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Breast Augmentation

The term “mammoplasty” (also referred to as “mammoplasty”) is used to describe any surgical procedure of the breast which can include augmentation, lift, or reduction surgery. Breast augmentation is a procedure to enlarge the breast. This can be achieved either through the use of an implant or by using the patient’s own fatty tissue that has been removed from the thigh or buttocks and injected into the breast. At Wall Street Cosmetic Surgery, our cosmetic surgeons are experienced and skilled in different types of breast augmentation procedure, including “natural breast augmentation” using the patient’s transplanted fat cells.

For many women who have experienced a fluctuation in their weight, have been pregnant, breastfed for a significant amount of time, or those who have small breast size due to genetic factors, a breast augmentation is a wonderful way to enhance their figure and to increase self-confidence. A breast augmentation may be perfect for you if this is what you are also looking to achieve!


Types of Implants

Saline:

An unsealed implant with a flexible plastic shell (for natural appearance, feel and movement) that is filled by the surgeon with sterile saline solution and then sealed shut. Usually, the saline implant is filled to its pre-determined size (by the sizes offered by the manufacturer), measured in cc’s, and then overfilled to a specific capacity to avoid “rippling” and “sloshing” after the patient’s breast is closed up. Rippling can occur when an implant is not filled to its optimal capacity, causing a visible “ripple” just underneath the skin of the patient. A sloshing noise can occur as well if the implant is not optimally filled or if a large air bubble is left inside of the implant shell.

Silicone:

A pre-filled flexible plastic shell filled with thick silicone that is completely sealed when inserted into the patient’s breasts. Silicone offers the most natural look and feel to a natural breast of the equivalent size. Silicone is often times the choice of post-mastectomy or lumpectomy patients who have lost all or part of their breast to cancer. Though there have been patients whose implants have ruptured years later, there is no evidence to support that silicone breast implants are less safe than saline implants.

High Profile:

This type of implant can either be filled with silicone or saline. The difference with the high profile implant is that, when lying on a flat surface, the implant is taller than a standard profile implant. Standard Profile: This implant is the most commonly preferred style of implant because it most-closely imitates the height and width of a natural breast.

Tear Drop Shape:

The tear drop shaped implant looks exactly as it sounds; it is oblong in shape with the thinner upper portion looking like the top of a tear drop. It increases gradually in size toward the bottom of the implant which is shaped like the bottom of a tear drop. The overall height of the implant is somewhere between a standard-profile and high-profile implant. This implant is best for women who wish to have an oblong shape to their breasts versus a rounder shape.


Types of Incisions

The place where the incision can be made is a personal choice for many patients and largely depends upon individual preference rather than practicality. For example, if a patient has hanging breasts with a crease underneath, it may be their preference to place the incision hidden under the crease. If they feel that an areolar incision (around the perimeter of the nipple) is not right for them, they can choose an incision under the arm or through the navel. Sometimes, the surgeon may favor particular placements for the incision and will suggest one of those options. The following is a list of the four different types of incision placements that we use for breast augmentation:

Inframmary

This incision is located on the underside of the breast, right in the crease where it is hidden from view. Many women choose this type of incision for that fact alone. For saline implants, the surgeon makes a ¼” incision in the crease under the breast and tunnels into the breast cavity beneath the muscle where the implant will be placed. The empty implant is then rolled up and a filling tube is attached to the bottom where the opening of the implant is located. The surgeon fills a syringe with saline solution and gently fills the implant, one syringe at a time, until the desired fullness is achieved. With silicone implants, the implant itself is already prefilled and sealed. The incision will be slightly larger underneath the breast to accommodate the pre-filled implant. However, the scar is just as hidden from view as with the incision made for a saline implant.

Transaxillary

A transaxillary incision is located in the armpit area. A very small incision is made in the armpit and then a tunnel is made using a surgical tool or endoscope in some cases. Even if an endoscope is not used with the transaxillary method, the only incisions are in the armpit and hidden from view. As with the procedure described above, the saline implant is rolled up and placed through the armpit incision and then filled when positioned in its place within the breast cavity underneath the chest muscle. The silicone implant procedure is also similar; the pre-filled implant is inserted through a larger incision than is made when inserting a saline implant. Even though the scar is well hidden in the armpit in either instance, many surgeons prefer not to use this method with a pre-filled implant.

TUBA

This is the most recently developed type of incision for breast augmentation. The full name for this type of procedure is the “Trans-Umbilical Breast Augmentation”. It is also referred to as the “No Scar” method. The procedure can only work with saline implants that are unfilled prior to insertion. A small, curved incision is made just above the navel so that when the incision is closed, it is camouflaged by the belly button’s natural shape. An endoscope (long, tubular camera) is inserted into the incision and a tunnel is made up the center of the abdomen in side of the fatty layer under the skin. Once the implants are placed underneath the chest muscle in the breast cavity, they are filled with saline and the small incision in the navel is closed with only a few dissolvable stitches.

Areolar

Also referred to as the “peri-areolar” and “nipple incision”, the areolar incision is located in a discreet area somewhere along the border of the nipple to gain access to the chest wall and breast cavity. This is one of the most direct ways of reaching this area and is also one of the most popular. Either unfilled saline or pre-filled silicone breast implants can be used with this method because the incision site can easily be widened as needed without compromising the ability to hide the scar afterwards. Your surgeon can best advise you about whether this type of incision is right for you; in some cases, a loss of sensation in the nipple (temporary or ) can occur.

We have two New York area offices conveniently located near most of our patients, both in Manhattan and on Long Island. You can book a free consultation by visiting our contact us form or by calling our main office at 516-259-0915.

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