Breast Augmentation Rancho Cucamonga
Breast augmentation, also known as augmentation mammoplasty is performed using breast implants to enhance small or disproportionate breasts. Women also may select breast augmentation because of changes they experience to their breasts due to age, pregnancy, weight loss or cancer.
There are multiple options for breast enlargement surgery and Dr. Bennett will discuss with you the benefits of textured versus smooth implants, shaped versus round implants, and saline versus silicone implants. Placement of your implants can be performed under the pectoralis muscle in a full submuscular, or dual plane, or sub-glandular location. The different choices have trade-offs to consider and this is why it is important to consider all your options and discuss them thoroughly at your consultation.
Women seeking breast augmentation today are custom fitted for their breast implants during their consultation and pre-operative appointment with Dr. Bennett. Dr. Bennett will perform a physical exam and take breast measurements to help ensure a precise breast implant fit.
- Saline or Silicone gel are the two breast implant types available. The outer shell is the same between the implants, however what fills the implant is what determines the type of implant. Saline breast implants are filled with salt water. Silicone implants are filled with silicone gel and are classified as highly cohesive (Memory Gel or Memory Shape Mentor implants) or high strength cohesive (Sientra Gummy bear) implants.
- Diversity in breast implant projection is available. Some women elect greater upper pole projection, or a more moderate projection, or even anatomic/tear drop shaped implants.
- A critical consideration in choosing an implant is the width of the implant should match the breast natural soft tissue. If the implant is too large then there is a higher risk of implant rippling and visibility.
Breast implant type is highly personal and luckily we have many choices so that your augmentation surgery can be customized to you. Dr. Bennett orders each implant based on the patient’s cosmetic goals and physiologic needs.
Dr. Bennett will examine the anatomy of the breast tissue, skin quality and the extent of desired enlargement in order to determine the appropriate incision location. There are three types of incisions that she uses for the breast augmentation including inframammary (at the breast crease), peri-areolar, and axillary (in the arm-pit).
Because of her very precise gentle surgical technique and injection of long acting pain medication Dr. Bennett’s patients are often able to return to normal activities within a few days following the surgery. At your preoperative consultation Dr. Bennett provides a complete list of instructions to follow before and after the breast augmentation procedure to assist in your recovery. She also has available recovery aids such as compression garments, an optional pain pump, and traditional and homeopathic medication to assist in the recovery process.
Explant surgery for Breast Implants
Things to know:
- Dr. Bennett is a Board Certified Plastic Surgeon.
- She has hospital privileges at Arrowhead Regional Medical Center, Redlands Community Hospital, and Riverside Community Hospital.
- Dr. Bennett has medical malpractice insurance.
- The surgery centers used by Dr. Bennett are accredited by the American Association for Accreditation of Ambulatory Surgery Facilities.
Dr. Bennett works with Board Certified Anesthesiologists that provide general anesthesia during the surgical procedure. This means the patient will be fully asleep and comfortable throughout the procedure. Usually nitrous oxide is not used. The main side effect of anesthesia is nausea and sore throat. Post operative anti-nausea medication is prescribed.
The surgical time is about 2.5 hours for Total Capsulectomy and slightly more for En bloc Capsulectomy. If a breast lift is desired by the patient this will require additional surgical time.
Dr. Bennett does not remove any fluid from saline implants before explanting.
En bloc Capsulectomy versus Total Capsulectomy
A saline or silicone implant is named by the material that fills the inside of the implant shell. Both implant types have a similar dense stretchy silicone shell. When implanted, the body will form a rim of scar tissue that is often very thin similar to the peel of an apple. This rim of scar tissue is called a capsule. Due to infection or inflammation the capsule can thicken or harden and take on more of the thickness of an orange peel.
When the implant capsule is thin and soft total capsulectomy would be indicated. Total capsulectomy allows the surgeon better visualization of the capsule because it entails opening the capsule, removing the intact implant and then completing the total capsulectomy. There is a color difference between the natural tissue and the scar capsule making it clear when capsulectomy is complete.
En bloc capsulectomy is a more aggressive surgery that requires a longer incision. En bloc capsulectomy is the process of removing a rim of tissue including the capsule without entering the capsule. This type of surgery was originated for cancer removal. This procedure becomes more dangerous because the implant is left in place during the removal and it creates an obstruction to the surgeons view in the upper portion of the breast. En bloc capsulectomy would be indicated for ruptured silicone implants.
Bia-ALCL is a rare type of breast implant capsule tumor that presents with fluid/seroma or thickening of the capsule. Bia-ALCL has only been found to be associated with TEXTURED implants. If a seroma or abnormal capsule is found at the time of explant then CD30 immunohistochemistry testing will be sent.
If the patient desires, the capsule tissue can be sent to a pathologist and cultures of the pocket can be sent, however, this would be an additional cost to the patient. Photos and videos can be taken during the procedure, as well as of the implants and capsule. All of the patient’s chart and photos are made available to the patient.
Dr. Bennett believes that safety is the number one priority for her patients. Total capsulectomy can be performed safely and completely. En bloc dissection is more difficult for visualization in the upper quadrants and along the chest wall, if it were to become an issue, safety would be a higher priority than keeping the entire dissection En bloc.
During the procedure cautery is used to control bleeding and all sutures are dissolvable. If a patient chooses to have a lift after implant removal no mesh would be used. A small drain is placed in the pocket to remove any residual blood or fluid. The drain usually can be removed after about 5 days.
Fat grafting entails using your own body fat to shape the breasts. However, a patient must have excess fat on the body to be removed, processed and placed into the breast to make an impact on the breast volume. At the time of capsulectomy, if the implant is above the muscle there is no plane to place the fat graft. When the implant is below the muscle and capsluctomy is performed then fat grafting can be performed in the upper pole of the breast above the muscle. In general, Dr. Bennett would recommend waiting to perform fat grafting for a second stage procedure about 6 months after removal to allow for healing and to finalize the shape.
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Rancho Cucamonga, 91739