breast-procedures

Breast Augmentation Surgery

Popular reasons for a breast augmentation procedure include:

  • Enhance existing breast size.
  • Improve the shape and symmetry of breasts.
  • Correct congenital breast deformity.
  • Restore lost volume from childbirth and breastfeeding.
  • Improve personal confidence.

Breast augmentation involves the use of an implant to augment the existing breast volume. There are many reasons why women choose to undergo breast augmentation. Some patients are looking to enhance their existing breast size and shape to improve the way they look and feel in clothing. Others may have a congenital breast deformity, which can be corrected with implants to provide confidence and a sense of normalcy.

After childbirth and breastfeeding, the expanded breast tissue undergoes a period of deflation, which creates volume deficiency at the top part of the breast. An implant restores this lost volume to improve the way patients feel in and out of their clothing.

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Breast Augmentation Procedure

ENHANCING BREAST VOLUME & SHAPE

Breast augmentation, often referred to as a boob job, utilizes silicone or saline implants to enhance both breast volume and shape. The goal is to create a natural appearance that compliments your existing body shape. Beautiful breasts, according to you.

What to Expect

All procedures are done in a balanced and natural esthetic.

Consultation

Breast augmentations involve an in-depth consultation where we will thoroughly review your goals and expectations. Patients are encouraged to bring photographs of several breast augmentation results that best represent their desired look.

During your consultation, many measurements are recorded, which ultimately facilitate implant choice. Several other factors must be taken into account including chest wall shape, desired appearance (cleavage, upper breast fullness), current breast volume and the capacity of the skin to accommodate an implant. Implants are either silicone or saline, and this is a decision that we will make together. Breast implants have been rigorously studied, demonstrating saline and silicone to have equivalent safety profiles.

Surgery

Surgery is performed at an accredited surgery center in Newport Beach, California, USA and typically lasts 1.5 hours. Under the care of a Board Certified Anesthesiologist, general anesthesia (fully asleep) is used to ensure maximal comfort and safety.

The incision is placed at the breast crease (inframammary fold), the armpit (transaxillary) or around the nipple (periareolar). The risks and benefits associated with each incision will be thoroughly discussed in order to determine which approach will work best for you. Implants are almost always placed below the chest wall muscle; maximizing the soft tissue coverage and minimizing the chance of implant visibility.

PRE-OPERATIVE GUIDANCE

1. Stop all Aspirin, Motrin, Aleve, Fish Oil, Supplements with Omega 3, Ginger, Garlic, Ginkgo Biloba and Turmeric – as these will thin the blood and complicate the surgery. You may take Tylenol as needed.
2. Medications – please notify us of any medications or supplements that you take regularly so that we may advise you appropriately.
3. Please fill all prescriptions prior to surgery so that they may be started immediately upon returning home.
4. Please no recreational drug use or smoking 4 weeks prior to and after the surgery.
5. Please have lab work completed 1-2 weeks prior to surgery.
6. Contact us immediately if you have any change in your health between your pre-operative visit and the surgery date.
7. Arrange for a driver to pick you up from the surgery center. Uber or Lyft are not acceptable. The driver does not have to remain onsite during surgery. they will be called when you are ready to be discharged from the recovery unit.
8. Make sure you have a responsible adult stay with you for the first 24-48 hours following surgery – this is for your safety.
9. DO NOT EAT OR DRINK AFTER MIDNIGHT THE NIGHT BEFORE SURGERY.

Visualizing the volumetric breast change on your own body can be invaluable to the surgical planning process! The Mentor™ 3D Breast Simulator app will facilitate the creation of a “wish picture” prior to your pre-operative visit and works best for augmentation and/or lift procedures. Simply take three pictures as instructed and begin simulating the desired look of your new breasts. When finished, you can securely send your photos to us at info@donaldmowldsmd.com.

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1. Take a shower using anti-bacterial soap – No lotions, hair products, powders, perfumes or makeup.
2. Wear loose comfortable clothing to the surgery center. We recommend wearing zip-up or button-up shirts and loose, comfortable pants.
3. Female patients will be given a urine pregnancy test at the surgery center.

We are here to help you through your recovery. Please do not hesitate to call our office.

Recovery

Patients are discharged home the same day and generally experience very minimal discomfort, often returning to work in the days following surgery. I put all of my breast augmentation patients on an enhanced recovery plan. This involves an immediate return to light everyday activities, which promotes muscle activity and blood flow, preventing lasting discomfort. I ask my patients to gradually resume their exercise regimen over 3-4 weeks following the procedure in order to ensure optimal healing. I ask that my patients wear a supportive bra with underwire for 6 weeks following surgery.

POST-OPERATIVE GUIDANCE

1. Prescriptions provided at your pre-operative appointment should be filled prior to surgery and started when you arrive home. Take the first antibiotic dose at dinner time.
2. Please take a daily stool softener (e.g. Colace) or laxative (e.g. Senokot) while taking the pain medication. Stop if stools become loose.
3. Do not take Aspirin, Motrin, Aleve or herbal medications as these interfere with your blood’s ability to clot.
4. Bruising is a normal part of surgery. Over-the-counter Arnica can help expedite its resolution.
5. Continue to remain hydrated following the surgery.
6. Resume your regular diet, there are no restrictions. If you become nauseous, carbonated beverages and crackers may help settle the stomach. Zofran (Ondansetron) will be prescribed and can be taken as well.
7. Make sure you have a responsible adult stay with you for the first 24-48 hours following surgery – this is for your safety
8. Keep all dressings in place, clean and dry. We will remove them at your first post-operative appointment.
9. Sponge bath only. Do not shower, soak or swim until cleared.
10. Sleep on your back preferably at a 45o angle until cleared for side sleep.
11. If you had a breast augmentation, you will be placed in the underwire bra you were instructed to buy immediately following surgery. Wear this at all times.
12. If you also had a breast lift or underwent a breast reduction, you will be placed in the underwire bra you were instructed to buy at your first post-operative visit. You will wear this for 6 weeks.
13. Ambulate throughout the day to prevent blood clots in your legs.
14. Do not lift anything heavier than a purse and no pushing, pulling, exercise or any activity that may raise your blood pressure until cleared.
15. No smoking – this inhibits wound healing, causing undesirable complications.
16. Driving – Do not drive or perform any tasks that require coordination or judgement for at least 72 hours after general anesthesia or while taking narcotic pain medication.
17. Please call the office if you experience fever, chills, increased pain, wound drainage or if you have any concerns. Our office hours are Monday-Thursday 9am-4pm and Friday 9am-12pm. To reach me after hours, please call the office and follow the prompts.

Results

The increase in breast volume will be apparent immediately following surgery. Breast implants initially appear high on the chest wall, eventually settling into a more natural position following a gradual relaxation in the skin beneath the nipple. The results are expected to be long lasting provided patients’ native breast tissue doesn’t undergo significant change (i.e. pregnancy).

Breast implants are not considered lifetime devices, which means at some point they will need to be replaced. The longevity of the implants is difficult to predict and varies by patient. Saline implant rupture manifests as a complete deflation of the breast, while detection of a silicone implant leak may require further investigation.

FAQs

I take implant choice very seriously as I believe that this is the key to a successful surgery. During your consultation we will spend time discussing your vision and how this can be achieved. I take several measurements of your breasts and chest during the consultation and we will discuss how these influence our implant choice. Finally, we will review pictures that are representative of the look you are trying to achieve. Using all of this information, we will decide on a range of implant shapes and sizes.

During your surgery, I have your pictures in the room and use them for reference as I try the different implant sizes we discussed until a match is determined. In this way, your wishes are my guide during surgery. Implant size and shape is a choice we make together. Some patients become fixated on achieving a specific bra cup size. I steer my patients away from this thinking because it is poorly standardized and has high inter-brand variability. A visual representation removes this ambiguity, allowing me to better understand what you want to achieve so that we can develop an accurate operative plan.

While there is no formal expiration, breast implants are not forever devices. The FDA recommends MRI screening for silicone implant integrity at 3 years and every other year thereafter. Saline implant rupture is easily detected as an immediate loss of breast volume. Approximately 20-40% of women with breast implants will undergo additional surgery within the first 8-10 years to revise the size of the implants or shape of the breasts, however this is not mandatory. The native breast tissue changes with time and life events such as pregnancy, which commonly motivate women to seek revisionary procedures.

Absolutely. Several studies have examined the ability of patients to breast feed following breast augmentation and clearly demonstrate that the rate of lactation issues is similar to those reported in postpartum women who did not undergo breast augmentation.

Rarely. The incidence of a change in nipple sensation following breast augmentation is less than 1% at 6 months. A majority of these patients experience hypersensitivity/hyposensitivity that resolves with time with a smaller percentage experiencing complete loss of nipple sensation.

The human body responds to implanted foreign objects by depositing a layer of scar tissue, commonly referred to as a capsule. As it pertains to breast implants, for reasons that are largely unknown, this scar tissue can shrink and squeeze the breast implant, causing an unnatural appearance and ultimately discomfort. Unfortunately, there is no way to predict who will experience a capsular contracture. Although the percentage of patients who ultimately get a capsular contracture is low (2-15%), it is a risk that we will discuss. Fortunately, this condition is not dangerous to your health and is remedied by removing the scar tissue and replacing the implant.

Typically, a couple of days off of work is sufficient. At three weeks you can begin light exercise., however I ask that you avoid any heaving lifting or stooping for 6 weeks. You may drive when you are no longer taking pain medication and you feel safe to do so.

During your consultation we will discuss your goals and expected result. The need for a lift is determined by your desired breast size, skin quality and the current position of your nipple with respect to your breast crease. For example, a breast with poor skin elasticity and a nipple that is below the crease typically require a lift at the same time as the augmentation.

Studies show that mammography is an effective means of screening for breast cancer in women who have breast implants. Special views are required so that the breast tissue can be completely imaged so it is important to make sure that your imaging center has experience with women who have breast implants.

The FDA recommends MRI screening for silicone implant integrity at 3 years and every other year thereafter. Studies show that the risk of silent rupture of silicone gel implants is approximately 15% at 12 years. This guideline is not meant to supersede the need for yearly mammography and breast examination as a part of formal breast cancer screening.

Request Consultation

BREAST AUGMENTATION

Receive an in depth consultation where we will thoroughly review your goals to personalize a plan focused on a natural and aesthetic result. Patients are encouraged to bring photos of several results that best represent their desired look. Dr. Mowlds is located in beautiful Newport Beach, CA but is also available via a virtual consultation for out-of-town patients.

Breast Procedures

Before & After

Stunning, natural results from patients.

Silicone or Saline Implants?

Each type of implant offers unique benefits and characteristics. Learn more in our blog post where we explore the differences to help you make an informed decision that best fits your personal preferences and goals.

breast-implant-types-blog
Silicone gel breast implants consist of a durable silicone shell that provides a more natural look and feel when compared to saline breast implants. Newer generations of implants are filled with a more cohesive gel that behaves like a “gummy bear,” maintaining its shape and firmness.
Saline breast implants have a silicone shell that is filled with sterile salt (saline) solution in the operating room. Compared to silicone gel implants, saline breast implants are placed through a smaller incision since filling occurs after they are positioned in the breast. Saline is not compressible and as such these implants tend to maintain an augmented look.
Implant removal surgery involves removing existing breast implants and the surrounding scar tissue (capsule). The breasts are often re-shaped to optimize aesthetics.

Breast Implant Placement

Should implants be placed over the muscle or under the muscle? It’s important to understand that the answer is not one-size-fits-all. Dive into our blog post to help you decide.

In this approach, the implant is placed beneath the fascia (muscle covering) between your breast tissue and the pectoral muscle. This placement is often chosen for its natural look and feel, as the implant moves with the natural breast tissue.

Here, the implant is placed beneath the pectoral muscle. This placement can offer a natural slope to the upper breast, especially beneficial for women with little natural breast tissue.
breast implant placement blog
Breast Procedures

All procedures are done in a balanced and natural esthetic.

Breast augmentation utilizes silicone or saline implants to enhance both breast volume and shape.

A breast lift, or mastopexy, involves repositioning the breast tissue and nipple on the chest wall, restoring a youthful appearance and feel.

Breast implants are not lifetime devices. As such, many women ultimately require revisionary breast procedures to replace their implants. Breast shape changes with time so revision breast surgery often includes additional procedures designed to create a natural, youthful breast.

Implant removal surgery involves removing existing breast implants and the surrounding scar tissue (capsule). The breasts are often re-shaped to optimize aesthetics.

During breast reduction surgery, breast tissue and skin are removed, contouring the breast into a smaller more aesthetically pleasing shape.

Restoration of form and function is one of the tenants of plastic surgery and breast reconstruction, specifically, epitomizes this mantra.

Capsular contracture, a complication that can occur in patients following breast implant augmentation, can be a source of discomfort and frustration. As a part of the normal healing process, the body creates a layer of scar tissue, or “capsule” around the implant. This capsule can become tight or thickened, causing the breast to feel firm, appear distorted or even become painful.

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Services & Procedures

All procedures are done in a balanced and natural esthetic.