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BREAST AUGMENTATION

Breast augmentation is one of the most popular procedures
that plastic surgeons perform because of its ability to quickly
and drastically enhance a women’s breast size and shape.

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Breast Augmentation Before And After Gallery

OVERVIEW

Having small breasts can be a very difficult problem for some women and can negatively affect their self-esteem and confidence. Breast augmentation addresses this problem directly and has helped countless women get a new found sense of confidence.

Breast augmentation is one of the most popular procedures that plastic surgeons perform because of its ability to quickly and drastically enhance a women’s breast size and shape. Although there are plenty of women who have naturally small breasts, breast augmentation is also suitable for women whose breasts have lost shape due to breast feeding.

DR CONSTANTINE’S PHILOSOPHY
ON BREAST AUGMENTATION

In general, I prefer to perform my breast augmentations through an inframamary incision and place the implant underneath the muscle in what is known as a dual plane. I feel that this provides the most consistent, long lasting, and natural results when compared to other techniques.

CHOOSING THE RIGHT SIZE

Choosing the right size of implant is the most important decision that a patient and I make during a consultation. I believe that a patient’s body tells me what size is appropriate for breast augmentation. During a consultation, I perform a detailed history and physical examination. Part of the examination includes multiple measurements of a patient’s chest, breast, and skin quality and elasticity. Once all of these measurements are taken, I can generally come up with 2-3 different implant sizes that will best suit a patient’s body. The next step is to talk to the patient about expectations and goals. If my proposed sizes align with my patient’s goals, we will proceed with surgery. If a patient asks for breast implants that are too large for her measurements, I will not perform her surgery. I do not believe in putting in whatever implants a patient wants. Placing implants that are too large (or too small) will cause problems in the future and increase reoperation rates, ultimately lead to bad results, and an unhappy patient. My goal is to provide the safest and most natural results for my patients. I do believe that every patient has an optimal “fill” that her breasts can accept, anything more or less will not produce a natural result.

WHICH IS BETTER, SALINE OR SILICONE BREAST IMPLANTS?

This question is brought up frequently during breast augmentation consultations. My answer is simple: there is not one that is better than the other, but there is one that’s better for you. I believe in providing my patients with all the important information about both types of implants, all the pros and cons and advantages and disadvantages. Once a patient has all the information and has all of their questions answered to a point where I feel they truly understand, I allow them to choose for themselves. I will never try to sway a patient towards one or the other; this needs to be your choice. They are being placed in your body and you have to live with them everyday.

SILICONE

Historically, silicone implants were widely used but controversy arose in the 1990s when the media questioned whether a rupture in the silicone implant could cause health problems, most notably autoimmune disorders. The FDA has looked at all available data exhaustively and determined that there was no statistical link between silicone implants and any autoimmune disorders.

Silicone implants have a softer and more natural feel. They tend to hold their shape better and have less rippling at the edges. The new generation silicone implants are made of a more “cohesive” gel which does not leak if there is a tear in the outer shell of the implant. Because of the softer feel and less rippling, silicone implants are ideal for thin patients with smaller breasts.

Silicone implants come “prefilled” and to an already determined volume, therefore they generally require a larger incision to place them into the pocket than saline implants.

The FDA has approved silicone implants for cosmetic use in patients over age 22 years of age. Because silicone implant rupture is harder to detect than with saline implants, the FDA recommends MRI screening for rupture 3 years after the initial placement and every 2 years after that.

SALINE

Saline implants feel less viscous than silicone and some people believe they feel is slightly less natural. Saline implants have a tendency ripple more than silicone. Saline implants have a recommended volume range making them somewhat adjustable. This can be helpful in correcting differences in size between a patients’ breasts to help achieve more symmetry. Saline implants are placed into the breast without fluid and then filled once they are in the pocket; therefore, the incision is smaller with saline implants as compared to silicone. Implant rupture with saline is very easy to detect, as most people notice it within hours to days of rupture, having a “flat tire” appearance. Implant rupture with saline implants is harmless as the saline fluid gets absorbed by the body immediately.

POCKET LOCATION

The breast implant can be placed directly under the breast tissue (subglandular), under the chest muscle (submuscular), or in combination known as a “dual plane.” Dual plane placement gives the advantages of both techniques and minimizes the disadvantages of each.

DUAL PLANE/SUBMUSCULAR BREAST AUGMENTATION

This is my preferred method of performing breast augmentation in the vast majority of cases. Adding more layers of tissue overlying the implant translates to less palpability and visibility of the implant. In thin women, placing the implant under the muscle gives a more natural appearance by hiding the edges of the implant. The muscle maintains most of its attachments to the sternum (breast bone) and rib cage, so most patients do not notice an appreciable decrease in strength. I feel that this technique gives the most natural, consistent, and long lasting results.

Submuscular augmentation is slightly more painful and adds a little more time for the implant to assume its final position. Most women have described the feeling as being very sore as if they had done a vigorous chest work out the day before.

SUBGLANDULAR BREAST AUGMENTATION

Subglandular augmentation places the implant under the breast tissue but over the muscle. This does not provide as much tissue coverage over the implant making the implant easier to see and feel. In thin patients, ripples in the implants are more visible with the subglandular approach.

Subglandular breast augmentation is typically less painful and gives a more immediate postoperative result. Because the implant is directly below the breast tissue, the implant has a more direct effect on the breast shape, making it a useful technique for tuberous or constricted breast deformity. Some have also advocated using this technique in competitive body builders, as putting an implant under such a robust muscle might make it susceptible to implant malposition.

INCISION TYPE

There are four incision locations which are used in breast augmentation. My goal is to choose the incision that permits the best access for precise implant placement while being the least visible.

PERIAREOLAR INCISION

The periareolar incision is placed at the lower and middle part of the areola just inside the pigmented portion of the skin. This incision generally heals very well making it difficult to detect as it is camouflaged by the darker skin surrounding it. In my opinion this incision is useful when the inframammory crease needs to be lowered in patients that have a constricted or tuberous type breast deformity. I also find it useful when the skin of the breast needs to be mild/moderately tightened in conjunction with a periareolar breast lift/mastopexy. There are some disadvantages, however, one of which is that damage to nerves which provide sensation to the nipple is possible. Another being that the incision is placed on the most visible or projecting part of the breast. Because this approach requires dissection through the glandular part of the breast, there can be internal scarring in the breast, which might problematic on screening mammograms later in life. Lastly, and one of the most important considerations is the fact that there is a higher risk of infection with this approach due to dissection through milk ducts surrounding the areola with contain bacteria within them. Placing the implant through a potentially contaminated field might predispose the capsule that later forms around the implant to a “subclinical” infection and may lead to capsular contracture.

UMBILICAL

This approach is somewhat controversial and not widely practiced. I don’t believe in it and do not use this technique.

POST OPERATIVE:

You will feel sore for a few days following your surgery, but I want you to be up moving around even on the day of the surgery. Most of your discomfort and/or pain can be controlled by medication prescribed. Antibiotics are administered as well.

I will place you in a surgical bra after surgery that I want you to wear until I see you back in the office. All sutures placed are on the inside and will absorb with time so there are not sutures to be removed in the office. You will have a dressing in place with a clear plastic tape that you will keep on until your first visit. You may shower the day after your surgery.

THERE IS NO CORRECT ANSWER TO THIS QUESTION SINCE EVERY PATIENT IS DIFFERENT.

Each type of implant has its advantages and disadvantages. This is why Dr Constantine sits down with every patient to explain what the pros and cons of each are, so that an informed decision can be made.

Testimonials

  • After years of overthinking it, I finally made the decision to get a breast reduction. I am so glad I chose Dr. Constantine to do my procedure. He is awesome!... Read More

    April Clark Avatar April Clark
    May 15, 2023

    Dr. Constantine and his team are amazing! From consultation to post op appointments, enjoyed every step of the process and am very happy with my surgery results. Only regret is... Read More

    Barrett Wolff Avatar Barrett Wolff
    February 15, 2023

    Dr. Constantine is fantastic! I highly recommend him based on his work and excellent communication.

    Kathleen McAdams Avatar Kathleen McAdams
    February 15, 2023
  • When I found out I had breast cancer I was so scared but Dr Constantine quickly put me at ease. Had a double mastectomy. Then a diep flap reconstruction and... Read More

    Elizabeth Hunt Avatar Elizabeth Hunt
    February 15, 2023

    I was diagnosed with breast cancer in 2021 and Dr. Constantine did my breast reconstruction and I also had lipo on my ankles/lower calf and knees after my treatment. I... Read More

    DESIREE ILO Avatar DESIREE ILO
    January 15, 2023

    I had the best experience. From the front desk to scheduling coordinator. All are are welcoming and professional. Dr.Constantine was easy to speak with and explained everything in great detail.... Read More

    ashley lusk Avatar ashley lusk
    December 15, 2022
  • Wonderful professional service! The staff is always friendly and helpful. Dr. C. Did a great job on me. I am very happy with my results!

    SHERE C Avatar SHERE C
    December 15, 2022

    Dr. Constantine is personable, explains procedures in detail, and has a wonderful bedside manner. His professional and skill is above reproach. He is honest about the results,... Read More

    Natalie Henderson Avatar Natalie Henderson
    November 15, 2022

    Dr Constantine took his time with us & thoroughly explained everything. He is very kind and professional.

    Paula&Will Mahand Avatar Paula&Will Mahand
    October 15, 2022
  • I had a great experience with Dr Constantine and his office. As others say, he put me at ease about the double mastectomy I had to have due to breast... Read More

    Joey Cade Avatar Joey Cade
    October 15, 2022

    From my first phone call to my follow up appointments Dr. Constantine and his team were just outstanding. Wish I could give more Stars. He answered every single question, took... Read More

    Ramona Moon Avatar Ramona Moon
    September 15, 2022

    So thankful for this practice! I have received wonderful care and have had wonderful results. Dr. Constantine is a kind person and exceptional doctor. He is an amazing surgeon. I... Read More

    Alexandra Bogan Avatar Alexandra Bogan
    September 15, 2022
  • Dr. Constatine is awesome!!! I was so nervous to have a double mastectomy, but he was able to calm my nerves, walk me through the process of expanders and now... Read More

    jrp31378 Avatar jrp31378
    September 15, 2022

    Dr. Constantine did everything right to make this journey have meaning for me and my family because I’d do it all over again knowing he and his office staff would... Read More

    Pamela Jones Avatar Pamela Jones
    August 15, 2022

    Dr. Constantine and Elizabeth have been amazing throughout my breast reconstruction journey! I’ve felt comfortable and confident with choosing Dr. Constantine and his team to address a surgery I never... Read More

    Erin Marino Avatar Erin Marino
    August 15, 2022
  • Had the best experience getting a rhinoplasty with Dr. Fadi Constantine, results were exactly as promised and exactly what I wanted. He made my nose look natural and matched it... Read More

    Dana Basatneh Avatar Dana Basatneh
    July 15, 2022

    I would recommend Dr. Constantine to anyone needing plastic surgery, regardless of the reason. Dr. Constantine’s bedside manner and artistic skills are his greatest assets. His staff goes above and... Read More

    Mrs. Stephen Anthony Brown Avatar Mrs. Stephen Anthony Brown
    July 15, 2022

    I had such an amazing experience here. The staff were incredibly helpful and always there to help with any questions I had before and after my surgery. Dr. Constantine was... Read More

    Kennedy Huff Avatar Kennedy Huff
    July 15, 2022

Quick Facts About Breast Augmentation

HOW LONG DOES THIS PROCEDURE TAKE?

The procedure usually takes about 1 hour.

WHAT TYPE OF ANESTHESIA DO YOU USE?

We use general anesthesia or local anesthesia with sedation.

WHAT ARE THE SIDE EFFECTS OF THIS PROCEDURE?

Patients may experience temporary swelling, mild bruising, and some pain.

HOW LONG IS THE RECOVERY TIME?

Patients can usually return to work within 3 days to 1 week, and resume more strenuous activities in 2-3 weeks.

WHEN CAN I SEE THE FINAL APPEARANCE?

It usually takes 6-8 weeks for the implants to completely descend into their final position.

HOW LONG DO THE RESULTS LAST?

The results of breast augmentation are considered permanent, but the average lifespan of an implant is 10 years. After this time, they can be replaced in a relatively minor procedure.

Dr. Fadi Constantine

Trained at some of the most rigorous
programs in the country, Dr. Constantine loves to perform the most delicate and demanding plastic surgery procedures. Our team is known for natural results without an “operated” look.

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