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Dayton, Ohio 45429

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Breast augmentation is the most common cosmetic surgical procedure performed. It is designed to enhance and increase the size and proportions of female breasts. While intended primarily to enlarge small or underdeveloped breasts, this operation can also help to reshape breasts that have lost volume following pregnancy or weight loss. Breast implants are also helpful to correct breast asymmetry, where one breast has not developed to a similar size or shape when compared to the opposite breast. When a breast is lost due to breast cancer, breast reconstruction may be possible using implant techniques.

There are several incision approaches utilized for modern cosmetic breast augmentation. Incision placement generally depends on a combination of the surgeon's opinion plus the patient's personal preferences as well as any unique anatomical proportions. When possible Dr. Apesos will make a small incision in the axillary (armpit) area and release both the breast tissue and the pectoral (chest) muscle to create a pocket. The submuscular pocket is chosen whenever possible to prevent breast contraction (hardness) and to enhance upper pole shape.

Once the space has been created it is rinsed with antibiotic solution and a deflated saline breast implant is placed in the newly created pocket. The saline implant is then inflated to the appropriate size, which the patient has preselected as her best choice. Silicone implants require a longer incision so they are usually placed through the nipple or the inframammary approach. For all implants a no-touch technique is used with antibiotic rinses throughout. Drains are not recommended.

The nipple approach may be recommended if the patient chooses or if more sagging or ptosis is present. Very few patients today choose the inframammary approach because of the scarring on the breast surface. The inframammary approach was very common and can be used if there is already a scar present on the breast or if the patient so desires. We have found no approach is associated with any different postoperative claims of nipple numbness. We do not use the belly button approach (TUBA) at this time.

Complications for all breast surgery include infection, bleeding, asymmetry of the breasts, loss of nipple sensation, rippling, hardness, and rupture of the implant with breast deflation. Although such situations occur in low numbers, patients should be aware of these as possible drawbacks to the procedure. If a saline implant ruptures the breast will shrink in size, if a silicone implant is thought to be ruptured an MRI scan or mammogram may be required to determine if a leak has occurred.

Concerns about the safety of silicone implants have actually never been medically proven in the mainstream scientific medical literature. The use of saline (physiological intravenous salt) solution to fill the implants does seem to result in less breast hardness or contracture from scar tissue development. The FDA restrictions on silicone implants have been released. Today silicone is available and FDA approved for 21 year old patients and older. Dr. Apesos has always been licensed by the FDA to utilize the silicone gel-filled implants for cases of 1) congenital deformity; 2) post mastectomy cancer reconstruction; 3) patients with silicone implants desirous of replacement with silicone, and 4) situations where saline implants have proven unsatisfactory. Now all plastic surgeons can also place silicone into any new cosmetic patients who are older than 21.

We perform breast augmentation surgery as an outpatient procedure in an approved surgical center or hospital. Most women are able to return to work in four to six days following surgery. The cost of augmentation may vary with special offers or if a mastopexy or lift is required. The surgical fees, implants (any size), operating room, general anesthesia, and follow-up care are generally included in our fees. For more information, contact our office for an appointment.

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