Every woman wants to look fantastic and feel great about her body but we’re not always born with a figure we love

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Breast Enlargement or Augmentation

Breast Enlargement, or Breast Augmentation as it is known, is the most common procedure I perform. It involves placement of an implant behind the breast tissue to improve breast shape and fullness. The procedure takes about an hour and is done under general anesthesia for patient comfort and safety. Implants can be placed either behind or in front of the chest wall muscle depending on individual anatomy. In most patients, the incision is placed in the fold beneath the breast, but an incision in the nipple border or under the arm is an option for some patients. A breast implant is a silicone shell filled with either saline (salt water) or silicone gel. Saline filled implants are slightly firmer, and may have folds and ripples in the shell that can be seen or felt through the skin. They are rolled up and inserted empty, then inflated through a long filling tube, so a slightly shorter incision can be made. Salt water is less adherent to the inside of the implant shell than is silicone gel, so it drops to the bottom of the implant and over time causes more downward pressure on the lower hemisphere of the breast. This gives saline implants a greater tendency to drop or “bottom out” over time – especially a large saline implant. In spite of these limitations, saline implants are still a reasonable choice for a young woman who hasn’t had children, has good skin quality and desires only a modest breast enlargement. Silicone implants are much more common in my practice. They look more natural and feel more like a normal breast. Silicone implants come pre-filled from the manufacturer, so a slightly longer incision is necessary to prevent implant damage on insertion. Since silicone gel is a more adherent filler than saline, silicone implants have less tendency to “bottom out” over time and are a better choice for a woman who wants a large implant and a fuller breast – although there is no implant that will defeat gravity indefinitely. In thin patients, palpable or visible implant folds can still occur, but this is much less common than with saline implants. Shortly after I started my practice in 1990, controversy arose concerning whether or not silicone implants caused connective tissue diseases (lupus, scleroderma, rheumatoid arthritis, etc). After more than a decade of intense scientific scrutiny, the Institute of Medicine concluded that there was no relationship between silicone implants and connective tissue diseases and the FDA released them for general use.

Breast implants, like your toaster or your refrigerator, are man-made devices with a limited life expectancy. There are no definite guidelines concerning the life span of an implant. Over time, the implant shell can fail (crack) simply from activities of daily living and may need to be replaced. As a general rule, if a patient’s breasts remain soft and natural and the mammogram is normal, it is unlikely that there is a problem with the implants. I do not advocate routinely changing out implants every ten years unless there is evidence on physical examination or on radiographic studies that there is a problem. I will spend considerable time at your consultation listening to what you hope to achieve with breast enlargement and making sure your expectations are realistic given your unique, individual anatomy. Variations in chest wall shape, rib position and spine configuration all play a role in the end result. So do breast position (wide spacing or narrow), breast shape (pointy or flat), nipple position, the amount of breast tissue present and the amount and quality of your skin envelope. Moreover, implants come in a variety of shapes and sizes. This is where the artistic aspect of the procedure comes into play. There is no assembly line or “cookie-cutter” breast augmentation. Each procedure is tailored to the patient’s desires and her unique anatomy. The time we spend up front pays off. I have performed well over 1000 breast enlargement procedures since 1990, and re-operation within the first year simply to change implant size has occurred in less than 1%. Breast augmentation is an outpatient procedure and most patients are back to their normal routine in 5 – 7 days, and back to strenuous excercise and heavy activity by 3 weeks.

I knew right away during our initial consultation that you were the right surgeon for me. I appreciated your honesty, attention to detail in answering my questions and your confidence and enthusiasm toward what I wanted to do. For the first time in my life, I am excited to go bathing suit shopping. No more plastic chicken cutlets for me!


Before and After Photos of Breast Enlargement Surgery

Seeing is believing. Click the link above to view a selection of Breast Augmentation Before and After Photos from patients who have allowed us to share their before and after photos on our web site. If you choose Mickel Plastic Surgery, we will select additional before and after images from our large selection of plastic surgery patient photos for you to study as you consider your options. We hope you enjoy this opportunity to see the possibilities of Breast Enlargement in Monroe, LA.