Breast Augmentation NYC
Best Candidates for Breast Augmentation
- Women who want larger and prettier breasts.
- Women whose breasts have shrunk because of pregnancy or weight loss.
- Women who have mild to moderate breast sagging. Breast augmentation provides additional needed fullness.
- Correction of breast asymmetry: women who have a breast smaller than the other
- If you already had a breast augmentation and are not happy with the result, it can be corrected with revision breast augmentation.
Dr. Beraka's Approach
- I have done over 1500 breast augmentations and I am an expert on breast implant research. I teach breast augmentation to residents and fellows.
- I make sure that your breasts look NATURAL after breast augmentation. If the breasts are too high and high on top, they look fake. If the breasts don't move after breast augmentation, they don't look real. These things can be avoided. Before the end of the operation, I place the patient into a sitting position on the operating table. That way, I can make sure that your breasts look natural and symmetrical. If they don't look as good as they possibly can, I keep working until they do. A good eye and attention to detail are critical.
- Most women can be exactly the size they want (see below for how we choose size). Going up two cup sizes is a good goal, and some of our patients just want to go up one cup size and be firmer. Occasionally a woman can go up three cup sizes.
- I advise women against using very large implants, because they look fake, they stretch your skin, and they age poorly. We see women who have had huge implants done elsewhere and who are very unhappy. We do not use implants larger than 500 ccs. for breast augmentation, and most of the implants that we use are in the 200 cc. to 400 cc. range. Rarely, a woman will want to be bigger than I think is safe and reasonable, and then I will just not operate on her.
- I use small incisions and very gentle gliding dissection for breast augmentation. This leads to little pain and quick recovery. Some women are back at work in 2 or 3 days.
- I do not believe in the notion that breast implants have to "settle" into the right position over time. Other than a little swelling, your breasts should look great right after surgery.
- I only perform procedures that are safe and approved. Therefore, I do not do breast augmentation through the belly button.
- Breast augmentation for severe sagging is not a good choice. Women ask for this because they want to avoid scars, but this approach actually creates a deformity. If you have a lot of sagging, you need a mastopexy (breast lift), or a combined breast augmentation - lift.
How to Pick the Right Size Implants
- This is the most common question asked by women, and we have a detailed protocol to make sure you get the right size breast implants. The right size for you depends both on the look that you want and on your anatomy. Please bring to us any photos of breasts that you like. During your preoperative visit, we show you many breast images so that you can pick the look you like. And we insert implants inside your bra so you can see the effect of different sizes. You need to bring an unpadded bra to the office as well as a tight T-shirt to put on over the bra.
- Then I study your anatomy. The implant sizes and profiles that will look good on you depend on the width of your chest and on the diameter of the base of your breasts. So I make careful measurements. I also examine the thickness and tightness of your tissues.
- We keep a large inventory of different sized and shaped breast implants in our office surgical suite. This way, we can always choose the best implant for you during surgery, without being committed in advance. Most plastic surgeons do not keep a breast implant inventory.
- And here is the crucial step. During surgery, I insert disposable implant SIZERS inside your breasts. This way I can confirm clearly, without any guess work, which size and shape gives you the look you want. Finally, we discard the seizers, and open the correct implants from our inventory.
- For most women I use cohesive silicone gel breast implants. They are called MemoryGel implants, manufactured by Mentor, and they are the #1 preferred gel implant in the United States. They look and feel most natural. "Cohesive" means that the gel stays in place and does not leak.
- I usually use Moderate Plus Profile implants or High Profile implants depending on the width of the breasts. I seldom use Moderate Profile implants, because they are underfilled and can show rippling.
- Most women do best with round, smooth-walled implants. 80% of the breast implants used in the United States are round, smooth-walled, Moderate Plus Profile implants. Textured teardrop shaped implants can have more complications and do not look more natural, but they are useful in special circumstances.
- Some women prefer saline filled implants and we certainly still use them. I get fine results with saline breast implants also.
- Silicone gel implants are approved by the FDA except for women under 22 years old. If you are younger than 22, we generally use saline filled implants.
- The Style 410 breast implant made by Allergan is a form-stable, super-cohesive, "gummy bear" type implant, which is in clinical trials, and is not approved by the FDA. (Mentor makes a similar "CPG" implant). These implants feel quite firm, but they probably will have a useful role in the future.
- Both silicone and saline implants have been determined to be entirely safe. In fact, a recent study showed that women with breast implants have a lower risk of breast cancer than the general population.
- The breast implants are placed either under your pectoral muscle or under your breast tissue (over the muscle). For some women, we use the "dual plane" approach, which is a combination of the two. This can be useful if there is a little sagging. The majority of women have implants under the muscle, but I individualize according to your anatomy. A "sub-fascial" approach is also described, but I do not find it useful.
- Scars: The scars from a properly performed breast augmentation are minimal. I use fiberoptic and endoscopic techniques to keep the scars very short. The scars can be placed in the armpit, in the fold under the breast, or just under the nipples. I individualize my approach depending on each patient's anatomy and on her preference. The scars fade with time, and we have a scar management regimen to make sure the scars fade faster.
- We do most breast augmentations in our fully accredited office surgical suite but it can also be done in the hospital. It is always an outpatient procedure done under light general anesthesia.
Breastfeeding and Nipple Sensation
You can breast feed normally after breast augmentation. Almost always, nipple sensation is normal after breast augmentation.
There are three key facts that you need to know about breast implants:
- Any implant can leak. The risk of leaking is low. In a recent study, MemoryGel implants showed a 1% incidence of leaking among breast augmentation patients after six years. (And nearly 98% of all patients in this study said that they would have the surgery over again, which is nice to know). But you may need to have your implants replaced because of leaking sometime in the future.
- Implants may become firm. This process is called capsular contracture, and typically it does not bother the patient. But occasionally it has to be surgically corrected.
- After breast augmentation, mammograms require special views, so you need to go to a mammographer who sees a lot of women with implants. We will tell you where to go.
Fat Injections for Breast Augmentation
- I do not do breast augmentation using the patientís own fat. This is experimental and serious complications have been reported. Also, calcifications following fat injections in the breast may interfere with mammography for breast cancer screening.
- The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) both do not recommend breast augmentation with fat injections at this time.
- We do use fat injections in the breast for touch ups of contour deformities and for post-mastectomy breast reconstruction.
Recovery Time After Breast Augmentation Surgery
- You will have some swelling and perhaps a little bruising for a few days. After the first week, you can resume your normal activities, including sexual relations.
- Most patients take 3 or 4 days off from work.
- Vigorous athletic activity such as running, Pilates, and spinning should be avoided for two weeks after breast augmentation surgery.
You may read and hear about pills, creams, and devices that claim to enlarge the breasts. Unfortunately, there is no safe and effective way to achieve breast augmentation without surgery.