Breast Augmentation Introduction
Through breast augmentation, Dr. John Kim helps his patients achieve their own unique and natural brand of change. Using saline or silicone implants to enhance the shape and size of the natural breast, Dr. Kim helps patients achieve the cosmetic improvement they desire. He will help create a more confident, beautiful you.
Women choose breast augmentation, or augmentation mammoplasty, for a host of reasons. It is an ideal procedure if you are unhappy with your native breast size and want larger, fuller breasts. It is also a great option if you have lost breast fullness or contour after weight loss, pregnancy, or breast feeding. Or, if your breasts are dissimilar in size and shape, breast augmentation can restore symmetry. Breast implants can increase breast fullness and projection, improve the overall balance of your figure, and enhance your confidence, self-image, and self-esteem. Breast augmentation can have a positive impact on your life, as it has for so many of Dr. Kim’s patients.
If you breasts sag or droop and you wish to improve this, the addition of implants alone will not fully correct the issue; Dr. Kim will recommend you combine your augmentation with a breast lift, also known as a mastopexy. The combination of the augmentation and the lift is called an augmentation mastopexy, and they can be performed in the same surgery.
Take a look at Dr. John Kim’s article “A systematic review and meta-analysis of single-stage augmentation-mastopexy” here.
Choosing Augmentation Mammoplasty
The decision to undergo augmentation mammoplasty is a very important and personal one. You should choose to have this procedure for you, and not to meet someone else’s expectations. Ideal candidates are in good physical health and have realistic expectations and goals. You should have fully developed breasts and be unhappy with their size, shape, and volume. During your consultation with Dr. John Kim, the two of you will discuss your expectations and the different options you have to achieve your augmentation goals. Namely, he will review the various implant shapes, types, fills, and projections, as well as incision locations.
During your consult visit, Dr. Kim will carefully examine your breast size, shape, skin quality, and nipple location. He will also explain the risks associated with this particular surgery. As with any surgery, there are risks associated with infection, bleeding, and anesthesia. Dr. Kim will help you to understand the risks so you can make a fully informed decision. It is important to note that the scientific literate has found no proven link between breast prostheses and autoimmune or other diseases.
Dr. Kim creates incisions that are small and hidden to minimize visible scarring. During your consultation, he will discuss which incision type is appropriate for your augmentation goals. Options include:
- Periareolar → located at the lower border of the areola (colored part surrounding the nipple)
- Inframammary → located directly underneath the breast, in the fold between breast and chest wall
- Transaxillary → located in a crease in the armpit
Saline or Silicone Implant Choice
Choosing your new breast size and shape is the most important decision you will make as you plan your breast augmentation. Several manufacturers create many different types of implants with variations in shape, profile, size, fill, and surface texture. Dr. Kim will assist in choosing the correct implant to match your desires for you new and improved breasts. You should be open and honest with Dr. Kim about your expectations. He will then explain how your personal anatomy and skin elasticity will impact your implant selection. One of the main considerations when choosing your implant is whether you want saline or silicone.
Saline implants are made from a silicone-based outer shell that is filled with sterile saline (saltwater) solution. The saline solution is typically added to the shell during surgery, but some saline implants come pre-filled. A major benefit of utilizing a saline implant is that Dr. Kim can adjust the final size intra-operatively (during your surgery) if adjustments are needed, since he can add or remove saltwater as he sees fit. Per your pre-operative discussions with Dr. Kim, he is aware of your goals and expectations, so he can use his surgical eye and expertise during the actual operation to ensure you are as satisfied as possible when you wake up.
Another benefit to using a saline implant is that if it were to rupture, the leaked saline solution will pose no harm to the body. In fact, our body naturally absorbs saltwater and excretes it easily. Upon noticing the rupture, you will come in to see Dr. Kim and he will surgically remove the implant casing and replace it with a new one.
Silicone implants consist of a shell filled with thick, elastic gel. This gel moves and feels like natural breasts tissue, so it is a popular choice among Dr. Kim’s patients. In 2012, a new type of silicone gel implant technology was approved by the FDA. These new implants consist of a highly cohesive, high strength gel, and thus they are referred to as “cohesive gel”, “gummy bear”, and “form stable”. When this type of implant is cut or penetrated, it retains its shape (hence “gummy bear”). As with normal silicone gel implants, these too feel like natural breast tissue and are thought to reduce the undesirable side effects of liquid-filled implants, namely folding, wrinkling, rippling, and over-filling.
When a silicone implant ruptures, it is much less noticeable than when a saline implant ruptures. The slow leaking of the silicone gel to areas outside the breast may go unnoticed for quite a while. Our bodies do not naturally absorb silicone as they do saline, though, so it is important to see Dr. Kim right away if you suspect a rupture, as he will need to surgically remove the shell and silicone and replace it with a new one.
Other Implant Features
In addition to fill type, implant size, shape, and profile are important considerations when choosing implants for your breast augmentation.
Breast size is a very personal decision, and you should choose a volume that you desire and is compatible with your individual anatomy. During your consultation, Dr. Kim may suggest you have 3D photographs taken so you can simulate how different sizes will appear on your body. Dr. Kim likes to offer his patients the opportunity to explore their options visually.
Breast shape options include round and anatomical. Round implants are spherical. Anatomical or “shaped” implants have a tear-drop form, in an attempt to more closely mimic the natural shape of the breast. Shaped implants are textured so as to avoid rotating within the breast cavity and to maintain their upright position. With spherical implants, they shape the breast the same regardless of how they are rotated, so these are often smooth in texture.
Breast implant profile refers to the projection from the chest wall. Projection options are typically high profile, moderate profile, and low profile. A low profile implant does not project as far from the chest as a high profile implant.
Breast Augmentation FAQs
Am I a good candidate for breast augmentation?
The best candidates for breast augmentation are women over the age of 18 who are unhappy with their breast size or shape and are looking to alter their appearance. Patients must also be psychologically stable, physically healthy and have realistic expectations.
What should I expect from my breast augmentation surgery?
Breast augmentation typically takes approximately one hour to complete. It is performed in an outpatient surgery center under general anesthesia. The implant will be placed in the chosen area through a small incision. Once the incision is made, the breast tissue is lifted to make a space or pocket into which the implant is then inserted. The implant will be placed either above or beneath the chest muscle. After the implant is inserted, the incisions are then closed. Tape may be used for added support and the breasts may also be wrapped with gauze or other bandages.
How do I choose the correct implant size?
Breast size is difficult to quantify and the implants themselves do not translate to a specific bra size. Choosing an implant size is a very personal decision. Dr. Kim will listen to your goals and desires for your surgery and will help you determine which size is best for your body, lifestyle and desires.
How Much Does Breast Augmentation Cost in Chicago?
Dr. John Kim is a leading breast augmentation surgeon in the Chicago area. The average cost of a breast augmentation procedure depends on the type of the implant (silicone vs saline), the desired size of the implant, and the type of procedure that the patient will be undergoing. Generally, breast augmentation surgery in Chicago will cost between $7,500 and $8,500. This expense includes the surgeon’s fee, the anesthesia fee, and hospital fees, but may not include post-operative care and prescriptions required. To receive a personalized breast augmentation cost estimate, schedule a consultation with Dr. Kim.
Can breast augmentation fix asymmetrical breasts?
If a woman has asymmetrical breasts, breast augmentation may help in creating a more symmetrical, aesthetic look. If size is an issue, one breast implant may be a slightly different size than the contralateral implant. Sometimes breast augmentation is performed on one breast and breast augmentation and lift, breast lift alone, or even breast reduction is performed on the opposite breast simultaneously.
What is the “profile” of an implant?
There are a few profiles of implants: low, moderate, moderate-plus and high. High profile implants project farther than moderate profile implants and are narrower in circumference. Moderate profile implants are wider in shape and do not project as far. The moderate-plus profile falls in the middle of the two. Choosing a profile that fits your body and frame is important. Board certified plastic surgeon Dr. Kim will help you decide which option is best for you.
How long does breast augmentation take?
Typically, breast augmentation will take between 1 and 1.5 hours to complete. Depending on the particular technique used, the size of the implant, and your personal healing process, the recovery time for breast augmentation varies.
How will I feel after surgery?
Following breast augmentation, patients may experience soreness, stiffness and feel tired. This may last for a few days. To alleviate discomfort throughout this time, you may be prescribed pain medication.
What are the risks associated with breast augmentation?
All surgery carries some degree of risk. While these risks are mostly rare, they include anesthesia reactions, breast-feeding complications (though these are lessened with inframammary implant placement), breast-tissue atrophy, calcium deposits, changes in breast and nipple sensation, deflation or rupture of the implant, excessive bleeding, hematoma/seroma, infection, mammogram interference, rippling, shifting of the implant and toxic shock syndrome.
How long is breast augmentation recovery?
The amount of time it will take to recover from breast augmentation varies among patients. Recovery time may be affected by technique as well. Most patients will be able to return to daily activities in seven to ten days, but should avoid strenuous exercise and other demanding activities for two weeks to a month, depending on Dr. Kim’s recommendations. The breast area may feel tight as the skin adjusts to the new breast size, and the breasts themselves may seem hard and feel tender, but will soften in time. Swelling is common and usually begins to fade within a few weeks. Increased sensitivity to physical contact of the breasts may occur for a month or longer. The scars will be pink following surgery.
How long will I need to take off of work?
The time needed away from work following your breast augmentation depends completely on the type of work that you do. Usually three to five days is needed for most professions; however, those who have more active jobs and use their arms more may need additional time. Eighty percent of your strength should return after two weeks. Those who need to lift infants (over 20 pounds) can do so after a week. Small children can be lifted after two weeks.
When can I expect to see the final result?
Results from breast augmentation are immediately visible. However, the implants take weeks to settle, so an ideal shape will not be achieved until approximately two months following surgery. Because of differences in the size of the muscle and implants, some patients may take more time to obtain their final result.
Will I need to have my implants replaced in the future?
Breast implants are not designed to be “lifetime” medical devices, but they can last several years with proper care. Some women have their implants for 25 years before they need to have them replaced. Some women end up having them replaced at seven to eight years.
It is immediately noticeable when a saline implant leaks, but the saltwater solution is harmlessly absorbed by the body. The implant can be replaced through a simple surgical procedure. Because it is often not quickly apparent that a silicone implant has failed, an MRI or an ultrasound must be used to detect this.
Should I wait until after having children to have breast augmentation surgery?
More than half the patients who get this procedure do it before having children, and most do not experience problems breast feeding afterwards. If this is a concern of yours, discuss it with Dr. Kim and he can talk with you about ways to minimize disruption of the glands to the nipple/areola. The underlying breast implant does not harm the breast-fed baby in any way. Women should bear in mind that future childbearing plans may have a potential impact on the shape of their new breasts.
Will I be able to breastfeed and/or detect breast cancer after my breast augmentation?
Research has not shown that having breast implants increases the risk of breast cancer or delays its diagnosis.
Do breast implants interfere with mammography?
Breast implants, whether located in the sub-muscular or sub-glandular location, can interfere with mammography. Mammography centers are well accustomed to performing mammography on patients who have had breast implants by taking a third view of the breasts.
Can sensation of the nipple/areola be lost after breast augmentation surgery?
A small percentage (less than 5 percent) of patients have permanent nipple/areola sensation loss after breast augmentation surgery. Many patients have temporary loss or hyper-sensitivity of the nipple/areola complex.
For more information on implant options, you can go directly to the manufacturers’ websites. Check out Mentor, Allergan, and Sientra for the latest in implant technology.
Take a look at Dr. Kim’s original article entitled “A multi-institutional perspective of complication rates for elective non-reconstructive breast surgery: an analysis of NSQIP data from 2006-2010” here.
Safety of Breast Implants
Clinical trials research supports the safety of implant use in augmentation mammoplasty. However, women with implants do need to be aware of their new breasts and take precautions to ensure their continued safety.
Implants may break or rupture for a variety of reasons. Blunt force or trauma, a surgical error, or even a routine mammogram can compromise the implant’s integrity. It is important to inform your mammogram technician that you have implants in place so she may know the correct pressure to exert so as to avoid rupture. When an implant ruptures, it needs to be surgically removed. Rupture is typically detected through an MRI or via visual observation of deflation. Capsular contracture is another issue to watch out for. As soon as an implant is placed during surgery, a capsule beings forming. This is the body’s natural response to placement of a foreign material. Gradually, this capsule may tighten, causing the implant to appear almost like a ball placed beneath the skin. The contracture typically causes the implant to sit high and tight on the chest, and it will feel hard, look distorted, and seem to protrude. The affected breast may become sensitive or painful as well. Surgical removal or loosening of the capsule may be required.
If you chose to have silicone implants placed, you may need to pay regular visits to Dr. Kim’s office in downtown Chicago to make sure the implants are properly functioning and have not ruptured. Ultrasound or MRI screening can assess the condition of the implants. In fact, the FDA recommends that starting 3 years after Dr. Kim places your implants you should receive MRI screening for rupture. They recommend an MRI every 1.5 years after the 3 year mark. For further information from the FDA on implant safety, click here. At this time, saline implants are FDA approved for women 18 years of age or older, and silicone implants are FDA approved for women 22 years of age or older. Visit www.breastimplantsafety.org to learn more.
Other Considerations for Breast Augmentation
During augmentation mammoplasty, Dr. Kim places the implant either under the pectoral muscle or directly behind the breast tissue. This will depend on the type of implant you choose, your desired size, and your individual body type.
When considering a breast augmentation, women should keep in mind that the procedure may require some maintenance after the fact. Often, implants needs to be replaced after several years. Your original set of implants is not meant to last throughout your lifetime, as over time the outer shell is more and more likely to fail. The FDA estimates that your implants need to be replaced approximately every 10 years. However, estimates in the literature vary.
As long as you as the patient remain happy with your look and the implants themselves remain intact and safe, there should not be any reason to replace them. It is essential that you monitor your implants and stay in tune with your body. If anything seems out of the ordinary, it is best to schedule a check-up with Dr. Kim so he can assess the status of your implants.
It is possible that this surgery may affect your ability to breastfeed in the future. Some women are able to successfully breast feed; others are not. Dr. Kim has seen that women choosing the inframammary fold incision (fold beneath the breast on the chest wall) or in the axilla (armpit) are less likely to encounter breastfeeding issues than women who opt for the perioareolar incision around the nipple. The periareolar incision may damage the milk ducts and nerves that stimulate breastfeeding. Additionally, the positional placement of the implant may affect breastfeeding. Submuscular placement (under the pectoral muscle) is less likely to damage the milk ducts. The implants themselves have not been shown to be of any danger to the infant. Be sure to bring it to Dr. Kim’s attention if you hope to breastfeed in the future.
The Day of Surgery
Dr. Kim will perform your breast augmentation in Prentice Women’s Hospital in downtown Chicago on the Northwestern campus. Dr. Kim will visit with you in the pre-operative holding area so he may mark your body to identify his plans for operating. He will also review with you which incision and implant choices you settled on during your consultation. You will also meet with the anesthesiologist who will be the physician administering your medicine throughout the surgery.
Typically, the augmentation mammoplasty surgery itself takes Dr. Kim about 1-1.5 hours. First, he creates his incision. Then, he creates a pocket behind the breast tissue or behind the pectoral muscle where the implant will sit. The implant is then placed and filled (if not filled pre-operatively) and positioned properly. Finally, Dr. Kim will close the incision.
When you wake up from surgery, your breasts may be wrapped. You will be allowed to leave the hospital a few hours after you wake up, pending no complications or need for further monitoring. You will likely feel tired following surgery, and you may feel some soreness or pain.
You will pay your first post-op visit to Dr. Kim’s office in Galter Pavilion in downtown Chicago a few days after surgery. At that time, Dr. Kim will review your pain medications, instructions for any activity restrictions, what garments you should be wearing, etc. It will take a few weeks before your breasts are completely healed, at which time you will start to enjoy your new breasts!
Below are some websites you may like to visit prior to settling on breast augmentation surgery. Do your research! There are many quality resources available to you to make the best, most informed decision possible for YOU.
For more information on breast augmentation, please contact board-certified cosmetic surgeon Dr. John Kim at his office at Northwestern Plastic Surgery.