Breast Enlargement

Breast Enlargement or augmentation is the most common of the cosmetic breast procedures. The goal of this procedure is to obtain a "tear-drop" shape with an increased size proportional to the rest of the body. During evaluation of patients, Dr. Aboolian considers the location of incision, the type of implants, placement of the implant either under the muscle or over the muscle, and the size of the implants. There are advantages and disadvantages of each choice.

Location of the incision may be placed at four different sites – around the nipple/areola complex, at the fold created by the bottom portion of the breast where it meets the chest wall, in the under arm area, or in the belly button. He has used all four of the incision sites however; he prefers an incision of approximately 3 cm, placed at the edge of the lower half of the areola. The incision becomes almost invisible in approximately four to eight months. There is almost always no loss of sensation to the nipple, unless the nerves supplying the nipples are cut during surgery, or extremely large implants are utilized which create tremendous pressure on the nerve supply. Future breast feeding is also not compromised with this incision.

At the present time, the U.S. Food and Drug Administration (FDA) permits the use of either saline or silicone filled implants. The most common implants used are saline filled and they may be used in anyone requesting breast enlargement. On the other hand, the use of silicone (gel) filled implants is restricted to women who satisfy specific criteria set by the FDA, such as those requesting breast reconstruction after trauma or cancer surgery or those needing a breast lift (mastopexy) with simultaneous enlargement. Furthermore, there are many variations of saline and silicone filled implants. Common types include textured, high profile, tear shaped and others.

Implants can be placed either on top or under the chest wall muscle. Dr Aboolian almost always prefers to place the implants partially under the muscle (90% under, 10% over the muscle). There are two main reasons for placing the implants under the muscle; the first is to lower the incidence of the most common complication associated with breast augmentation which is capsular contracture (a condition where scar tissue forms around the implant and causes hardness). The second reason is that the implant is more effectively camouflaged, thus decreasing the chance of implant visibility. Furthermore, the partially under the muscle technique produces the most natural appearance.
Perhaps most important for aesthetics result, is the development of a partnership between the doctor and the patient. Most individuals agree with physician recommendations for implant size. Experience with thousands of enlargement procedures is critical in assisting patients to achieve the most appropriate implant size when seeking breast enlargement.

The procedure takes a little less than two hours to complete, and is performed in an outpatient setting where the patient is sent home within several hours following surgery and recovery. Within five to seven days most people resume the majority of their daily activities. Return to vigorous exercise requires more healing time.