Breast augmentation, reduction, reshaping

Cosmetic surgical procedures

Benefits

Feel and look more feminine and more attractive
Be able to wear a wider variety of clothes (from swimsuits to evening gowns)
Reverse droopiness caused by pregnancy or aging
Improve symmetry between the two breasts

Types of Breast Prostheses

All breast prostheses have a silicone plastic outer shell. The shell contains either saline (salt water of the same concentration that bathes all our body tissues) or silicone (more the feel of natural breast tissue).
Most breast prostheses are round, although some are teardrop-shaped, with more fullness in the lower part
Most breast prostheses are “moderate profile,” although some women choose “moderate plus” or “high profile” implants. These have a narrower diameter and more projection.

Breast Augmentation

The biggest problem nationwide is still capsular contracture (firmness of the breasts from tight scar tissue around the implants). I modify the commonly used techniques, and have a lower rate of capsular contracture than reported nationwide. For example, most surgeons place the implants below only the pectoralis muscle. I place it under all four muscles in the breast area. In this way, the implants rest directly on the rigid chest wall, so scar tissue cannot tighten behind the implants. I also use drains to remove any oozing. They stay in place about five days, and decrease swelling, bruising, and pain. The lack of blood around the implants probably also decreases the risk of capsular contracture and infection. Although it takes more time and effort to use the drains, I feel that they are in the patient’s best interests. I usually place the scars around the lower areola. These are the best quality scars, and allow easy positioning of the implants and excellent control of bleeding. If breast reshaping is desired in the future, these scars are part of all standard reshaping techniques.

Breast Reduction or Reshaping

I use short scar techniques whenever possible. However, oftentimes, longer scars are indicated for optimal reshaping and nipple repositioning. Choices often need to be made after the patient is told about the benefits and limitations of different procedures.

Esthetic surgery must be performed within the context of general health. Accordingly, I started the first multi-disciplinary breast disease panel in Contra Costa in 1985 where breast health experts discussed care options directly with patients.