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A breast augmentation is a surgical procedure in which silicone or saline implants are placed to enhance the size and shape of the breast.
Good candidates for breast augmentation are women who are looking to enhance the size and shape of their breasts because they are under-developed, misshaped or have decreased volume due to pregnancy or weight loss.
When you come in for your initial consultation, you will meet with both Dr. Maloney and one of our clinical coordinators. Maloney Plastic Surgery is one of the only practices in Tucson, AZ to offer Vectra 3D (three dimensional) technology to our patients. One of the first things we will do at your consultation is use VECTRA imaging technology to take a 3D image of your body from the bellybutton to the neck. This exciting technology will perform breast measurements to determine which implants will work best for you and your breast. It will determine if one breast is smaller or larger than the other and by how much. With Vectra 3D imaging technology we can “implant” the exact manufacturer, size and shape implant you are considering and show you how that implant will look on your body. We can view the image from different angles giving you an accurate idea as to how the final result will appear.
After Vectra imaging, Dr. Maloney will examine you to determine if you are a good candidate for the procedure. He will discuss the details of the operation and show you before and after photos. Dr. Maloney will explain the differences as well as the pros and cons of both the saline and silicone implants. Saline implants are a silicone shell filled with saline (salt water). Silicone implants are a silicone shell filled with a silicone gel. There are different levels of cohesiveness/thickness of the gel inside the implants ranging from the traditional Inspira gel to the highly cohesive “gummy bear” gel. Click here to see a video of Dr. Maloney demonstrating the difference in the gel inside the implants. The silicone implants give a very natural look and feel to the augmented breasts and are the most popular implant in our practice today. The new generation of silicone implants are much different than the old ones that were taken off the market years ago. The new generation of silicone implants are made out of a silicone gel, not a silicone oil as they were in the past. The silicone implants have a low rupture rate and are very safe. The saline implants are good in a patient who is looking for a lot of cleavage and roundness of the breasts or a patient or someone wanting a very small incision.
Once you have met with Dr. Maloney, one of our experienced coordinators will review surgical fees, financing options and answer any other additional questions you may have. If you choose to have surgery with Dr. Maloney, you will return for another consultation about three weeks prior to your operation. At this pre-operative appointment Dr. Maloney will review the surgical plan with you as well as go through consent forms and give you your prescriptions. We will review your Vectra images to make a final decision about the implant style and shape. You will be provided with Dr. Maloney’s personal cell phone number and our after-hours phone number. A member of our team will go over all of your surgical instructions and give you a packet of information so when you leave this appointment you are ready for surgery.
Once you have met with Dr. Maloney and have chosen a surgical date for your breast augmentation, you should plan for your care and recovery after the operation. You will need to arrange a ride to and from the surgery center as well as arrange for someone to stay with you for the first twenty-four hours. You should take three days to two weeks off of work for this operation depending on the type of work you perform. Please speak to one of our team members for more specific questions related to returning to work. If paperwork is required by your employer for your time off, please obtain it ahead of time and bring it to our office. If you smoke, you must quit a minimum of three weeks before surgery. We suggest six to eight weeks, but three weeks is the minimum. Smokers heal more slowly and can have wound healing problems. If you take aspirin or another medication that cause bleeding, you should stop taking it three weeks before surgery. This is because it causes increased bleeding at the time of surgery and therefore more bruising. If you are taking any diet pills (prescription or over-the-counter) or if you are taking Metformin (a common diabetes medication), you should stop one week prior to surgery because of anesthesia risks. All medications, herbs, vitamins and dietary supplements you are taking should be carefully reviewed with Dr. Maloney prior to surgery. If you are under the care of a physician for any health issues, we may require surgical clearance from your physician and/or cardiologist.
At your pre-operative consultation with Dr. Maloney you will be given a map to the surgery center and your prescriptions. You should get these prescriptions filled before surgery because you will need one of them the morning of your procedure. You will leave the operating room in a surgical bra. We suggest you purchase an inexpensive sports bra to wear for the first two weeks after surgery. Sports bras that zip up the front are ideal. Bags of frozen peas or corn work well as icepacks after your procedure. You need to stay hydrated after surgery. We suggest you begin a stool softener as narcotic pain medication and anesthesia can make you constipated.
If you are having surgery before 10:00am, you cannot have anything to eat or drink after midnight, this includes water. If your procedure is scheduled for after 10:00am, we suggest drinking 16-24 ounces of Gatorade or other “sports drink” (the full sugar version, not diet) four hours before your operation. Studies have shown this will decrease dehydration and nausea post-surgery. You should not have anything to eat or drink other than the Gatorade. If you are taking prescription medications, please get instructions regarding your medications from our team. Do not put any lotions, deodorant or make-up on the day of surgery. Please do not wear any jewelry to the surgery center. You should wear comfortable clothes that are easy to get on and off. A shirt that zips or buttons up the front is preferable, as are loose workout type pants or sweat pants. Bring your picture ID when you check into the surgery center. You will check in and then be taken back to the pre-operating area where Dr. Maloney will come and discuss the surgical plan, answer any additional questions you have and mark the surgical site. At this time you will meet the anesthesiologist and ask him/her any questions you may have.
There are several different options of implants in the market today. When you come in for a consultation, Dr. Maloney will discuss the options that will work best for you and your goals.
Saline implants are composed of a silicone shell filled with sterile saline. These implants are empty when Dr. Maloney places them in the pocket. They are then filled to the appropriate volume. These implants are most popular in women who are looking for an overfilled, round appearance to their breasts.
Silicone implants are composed of a silicone shell, filled with a cohesive silicone gel. The gel implants are the most popular implants in the market today. Unlike their predecessors that were a silicone shell, filled with a silicone oil; the new generation of highly cohesive gel implants can literally be cut in half and the gel will remain in place. Placement of the cohesive gel implants gives you a soft, natural look and feel to the breasts.
Click here to see a video of Dr. Maloney demonstrating the difference in the gel inside the implants.
Click here to see a video of Dr. Maloney backing over a silicone implant with an SUV.
Many patients ask about the different profiles of implants and when each should be used. The most important measurement we take at your consultation is the measurement of the base diameter or width of your breasts. Once Dr. Maloney has taken this measurement and discussed your goals, he can offer you some choices of implants that would fit well into that measurement. If you choose an implant that is wider than the base diameter, the implants may be too wide for your body and be “in your armpit”. If you choose something too narrow, the implants do not fill out the entire breast. The low, moderate, moderate-plus, high and ultra-high implants allow Dr. Maloney to choose a variety of implant volumes with you, but still remain in the same base diameter. For example if your base diameter is 12cm, the volume in the moderate implant is 235cc, the moderate-plus is 300cc, the high profile is 375cc and the ultra-high profile is 535cc. As you can see, this gives both you and Dr. Maloney several options in terms of size and volume while remaining within the same base diameter measurement.
A breast augmentation operation takes about an hour. The anesthesiologist will put you to sleep for this operation for your safety and comfort. The incision for a breast augmentation is made below the breast in the inframammary fold, around the areola or in the armpit (transaxillary). All three of these incision options leave a well concealed scar. Dr. Maloney will create a pocket underneath the chest muscle, large enough for the implant to be placed. He will insert the implant using a Keller Funnel allowing for a “no-touch” technique in which the implant never touches the skin. Click here to see a video of Dr. Maloney demonstrating the use of the Keller Funnel. Dr. Maloney will close the incision with dissolvable sutures. You will wake up in the recovery room and be ready to go home in about an hour.
You will leave the surgery center with a small dressing over your incisions and be wearing a post-operative bra. You should rest and eat a healthy diet high in protein for optimal healing. Please avoid alcohol and refrain from smoking. We recommend early and frequent ambulation after surgery to reduce the risk of blood clot formation in the legs and to speed up your recovery. You may remove your dressings and shower the day after surgery. You will return to the office for your first post-operative exam one to three days after surgery. Discomfort and tightness of the chest are normal after surgery. Be sure to take your antibiotics starting the morning of surgery until they are all gone. A low grade fever is usual after any surgical procedure. You may wear a sports bra for the first few weeks. You will not be your final size/shape for about three weeks because the implants need some time to fall into the pocket. Because of this, we do not recommend buying new bras or getting measured for new bras until this three week period is complete. At your pre-operative appointment you will receive our after-hours number and Dr. Maloney’s personal cell phone number. If you have any questions during the recovery phase, please do not hesitate to call the office any time, day or night.
After the procedure you will have a breast size and shape that is more aesthetically pleasing.
A breast augmentation has both aesthetic and health risks, and it is the woman’s personal decision whether the benefits outweigh those risks. More commonly seen risks include breast asymmetry, firmness, changes in nipple or breast sensation or capsular contracture. There are also more uncommon, but more complicated risks such as infection, which may require the removal of the implant, bleeding and deep vein thrombosis. For a full list of risks, go to www.plasticsurgery.org.
Allergan’s Natrelle Gel Implants come with a warranty in the event an implant ruptures or if the patient develops a capsular contracture. The Confidence Plus® warranty is free of charge to the patient and covers augmentations after July 1, 2014.
For saline implants, the Confidence Plus® warranty offers lifetime free implant replacement for both the affected and the contrlateral implant in the event the implant ruptures. Patients do have the option of enrolling in the Confidence Plus Premire® warranty within 45 days of surgery at a charge of $200 (payable to Allergan direct). The Confidence Plus Premire® warranty offers not only the implant replacement, but up to $2,400 in financial assistance for the surgeon’s, facility and anesthesia fees. This is something the patient enrolls in on their own should they choose to do so at www.natrelle.com/warranty.
For silicone gel implants (including Inspira, Soft-Touch and Cohesive), paients are automatically enrolled free of charge in the Confidence Plus Premire® warranty. The Confidence Plus Premire® warranty offers lifetime free implant replacement for both the affected and the contrlateral implant in the event the implant ruptures. For the first ten years after surgery, Allergan will pay up to $3,500 in financial assistance toward surgon’s, facility and anesthesia fees. The Confidence Plus Premire® warranty also covers implant replacement for both the affected and the contrlateral implant in the event a patient develops a capsular contracture (Grade 3 or 4) within the first ten years.
For more information on the Confidence Plus® warranty and the Confidence Plus Premire® warranty, please visit www.natrelle.com/warranty.
Dr. Maloney is a Harvard trained, board certified plastic surgeon who returned to his home town of Tucson, AZ to open Maloney Plastic Surgery in 2002.