surgery. Incisions in the inframammary (under the breast) crease also hide extremely well. They are not at all visible on the breast when in the upright position. If the incision is properly positioned and meticulous attention to detail is given while closing the incision, which Dr. Cangello prides himself in, the resultant scar is usually minimally visible in time. Dr. Cangello recommends using Biocorneum which is a liquid form of silicone gel starting two weeks after surgery to help minimize the appearance of the scar. Other over the counter scar creams have proven ineffective and can be expensive. Biocorneum has the added benefit of having SPF 30 in it so that scars don’t become hyperpigmented (darken) from UV or sun exposure. We provide Biorcorneum to our patients. If necessary, Dr. Cangello also has lasers in his office that can be used to improve the appearance of scars in people who have hypertrophic scars or who are prone to poor scarring.
You will be sent home with medications that include the following: something for pain, an antibiotic to take for a few days and some medication to prevent nausea. Stool softener, if necessary, can be purchased over the counter. The amount of pain that breast augmentation may cause varies from patient to patient. Most patients report that they experience very little pain and only require narcotic pain medicine for the first day or so after the operation. You will be asked to take the antibiotic routinely as directed until it is finished. Anti nausea medication should only be taken as needed. Patients who have jobs that do not require physical labor/activity can usually return to work in just a couple of days. Dr. Cangello asks that his patients do not return to strenuous physical activity for approximately four weeks, although patients feel good enough to do so much sooner, only one or two weeks after surgery. There is no such thing as a “quick recover” breast augmentation, or any surgery for that matter. The body requires four to six weeks to heal all wounds as a matter of wound healing biology. It does not vary based upon who does the operation or the type of technique employed to perform the operation. Dr. Cangello is very conservative and wants to assure his patients achieve the most stellar outcomes which are better assured when activity is minimized until things are completely healed.
In general, swelling is usually completely resolved and the implant settled in position for the near final result in about three months. Until such time the breasts may look a bit asymmetric or even awkward in shape. Invariably, as swelling subsides and the skin envelope stretches to accommodate the new implant the breasts improve in their appearance over the first one to three months. After four weeks you can wear any type of bra you chose. You may return to limited activity within a few weeks and may resume exercise and full activity usually in four to six weeks.
See Breast Augmentation at the American Society of Plastic Surgeons
Please call the office at 212-644-4416 to set up a consultation or if you have any questions about this procedure that you would like answered.
Copyright © 2014 Dr. David Cangello. All rights reserved.