Breast Augmentation in Southlake

About Breast Implants

Breast augmentation surgery (enlargement, enhancement) utilizes breast implants to increase the size of the breasts, improve the shape of the breasts, improve symmetry, and give a moderate degree of uplift and fullness to the breasts.

The operation by Dr Kasden in our facility in Southlake, also improves balance to the feminine figure. Patients typically request breast augmentation to replace volume that was lost after childbearing. Other reasons commonly cited include correcting under developed or small breasts, improving asymmetry of the breasts, and improving cleavage and/lateral fullness of the breast. After breast augmentation, patients report improved self-esteem, self-confidence, and satisfaction with appearance in and out of clothing.

The goals of breast augmentation are many. Some patients prefer a natural and proportioned breast.

Others prefer a “fake” appearing large breast, while many prefer something between the two. There are no “right” or “wrong” choices. Since many different types of results can be created with breast augmentation, the goal is to match your desires with the possibilities of surgery. In order to achieve your goals, many surgical choices must be considered:

Shape of breast implants

Implants come in two basic shapes; round and tear dropped (also called anatomically shaped). From my professional experience, I prefer the round implant versus the anatomically shaped implant for cosmetic breast augmentation. The round implant tends to give the best result in most patients compared with the teardrop-shaped implant. The round implant produces more fullness that looks more natural compared to the anatomically shaped implant. Additionally, the round implant is less likely to cause visible or palpable ripples, contractures, or to fail prematurely.

Surface of breast implants

The implant surface comes textured (“fuzzy”) or smooth.

The textured surface is useful when the implant is placed in the sub-glandular (“above the muscle”) position as it reduces the incidence of capsular contracture (the tendency of the breast to get firm or hard to vigorous scar tissue formation). However, the textured surface tends to make these augmented breasts feel firmer then the smooth surface implants. Another downside to textured implants is that they are more likely to create visible and palpable ripples on the surface of the breast. Textured implants are also more likely to fail prematurely.

Smooth surface implants placed under the muscle (“sub-muscularly”), have approximately the same incidence of capsular contracture as the textured implant placed in this position. They have the added benefit of producing a more natural appearing and behaving augmented breast compared to the textured implant. The smooth surface implant is less likely to form ripples, it requires a smaller incision than the textured surface implant, and tends to have a longer lifespan (approximately 14 years).

Placement of breast augmentation incisions

Commonly performed incisions include the inframammary incision, peri-areolar incision, and, transaxillary (arm pit) incision. Each of these incisions has their own benefits and drawbacks.

The transaxillary incision places the scar off the breast, which is desirable. However, this approach has the highest incidence of mal-positioned implants, and the incisions may be visible.

The peri-areolar incision is nicely camouflaged. However, this approach has the drawback of injuring healthy breast tissue, and has the highest incidence of permanent sensation loss to the nipples. Additionally, this approach has the highest rate of infection (though still very low!) and capsular contracture.

The infra-mammary approach allows excellent exposure to create an aesthetic result. This approach minimizes injury to healthy breast tissue and nerves to the nipple. Although the scar is visible on the breast, it is generally quite acceptable.

Placement of Breast Implants

The implant may be placed in the submuscular (“under”) or sub-glandular (“over”) positions. Like other surgical choices, each position has benefits as well as drawbacks.

The sub-glandular placement is technically easier to perform than the sub-muscular placement, and recovery is quicker, easier, and less painful.

The submuscular placement of breast implants is technically more difficult, and the recovery is more painful. The breasts tend to take a bit longer for the result to be complete.

Despite the drawbacks, the real benefit of placing breast implants under the muscle is that there is more padding above the implant which makes the implant less palpable and gives an added degree of protection in the event of a trauma. Additionally, the muscle acts like an internal support or bra, and reduces the tendency of the breast to sag over time.

Most importantly, the tendency to form a capsular contracture is greatly diminished when the implant is placed below the muscle.

Type of Breast Implant (Fill)

The implant fill material is either saline (saltwater solution), or silicone gel. Many patients ask, “Which implant is best?” The answer is that there is no “best” implant.

To decide which is best for you, you need to understand the differences between the two types. In general, silicone gel filled implants tends to form a softer more natural breast than the saline filled implant. It must be emphasized however, that the saline implants can produce outstanding results too, and must not be discounted.

Cost of Breast Implants

Silicone gel implants costs significantly more than the saline filled implants. The FDA recommends that all silicone gel patients obtain an MRI three years after implantation, and every two years thereafter to ensure implant integrity. If a rupture is suspected, an MRI will also be needed for evaluation. The MRI’s may or may not be covered by insurance.

Additionally, the insurance company may not cover any claims related to silicone gel filled breast implants. It is therefore important for each patient to check for insurance coverage when considering silicone gel implants. Importantly, both implant types come with a lifetime warranty.

Saline filled implants on the other hand, are significantly less expensive than silicone gel implants. Because the implants are not filled until they are implanted, they are smaller and therefore require a smaller incision. If a saline filled breast implant ruptures, the salt water harmlessly is eliminated in the urine, and the deflation is easily detected. Additionally, there is no need to obtain MRIs with saline implants.

Who are the Best Candidates for Breast Augmentation?

The best candidates are patients who are generally in good health. Your weight should be stable and within about 10 pounds of your “target weight” (I define your target weight as the weight that you can comfortably maintain, as opposed to your “ideal body weight” which is based on your height, and is commonly lower than your “target weight”). You should not have significant abnormalities of your blood work, and you must be emotionally ready to go through a significant operation and recovery. You will need help at home during the early part of your recovery. Smoking increases risks of just about every complication, so it is best to not smoke for at least one month before and after surgery. For your health, you should quit smoking anyway. The operation should NOT be performed if you have any active infections.

Preparation for Breast Augmentation Surgery

Breast Augmentation is a significant operation, so you should be in the best physical condition possible.

On your pre-operative visit, you will be given specific instructions on medications to avoid and on your pre-operative diet. You will need to have someone to drive you to and from the surgery center, and stay with you after surgery. You should plan to have help around the house for at least a few days, and perhaps longer.

On the day of surgery, you should wear loose fitting clothes, button or zipper up shirt, and flat, safe, comfortable shoes. Do not wear jewelry or makeup.

After surgery, many patients find it easier to sleep on a recliner or a “bed buddy”/”husband” reading pillow. The pillow is inexpensive, and can be purchased at a local discount bedding store. I do not recommend renting a recliner, as they are not usually sanitary.

Type of Anesthesia used During Breast Augmentation

General Anesthesia (you will be “asleep”) while an anesthesiologist monitors your vital signs. Local anesthesia will be administered during surgery to help you wake up comfortably.

Recovery Time Following Breast Augmentation Surgery

Breast augmentation is a significant operation, and requires an appropriate commitment on your part to the recovery process. Because the pectoralis muscles (large anterior chest wall muscles) are surgically manipulated, you should expect significant pain and discomfort for the first several days; however, I will prescribe adequate analgesics and muscle relaxants for your comfort.

The pain gradually subsides, but you may expect to be stiff and sore for many weeks to come. It is very important to walk frequently, cough, and deep breathe. These simple exercises help to reduce risks of pneumonia and blood clots in the legs, and help relax the muscles, which eases the discomfort.

Your appetite in the first few weeks may be reduced compared to normal. It is OK if you do not eat that much, however you should eat small meals frequently to maintain your strength. It is very important however to keep hydrated, so drink a lot of fluid. Fluids should include fruit juices, and perhaps Gatorade® like products. You should also take stool softeners during your recovery to help prevent constipation.

After surgery, you will likely feel fatigued. Stamina usually starts to return after a couple of weeks and you should feel almost back to normal in about three to four weeks.

Results of Breast Augmentation

Initially the implants tend to be higher and larger than you may anticipate. They may look “funny”, and lack lower pole fullness too. After about three or four weeks, as the muscle spasm relaxes, and the swelling resolves, the implants begin to look better and better. You can expect continued improvement for up to a year and sometimes longer. Because of so many different body types, so many surgical choices, and so many different surgical goals, an exact result cannot be guaranteed. However, long as you have realistic expectations, you should be very happy with your results.

Risks/Complications of Breast Augmentation

Breast augmentation is a significant operation that is usually performed without complication. However, some serious complications may occur from time to time. The most serious complications include blood clot formation in the legs, which can break off and travel to the lungs. Pneumonia is possible, but not common.

Occasionally wound healing or tissue loss problems may result. Infection is very uncommon, if it involves the implant itself, the implant may require removal and replacement months later. Other complication include capsular contracture, synmastia (too much cleavage), implant mal-position, asymmetry, loss of sensation, poor scar formation, dissatisfaction with result, implant deflation, need for further surgery in the future. I always recommend that you purchase the supplemental warranty for $100.00 within 30 days of surgery for this reason (I do not have a financial interest in the company, and the warranty is purchased directly through them).

In order to minimize your complication risks, and optimize your outcome, it is imperative to communicate all changes in your health status immediately to Dr. Kasden. From the pre-operative period extending through the point you are healed, even subtle changes may indicate something significant in a surgical patient. Do not take or change medications without first checking with Dr. Kasden. Likewise, do not undergo any treatments unless you inform Dr. Kasden first. Finally, comply with all instructions, and discuss your situation with Dr. Kasden.

The risk of other complications may apply to you depending on your particular medical history. Be sure to share with me all information about your medical history so that we can minimize your risks.

The anesthesiologist will review anesthetic risks with you.

Disclaimer

The information on this site is intended to help you with your quest for knowledge. Any decision to undergo a treatment or surgery is an individual decision, which can only be made in consultation with your plastic surgeon. No warranty is implied or made regarding the information contained on this web site.

If you feel that any information presented is inaccurate, or you would like to provide feedback, please contact our Southlake plastic surgery office at (817) 416-9980 or use our online form to send an email.

Breast Augmentation in Southlake

About Breast Implants

Breast augmentation surgery (enlargement, enhancement) utilizes breast implants to increase the size of the breasts, improve the shape of the breasts, improve symmetry, and give a moderate degree of uplift and fullness to the breasts.

The operation by Dr Kasden in our facility in Southlake, also improves balance to the feminine figure. Patients typically request breast augmentation to replace volume that was lost after childbearing. Other reasons commonly cited include correcting under developed or small breasts, improving asymmetry of the breasts, and improving cleavage and/lateral fullness of the breast. After breast augmentation, patients report improved self-esteem, self-confidence, and satisfaction with appearance in and out of clothing.

The goals of breast augmentation are many. Some patients prefer a natural and proportioned breast.

Others prefer a “fake” appearing large breast, while many prefer something between the two. There are no “right” or “wrong” choices. Since many different types of results can be created with breast augmentation, the goal is to match your desires with the possibilities of surgery. In order to achieve your goals, many surgical choices must be considered.

Shape of Breast Implants

Implants come in two basic shapes; round and tear dropped (also called anatomically shaped). From my professional experience, I prefer the round implant versus the anatomically shaped implant for cosmetic breast augmentation. The round implant tends to give the best result in most patients compared with the teardrop-shaped implant. The round implant produces more fullness that looks more natural compared to the anatomically shaped implant. Additionally, the round implant is less likely to cause visible or palpable ripples, contractures, or to fail prematurely.

Surface of Breast Implants

The implant surface comes textured (“fuzzy”) or smooth.

The textured surface is useful when the implant is placed in the sub-glandular (“above the muscle”) position as it reduces the incidence of capsular contracture (the tendency of the breast to get firm or hard to vigorous scar tissue formation). However, the textured surface tends to make these augmented breasts feel firmer then the smooth surface implants. Another downside to textured implants is that they are more likely to create visible and palpable ripples on the surface of the breast. Textured implants are also more likely to fail prematurely.

Smooth surface implants placed under the muscle (“sub-muscularly”), have approximately the same incidence of capsular contracture as the textured implant placed in this position. They have the added benefit of producing a more natural appearing and behaving augmented breast compared to the textured implant. The smooth surface implant is less likely to form ripples, it requires a smaller incision than the textured surface implant, and tends to have a longer lifespan (approximately 14 years).

Placement of Breast Augmentation Incisions

Commonly performed incisions include the inframammary incision, peri-areolar incision, and, transaxillary (arm pit) incision. Each of these incisions has their own benefits and drawbacks. The transaxillary incision places the scar off the breast, which is desirable. However, this approach has the highest incidence of mal-positioned implants, and the incisions may be visible. The peri-areolar incision is nicely camouflaged. However, this approach has the drawback of injuring healthy breast tissue, and has the highest incidence of permanent sensation loss to the nipples. Additionally, this approach has the highest rate of infection (though still very low!) and capsular contracture. The infra-mammary approach allows excellent exposure to create an aesthetic result. This approach minimizes injury to healthy breast tissue and nerves to the nipple. Although the scar is visible on the breast, it is generally quite acceptable.

Placement of Breast Implants

The implant may be placed in the submuscular (“under”) or sub-glandular (“over”) positions. Like other surgical choices, each position has benefits as well as drawbacks.

The sub-glandular placement is technically easier to perform than the sub-muscular placement, and recovery is quicker, easier, and less painful.

The submuscular placement of breast implants is technically more difficult, and the recovery is more painful. The breasts tend to take a bit longer for the result to be complete.

Despite the drawbacks, the real benefit of placing breast implants under the muscle is that there is more padding above the implant which makes the implant less palpable and gives an added degree of protection in the event of a trauma. Additionally, the muscle acts like an internal support or bra, and reduces the tendency of the breast to sag over time.

Most importantly, the tendency to form a capsular contracture is greatly diminished when the implant is placed below the muscle.

Type of Breast Implant (Fill)

The implant fill material is either saline (saltwater solution), or silicone gel. Many patients ask, “Which implant is best?” The answer is that there is no “best” implant.

To decide which is best for you, you need to understand the differences between the two types. In general, silicone gel filled implants tends to form a softer more natural breast than the saline filled implant. It must be emphasized however, that the saline implants can produce outstanding results too, and must not be discounted.

Cost of Breast Implants

Silicone gel implants costs significantly more than the saline filled implants. The FDA recommends that all silicone gel patients obtain an MRI three years after implantation, and every two years thereafter to ensure implant integrity. If a rupture is suspected, an MRI will also be needed for evaluation. The MRI’s may or may not be covered by insurance.

Additionally, the insurance company may not cover any claims related to silicone gel filled breast implants. It is therefore important for each patient to check for insurance coverage when considering silicone gel implants. Importantly, both implant types come with a lifetime warranty.

Saline filled implants on the other hand, are significantly less expensive than silicone gel implants. Because the implants are not filled until they are implanted, they are smaller and therefore require a smaller incision. If a saline filled breast implant ruptures, the salt water harmlessly is eliminated in the urine, and the deflation is easily detected. Additionally, there is no need to obtain MRIs with saline implants.

Who are the Best Candidates for Breast Augmentation?

The best candidates are patients who are generally in good health. Your weight should be stable and within about 10 pounds of your “target weight” (I define your target weight as the weight that you can comfortably maintain, as opposed to your “ideal body weight” which is based on your height, and is commonly lower than your “target weight”). You should not have significant abnormalities of your blood work, and you must be emotionally ready to go through a significant operation and recovery. You will need help at home during the early part of your recovery. Smoking increases risks of just about every complication, so it is best to not smoke for at least one month before and after surgery. For your health, you should quit smoking anyway. The operation should NOT be performed if you have any active infections.

Preparation for Breast Augmentation Surgery

Breast Augmentation is a significant operation, so you should be in the best physical condition possible.

On your pre-operative visit, you will be given specific instructions on medications to avoid and on your pre-operative diet. You will need to have someone to drive you to and from the surgery center, and stay with you after surgery. You should plan to have help around the house for at least a few days, and perhaps longer.

On the day of surgery, you should wear loose fitting clothes, button or zipper up shirt, and flat, safe, comfortable shoes. Do not wear jewelry or makeup.

After surgery, many patients find it easier to sleep on a recliner or a “bed buddy”/”husband” reading pillow. The pillow is inexpensive, and can be purchased at a local discount bedding store. I do not recommend renting a recliner, as they are not usually sanitary.

Type of Anesthesia used During Breast Augmentation

General Anesthesia (you will be “asleep”) while an anesthesiologist monitors your vital signs. Local anesthesia will be administered during surgery to help you wake up comfortably.

Recovery Time Following Breast Augmentation Surgery

Breast augmentation is a significant operation, and requires an appropriate commitment on your part to the recovery process. Because the pectoralis muscles (large anterior chest wall muscles) are surgically manipulated, you should expect significant pain and discomfort for the first several days; however, I will prescribe adequate analgesics and muscle relaxants for your comfort.

The pain gradually subsides, but you may expect to be stiff and sore for many weeks to come. It is very important to walk frequently, cough, and deep breathe. These simple exercises help to reduce risks of pneumonia and blood clots in the legs, and help relax the muscles, which eases the discomfort.

Your appetite in the first few weeks may be reduced compared to normal. It is OK if you do not eat that much, however you should eat small meals frequently to maintain your strength. It is very important however to keep hydrated, so drink a lot of fluid. Fluids should include fruit juices, and perhaps Gatorade® like products. You should also take stool softeners during your recovery to help prevent constipation.

After surgery, you will likely feel fatigued. Stamina usually starts to return after a couple of weeks and you should feel almost back to normal in about three to four weeks.

Results of Breast Augmentation

Initially the implants tend to be higher and larger than you may anticipate. They may look “funny”, and lack lower pole fullness too. After about three or four weeks, as the muscle spasm relaxes, and the swelling resolves, the implants begin to look better and better. You can expect continued improvement for up to a year and sometimes longer. Because of so many different body types, so many surgical choices, and so many different surgical goals, an exact result cannot be guaranteed. However, long as you have realistic expectations, you should be very happy with your results.

Risks/Complications of Breast Augmentation

Breast augmentation is a significant operation that is usually performed without complication. However, some serious complications may occur from time to time. The most serious complications include blood clot formation in the legs, which can break off and travel to the lungs. Pneumonia is possible, but not common.

Occasionally wound healing or tissue loss problems may result. Infection is very uncommon, if it involves the implant itself, the implant may require removal and replacement months later. Other complication include capsular contracture, synmastia (too much cleavage), implant mal-position, asymmetry, loss of sensation, poor scar formation, dissatisfaction with result, implant deflation, need for further surgery in the future. I always recommend that you purchase the supplemental warranty for $100.00 within 30 days of surgery for this reason (I do not have a financial interest in the company, and the warranty is purchased directly through them).

In order to minimize your complication risks, and optimize your outcome, it is imperative to communicate all changes in your health status immediately to Dr. Kasden. From the pre-operative period extending through the point you are healed, even subtle changes may indicate something significant in a surgical patient. Do not take or change medications without first checking with Dr. Kasden. Likewise, do not undergo any treatments unless you inform Dr. Kasden first. Finally, comply with all instructions, and discuss your situation with Dr. Kasden.

The risk of other complications may apply to you depending on your particular medical history. Be sure to share with me all information about your medical history so that we can minimize your risks.

The anesthesiologist will review anesthetic risks with you.

Disclaimer

The information on this site is intended to help you with your quest for knowledge. Any decision to undergo a treatment or surgery is an individual decision, which can only be made in consultation with your plastic surgeon. No warranty is implied or made regarding the information contained on this web site.

If you feel that any information presented is inaccurate, or you would like to provide feedback, please contact our Southlake plastic surgery office at (817) 416-9980 or use our online form to send an email.

If you feel that any information presented is inaccurate, or you would like to provide feedback, please contact our Southlake plastic surgery office at (817) 416-9980 or use our online form to send an email.

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Breast Augmentation with Lift

Breast augmentation combined with breast lift surgery will increase the size of the breasts, improve breast symmetry & shape and give uplift to the breasts.

A breast lift will elevate the nipple to a more youthful, attractive position, while giving the breast a more perky appearance. If necessary, the size of the areola can be reduced.

The overall shape of the breast is improved as well. The real benefit to having this procedure is how it makes you feel about yourself. Women who have this procedure enjoy improved self-esteem and more self-confidence.

Patients report greater enjoyment of their intimate lives with their significant others as a result of feeling better about themselves.

Breast Implant Revision

Over time, breasts change. This is also true for the augmented breast.

A secondary breast augmentation or breast implant revision is essentially a re-do breast augmentation that can restore the breast to its initial beauty, size, shape and softness.

Revision breast augmentation can also increase or decrease breast size as desired.

Procedures commonly performed during a secondary breast augmentation include mastopexy or breast lift, tummy tuck, liposuction, and face lift.