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Breast Augmentation

Women who are unhappy with the size and shape of their breasts can give a boost to the bust line and improve their self-confidence with breast implants. Breast augmentation from board-certified plastic surgeon Christine Petti, MD can give your breasts fuller volume and a more contoured, sensual appearance. She approaches every patient uniquely since individual characteristics such as breast size, skin, tissue, folds, nipples/areolas, possible stretch marks, and state of droopiness of the breast can significantly differ among patients and even among breasts in the same patient. Dr. Petti takes careful measurements of all aspects of the breasts and records them for each patient in preparation of the individual surgical plan. Every breast enhancement surgery that Dr. Petti plans is a customized operation designed exclusively for each patient. Whatever your reasons for desiring breast augmentation surgery, Dr. Petti has a wealth of experience in an array of breast enhancement procedures and will work with you to achieve your goals with results that look and feel natural and beautiful.

There is no one way to perform a breast augmentation; the operation must be varied to fit every patient and from one breast to the other in the same patient.
Christine Petti, MD

Dr. Petti discusses breast implant revision surgery and shows us an example of an implant that was replaced in a patient.

What is Breast Augmentation?

Breast enlargement, or augmentation, is a procedure which adds volume to the breasts with the placement of implants. Breast augmentation also serves to make the bust line more proportionate to your body frame. Women who have breast enhancement are often those who are:

  • Not happy with the size of their breasts
  • Afflicted with asymmetrical breasts
  • In need of correcting a reduction in breast volume after pregnancy or weight loss

If you are considering breast augmentation, Dr. Christine Petti can give you a visual image of what your breasts can look like before you even have the procedure. With state-of-the-art computer imaging at our practice, you’ll be able to see the likely outcome of the procedure and get an idea of how breast enlargement can significantly improve the appearance of your breasts.

Am I a Candidate for Breast Augmentation?

The best way to find out if you are a good candidate for breast augmentation is to schedule a breast augmentation consultation with Dr. Petti. During this appointment, she will examine your breasts and review your medical history, current health status, and lifestyle. Depending on her findings, she will make the determination about your fitness for surgery and whether breast augmentation is the appropriate procedure for creating the results you desire. In some instances, women may be better suited for a different procedure, such as breast augmentation-mastopexy (BAM), which combines breast lift surgery with the placement of implants.

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Video Case Highlight

21-year old nulliparous female status post breast augmentation with subpectoral Natrelle Inspira high cohesive (gummy bear) round, smooth, full projection silicone gel breast implants, 335 cc; bra size 34 C-D at 3-months postop.

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What Are My Breast Implant Options?

The volume and appearance of the breasts can be enhanced in a variety of ways thanks to the many sizes and projections of implants available. To achieve your goal results, Dr. Petti is proud to offer you a completely customized procedure specifically based on your unique desires and anatomy. Whether you’re interested in breast augmentation alone, or as part of a Mommy Makeover procedure, Dr. Petti will meet with you during an initial consultation to talk about all aspects of treatment and show you your breast implant options. You will decide on such implant factors as saline vs. silicone, projection, and how the implants will be placed. With every detail established, Dr. Petti is able to not only enhance your breasts, but also address your overall body contour. She will adjust the implant-type of your choice to complement your unique body structure for the most balanced proportions and natural-looking results.

Types of Breast Implants

Dr. Petti offers a wide range of breast implant options for her patients, so that they can enjoy the satisfying benefits of a breast augmentation procedure that is highly customized for their unique needs and goals. The types of breast implant options include saline and cohesive silicone gel.

Natrelle® Inspira™ Highly Cohesive Silicone Gel “Gummy Bear” Breast Implants

Available in smooth models of increasing projections, the Natrelle® Inspira™ “gummy bear” breast implant can provide excellent shaping and volume enhancement, especially if you desire a fuller upper pole (the top portion of the breast). One of the many benefits of this implant is the significant degree of lift or “cleavage” that can be achieved. Other optional characteristics include:

  • A traditional silicone gel model for a natural look and feel
  • A recently FDA-approved, highly cohesive-gel (“gummy bear”) model, which offers a reliable round shape and a reduced likelihood of rippling due to its increased form-stability.
  • Four projection types: low, moderate, full, and extra full for personalized breast shaping
  • A wide range of diameters and volumes to provide a customized look and optimize your results

Get more information about Breast Augmentation with Natrelle® Inspira™  from Allergan® 

As with all silicone gel breast implants, the Natrelle® Inspira™ can potentially rupture without any noticeable signs. While this event is highly unlikely, we recommend women undergo routine MRI testing to identify this concern should it occur. Since the Natrelle® Inspira™ Cohesive breast implants are created with form-stable cohesive silicone gel, they are generally less likely to leak or rupture than traditional silicone or saline implants.

Saline Implants

  • Feel less natural in a thin, small breasted patient with little to “cover” the implant, even if it is placed below the muscle (subpectoral).
  • Feel more natural if placed behind a breast with more substance, which “buries” the implant behind the breast tissue making it difficult to tell if the implant is saline or silicone gel.
  • Have a higher rupture rate, but can be self-detected since the breast deflates when the implant deflates. This makes notifying the plastic surgeon much easier for the patient who can then have the implant replaced.
  • Tend to wrinkle more which can be a very big factor in a thin patient with small breasts.
  • Can feel stiffer and less natural than gel, no matter if it is placed under the muscle or on top of the muscle.
  • Can settle down in the lower breast if a large size is used in a patient with a tight breast.

Breast Implant Shapes

Dr. Petti uses smooth, round breast implants that are customized to a patient’s desires and anatomy. The size and projection that is right for you will depend on your natural breast characteristics and the look you’d like to achieve with augmentation. Dr. Petti can explain the benefits of each option to you, and even show you what your results could look like with different implants using state-of-the-art computer imaging technology.

Round Implants

Breast implants of all types—saline, silicone, and highly cohesive silicone—can come in a round shape and a variety of different projections. The projection measurement refers to the distance the front side of the implant extends from the chest. Implant projection is usually labeled from low to high. Round breast implants tend to provide enhanced fullness in the upper pole (half) of the breast, which can increase the appearance of cleavage and create an all-around curvier look.

Projection Types: Extra Full, Full, Moderate, and Low

Breast Implant Placement

Since every patient is different, there is no singular approach to accomplishing breast augmentation. Breast implants can either be placed behind the chest muscle (subpectoral), or behind the breast tissue (submammary). Where the implant is placed, along with the type, size, and projection of the implant, will have a significant impact on the ultimate outcome of the breasts and the longevity of the results. Using information gleaned during your appointments with Dr. Petti, she will formulate a customized surgical plan that can help you achieve the most natural-looking results.

Under the Muscle
Over the Muscle

Dr. Petti’s Signature Breast Augmentation Techniques

Dr. Petti’s decades of experience and her signature breast augmentation techniques set her apart from other plastic surgeons. Over the span of her career, Dr. Petti has continually refined her approach by integrating her keen sense of artistic beauty and balance, with surgical skill. The adjustments she has made in her surgical techniques have enriched her capabilities and helped her to attain the consistently superior results she is known for.

There are certain technical surgical maneuvers Dr. Petti has developed which help her create long-lasting, natural-looking breast augmentation results:

One Fingerbreadth Cleavage

Using the width of her index finger, Dr. Petti measures the space between the breast implants— once they have been placed—ensuring they are close enough to each other to create optimal cleavage. The goal of her signature “one fingerbreadth” approach is to create cleavage that is naturally full and appealing for every patient.

The Internal Bra

To prevent breast implants from shifting over time, Dr. Petti creates an “internal underwire design bra” using a specialized suturing technique that reinforces the outer border of each breast pocket. She also sutures beneath the breasts to secure the inframammary ligament. This technique creates internal support along the outer breast curve and underneath the breast fold, much like an underwire bra. The internal bra holds the implants in their ideal position on the front of the chest, which maintains central cleavage and natural-looking curves along the outer sides of the breasts.

Hidden Scar Placement

Incisions are placed carefully within the lower fold of the breast to keep them hidden from view. Dr. Petti’s breast augmentation patients describe their scars as inconspicuous and nearly invisible.

How Is Breast Augmentation Surgery Performed?

The breast augmentation procedure is typically performed under general anesthesia. An incision is made either around the areola (the dark-skinned area surrounding the nipple), or in the crease of the breast, making any residual scarring very discreet and virtually invisible. The breast pocket or space for the implant, whether under the muscle (sub-pectoral) or on top of the muscle/under the breast (sub-mammary), must be created carefully and precisely. This is because the breast pocket will determine the breast shape, central cleavage, lateral (outer) breast projection, and anterior (front) breast projection. Dr. Petti takes a meticulous well-planned approach when dissecting the implant pocket to ensure a natural looking symmetrical result for each patient. The implants are then placed beneath the chest muscle or directly behind the breast tissue, and the incisions are then closed. Breast enlargement procedures typically take about one to two hours to complete.

Dr. Christine Petti can combine breast implant procedures with other options, including Smartlipo Triplex™, liposuction, tummy tuck, or facial plastic surgery for a more complete aesthetic makeover.

What Is Recovery from Breast Augmentation Like?

You can expect some degree of discomfort for a few days following breast surgery. Any pain can be managed with medication. Some side effects of the procedure include swelling, bruising, and a sensation of numbness in the nipples; however, these effects should dissipate in the first few weeks of recovery. You should avoid strenuous activities and stimulation to the breasts for about three to four weeks after surgery. Normal daily routines can typically resume within one week. Patients should be advised that too much activity following surgery can jeopardize the results. Dr. Petti and her experienced staff will be very diligent about following you after surgery to be certain post-operative instructions are followed.

Will I Have Breast Augmentation Scars?

Dr. Petti’s expertise and experience performing breast augmentation help her to minimize the presence of visible scarring. She is careful to make the incisions in areas that can naturally conceal or camouflage any residual scar tissue. The location of your incisions will depend on the technique that Dr. Petti uses for your breast augmentation. If she employs a periareolar approach, the incision is a small half-circle made along the lower border of the areola within the darker pigmentation. The coloration of the areola tissue helps to hide any scars, and once the incision has fully healed and matured, the scars are often barely visible. When the inframammary approach is utilized, the incision is placed along the natural crease below the breast. Often, the scar left by this type of incision is easily concealed by the bottom portion of the breast.

If you are concerned about scarring, we encourage you to discuss this matter with Dr. Petti during your consultation, as well as examine before-and after photos of her patients to see what these healed incisions typically look like.

Breast Augmentation Case Study: Tuberous, Constricted Breasts with Before & After Photos

This breast augmentation case study includes Dr. Petti’s plan for augmentation mammoplasty with correction of tuberous, constricted breasts using subpectoral placement of Natrelle® Inspira smooth, highly cohesive, full profile, 385 cc, silicone gel (gummy bear) breast implants.

Pre-Operative Patient Details

20-year-old female with tuberous, constricted breast deformity since puberty. This condition is characterized by the following:

  1. Tuberous, triangle-shaped breast with breast tissue located directly under the areola
  2. “Puffy” areola created by “herniation” of the breast tissue beneath the areola
  3. Tight breast skin, especially on the lower pole of the breast
  4. High position and tight skin of the inframammary fold (see lines demonstrating this in the photograph) with
  5. Underdevelopment of the lower pole of the breast tissue
  6. Wide intermammary space (lack of cleavage)

Dr. Petti’s Surgical Plan

Correction can be achieved in a case like this with:

  1. Augmentation mammoplasty with a subpectoral or in some cases, submammary pocket for implant position. In this case, this patient has very little breast tissue and high nipple-areolar position, so a subpectoral pocket is ideal.
  2. The breast parenchyma must be scored or opened-up internally to make the breast tissue drape harmoniously over the width of the implant.
  3. The inframammary fold must be lowered, but also supported with sutures of the inframammary fold (sutures are placed in the design of an “underwire bra”) to prevent implant migration inferiorly toward the abdomen.
  4. Cleavage can be achieved by these maneuvers and with careful medial dissection of the pocket to allow the implant to be placed centrally on the hemi-chest (that is, on the top of the right and left side of the chest and not off to the side). When implants are improperly placed off to the sides, as so often can be seen, the patient ends up with no cleavage!
  5. Cleavage can be maintained by the suture technique performed at the time of closure to secure the chest laterally and inferiorly (again, in the design of an “underwire bra”) so the implant heals in the chest with cleavage, produces upper-pole fullness and lateral fullness, and looks natural and supported.

How Much Does Breast Augmentation Cost?

According to the American Society of Plastic Surgeons (ASPS), the national average for breast augmentation is $3,718; however, pricing can fluctuate greatly based on the details of the surgery, the experience of the surgeon, and the geographical location of the practice.

At Dr. Petti’s practice, the exact cost of breast augmentation varies from patient to patient. The price of your breast augmentation will depend on several factors, such as the type and size of the breast implants, the surgical approach used, difficulty of the procedure, surgeon’s fee, anesthesia, and any post-surgical medications and garments. At the end of your consultation, Dr. Petti will provide an inclusive price quotation for you to review. If you are interested in exploring financing options to help you pay for your breast augmentation, we offer loan options through CareCredit®, Prosper Healthcare Lending™, LendingUSA®, and United Medical Credit®.

Additional FAQs About Breast Augmentation and Implants

To provide you with the most helpful and relevant information, we have gathered many of Dr. Christine Petti’s answers to common questions about breast augmentation and breast implants. If you would like more information from Dr. Petti regarding your specific concerns, we encourage you to contact our practice to schedule a one-on-one consultation.

How do I choose the right size/projection for my implants?

Based on an examination of your breasts and a discussion of the personal goals you would like to achieve with breast augmentation, Dr. Petti will guide you through the breast implant selection process. There are many types, sizes, and projections to choose from, and they can be filled with either saline or silicone materials. Using advanced computer imaging, Dr. Petti can provide you with a visual representation of several new looks to help you make a final decision on which implants you ultimately desire.

Can I still breastfeed after breast augmentation?

Since breast implants are always placed behind the milk ducts, there should be no interference with breastfeeding. It is important to note that not all women can breastfeed and, if you have not had children prior to your breast augmentation and find you cannot breastfeed later, it is most likely due to naturally occurring obstacles rather than the breast augmentation procedure. If you are planning to have children after breast augmentation it is important to mention this to Dr. Petti so that she can be sure to use an approach that will best protect your ability to breastfeed.

How old is too old for breast augmentation?

There is no upper age limit for breast augmentation. Candidates need to be in good overall health, have the ability to heal properly, and have good skin and muscle quality for supporting implants. Ultimately, a consultation with Dr. Petti can provide the answer about your candidacy for breast augmentation. For some women, their appointment with Dr. Petti reveals that they may be better served by a breast lift or breast lift with implants. We encourage any woman considering breast augmentation to schedule a consultation with Dr. Petti to get the answers she is looking for.

Do implants interfere with mammograms?

Regular mammograms are essential for protecting your health. Under the right conditions, accurate mammograms can be performed for women with breast implants. Before your mammogram, it is important for you to let your radiology technician and/or radiologist know that you have breast implants. To account for your implants, more images can be captured from different angles to ensure all of the breast tissue can be analyzed. In some instances, your radiologist may recommend an MRI to provide the most comprehensive imaging of your breasts.

How long do breast implants last?

Breast implants are not intended to be permanent, and they will eventually need to be replaced. For women who do not experience any complications, breast implants can often last ten years or more before they need to be exchanged with new implants. During your consultation, Dr. Petti can explain the manufacturer warranties that are offered with different breast implant types and models.

Schedule Your Breast Augmentation Consultation

To give your breasts the youthful, perky, sensual contours you’ve been dreaming of, breast augmentation with implants may be what’s right for you. Dr. Christine Petti emphasizes a customized approach to achieve natural-looking results in all of her breast procedures, so nobody will have to know that you’ve “had work done.”

For more information on breast augmentation with implants from Dr. Petti, please contact Palos Verdes Plastic Surgery Medical Center.