There Are Various Types Of Incisions For Silicone Breast Implants

A augmentation mammoplasty procedure is usually performed in a state of the art outpatient facility under general anesthesia and most often take approximately one and a half hours to perform. In the holding area prior to surgery, the patient’s “before” pictures are taken and then the breasts are marked. After speaking with the anesthetist/anesthesiologist, the patient is brought to the operating room. After he or she is asleep, local nerve blocks combined with a medication that shrinks blood vessels and capillaries to reduce any bleeding are instilled.

Next, the incisions are made and the “pockets” created – generally under the pectoralis muscle – and the implants are placed. Saline implants are inserted into the “pockets” while empty and then filled after in position. An antibiotic solution is generally added to the saline which some studies suggest reduces the incidence of capsular contracture (firmness and hardening of the healing tissue around the implant). Cohesive silicone gel implants are pre-filled and require a slightly larger incision to be placed. The operating room table back is elevated to place the patient in a sitting position to check implant position and symmetry.

Minor adjustments are made to the implant “pockets” as necessary to obtain the best possible results and symmetry. After the table back is lowered, a long acting anesthetic is placed into the “pockets” which greatly reduces postoperative discomfort. The incisions are closed with sutures predominantly below the surface of the skin to avoid cross-hatching suture marks and optimize the chances for the finest scars. Steri-strips are applied as well as being placed in a post surgical bra.

Every patient will be given the proper instructions on how to deal with their new breasts in order to achieve optimal results. This will include many things such as exercises to do each morning to ensure that breast implants stay in place.

Most cosmetic surgeons and patients agree that the new cohesive silicone gel implants have a more natural feel and are less likely to produce rippling than saline implants. The cohesive gel implant, however will require a slightly larger incision to allow placement.

There are several different locations for incision placement. An infra-mammary incision is placed in or near the crease under the breast. An areolar incision is placed in the border of the lower part of the areola (pigmented area around the nipple). An axillary incision is placed in a natural crease in the hair bearing skin of the armpit. The trans-umbilical incision is in the upper aspect of the “belly button” and is for saline implants only. Most plastic surgeons generally prefer the areolar incision because of the excellent quality of the scars which are generally imperceptible. However, the final choice of incision placement will ultimately be up to the patient.

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