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2. Preparation for Breast Augmentation

What information should you consider before proceeding with breast augmentation?

During your consultation at the California Center for Plastic Surgery, Dr. Younai will review your options for different types, shapes, textures, and sizes of saline or silicone breast implants, as well as, different approaches for breast enlargement.

Breast implants can be inserted via an armpit incision (transaxillary), areolar/nipple incision (periareolar), breast fold incision (inframammary), or belly button incision (transumbilical). While an armpit or transaxillary incision scar might not be very noticeable, it usually results in the breasts being too far apart, causing lack of a strong cleavage. It also carries a higher risk for implant displacement and breast asymmetry.

An inframammary or periareolar approach can usually produce the nicest cleavage and the most precise placement of breast implants. While the transumbilical approach is marketed by some plastic surgeons as "scarless breast augmentation," indeed it is not so! I have personally consulted women who were not pleased with the belly button scar; especially since they were no longer able to wear cut-off tops. The transumbilical route of breast implant insertion also carries an increased surgical risk of possible damage to internal organs if the inserting metal rod is misguided.

What determines the extent of the cleavage with breast augmentation?

Breast cleavage is considered one of the most visible and attractive esthetic features of breasts. Reviewing many before and after pictures of breast augmentation from plastic surgeons throughout Beverly Hills, Los Angeles, and Southern California, it always amazes me to see the lack of a strong cleavage in these pictures. Why is that? Insertion of a breast implant via the periareolar or inframammary approach ensures precise placement and strong, beautiful cleavage, which usually cannot be achieved via the axillary or transumbilical approach. The second most important factor is the size of the implant; larger implants are wider and result in stronger cleavage. Choosing an optimal implant size is a very crucial decision, which involves close-decision making between you and your plastic surgeon. Finally, the basic shape of your breasts, chest, and possible existence of chest wall deformities or concavities can affect the extent of cleavage.

Preparation for - Breast Augmentation, Lift, Reduction

The surgeon will provide very specific instructions prior to surgery so you will have an optimal and safe experience. These include what medications to avoid to prevent excessive bleeding and bruising, required medical exams, what to eat and drink prior to surgery, and the prescription of an anti-nausea pill to take on the morning of the surgery. In all cases, you will be asked to have a reliable friend or family member take you home after the surgery, as you will not be allowed to drive.

  • Tend to all of your chores and to do things before your surgery so you don't have to worry about taking care of things early during your recuperation. You are not allowed to engage in heavy lifting for several weeks after surgery. This means if you usually clean the house, you should do so in advance of your surgery.
  • Have your hair cut and colored, wax your legs, pay your bills, and take your dog to the vet before your planned day of surgery!
  • If you an avid tanner, don't tan your breasts for one week before, and six weeks after, your surgery. Any sun or tan burn of your breast skin can potentially increase the risk of infection of skin damage with breast augmentation.
  • If you have nipple rings you must replace them with a plastic ring at least one week before surgery and wait for your surgeon to tell you when you can have them replaced.
  • Rent your favorite movies, and leave easily prepared foods and snacks in areas where you will not have to lift or reach. Place all of the medications, tissues, reading materials, water bottles on one table, within easy reach.
  • Have ready ice cold cola drinks, ginger ale, or sport drinks close to your bed. Avoid drinking too much plain water after surgery, because it makes you more nauseated.
  • After surgery take your nausea pill about one hour before your other medications to lessen nausea. Also, have some over-the-counter anti-acids available at your bedside.
  • Some surgeons recommend putting cold packs on you breasts afterwards. In my opinion, even though cold might lessen the inflammation, it can also cause frost bites or skin damage while your breasts are numb after surgery.
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Dr. Sean Younai
is a Board Certified Cosmetic Plastic Surgeon, who practices in Encino, Los Angeles, Southern California.
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