The breast augmentation procedures performed in our Aventuraplastic surgery facilities are very popular operations in this visual world. If you want volume, a little or a lot, it can be done. Dr. DiGeronimo always like a sexy, normal, natural size, but the choice is the patients'. He will guide and help you achieve the look you want.
Breast enhancement is usually done to add more volume to whatever breast size you already have. It is the patients' preference as to the amount of volume or additional size you want. This is accomplished by placing a saline or silicone implant behind the breast either over or behind the muscle for a natural look. Dr. DiGeronimo will discuss the options that are best suited for the look you want. Breast augmentation can be complemented by additional procedures such as breast lift, or areola repositioning if needed.
A very popular operation in this visual world. If you want volume, a little or a lot, it can be done. Dr. DiGeronimo always likes a sexy, normal, natural size, but the choice is the patients. He will guide and help you achieve the look you want.
Saline or Silicone
Both are good, but there are very specific reasons why one or the other could be a better choice. Saline-filled implants with a smaller size in patients with moderate or more breast tissue and body fat. Skinny thin patients could be better using Silicone gel. Dr. DiGeronimo can explain exactly why he recommends one or the other. Many times either would be a good choice and the patient can choose if she has a preference. For example, “My sister had silicone and I want the same type of implants”.
Dr. DiGeronimo, in any case, will help you make the best decision, customized to your needs.
General Facts Regarding Breast Augmentation or Enlargement
These informational materials presented to you is to aid you in making the decision regarding possible Breast Enlargement or Augmentation Surgery. This online information is not meant to be a substitute for personal interest or attention. Each patient’s procedure always receives individual thought, planning and care.
Please read this information carefully and review it several times at your leisure. Please discuss any questions or comments relating to this information with Dr. DiGeronimo prior to making any FINAL DECISION TO ASSURE COMPLETE UNDERSTANDING OF ALL THE INFORMATION INVOLVED.
There are several basic points of information that the individual considering breast augmentation should be aware of:
I. The exact size or shape of the breasts cannot be chosen or determined with certainty prior to the procedure. There is a variability and unpredictability in the results of inserting any particular size or shape prosthesis in performing breast augmentation. The patient must understand that there is no way to determine the exact final result prior to this procedure.
II. Structure or Type of Prosthesis Used for Breast Enlargement or Breast Augmentation.
Currently, only saline (salt water) filled prosthesis are recommended (and used by Dr. DiGeronimo) for routine type breast enlargement or augmentation. Other types of prostheses exist and have recommended in the past. These have included prosthesis filled with a silicone gel substance. The salt water or saline filled prosthesis that are currently recommended and approved still contains an outer shell or wall made of a silicone (silastic) sheeting. This is not a liquid or gel substance. The saline or salt water is then placed within this silicone shell.
The surface texture of the silicone (silastic) shell of the prostheses can also vary. Some prostheses or implants will have s smooth wall and some will have one of a variety of textured or rough surfaces. Each type of surface seems to have certain possible advantages and disadvantages. The final decision as to which prostheses are used will vary from patient to patient.
Unless otherwise indicated, a smooth-walled prosthesis will be used for this procedure. In addition to saline, other medications such as antibiotics may be placed within the prosthesis to help prevent possible problems associated with this procedure.
It must be understood and realized that every prosthesis, every procedure and every medication have some potential risks and possible complications associated with it. The objectives and possible advantages of each must be weighed against the risks and possible complications. Great effort is made to reduce the chances for problems and complications. All questions in this regard must be discussed and fully understood prior to proceeding with any procedure.
III. The Prosthesis is Placed Into The Body Behind The Breast Tissue.
The prosthesis may be placed above the chest muscle (pectoralis muscle) or below the chest muscle.
Dr. DiGeronimo generally places the prosthesis under the chest muscle. This may vary with each individual. The reasons for specific placement will be discussed with you prior to the procedure. It is important that you understand the reasons for this choice prior to the procedure being done. Placing the prosthesis beneath the muscle may produce some movement of breast and prosthesis and some distortion of the breast muscle with the movement of the chest muscle, arms, and shoulders. This, too, must be understood prior to proceeding with the procedure.
IV. The Prosthesis Is Inserted Into The Body Through An Incision That Always Leaves A Scar.
There are three different areas for the placement of the incision.
A. Inframammary Incision: This incision is placed in or near the crease under the breast and generally measures approximately one and one half to two inches in length.
B. Peri-areolar Incision: This incision is generally placed in the border or edge of the areola (pigmented area around the nipple). Generally, this is placed in the lower aspect of the areola.
C. Axillary Incision: This incision is made in the axilla or armpit area and also generally measures one and one half to two inches in length.
Dr. DiGeronimo will discuss these alternatives with you. It is important that you understand that the healing of any of these scars is unpredictable and may result in a permanent noticeable scar. It is also important that you understand the choices of options for these incisions, approaches, and reasons before the final choice of incisions and approaches are to be used.
The Operation For Breast Augmentation May Be Performed In An Outpatient Facility Or The Hospital
There are also different kinds of anesthesia that can be used for the breast augmentation or enlargement procedure. Dr. DiGeronimo most frequently performs this procedure under general anesthesia alone. However, local anesthesia with intravenous sedation might also be used in certain circumstances. In the hospital, the anesthesia is generally administered by a D.O./M.D. Anesthesiologist or possible by a Certified Registered Nurse Anesthetist under additional supervision by a D.O./M.D. Anesthesiologist.
Preoperative discussions with Dr. DiGeronimo and his judgment during the operation itself will determine the size of the prosthesis that is used. There are some unpredictability and variability in the reaction and response of tissues and the healing process in each patient. These cannot be predetermined before the surgery. It should—also be realized that along with the enlargement of the breasts, it is frequent that the nipples (or more accurately, the dark skin around the nipple projection called the areola) will also be larger or wider following breast augmentation. This will remain on a permanent basis. Also, some women may find an increase in the visibility of veins or blood vessels of the breast skin following the surgery. This, too, must be accepted as a possible permanent change. It must also be realized that the final shape of the breast frequently is not obtained or several months (up to approximately one year) following breast augmentation surgery. Frequently, there is some distortion and increases swelling and fullness in the upper part of the breast or chest area. This generally subsided and improves over several weeks to several months following the surgical procedure. The breasts will remain firm for an undetermined amount of time during the normal healing process.
If you have any other questions regarding this surgery please let us know so we can help you make your decision regarding breast augmentation.
To Prepare for Surgery
1. Every patient must have a written medical clearance from his/her family physician with the following:
a) a history and physical and a letter stating that he/she is in good physical condition and able to undergo the surgery.
c) Electrocardiogram if you are forty years of age or older or have cardiac problems
d) Mammogram if requested by the physician.
2. Do not take any aspirin or medications that contain aspirin, Advil, Motrin, Ibuprofen or Vitamin E for two weeks prior to surgery and for two weeks following surgery. Tylenol or Extra Strength Tylenol may be taken as needed. Please refer to the list available from the office of aspirin related products to make sure you avoid them for at least two weeks prior to surgery.
3. Patients who smoke must refrain from doing so for at least two weeks prior to surgery and two weeks following surgery. Smoking will increase the risks and possible complications associated with surgery, healing and with anesthesia.
4. If you take any medications such as for your heart or high blood pressure pills, diabetes medication, birth control pills, etc., please be sure to discuss these with Dr. DiGeronimo. You will be given special instructions regarding the taking of these medications prior to the surgery. If you are going to a recovery facility following the surgery, bring all the medications with you on the day of surgery.
5. At least two weeks prior to surgery you may begin taking 1000 mg of Vitamin C, 50mg of Zinc, 200 mg of Bromelain on a daily basis. This is not required these are all recommended for patients to decrease swelling and bruising during the healing phase of the surgery.
6. Carefully shave under the arms 48 hours prior to surgery. If there are any long hairs in the area of the nipples, carefully slip them with a small scissor. DO NOT SHAVE OR PLUCK THEM.
7. On the night before the surgery be certain to take all medications that you have been instructed to take such as antibiotics.
8. On the night before surgery take a shower and wash your hair. Carefully wash your chest, arms, shoulders, and underarms. This should be repeated on the morning of surgery. Do not use deodorant or skin lotions after you shower.
9. DO NOT HAVE ANYTHING TO EAT OR DRINK INCLUDING WATER after midnight the night before the surgery unless otherwise instructed by Dr. DiGeronimo.
10. If you are not returning home following the surgery, bring with you an overnight bag in which you have changes of underwear, a fresh robe which opens all the way down the front or pajamas which open all the way down the front, slippers without heels, toiletries and ALL MEDICATIONS.
11. Please be sure to provide the office with the name of someone to contact if necessary. If you are not going to a recovery facility or are not staying overnight in the hospital, please make arrangements to have a responsible adult drive you to and from the surgery and spend at least the first night with you.
The Day of the Surgery
1. As previously stated, shower the morning of the surgery.
2. Brush your teeth (using a very small amount of water) and use a mouthwash on the morning of surgery.
3. Do not wear any makeup, hair spray, jewelry, pantyhose or stockings on the morning of surgery. Leave all valuables at home.
4. Please be prompt. Please be sure you have followed all the instructions. Preparations will begin when you arrive.
5. When you arrive for surgery, you will change into a gown. An Intravenous line will then be started in your arm and you may be given some medications through the intravenous line. Dr. DiGeronimo will generally make some marks on your chest with a felt-tipped marker prior to the surgery prior to your being brought into the operating area.
6. Surgery time varies with each patient. Please inform your family and friends that you will be with us for several hours.
After the Surgery
1. After the surgery is completed you will have a dressing in place around the breast area. There may also be an ace bandage or elastic Velcro type dressing in place. Do not remove these dressings. it may be left in place for up to one week.
2. You are to go home or to a recovery center and remain in bed with your head and shoulders elevated on two or three pillows with bathroom privileges with assistance. Continue to sleep with your head and shoulders elevated for one week following the surgery. Elevating the mattress at the head of the bed with two pillows placed under the mattress can also be helpful. This, of course, should be done prior to the surgery or by someone other than the patient following the surgery.
3. Remain as quiet as possible for the first 48 hours following the surgery.
4. Take all prescribed medications.
5. You may have moderate amounts of liquids and soft foods as desired and tolerated the first night following the surgery. The following day you may resume a normal diet. No alcohol for a period of seven days following the surgery.
6. ARM MOTION IS TO BE COMPLETELY RESTRICTED. DO NOT EXTEND YOUR ARMS ABOVE THE SHOULDER LEVEL. DO NOT LIFT. DO NOT PUSH. DO NOT PULL. DO NOT REACH. DO NOT BRACE YOUR ARMS WHEN GETTING OUT OF A CHAIR OR BED.
7. Wear clothing that fully opens down the front for the first two weeks following surgery.
8. Avoid the sun and heat until after the swelling and bruising have subsided. You should avoid hot showers or baths during the first two weeks following surgery. Increasing the temperature of the chest and breast area can cause blood vessels to dilate and may increase the chances of bleeding, bruising and swelling. You must avoid direct sun exposure to any scars or incision area from the surgery. Sun exposure may make scars darker and more obvious following the surgery.
9. You may experience some swelling, tingling, itching, and numbness of the breasts or nipples and various other parts of the chest, shoulders and arms. This may last for a variable length of time. These generally subside gradually, although some numbness, tingling, and itching may remain on a permanent basis. Complete healing takes approximately 12 months.
10. Report any sudden increase in pain or size of breast immediately at any time. Moderate and gradual lessening in pain and swelling are normal and are to be expected following this surgery.
11. If you have the trans-axillary approach (incision under the arm) you should avoid shaving your arms and the use of underarm deodorants until all of the stitches have been removed.
12. If you have the inframammary approach (incision under the breast) no underwire bra should be worn for at least 8 weeks following the surgery unless otherwise instructed or discussed with Dr. DiGeronimo.
13. Generally, the following instructions apply. However, there may be exceptions from individual to individual. Discretion should be used in following these instructions. Do not push yourself. Let comfort be your guide as to how fast you progress. “IF IT HURTS, DON’T DO IT.”
A. AFTER ONE WEEK YOU MAY:
1. Drive a car with an automatic transmission.
2. Do light cooking.
3. Take a shower after the dressing is removed making sure the water is lukewarm and not hot.
4. Use underarm deodorant (unless underarm incision was used).
B. AFTER TWO WEEKS YOU MAY:
1. Indulge in limited sexual activities.
C. AFTER THREE WEEKS YOU MAY:
1. Wash and set your hair (Prior to this time you may have someone else wash and set your hair)
D. AFTER ONE MONTH YOU MAY:
1. Do light exercising. NO STRENUOUS BIKE RIDING, GOLF, TENNIS, JOGGING OR HIGH IMPACT AEROBICS.
2. Indulge in normal sexual activities
3. Sunbathe with incisions covered with a bandage or with the use of #30 sunblock.
E. AFTER TWO MONTHS YOU MAY:
1. Indulge in heavy exercise and sports
2. Do heavy housework
3. Take a sauna or steam bath
After a three-month period following surgery, you may purchase any type of bra you wish. Underwire bras are not recommended for daily use. If you have undergone breast lift surgery (mastopexy) with implants, remember – your breasts have added weight; support is necessary to prevent sagging. This does not mean that you cannot go braless on occasion, but support is recommended for the majority of the time