Whether you wish to enlarge your breasts to improve symmetry, to make your body more
proportional, or to reshape your breasts because of sagging and loss of volume from
weight loss or pregnancy, modern breast augmentation may be your answer!
As you begin to look into the subject, you will readily appreciate that you may have a lot of
choices; depending on your anatomy, your body image and other factors, we will be
pleased to assist you in tailoring the most beautiful and most appropriate implant choice for
your body. Truly, every woman is unique, and it is a privilege to be able to help her
maximize her beauty and attractiveness.
The possible combinations for breast augmentation surgery may be confusing. There are
four incision choices, three placement locations (as relates to the chest muscles) and two
basic types of implant, silicone gel-filled and saline-filled. In addition, each implant type
may be available in shaped (anatomical) and round; each round implant has three profiles
(heights, or projections). But--don't worry! Dr. Shuell will review these choices with you and
help you determine the ideal implant and procedure that suits your body--and your
personality.
SURGICAL APPROACHES
- Inframammary Approach: the most common approach used to perform a breast
augmentation is through a small, gently curved incision placed beneath the breast, ideally
disguised within the line of the final breast crease. While it is true that there will be a
scar on the breast itself, the scar is usually quite unobtrusive, and remains completely
hidden by lingerie and swimsuits. The inframammary approach allows your surgeon to
have a direct visual access to the structures underneath the breasts; this approach allows
placement in any of the three possible locations of an implant. The inframammary
incision is used for routine placement in normally-formed breasts, and is particularly
useful--even necessary--in special circumstances such as the presence of major
asymmetry, severely tubular breasts, and when internal restructuring and repositioning
of previous implants is required. Recovery is very quick and patients usually report
minimal to virtually no awareness of their wound post-operatively. As always, Dr. Shuell
will review this and any other technique for your complete understanding.
- Trans-Axillary Approach: Access to the planned breast implant pocket through an
underarm (axilla) approach is a time-tested and reliable means of performing breast
augmentation. Your implant can be situated in any of the three locations available
through the trans-axillary incision. Becoming even more popular as time passes, the
TASF (sub-fascial) technique is another of the 'scarless' breast augmentations, as the
scars are hidden within the folds of the underarm creases, and remain remote from the
breasts.
- Peri-Areolar Approach: An incision may be placed at the junction of the areola with
the lighter surrounding skin; this tends to hide the scar from view; a variation is to place
an incision entirely within the darker areolar margins. The breast augmentation then
proceeds much like the inframammary approach. Dr. Shuell uses this approach less often,
as it can cross over ductal anatomy and potentially affect nursing; a full discussion
of risks and benefits will be available to you to aid in your choice.
- Trans-Umbilical Approach: 'TUBA,' as it is called, is a 'scarless' access, placing a
single incision within the belly button, then moving in an upward direction toward each
breast base. Though only saline-filled implants are placeable via this route, many patients
love the virtually invisible scar, with no evidence of a scar on the breasts or the
underarms. The natural drainage of fluids from the breast pockets downward to the belly
button seems to reduce post-operative bruising and discomfort, and may also decrease
the risk of capsular contracture in the future.
