Surgical Procedure

A deep sedative or light general anesthetic will be used. An anesthesiologist will be available at all times to insure your comfort and safety. The operative time is approximately an hour and a half. A small incision is placed in the fold beneath the breast, around the areola or in the armpit. A pocket, which will accommodate the implant, is created beneath the breast tissue, either above or below your chest muscles. The location of your incision, as well as options relating to implant types, sizes and location of the pocket will be discussed with you at length pre-operatively. Implants vary greatly in type (and cost!), but basically all have a silicone rubber shell. Implants used today are filled with either silicone gel or saline (salt water) solution. Implant surfaces may consist of traditional smooth rubber or a textured rubber surface. In addition to the traditional implants, your surgeon has the option of choosing high profile or anatomic shaped implants for you. With so many implants available, it is obvious that no single implant is ideal for all circumstances. Your surgeon will review the latest controversies regarding breast implants, FDA regulations and your options.

The manufacturer of your breast implants expects the implants to last a long time, but everything man-made does break or wear down eventually. The life span of all types of implants can be shortened by trauma or mechanical failures. Such a rupture may be clinically undetectable to you or your surgeon if you have silicone gel filled implants, but could be picked up during mammography or other specialized tests. Rupture or leakage of the older gel implants often led to gel migration or formation of lumps within your breast as a result of scar tissue developing around the free silicone, necessitating future breast biopsies and implant replacement.  Today’s gel-filled implants contain a “cohesive” gel that stays intake even with shell rupture and will be less likely to migrate.  However, rupture of a saline filled implant, will generally be obvious because the breast will resume its previous size and shape over a short period. Unfortunately, no one can predict in advance when an individual implant will fail. Replacing an implant will become necessary if a leak is detected. It is strongly suggested that you return to see your plastic surgeon at least once a year for a breast examination. These examinations are provided by our office without cost to you.

You may choose to have a catheter inserted which is connected to a “pain pump” which infuses local anesthetics into the surgical field for the fist few days.  Such pumps will greatly enhance your comfort during the early postoperative phase.  A loose circumferential wrap is fitted at the completion of your operation, mainly to hold your dressings in place.    You will be instructed when to remove this wrap and to begin implant manipulations (“massages”).