Dr. Joshua Kreithen is one of the leading Sarasota breast augmentation specialists. Over the years, he has helped numerous women enhance both their physical appearance and psychological well-being through breast augmentation surgery. In order to deliver the best possible aesthetic results, Dr. Kreithen carefully customizes each breast implants procedure. Please read on to learn more about breast augmentation and Dr. Kreithen's treatment approach.
The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate. Poor healing of the skin is most likely to affect smokers, so smokers must quit at least one month prior to surgery and refrain from smoking at least one month after the surgery.
Procedure:Enhance the size of breasts using inflatable implants filled with saline or silicone.
Length: 1 to 2 hours.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient.
Side Effects: Temporary soreness, swelling, change in nipple sensation, bruising. Breast sensitive to stimulation for a few weeks.
Risks: Lack of implant permanence -- surgical removal or replacement of the implants may be required to treat problems, including: deflation; the formation of scar tissue around the implant (capsular contracture), which may cause the breast to feel tight or hard; bleeding or infection. Increase or decrease in sensitivity of nipples or breast skin, occasionally permanent. Mammography requires a special technique.
Recovery: Back to work: a few days. Physical contact with breasts: 3 to 4 weeks. Fading of scars: several months to a year or more.
Duration of Results: Variable. Implants may require removal or replacement.
A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.
In 2006 the Food & Drug Administration (FDA) has determined that new gel-filled implants are safe and are available to women over the age of 22.
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.
As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.
A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.
Most women have a natural breast asymmetry. Usually one breast is larger than the other, and nipples may differ in size or be in different positions on the breast. Of course the goal with breast enhancement is perfection, but placing implants can exaggerate your natural asymmetry.
Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.
There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the body will harmlessly absorb the salt water.
If a break occurs in a gel-filled implant, however, one of two results may occur. If the shell breaks, yet the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all of the silicone gel in the breast tissue if a rupture occurs.
A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants and the symptoms of what doctors refer to as "connective-tissue disorders," although the FDA has requested further study.
While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast containing an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.
While the vast majority of patients do not experience these complications, Dr. Kreithen will discuss each of them in depth to make sure you understand the risks and consequences of breast augmentation.
During your initial consultation, Dr. Kreithen will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, he may recommend that you also pursue a breast lift in Sarasota.
Be sure to discuss your expectations. Dr. Kreithen will describe your alternatives and the risks and limitations of each. He will also give you a copy of the manufacturer's insert that comes with the implant he will use -- just so you are fully informed about it. And, be sure to state if you smoke, or if you're taking any medications, herbals, vitamins, or other drugs.
Because most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure.
Dr. Kreithen will discuss the specifics of the procedure with you, as well as the benefits and risks in depth.
At the completion of your consultation, you will meet with our patient coordinator. You will be given an estimate of the cost of your procedure and have the option to schedule your procedure if you so choose. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation. Dr. Kreithen realizes the importance of your decision and will be happy to meet with you a second time to discuss the surgery.
Dr. Kreithen will give you instructions to prepare you for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
A breast augmentation will most likely be performed at our new state-of-the-art Holcomb – Kreithen Plastic Surgery Medical Center operating room. It's usually done on an outpatient basis. Complex procedures may require a short inpatient stay.
Breast augmentation is usually performed with a general anesthesia, so you'll sleep through the entire operation. Some of our Sarasota breast augmentation patients prefer local anesthesia combined with a sedative to make them drowsy; they will be relaxed but awake during the procedure and may feel some discomfort.
The method of inserting and positioning your implant will depend on your anatomy and your preferences. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Working through the incision, Dr. Kreithen will lift your breast tissue and skin to create a pocket, usually underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.
The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing. After your surgery, you should wear an appropriately sized sports bra that closes in the front.
You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication.
Within the first week, the gauze dressings will be removed. You should wear your sports bra as much as possible for six weeks. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Swelling in your breasts may take three to five weeks to disappear.
Most of our breast augmentation patients are able to return to work within a few days, depending on the level of activity required for the job. It is not safe to drive a car within 24 hours of taking pain medication, as reflexes and alertness may be altered.
You should wait six weeks before strenuous activity or exercises, and not lift more than 10 pounds in each arm. Walking and other normal activities can resume when you feel comfortable. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually four to six weeks after surgery.
Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading, as discussed earlier.
For most of breast augmentation patients, the result of breast augmentation is satisfying, even exhilarating, as they learn to appreciate their fuller appearance.
Regular examination and routine mammograms for those in the appropriate age groups at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.
Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you've met your goals, then your surgery is a success.
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