Breast Augmentation

Under the care of Dr. Preminger, breast augmentation is performed on an outpatient basis. During pre-op consultations, the implant type, size and placement will have been decided. Incisions can be made within the crease of the breast fold, along the lower border of the areola, or within the underarm fold (transaxillary). Dr. Preminger will factor in patient preference and anatomy when deciding which type of incision to use.

The procedure generally lasts from one to two hours and is performed using general anesthesia. After the breast implants have been correctly positioned, the incisions are closed with sutures, and then covered with surgical bandages. A sports bra and compression band is also used right after the operation to help keep the implants stable during the recovery process.

Preparing for Breast Augmentation

Preparing for breast enhancement entails a good deal of planning. Dr. Preminger will assess your motivations for breast augmentation surgery, review your medical history and preexisting health conditions and take measurements to determine a baseline for desired fullness. Ideal candidates for breast augmentation are patients in good health with realistic expectations about how the surgery can help them both physically and emotionally.

Pre-operative consultations are in-depth, allowing Dr. Preminger to develop a detailed surgical plan that suits the patient’s lifestyle, anatomy and goals. After being educated on the pros and cons of silicone versus saline breast implants, and choosing your implant type, a customized treatment is designed. Considering breast surgery risks is another component of the planning process.

Implant placement and technique will also be evaluated. Women who are naturally small-chested may do better with the implants placed beneath the chest muscle, rather than directly under the skin. In general, Dr. Preminger prefers this approach since the muscle provides added coverage for the implant and allows for a more natural shape. Other advantages of this technique include less risk of capsular contracture, and fewer difficulties with mammograms.

When women are considering breast augmentation surgery, one of the biggest decisions is whether to choose saline, silicone, gummy bear, or IDEAL breast implants. Each has distinct advantages and appeal. Dr. Preminger will discuss your aesthetic goals in light of your current cup size to help determine which implant will create a breast profile in proportion with your body.

Gummy Bear implants

Gummy Bear implants are the latest newcomers to the market, made with a “form stable” or highly cohesive gel that maintains its shape over the years. Proponents of the gummy bear implant say that it looks and feels even more like natural breast tissue than traditional silicone implants, thanks to its revolutionary high-strength gel that defies gravitational forces.

Besides its gummy bear-like feel, this implant is the only one designed with a tear drop shape. Approved by the FDA a couple of years ago, these implants have a good safety record, with a lower risk of capsule contracture as well as lower reoperation rates. Preliminary studies have also shown they are less likely to ripple or leak due to the viscous, almost solid-like, nature of the gel. These implants are an excellent option for primary breast augmentation, revision augmentation and total breast reconstruction.

Saline breast implants

As their name implies, saline implants are filled with a sterile saltwater solution. The outer shell is made of a smooth or textured silicone. Some implants are pre-filled with saline solution, while others are filled with saltwater at the time of breast augmentation surgery, allowing for a much smaller incision. The FDA approved saline implants for breast enhancement surgery in women aged 18 and older, as well as for breast reconstruction in patients of any age.

While scars are smaller, saline implants may not feel quite as natural as their silicone counterparts, and tend to ripple more. On the other hand, scar formation and capsular contraction is much less common in saline implants compared to their silicone counterparts. For optimum results, appropriately sized implants will be placed under the chest muscle, with sufficient soft tissue coverage. Since saline implants can be filled during surgery, your surgeon can easily correct any breast asymmetry.

Video Transcription:

[Dr. Preminger] The most important thing that you need to know about breast augmentation is that it’s safe and that you have a lot of options. Those include implant size and the type of implant. So these days, we have lots of different options. And those include the traditional saline implant, silicone implants and new gummy bear implants.

We also have newer shaped devices. So one of the questions patients always have for me is, “Are silicone implants safe?” In 1992 the FDA actually pulled silicone implants off the market. The data that was used to pull them off the market, was found to not be valid. And so now we have silicone implants back on the market since 2006. We have the newest, cohesive 5th generation gels that have shown to be completely safe.

When we talk about breast implants the other questions that come up are incision placement– where do we put the implant in from? There are different options as far as that’s concerned as well. And those include the underarm, the area underneath the breast and the areolar or the pigmented area underneath the nipple.

[Patient] I wanted to have breast implants done because I felt I needed to be a little bit more proportionate. I had always spent a lot of time in the gym and worked on my body and I just felt that that was one area where I couldn’t really exercise or fix on my own. I started to look into the procedure and I decided it was something I wanted to do.

I chose Dr. Preminger because when I met with her, I felt really comfortable. I had researched a really long time and wanted someone very knowledgeable in the area– that specialized in that area. I also felt really comfortable that she was a woman and she just gave me the time to make the decision. I didn’t feel rushed into anything.

[Dr. Preminger] In this case, the patient actually has an asymmetry or a size difference between her two breasts. Her left breast was larger than her right. And that’s actually not at all uncommon. In fact, most womens breasts are not exactly the same size. I like to tell women that they’re more like sisters than twins. In order to accommodate and compensate for this difference, I actually used two different size implants. So I used a larger implant on the right side than the left to accommodate for the fact that her left breast was actually larger than the right.

So the hardest part about breast augmentation is actually all of these choices. Once we’ve made these decisions, the recovery and surgery itself is actually quite easy. People are amazed by how quickly they’re back to their activities. They’re back at work within a week usually. They’re very, very satisfied with the results.

[Patient] The recovery was perfect. I was in less pain than I thought I would be in. I was up the next day walking around. I was out that weekend. I felt very minimal pain. I was back in the gym a little while after that. The recovery process was extremely smooth.

I would definitely recommend Dr.Preminger for this procedure because she just made me feel very comfortable. And like I was the one making all the decisions and she displayed all possible options.