I Need to Find a Surgeon. How Many CC's, Saline or Silicone, Profile, Under Muscle?
Doctor Recommendation in Seattle for Breast Augmentation
Doctor Answers 7
Breast Augmentation, Breast Enlargement, Breast Implants
Sleepless in Seattle over small breasts? You will need to schedule a few consultations with board certified plastic surgeons in your area. There are many things to consider before the surgery and it is very difficult to assess you by looking at two pictures. What is your age and did you have children and breast feed them? What is the tissue quality and stretch ability of your skin and muscles of the chest wall. What are your chest wall measurements? Did you want saline or silicone gel? Allow your plastic surgeon to offer you a few options and then you can decide what is best for you.
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How to pick a plastic surgeon.
Tips on picking a Plastic Surgeon
1) Is the surgeon a member of the American Society for Aesthetic Plastic Surgery? Members usually do a lot of cosmetic surgery.
2) Did you sense a commitment to excellence in the office. Did the surgeon spend a lot of time with you? Someone who rushes through the consultation may rush through the surgery.
3) Were you treated as an individual? Did the surgeon present you with a surgical plan tailor made for you?
4) Plastic surgeons have to have a good eye and meticulous technique. Did the surgeon show you A LOT of before and after pictures, and did you love the results?
5) Talk to other doctors you know. Established plastic surgeons have a reputation in the community, good or bad.
6) Ask to speak to a patient who has had the procedure you want. You are looking for a surgeon who does a lot of what you want. Many patients are eager to share their experience. Privacy is preserved by having the patient call you.
7) If you are having breast augmentation, ask if the surgeon has a large inventory of different size and shape breast implants available in the operating room. A surgeon who does a lot of breast surgery will have an inventory. This way, the final implant choice does not have to be made in advance.
8) With office surgery, make sure the surgical facility is ACCREDITED. Very important safety assurance.
9) Make sure the anesthesia is given by a BOARD CERTIFIED ANESTHESIOLOGIST. Another very important safety factor.
10) Make sure the office has trained nurses available for hands-on post operative care. This can really speed recovery.
Breast augmentation choices
Thank you for including pictures. This is the best way to gain accurate information. Most plastic surgeons agree that a submuscular approach yields a more favorable long term outcome than a subglandular approach. There are also proponents of a subfascial augmentation, but I am not one of them. Subglandular augmentations (under the breast) in thin women lead to implant palpabitity. This means you may feel the implant more easily, even on the superior and medial pole of the breast. In practice, most implants are placed in a dual plane position. This means that the top of the implant is beneath the muscle, and the bottom of the implant is only beneath the breast. This gives a more natural contour. The look of two grapefruits on the chest that was common in the 80's is from a subglandular approach.
Submuscular implant placement is complicated by capsular contracture in about 30% of patients. This means the implants may become firm and even painful. Submuscular placement is complicated by capsular contracture in less than 10% of patients.
The profile of the implant depends, in part, upon your breast measurements and your personal goals. Higher profile implants are narrower and yield more projection than low or moderate profile implants. Surgeons refer to implant charts and measurements as well as your measurements to give you the appropriate fit.
I prefer silicone implants to saline. They are softer than saline implants and have less of a propensity for rippling. But they are also more expensive. Before choosing silicone implants, however, refer to the FDA's website for silicone implants.
As far as a surgeon recommendation, you best referral is a personal referral. If you know someone who has had exceptional results, go to her doctor. And, just like every doctor will tell you, stick with those who are board certified. This will keep you safe. After all, this is elective surgery, so risks should be minimized. Good luck!!
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Breast Enhancement Surgery
There are many good board-certified plastic surgeons in Seattle. You should do your due diligence by checking with the American Board of Plastic Surgery.
You may find the following guidelines helpful as you embark on your “breast augmentation journey”.
1. Make sure you are doing the procedure for the right reasons (for yourself) and that you have realistic expectations. Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life situation. You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.
2. Make sure you have your surgery done by a well experienced board-certified PLASTIC SURGEON. You should be aware that there are surgeons, not formally trained in the field of plastic surgery, who will offer to do your breast augmentation surgery. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants.
3. COMMUNICATE your goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. By the way, the most common regret after this operation, is “I wish I was bigger”.
4. Choose the position (preferably sub muscular) and the type of implant used carefully. These choices may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture.
5. Time your surgery as carefully as possible. in general, if you can avoid significant weight gain/loss after the breast surgery you will improve your chances of not needing further surgery. Pregnancy and breast-feeding will also potentially cause changes in the size/shape/position of the breasts that may necessitate further surgery to correct.
Following these guidelines may help in reducing the chances the further surgery will be necessary; however, realistically speaking most young ladies undergoing breast augmentation surgery will likely need some type of revisionary surgery during their lifetimes.
I hope this helps.
Selecting the right surgeon for you
I recommend you find a board certified plastic surgeon who is a member of the American Society of Plastic Surgeons (ASPS). To find a member ASPS surgeon near you, please visit the ASPS website link. I've listed it below for you. Best of luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.