Orange County Breast Augmentation Surgery

Dr. Hootan Daneshmand

Breast augmentation, also called augmentation mammoplasty, involves the placement of implants to increase breast volume and enhance shape. Orange County breast augmentation is very helpful in treating women who have been pregnant and have volume loss and breast ptosis (sagginess). In addition, many women choose to have their breasts enlarged in order to simply have a fuller cup size. Orange County breast enhancement can safely be performed after the breasts are fully developed.

Breast augmentation surgery has become one of the most popular cosmetic procedures in the United States today. Breast augmentation is the second most common cosmetic surgical procedure performed on women in America. It is estimated that
1 to 2 million women in the United States have had breast augmentation, with over 250,000 women in 2003 alone. This represents over 1% of the entire adult female population and a 20% increase from 2002.

Orange County breast enlargement surgery is carefully tailored to the individual patient. This surgery is designed to meet your individual needs with the goal of giving you the size and shape you want. Breast augmentation can help create cleavage and upper breast fullness or may be used to re-establish the breast size and shape. Orange County breast implants can be used together with lifting procedures to restore a more youthful breast shape and size.

There is a great deal to learn and understand prior to undergoing surgery in Orange County for larger breasts. At Silhouette Orange County Plastic Surgery, we strongly believe that a well-informed patient will make a better decision when it comes to undergoing surgery. We hope that the following commonly asked questions can help you gain a more complete understanding of Orange County breast surgery. We welcome you to visit with Dr. Daneshmand to discuss your individual desires and questions regarding breast surgery or other procedures such as Orange County Liposuction.

Am I a good candidate for surgery?

Breast augmentation can be used to enlarge smaller breasts, fill out breasts that have lost volume after childbirth and aging, or to correct underdeveloped or deformed breasts. How well breast augmentation will suit you will depend on your individual examination and personal expectations. As long as there is an informed and clear understanding as to the reasonable expectations of the procedure, you can anticipate a satisfying benefit from breast enhancement surgery.

Is breast augmentation safe?

Yes. Breast augmentation is a commonly performed surgical procedure. The surgery can be performed in an outpatient setting. More and more women are choosing breast enlargement surgery, with good reason. Breast enlargement is proving to enrich women’s’ lives and restore their self-confidence. With safer procedures and less scarring than ever, it is clear why women are choosing breast enlargement. *Every surgical procedure carries some risk. For a discussion of the specific risks of breast augmentation please continue below.

What is Breast Augmentation?

Why Choose a Board Certified Surgeon?

One way to lessen the risks of breast augmentation surgery is to seek out a board-certified plastic surgeon (certification from the American Board of Plastic Surgery). These qualifications ensure that you and your well-being are in good hands. Each ASPS Member Surgeon:

  • Has at least five years of surgical training and a minimum of two years of plastic surgery training.
  • Is board-certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
  • Is trained and experienced in all plastic surgery procedures, including breast, body, face, and reconstruction.
  • Is peer-reviewed for safety and ethical standards prior to attaining the honor of active membership.
  • Only operates in accredited facilities.

Should the implants be placed above or below the muscle?

There are several advantages to placing the implants below the muscle (submuscular). The extra coverage of the implant in the upper portion of the breasts assists in achieving a more natural contour and appearance. The implant is also less likely to be as palpable when it is placed under the muscle. The nerves that supply nipple sensation are less likely to be affected by this approach. There is evidence that scar tissue formation around the implant (capsular contracture) is reduced. Another important benefit is that there is less interference with mammography because the implant is partially separated from the breast tissue by the muscle. For these reasons, we generally feel that it is advantageous to place the implants below the muscle. However, breast surgery must be individualized and there are some situations where placing the implant above the muscle (sub-glandular) may be more appropriate.

Where is the incision located?

There are four main choices for incision location: periareolar, inframammary fold, transaxillary, and transumbilical. There are advantages and disadvantages to each approach.

  1. The periareolar incision heals with an extremely inconspicuous scar because of the natural color border present between the areola and surrounding breast tissue. The periareolar incision can be used in almost all patients and most choose this location. Another advantage is that if a small lift is necessary, it may be done through this incision to correct minor asymmetries.
  2. The inframammary fold location is also possible. The main disadvantage of this approach is that the potential for a visible scar if a bathing suit “rides up” when lying down.
  3. Although the transaxillary approach is not as widely applicable and has certain limitations, this works well for some patients. Again, the main disadvantage is scarring in a potentially visible area. The location of the incision does not influence the potential for numbness of the nipple postoperatively.
  4. An incision in the umbilicus (belly button) can also be performed. However, this may not be advantageous as it will void the warranty of the implants.

What type of implants are best?

The shape or style of implant is dependant upon your breasts and your goals. Most women will get the best aesthetic result from round, moderate profile implants. High profile implants may be helpful in women with thin chests who require a smaller breast width for a given projection. Anatomic or “teardrop” implants are occasionally useful. Studies have shown that round implants are equally anatomic and natural appearing once implanted. The type of implant certainly must be individualized to the patient, but most often, round, moderate profile implants achieve the best shape. Implants also come in smooth and textured varieties. There are advantages and disadvantages to both types depending on the particular patient characteristics.

How does the surgeon know what size implants to use?

It is extremely important that you and your plastic surgeon are in agreement regarding your desired breast size and shape. Using named cup sizes is helpful, but not completely accurate because bra sizes vary among manufacturers. A combination of approaches is used. First, measurements of your chest wall and breast are taken. This is followed by getting a preview of your proposed look by trying on implants under a bra in our office and viewing other patient photographs. Another method of size estimation is to place dried rice in a Ziploc bag and measure the ounces (1 ounce = 30cc) to achieve the desired fullness. Finally, pictures of breasts that match your desire can help your surgeon give you the look you want.

Do the implants deflate?

Yes, they can deflate (rupture), but this is not harmful to you. The saltwater is merely reabsorbed by the body and the affected breast will flatten. Rupture of saline-filled implants occurs at about 1% per year, per implant. It is usually a simple procedure to remove the implant and replace it with a new one into the pre-existing pocket. The implant manufacturers offer a warranty for implant rupture, which will help with replacement costs. At this time, it is also possible to change implant sizes or potentially switching to another type or style of implant.

Saline implants or Silicone gel implants?

(See Video “Are Silicone Breast Implants Safe?”)

Silicone gel implants can currently only be used in certain clinical situations dictated by the Food and Drug Administration. This is done under a research protocol and includes patients with a breast deformity such as tubular breast, those in need of reconstruction after mastectomy, and women who have ptosis (sagging breasts) requiring a lifting procedure. For women who undergo breast augmentation to enhance the size of their breasts without the need for a lift, saline implants are used. These are implants filled with sterile saltwater. Saline implants, when used properly, can create a natural-looking, enhanced breast. Please see our photo gallery to evaluate for yourself.

What is capsular contraction? How do I avoid it?

Capsular contracture is when the scar tissue that your body forms around the implant becomes thick and heavily scarred. This is not dangerous to you, but it can cause the breast to become tight, hard, and unattractive. Evidence supports that breast massage after surgery can help to decrease the tendency towards capsular contraction. Additionally, submuscular implant placement can reduce the incidence of contracture. It is very important to follow your surgeon’s instructions in the postoperative recovery period to minimize the chances of capsular contracture.

What about mammography?

Women with breast implants should follow the same mammography schedule as women without implants. Mammography technicians are well versed in compression and displacement techniques used to maximize the efficacy of mammograms on women with implants. Additional modalities such as ultrasound and MRI examinations may also be helpful in certain cases. It is recommended that all women 35 years of age or older have a baseline mammogram prior to undergoing any breast surgery.

Will breast implants increase my risk of breast cancer?

The breast implants themselves do not cause cancer. There is a slight decrease in mammographic breast tissue visualization after implants and additional modalities such as ultrasound or MRI may be used to aid in screening. Previously augmented women do not develop breast cancer at a higher rate than women without breast implants. Mortality from breast cancer is not increased in women with implants and there is no worse prognosis for augmented women who develop cancer versus nonaugmented women.

Does breast augmentation affect my nipple sensation?

Approximately 10-5% of women can have a decrease in nipple sensitivity after implant placement. Care is taken during surgery to avoid harming the nerves that provide sensation to the nipples, although it is not completely avoidable.

Where is the surgery performed?

Breast augmentation is performed at accredited outpatient surgical facilities. Anesthesia is performed by board-certified anesthesiologists and your recovery is supervised by highly trained nurses. This ensures the highest degree of safety and the lowest infection rates.

What kind of anesthesia is used for the procedure?

General anesthesia is the preferred method of achieving adequate sedation and pain control. You will be entirely asleep for the duration of the procedure and awake in recovery before you know it. Board-certified anesthesiologists deliver the anesthesia and care for you before, during, and after surgery so that you have a comfortable and safe experience.

What is the recovery period?

The surgery is performed on an outpatient basis and you will able to go home after surgery. You will be walking around the day of surgery. The degree and duration of discomfort varies from patient to patient. Most women are able to stop taking pain medication after 2-3 days and are back to work and non-strenuous activity at 5-7 days. Low impact activity and exercise may begin at 4 weeks and unlimited activity at 6 weeks.


Medical News on Breast Implants:

Anaplastic Large Cell Lymphoma (ALCL)

In 2011, the FDA identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin’s lymphoma. At that time, the Agency was aware of approximately 60 cases of ALCL in women with breast implants, out of approximately 5-10 million women who had received breast implants worldwide. This included 34 unique cases that were described in the medical literature from January 1, 1997, through May 21, 2010, and additional cases identified by international regulatory agencies, scientific experts, and breast implant manufacturers. Based on this data, the FDA cautioned patients and health care providers that women with breast implants might have a very low but increased risk of developing ALCL.

The FDA also posted on this website a detailed analysis of the 34 cases of ALCL in women with breast implants, provided physicians with interim recommendations on identifying and confirming ALCL, and worked with breast implant manufacturers to include information regarding ALCL in the patient and physician labeling.

Because the FDA knew of so few cases of this disease, it was impossible to determine what factors increased the risk. In a report summarizing the Agency’s findings, we emphasized the need to gather additional information to better characterize ALCL in women with breast implants.

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