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What is breast augmentation?

Breast augmentation with breast implants improves breast fullness and proportionality, whether unsatisfactory breast size is related to heredity, volume loss from pregnancy, breastfeeding, or significant weight change. Breast augmentation also treats congenital breast asymmetry. Breast implant choices range across a broad spectrum, including textures, volumes, profiles (fullness), shapes and compositions.

Who is a good candidate for breast augmentation?

Good candidates for breast augmentation are women in good health who have small breasts, breast asymmetry or developmental issues, or breasts that have lost their fullness and shape from metabolic changes, aging, pregnancy or significant weight loss. During the initial consultation you will discuss with Dr. Shermak what you would like to improve so she can understand your expectations and determine how to best achieve the desired result. Surgery is customized to your desires and needs.

Breast Augmentation
Breast Augmentation

How do we choose a size that’s right for me?

Dr. Shermak will spend time with you, learning about your medical history and performing a physical examination. You will then try on actual breast implants in a bra, and the implants match those you can ultimately have placed surgically. Dr. Shermak will personally size you herself; and if you have questions or concerns about your choice, she welcomes you to return prior to your surgery date to reassure you that the size you choose will best meet your goals. You should have a very good idea of what you will see after surgery is done. The choice is yours, and Dr. Shermak will be happy to offer any expertise to assist in that decision.

Details About Breast Augmentation Surgery

What type of incision is involved?

Incisions that are endorsed by the implant manufacturing companies include: in the breast fold; around the nipple; and in the underarm. In the majority of cases, access is performed in the breast fold, with research demonstrating less risk of scar tissue and infection with this access. In revision cases, the original access incision may be used. If you are having a breast lift performed at the time of breast augmentation, the incisions for lifting will incorporate placement of the implant. If you have a preference with regard to your incision, that will be taken into account and discussed.

Where will your implant be located anatomically?

The layers of the chest include skin, breast, muscle, ribs, and lung, from superficial to deep. Implants are placed either above the muscle directly behind the breast tissue or under the muscle above the ribs. The more often-performed location for breast implant placement is under the muscle. This location has lower likelihood of visibility, scarring (capsular contracture), and assists later in mammographic screening. The muscle continually massages the implant and impedes scar formation, while camouflaging the implant contours, making it look more smooth and natural.

In what scenarios are implants preferably placed above the muscle, directly behind the breast tissue?

  • When someone is undergoing an implant exchange/size change and the implant is already in that location and has done well
  • When a woman has a developmental deformity that requires expansion of the breast mound
  • When an implant has not “done well” under the muscle and requires a position change
  • When an anatomically shaped implant is placed
  • When there is a good amount of breast tissue that can hide implant contours.

Will breast augmentation hurt breast monitoring for cancer?

The short answer is “no.” Women with implants are not likely to have missed cancers or more aggressive breast cancers. Be sure to tell your mammography technician that you have breast implants prior to imaging procedures.

Saline vs. silicone implants?

This topic will definitely be discussed with Dr. Shermak in depth during consultation. Silicone implant technology has evolved a great deal over a recent time. Silicone implants are round or anatomically-shaped, and Dr. Shermak will discuss the pros and cons of these different options for your goals and needs. Saline implants are a nice option in patients who have asymmetries; who have a good amount of breast tissue to camouflage the implant; and who desire a more economical alternative.

Silicone gel implants are now comprised of “cohesive,” cross-linked gel that is form-stable. As an implant wears and ages over time, this gel will not leak out into the breast space like the traditional gel implants. Duration of silicone gel implants surpasses the generations of implants that have preceded the current implants today.

What is the recovery like for breast augmentation?

Surgery is performed as an outpatient. One may experience temporary discomfort, swelling, or numbness. Most women resume regular activities and return to low impact activity after 1 week. Heavy exercise and lifting are discouraged for 3 to 4 weeks.

FAQ

How long does surgery take?

Surgery typically takes anywhere from an hour to 90 minutes, depending on the need to obtain symmetry in cases where there is significant baseline mismatch.

Is breast augmentation painful?

Dr. Shermak does everything she can with operative anesthesia, local anesthetics, and postoperative medications to assure her patients are as comfortable as possible after surgery. Her patients are up and about immediately after surgery.

Is breast augmentation safe?

Breast augmentation is one of the top surgical procedures performed by plastic surgeons. As long as the patient is vetted to be safe for surgery, and the facility is fully accredited (all of the surgical facilities Dr. Shermak uses are!), then you should have an optimal surgical experience. Surgery typically takes up to 90 minutes, and is most often performed in an outpatient surgical facility.

Breast augmentation recovery: What can I expect?

Normal day-to-day activity is resumed in the days to week following your surgery. You can shower the day after surgery, but Dr. Shermak insists that you hold off from swimming or vigorous working out for three to four weeks. Dr. Shermak will plan to see you within days after your surgery, and in the following weeks to help optimize your postoperative recovery.

When does swelling after breast augmentation begin to subside?

There is not typically a great deal of swelling in most cases. After several weeks, the acute swelling should resolve. Breast implants may take months (or even years) to completely settle.

How Do You Massage Breasts After Breast Augmentation?

Dr. Shermak recommends that her patients massage round saline or gel implants at about two weeks after surgery. She will instruct you on moving your implant upward and inward with compressive massage in a postoperative visit.

Do I need a Breast Augmentation, a Breastlift, or Both?

This is best determined during your office visit with Dr. Shermak. In cases where a woman wants more fullness, Breast Augmentation provides that. If there is sagging either from development or pregnancy, Breastlift may be necessary in centering the breast more optimally around the implant. In some cases, women do not desire Breastlift and only desire Augmentation, even if the nipple is on the low side.

Should I Wear A Surgical Bra After Breast Augmentation?

Yes. Dr. Shermak recommends you wear a soft, supportive bra without underwire for at least 6 weeks after surgery. You only need to wear the bra throughout the day and night for the first weeks after surgery.

What is your advice for Exercise After Breast Augmentation?

You may start lower body exercise within weeks of surgery as long as you keep your arms immobile. Upper body exercise may begin about a month after Breast Augmentation surgery.

What are the signs of Capsular Contracture After Breast Augmentation?

Capsular contracture describes the development of firm scar tissue around a breast implant, causing implant firmness, functional tightness, and possibly even a visible difference in the breast. If the breast is stable and comfortable, there is a low likelihood that capsular contracture is present. With the latest generation of silicone gel implants and preferred incisions and pocket placement, capsular contracture is far less common with contemporary Breast Augmentation.

How do you massage breasts after breast augmentation?

Dr. Shermak recommends that her patients massage round saline or gel implants at about two weeks after surgery. Massaging several minutes twice a day is all that is necessary to minimize scar tissue that develops around implants. She will instruct you on moving your implant upward and inward with compressive massage in a postoperative visit.

Do I need a breast augmentation, a breast lift, or both?

This is best determined during your office visit with Dr. Shermak. In cases where a woman wants more fullness, breast augmentation provides that. If there is sagging either from development or pregnancy, a breast lift may be necessary in centering the breast more optimally around the implant. In some cases, women do not desire a breast lift and only desire augmentation, even if the nipple is on the low side.

What are the signs of capsular contracture after breast augmentation?

Capsular contracture describes the development of firm scar tissue around a breast implant, causing implant firmness, functional tightness, and possibly even a visible difference in the breast. If the breast is stable and comfortable, there is a low likelihood that capsular contracture is present. With the latest generation of silicone gel implants and preferred incisions and pocket placement, capsular contracture is far less common with contemporary breast augmentation.

Should I wear a surgical bra after breast augmentation?

Yes. Dr. Shermak recommends you wear a soft, supportive bra without an underwire for at least 6 weeks after surgery. You only need to wear the bra throughout the day and night for the first weeks after surgery.

What is your advice for exercise after breast augmentation?

You may start lower body exercise within weeks of surgery as long as you keep your arms immobile. Upper body exercise may begin about a month after breast augmentation surgery.

I am not happy with the results from breast augmentation surgery performed elsewhere. Although my surgeon came highly recommended, he is not interested in my concerns and I am dissatisfied and disappointed. What should I do?

Come see Dr. Shermak. She specializes in revision surgery after unsatisfactory breast surgery, having completed a fellowship focused on achieving optimal results for complex breast surgery cases. Unsatisfactory outcomes Dr. Shermak successfully addresses include asymmetry, malposition, capsular contracture, and poor shape and size.

Dr. Shermak is happy to have a conversation with you, to hear your concerns and see how you can achieve excellent results consistent with your desires. Dr. Shermak is known for the way she connects with her patients, and she will serve as an active resource before, around the time of, and after your breast augmentation procedure.

Next Steps Schedule a Consultation

For more information about having breast augmentation in Baltimore Maryland, call our plastic surgery office at 410-324-6592 to schedule your personal, complimentary consultation today.