Breast augmentation is one of the most common procedures performed by Dr. Charles Hsu, a plastic surgeon in Beverly Hills. Women may choose to undergo breast augmentation because of breasts that are under-developed, differences in breast size (breast asymmetry), or changes after pregnancy or breast-feeding. In addition, weight loss, aging, and childbirth may change a woman’s breast volume and shape. Breast augmentation can be performed with either saline or silicone implants and may be performed with a breast lift, if needed.
Best Candidates for Breast Augmentation
To correct size differences between the breasts
To return to a breast size they were before breastfeeding or pregnancy
To increase the fullness of the breasts
To increase the substance or firmness of the breasts
During the consultation, Dr. Hsu discusses the reasons the patient wants to have breast augmentation and what their goals are for the surgery. He will also take careful measurements of the dimensions of the patient’s current breasts to aid in the selection of an implant. Dr. Hsu will also need a complete medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. For patients over 40, Dr. Hsu will need to see recent mammogram results. After giving a thorough examination, Dr. Hsu and the patient will create a surgical plan and determine the size and type of implant that will best fit the patient’s body.
Saline or Silicone Implants?
Patients can choose between saline or silicone breast implants. Both are very safe and have been rigorously tested by the Food and Drug Administration (FDA). Currently, the FDA allows silicone and saline implants in patients of any age. About 85% of Dr. Hsu’s patients tend to choose silicone because it feels more natural and the other 15% choose saline because it is slightly cheaper.
The procedure usually takes about 1-2 hours to complete. Dr. Hsu will make a small, thin incision and then form a pocket under the pectoralis muscle for the breast implant. During the surgery, Dr. Hsu will put a temporary implant of the size the patient chose before the surgery and raise up the table to see if the implants look symmetrical. Then he will lower the table back down, take out the temporary implant, wash out the area, and put in the breast implants. Dr. Hsu finishes by using a special skin closure technique with multiple layers of dissolvable stitches to give the patient the thinnest, most inconspicuous scar
Recovery and Post-Op
Immediately after the surgery, Dr. Hsu will add surgical dressings and a support bra to the chest to aid the patient’s recovery. Patients may feel stiff and sore in the chest region for about 5 days, but they should be able to walk on their own, which should be done often to promote blood circulation and prevent blood clots. Most patients can return to work and light activities in 3 – 7 days, but regular and strenuous activities should be avoided for at least 6 weeks. Patients must be careful and gentle with their breasts and attend all follow up appointments with Dr. Hsu.
From Dr. Hsu
“I’ve found that my approach to breast augmentation is slightly different from that of many of my colleagues -- as a stylistic difference, I tend to favor implants that are on the smaller, more moderate size, in order to maximize the natural appearance of the end result. I’m not generally a fan of the very large implants. If patients come to me asking for implants that I feel are too large for them, I will usually refer them to see someone else.
Placement of smaller- to moderate-sized implants requires experience in order to maximize their appearance. I’ve found that their placement must be done more carefully than that of large implants, but with careful surgical technique and placement, patients can get a very nice result that looks fuller in the breast without being distractingly large.
In my experience, one of the most important goals from breast augmentation surgery is to achieve an aesthetically pleasing breast cleavage. Many factors are important for this, but probably the most important is the surgeon’s placement of the implant. The implant size and shape should be carefully selected in discussions between the surgeon and the patient, and then the placement of the implant should be done in a manner that keeps in mind the goals for the patient’s post-operative cleavage.”
Frequently Asked Questions
Will I need to get another procedure done after some time?
Due to the effects of aging and gravity, some women will need to go through further breast surgeries to reshape their breasts. Other women will simply need a breast lift to maintain their results. There are also few lucky women out there who won’t need any further surgeries at all.
Can implants in my breast rupture?
Breast implants are not made to last a lifetime. Manufacture warranty lasts about 10 years but on average implants last anywhere from 10-20 years. For some they last shorter, while for others, they last a lifetime. If the implant ruptures in the future (whether silicone or saline), the replacement operation is quite straightforward and usually takes about 30-45 minutes. The previous incision is used so that there is no new scarring, the old implant is removed, the area is carefully washed out, and a new one is placed. If a silicone breast implant is leaking, the gel will need to be removed before placing a new implant. When a saline implant has ruptured, the silicone shell simply collapses and is easily removed. The body safely absorbs the saline from the breast implant.
Tips to having a successful consultation?
It is best to wear a sports bra and a form-fitting shirt to the consultation in order to try on tester implants. Dr. Hsu will choose a couple different sized implants that he thinks will fit the patient. The tester implants should be placed in the bra and then the shirt should go on to get the best idea of what the implants will look like. The exact cup size that is measured after surgery is not as crucial. What matters most is that the implants fit the body well, and the patient likes how they look.