Tag Archives: Breast Augmentation

Breast Augmentation, Breast Enlargement: “What about the muscle?”

Cosmetic breast enlargement or breast augmentation is done to give a women a more attractive, full, and larger shape to the breast. The operation has a very high success rate and is considered extremely safe. The operation is almost always done on an out-patient basis with a reasonably quick recovery. Women interested in the cosmetic operation often ask about “muscle work” or “the muscle” and this educational writing on breast augmentation will review this.

The chest of a women has a large flat fan shaped muscle called the pectorals major muscle beneath the breast. This is the large chest muscle you see in male body builders. This pectoralis muscle is the main muscle for breast enlargement. The serratis anterior muscle and the rectus abdominus muscles play a smaller role for breast surgery, but most of the focus is on the pectoralis muscle.

Breast implants are placed either beneath the pectoralis muscle or on top of it. Placing it beneath the muscle is called sub-muscular placement. Placing the breast implant on top of the muscle is called sub-glandular. This means beneath the breast- BUT on top of the muscle! Breast augmentation technique involves placing the implant in one of these two locations.

Most medical studies show superior results with placing the breast implants beneath the muscle. The muscle provides improved coverage and lower complications. Dr. Saunders emphasizes how the muscle and breast together are an important concept he calls “soft tissue coverage.”
“Soft tissue coverage” is all the muscle, breast, and skin that are covering the breast implant and “hiding” it. The more tissue or coverage that hides the breast implants- the better the result will be.

Imagine a women who naturally was as “flat as a board” and then gets extremely large breast implants. She now is at the beach! She will look fake, round, and not natural. Many people don’t want this result after breast augmentation surgery. She looks like this because she has poor “soft tissue coverage.” She has mainly “skin” covering the breast implants. She will also have a worse “feel” and a worse “look” to the breast with higher complications.

It is placing the implants beneath the muscle that gives us the most “soft tissue coverage” possible. Dr. Saunders tries to get the breast implants behind all the muscle possible that a women has on her chest. These breast augmentation techniques give the best results with the softest breast, most natural result, and lowest complications. Understanding the importance of the muscle is the key to understanding the latest breast augmentation techniques.

More info: Saline vs Silicone Breast Implants

Breast implants placed on top of the muscle sometimes is done. As far as breast enlargement techniques is concerned- this can be a mistake! It is not the first choice for location as described above. Higher complications can occur in this location. These problems might be seeing the breast implants (wrippling) or feeling the breast implants (palpability) more than normal or desired. Options include placing them beneath the muscle or switching to Silicone breast implants. Saline breast implants versus silicone breast implants is discussed in detail in another educational writing. You can link to this now. It is called – Breast Implants Saline or Silicone? For extra discussion- consultation is recommended in this situation.

People interested in breast augmentation cosmetic surgery or breast enlargement cosmetic surgery or other topics such as breast augmentation cost, breast augmentation recovery, or breast augmentation technique should please call the office for an appointment. Dr. Saunders will review your breast surgery with you in detail!

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. Please check out the breast enlargement before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Click here to visit our Breast Augmentation photo gallery.

Breast Augmentation, Breast enlargement: What is settling?

Cosmetic breast augmentation or breast enlargement is one of the most commonly performed cosmetic surgery procedures done each years! Statistics by the American Society of Plastic Surgery show that this operation is in the top three almost every year. Results and patient satisfaction is usually very high with cosmetic breast surgery.

However, women need to understand that it is not an operation where the breast implants are placed and “presto-chango” you wake up with perfect breasts. It takes time for healing to occur- and that is what this writing will focus on. Breast augmentation or breast enlargement involves putting breast implants behind the muscle. They are almost always placed there. The muscle is the pectoralis muscle predominantly, but also the serratis on the side to a lesser degree.

The placement of breast implants behind the muscle is called sub-muscular breast augmentation or breast enlargement. The muscle provides soft-tissue coverage and improved results. However, the space behind the muscle is very tight at first and it takes time for this space to stretch out.

This process or “stretching” is commonly referred to as breast implant dropping, breast implant settling, and or breast implant drop and fluff! These are layman terms for the changes that occur after this cosmetic breast operation. This stretching out of the muscle does take time- a short period of time usually but sometimes several months or even longer. Most people however can look good in just a couple of weeks! This is true especially in clothing or swim suits, but undressed it can be seen longer.

This process of breast augmentation settling is gradual, because it takes time for the muscles to stretch out and relax. It is similar to the slow changes that happen to the abdominal muscles with pregnancy. However, getting stretch marks in the skin with breast implants is exceedingly rare but more common with pregnancy.

During this process of breast enlargement settling, the breasts will gradually change and soften. The shape and appearance changes also. The breasts tend to slowly look more round and natural. It takes time, so be patient! Sometimes the breasts even look bigger as the muscle relaxes and the implants “come out.”

Breast enlargement settling gradually occurs and the implants “drop” during this process. When this happens the nipple comes down. It might seem unusual but breast implant settling or breast implant dropping occurs inside. So as the breast implant drops- the nipple moves up! This is extremely normal! When breast implants settle this is what happens.

Breast augmentation recovery or breast enlargement recovery has two phases. The first phase is the short period around the actual operation. This is the part unfortunately where pain is involved. However, Dr. Saunders uses a “Pain-Buster” to really decrease this and help make it as pain free as possible. The second phase of breast augmentation recovery is this slow stretching of the tissue and muscle that is called breast enlargement dropping or breast augmentation settling.

This second phase does take time as described above but usually there is no real pain with this phase! Breast massage or breast implant displacement are stretching maneuvers that are done to speed up the breast implant dropping. Dr. Saunders has a breast implant massage technique video that shows this in detail. He also has another educational writing that talks about and explains breast implant massage in detail.

People interested in breast augmentation or breast enlargement or other topics such as breast augmentation cost, breast augmentation recovery, or breast augmentation technique should please call the office for an appointment.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. Please check out the breast augmentation before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Click here to visit our Breast Augmentation photo gallery

Breast Lift Surgery and Breast Reduction Surgery: Understanding the incisions or Scars

The writings or blogs are posted most recently on the top. For example, patients who are reading these writings on breast lift cosmetic surgery, it is best to scroll down and start reading the writings at Wilmington Breast Lift and Breast Reduction. This would be first. The later ones are in sequence as they have been added later.

Breast lift incisions or scars are of major concern. Poor scars on the breast are, in fact, one of the major causes for law suits against plastic surgeons. Breast incisions typically heal well and fade with time, but they can heal poorly or become hypertrophic or keloidal. Poor scars can be described as raised, red, and unsightly. A woman can have an operation to make the breast prettier, and all of a sudden she ends up with bad scars. She has become “scarred”. This is never the goal, of course. Most women do not end up like this. Most women have good or excellent results with incisions that fade well. The risk that the incisions do not fade well is one of the main risks a woman must face. Medical studies and medical research have shown extremely high satisfaction rates with these operations. The medical literature would support the conclusion that these operations really work. They improve symptoms of back and neck pain, and they greatly improve the shape and attractiveness of the breast. Most women are pleased with their operation, their surgeon, and would do it again if asked. However the “Real-Reality” of these breast operations, like many operations, is that the patient and doctor take a statistical chance. This is the chance that the incision doesn’t fade, as it is expected to, after breast lift or breast reduction surgery. The incisions or the scars and how they fade are of utmost importance. Certain operations like cosmetic eye lifts almost never get bad scars. Breast lift and breast reduction surgery have a greater chance. Although this rate is still very low, I believe it is the major factor that must be discussed before surgery. If a woman hates her breasts, and she cannot stand to look at them in the mirror, then she is an excellent candidate for this type of breast surgery. She typically will love the new shape and appearance of her breasts. The incisions are a necessary trade-off. In the great majority of cases, the incisions fade very well. They never go away. However, there really is no other option besides surgery, except not having the operation. No creams, suction massage, or puppet strings will work and lift the breast. These are not reality. You live with the existing shape of the breast or have the operation. In this scenario described, where the woman cannot stand her breasts and she believes it is not a minor issue but a major dissatisfaction, then she typically will be happy with surgery. This is a patient that probably will like the results of the breast lift. The necessary trade-off of the incisions will be outweighed by the improvement in appearance, and she will feel the operation has been worth it.

In contrast to breast lift, breast augmentation or breast enlargement have very small incisions. The incision for breast augmentation is small because the implant can be “rolled up” and placed in “empty.” It is then “filled up” inside the breast under the muscle. The incision for breast augmentation is much smaller than the breast lift and has a very high rate of fading extremely well.

Women interested in breast lift, breast augmentation, breast lift and augmentation, breast lift recovery, breast lift cost, and breast lift incisions should come in for a consultation with Dr. Saunders. Please also see the breast lift before and after photos and the breast augmentation before and after photos.

More information on Breast Lift Surgery and Breast Reduction Surgery

The writings or blogs are posted most recently on the top. For example, patients who are reading these writings on breast lift cosmetic surgery, it is best to scroll down and start reading the writings at Wilmington Breast Lift and Breast Reduction. This would be first. The later ones are in sequence as they have been added later.

The circumareolar pattern for breast lifting is mainly used for very small degrees of breast hanging. If it is used for more hanging than very small amounts, the result can be a shape that is very unnatural, with a flat and/or poor shape. A major understanding is that to make the breasts attractive in shape, with the nipples attractively lifted, the scars are a necessary evil. Make too few incisions, and you may end up with this poor shape and unattractive breasts. Larger breast incision patterns typically end up with attractive breasts with the main remaining issue being the fading of scars. Unattractive breasts after lifting or breast reduction may have changes that are difficult to correct even with re-operation. This type of re-operative surgery can be necessary after poor results. Think of it like a seesaw. On one side are breasts with minimal hanging. Some women might even say they don’t need lifting. These women can have small incisions, because there is a small amount of loose skin that needs to be removed. On the other side of the seesaw is significant hanging of the breasts, and the nipples are probably pointing significantly down. These breasts have significant amounts of loose skin and larger incision patterns are necessary. The “Real-Reality” is you cannot remove lots of loose skin with small patterns. Your anatomy determines the operation you need, typically not your wishes. Everyone wants a small incision, including the doctor.

The circumareolar pattern, as I have described, allows for only small amounts of skin removal and is for a limited number of patients with small degree of hanging. There are other problems with this pattern, including poor scar formation around the nipple, poor projection of the breast, a flat shape, and widespread nipples. Some doctors never use this pattern, because of these risks. I believe, if the woman has the correct anatomy, then the results from this pattern can be what is desired, and can be achieved.

The second pattern around the nipple and down, the “lollipop” pattern is much more frequently used than the other patterns. I like to think of it as a compromise pattern between the three patterns described. Moderate degrees of hanging and breast reduction can be done through this pattern. Lower risks of poor shape after surgery can be expected, compared to the circumareolar technique. The final pattern or “anchor” pattern might be called the “classic” incision pattern. It allows for as much skin removal as is necessary for women of any degree of breast size or shape. More severe degrees of hanging and very large breasts are typically best treated with this incision pattern. Once again, your anatomy and shape are major determinants, in regards to which pattern you will need.

Most breast lifts are done with the “lollipop” incision pattern. Patients with very little hanging can have the nipple incision only. Patients with large degrees of hanging will need the “anchor” pattern. The pattern of incision needed can change if a women decides she wants a breast lift and augmentation. A breast augmentation added to a breast lift leads to a bigger volume or size in addition to the lifted shape. The breast implant “takes up” extra skin and some patients will need smaller incisions because of this. Women interested in breast lift and augmentation might find they need just a “lollipop” incision instead of the “anchor” pattern if they add breast implants to the lift.
Finally, some women just need breast augmentation and no lift. This is if you have very little hanging however.

Women interested in breast lift, breast lift and augmentation, breast lift recovery, breast lift cost, and breast lift incisions should come in for a consultation with Dr. Saunders. Please also see the breast lift before and after photos and the breast augmentation before and after photos.

Choosing Breast Implant Size in Delaware — Do Your Homework!

Cosmetic breast augmentation or breast enlargement is a fantastic plastic surgery procedure with high satisfaction and results! Once a women has decided on proceeding with her breast augmentation, it is time to decide on breast implant size. This is an extremely important part of the process before breast enlargement surgery or cosmetic breast enhancement. It also is one of the fun parts of your surgery!

Dr. Saunders uses the term “Do Your Homework” because effort is important. For anyone who has children, you know that effort, when doing your homework, is important, or you don’t learn as much. Dr. Saunders tells his Delaware plastic surgery patients and his Pennsylvania plastic surgery patients to put maximal effort into their homework to get the best results. Picking your size for breast augmentation is extremely important and fun, and Dr. Saunders will work closely with you to help you find the right size for you.

“Homework” has two parts. The first is photographs, and the second is the “Rice Test.” Photographs can help a patient choose breast implant size before breast augmentation surgery. Patients should look at Playboy, the Internet , or Dr. Saunders’ web page. Look for women who you think have the size you like. Pick three or four different pictures or women, as we are looking for consistency. We don’t want someone to hope for a C cup and bring in photos of Dolly Parton, who is obviously much bigger. This would not be consistent. Finding this out before surgery allows us to make changes that will increase our chances of getting the perfect size after breast enlargement surgery. The pictures can also be found on the Internet or Dr. Saunders web page in the breast augmentation before and after photos section. Dr. Saunders also has a video on his web page that can help you with the different sizes and choices for you.

When looking at the photos, do not get misled by the models statistics saying she is a particular bra size and she looks like a different cup size. It is extremely common for the women to look like a natural C cup, yet say she wears a D cup. Many bras run small, like Victoria’s Secret. Do not let this confuse you. The goal of surgery is to like your breast size with no bra on. You then will find a bra that fits. This bra might have a different letter cup. Many bras run small as described. Manufacturers of bras tremendously vary. You can be a C cup at one store, a D cup at another, and a B cup at a third. To repeat, the goal of a cosmetic breast augmentation procedure is for the patient to be happy with no bra on! After healing we can find a bra that fits, but the cup size might vary from one bra to another.

The Rice Test is the second part of “Doing Your Homework.” Rice bags are made and stuffed in your bra. Take an old pair of stockings and cut them off six inches above the ankle. Pour dry rice in to the stocking and tie a loose knot. Wear a sports bra with no padding or under-wire. Use one for each breast. Press the bags flat and try and shape them like a breast, so they look natural. Try on different outfits with them on. Take out the rice bags and add more rice to each side. Keep trying more and more rice until you find the best size for you!! When you are done, pour the rice into a measuring cup and measure the rice. Use the metric scale if your measuring cup has it.  The “Rice Test” is a volume test. We are looking for the volume of rice added to your breast that makes you happy.

Dr. Saunders uses five different factors or variables to help you pick your implant size before your breast enlargement procedure. The first two are the photos and the “Rice Test” results. The third factor is your precise measurements done by Dr. Saunders on your examination, including your breast base diameter and breast height. The final two factors are your desires and goals as a patient and Dr Saunders’ opinion to help you achieve these goals. By putting all these variables together, his patients have extremely high satisfaction rates from his after cosmetic breast augmentation.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery in Delaware and Chadds Ford, Pennsylvania. Please check out the breast enlargement before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!