APPROACHES FOR BREAST AUGMENTATION
In our Beverly Hills practice we perform breast augmentations using high profile smooth round saline breast implants placed in the dual plane technique. The implants are placed half under the muscle and half over the muscle on the lateral half of the breast. The incision site that we prefer is under the areolar, called the periareolar approach because it allows the implants to be placed safely and predictably with excellent visualization of all anatomical structures during the surgical dissection.
The periareolar approach is especially useful when women have any degree of sagginess or ptosis to the breasts because it allows accurate release of the pectoralis muscle along the sternum and along the inframammary fold. It also allows the pocket dissection to be quite nicely made and as precise as possible in that you are directly above the area being released and the pocket being open.
Postoperatively, our patients have dressings removed on the next morning. The Bias wrap is removed. The patient is placed into an athletic brassiere. Dry 4 x 4 gauze dressings are placed on the incision sites and if necessary, an upper pole compression strap is used in order to soften the upper part of the pectoralis muscle and allow the implants to settle to a normal position.
The patients are always seen one week later at which time the dressings are removed and now replaced twice to three times a day for the next seven days and sutures are removed on day 14. At this time they continue with the strap as necessary and a sports bra and the area is kept clean and dry.
FUTURE BREAST IMPLANT MAINTENANCE
Normally, a regular bra should be worn throughout the woman’s life. Under-wire support helps to maintain their position. Athletic brassiere should be worn at night in order to prevent gravitational descent or falling of the breast implants. Vitamin E or Mederma can be used on the scars for up to one year.