For many women, breasts and body image are intricately linked. If you’ve been dissatisfied with your breasts, you have a constant reminder every morning when you get out of the shower or when you’re looking for a new swimsuit or workout clothes. Maybe you feel your breasts aren’t in proportion with the rest of your figure. Maybe you have some degree of asymmetry. Maybe you’d just like to have a shapelier figure.
The reasons a woman seeks to have breast augmentation are purely personal and unique to her. Dr. Kimmel’s board certification and extensive experience with augmentation assure you’ll be thrilled with your new figure.
When considering breast enhancement surgery or indeed any cosmetic procedure, be sure to select a qualified, experienced plastic surgeon, certified by the American Board of Plastic Surgery (ABPS). As a board-certified plastic surgeon with over 20 years of clinical practice experience and member of the American Society of Plastic Surgeons (ASPS) and American Society of Aesthetic Plastic Surgery (The Mark of Distinction in Cosmetic Plastic Surgery® ASAPS), Dr. Robert Kimmel welcomes the opportunity to help you achieve your goals and enjoy a happier, more confident lifestyle.
Breast augmentation is a surgical procedure where saline or silicone breast implants are placed into pockets created in front or behind the pectoral muscle on the chest. Augmentation changes the breast size, projection characteristics, and volume, particularly on the upper breast. Breast augmentation is a popular procedure with Dr. Kimmel’s patients, and for the whole country. For the past number of years, this procedure has been the most popular cosmetic surgery in the U.S.
The reasons a woman elects to augment her breasts are myriad. Often a patient expresses the desire to have breasts that are more proportional to the rest of her figure. In many cases, patients have never been happy with the size or shape of their breasts. With the passage of time, the breasts can flatten to a degree, and some patients want to add volume. Other patients simply want to have larger breasts and a curvier figure.
One thing that Dr. Kimmel stresses with his patients considering augmentation is that the decision needs to be made for you first and foremost. This isn’t something to have done due to pressure from a spouse or partner. It’s important that this is what you want.
That said, breast augmentation has one of the highest satisfaction rates of all cosmetic procedures. A recent survey conducted by the American Society of Plastic Surgeons found that 98 percent of women felt their augmentation either met or exceeded their expectations. Over 90 percent of the women also said they felt the procedure increased their self-esteem.
Contrary to the stereotypes often portrayed by the media, most women who are interested in breast enhancement are seeking only a modest increase of about 1 – 1 ½ bra cup sizes and generally, wish to appear “noticeable but not unnatural”.
Some patients seek enhancement because their breasts never developed to a size that meets their expectations, while other patients desire improved balance in the proportion between their upper and lower body, allowing improved fit and greater flexibility in clothing styles. Still, other women may want to establish symmetry between breasts of significantly different sizes (see ‘Breast Asymmetry Correction’). A progressive loss of breast volume may commonly occur following pregnancy, weight loss or aging and is readily treated by breast augmentation.
During your initial consultation with Dr. Kimmel, he will go over with you in detail the breast implant options that would be a good fit.
Breast implants are all made with a silicone-grade outer shell. The different options are classified by what is used to fill the implants. This basically comes down to saline or silicone gel, with a couple of variations within each category.
Silicone gel implants consist of a silicone outer shell filled with medical-grade silicone gel. Today’s silicone gel is more “cohesive,” meaning it stays together and within the shell more if the implant ruptures. Compared with the more-liquid silicone used in the 80s and 90s, today’s gels are more like gelatin.
The consensus is that silicone implants feel more like natural breast tissue when compared with saline implants. An obvious disadvantage is if the implant ruptures. This can allow some of the silicone gel to leak into the breast pocket that was created to hold the implant. When this happens, the patient doesn’t usually know, as the implant retains its shape. The leak will show up on the regular mammograms necessary with silicone implants. The ruptured implant and any leaked gel will need to be removed and the implant replaced.
Saline implants consist of a silicone outer shell filled with a sterile saline solution. Unlike silicone implants, which are filled at the factory, saline implants are placed into the breast pocket empty and are then filled in place. This allows these implants to be placed through smaller incisions. It also allows some flexibility with size.
If a saline implant ruptures, the body simply absorbs the saltwater. But when this happens the implant will fully deflate, leaving the patient with one flattened breast. And, while the saline will be absorbed, the ruptured shell will still need to be surgically removed and replaced.
Ideal Implant® is a relatively new option in saline implants that are becoming popular. The Ideal Implant® is made with a series of nested implant shells and two separate chambers that hold the saline solution. These implants provide the security of saline solution (in case of rupture), but they feel more natural, like silicone implants. Plus, unlike regular saline implants, they don’t have problems with wrinkling and folding.
Although technically silicone, gummy bear implants are different and deserve their own description. Gummy bear implants are made with “highly cohesive” silicone gel — think of the consistency of a gummy bear. This gel is much thicker than the gel used in other silicone implants. If a gummy bear implant is cut in half, the gel will remain within the shell and not leak out.
Gummy bear implants are also created in a teardrop shape, which is closer to the shape of the natural breast.
Dr. Robert M. Kimmel performs the breast augmentation procedures at Keystone Surgery Center (KSC), a State Licensed, Nationally Accredited Ambulatory Surgery Center (see ‘about Keystone Surgery Center’), on an outpatient basis under general anesthesia, lasting 1 ½ to 2 hours.
Keystone Surgery Center represents an ideal environment for any cosmetic or reconstructive surgery that you may be considering.
“There is nothing I would say to change. Every employee on the day of my surgery treated me so well. They accommodated me in everyway possible and helped alleviate my worries and stress. Everyone there helped make the day as easy for me as possible, which was greatly appreciated.”
-E.K. from Orwigsburg, PA
This is not a difficult procedure. During your consultation with Dr. Kimmel, the two of you will discuss the options for your incision location. Implants can be inserted through an incision made around the areola (areolar), along the breast crease (inframammary), or through the armpit (transaxillary).
Augmentation is performed as outpatient surgery at our fully accredited Keystone Surgery Center. Patients are placed under general anesthesia. The surgery takes from 45 minutes to one hour. Incision length is generally about one inch for placement of saline breast implants and 1.5-2 inches for silicone implants. This difference is because saline implants are filled after placement, while silicone implants are placed already filled.
After the incisions are made, a pocket is created behind each breast that will hold the implant. Then the implants are inserted. Dr. Kimmel checks for symmetry and position and then closes the incisions with tiny sutures to minimize scarring.
Dr. Kimmel has extensive experience with various incision locations. He takes meticulous care to avoid injuring the nipple (to not affect sensation) or the milk ducts (to not impact breastfeeding).
Many of our Keystone patients are surprised at how easy it is to recover from augmentation surgery. You’ll return home just a couple of hours after your surgery. Dr. Kimmel will have placed bandages on your breasts and you’ll be wearing a surgical bra for support. We prescribe pain medication, but most patients don’t feel the need to use it, opting instead for over-the-counter pain medication. The pain isn’t acute, but more a feeling of soreness. Some patients equate it to the feeling after a hard upper body workout at the gym.
After one day, you’ll return to either our Pottsville or Hazelton offices and Dr. Kimmel will remove the bandages and check your incisions to be sure healing is progressing as expected. At this point, we’ll show you how to massage your breasts to relax the muscles and help the implants settle into their breast pockets. This type of postoperative massage has been proven to significantly reduce the risk of capsular contracture (where scar tissue contracts and hardens around the implant) and decrease discomfort.
Most patients can return to work approximately 3-5 days after surgery. Your sutures will be removed after one week. You’ll wear a support bra 24 hours a day for one month after your surgery so as not to place any stress on your incisions. This is very important. Normal activities can resume in 1-2 weeks, but any impact exercise will need to wait for one month. Upper body exercise, such as lifting weights, will need to wait for six weeks.
After breast augmentation surgery, most women return to work in 1 to 2 weeks.
Breast implants have become more durable, particularly the new gummy bear implants. Still, you shouldn’t think of augmentation surgery as a one-and-done procedure. Most implants have a 10-year warranty, as an offset should a replacement be necessary. That’s a good benchmark for expectations of durability. Some implants can last far longer; others fail sooner. When a rupture occurs, you’ll need to have the implants replaced. So, you should probably estimate having at least two additional surgeries in your lifetime. Replacement surgery usually can be done through the original incisions.
The most obvious incision scars are for inframammary placement on the breast crease. These scars are short and fade quite quickly. Incisions around the areola or through the armpit make scars that are virtually undetectable in a very short period of time.
With current digital technology, there is no problem obtaining a mammogram after breast implants have been placed, and implants have no effect on a woman’s ability to breastfeed. Immediate gratifying results and long-lasting figure improvement combined with a confirmed safety record make breast enhancement an appealing choice for many women.
Breast augmentation is a major surgery, so it entails all of the potential risks such as anesthesia reaction, bleeding, infection, and the like. For augmentation, there are some specific risks. These include the loss of nipple or breast sensation, implant leakage or rupture (if the implant is somehow nicked during placement), or improper positioning.
The main problem or complication with breast implants is the formation of scar tissue around the implant. This is called capsular contracture. This is the body’s reaction to the implants, which is to build scar tissue around them. If the scar tissue becomes too aggressive, it may deform the implants and cause them to feel overly firm or hard. If this happens, they will need to be replaced and the excess scar tissue removed.
More information is available on the FDA website.