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Breast Augmentation

Breast Augmentation San Antonio Texas

Breast Augmentation San Antonio TX

Women seek breast enhancement (augmentation mammoplasty) for a variety of reasons.  For many women, it is not just to increase the size of their breasts, but may be to feel more comfortable in a swimsuit or confident out of clothes.  It may be to return to their pre-pregnancy shape and volume.  Some aim to correct an asymmetry or abnormal breast development that has plagued them since adolescence.  Whether a woman wants people to know they’ve had a “boob job” or prefers a more reserved look, Dr. Albright will assist you in achieving your specific goals.  Check out Before and After photos and the blog article 5 Tips to Before and After Photos.

Given the variety of goals and body shapes, breast augmentation may seem a bit overwhelming.  Relax! Dr. Albright has the skills and experience to walk you through the options that are best for you.  He will explain breast implants and augmentation techniques in a way that makes sense.  Breast lift, Breast Augmentation with Breast Lift, or Breast Fat Graft might be another option for you. Dr. Albright takes the time to explain the relative risks and benefits of different augmentation techniques so you can make the best decision for you.

Breast Augmentation FAQ’s

What is the recovery time and activity restrictions after breast implants?

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What is the recovery time and activity restrictions after breast implants?

Dr. Albright wants all of his patients to get the best result possible.  What we do after breast augmentation surgery is just as important as the surgery itself.  Although there are slight variations in breast augmentation techniques, patients will have 2 weeks with minimal reaching/pulling with the arms, and less than 20 pounds lifting of weight.  This is followed by 2 more weeks of less than 45 pounds lifting, but during this time you may reach and pull with the arms.  In total, there will be 4 weeks of no intense exercise and you will be in a bra 24/7 except for showering.  After these 4 weeks, most patients may begin regular exercise as tolerated. Worried about drainage tubes after your breast cosmetic surgery...?  Don't be.  Dr. Albright rarely uses drains with this procedure.

When will I see results from my Breast Augmentation?

‍For most patients there will be initial swelling from surgery followed by gradual resolution of the swelling with a resulting loss of volume.  Around 2 months, most of the swelling has resolved and you will be at your approximate breast size.  At this point you can go out and purchase your new wardrobe (bras, bikinis, etc)!  However, even at this point, you may not have your final breast SHAPE out-of-clothes (how the breast will look when standing naked).  This is because the overlying soft tissues are still adjusting to the implant which takes about 2-3 months for above-the-muscle implants to about 4-6 months for below-the-muscle implants.  Depending on your goals, this may help you figure out when to schedule your .

How can I maintain my results from breast augmentation?

‍Understanding that the biology of aging can’t be reversed with a scalpel, there are some common sense precautions you can take to prolong the longevity of your result.  Breast tissue and breast implants have weight.  In fact, breast implants are typically heavier than native breast tissue for the same volume.   Gravity and activities will move this weight over time, and eventually overpower the soft tissue support creating droopiness and a poorly positioned implant.  For this reason, Dr. Albright recommends wearing breast support as much as possible, including at night, for life.  Related to this concept of soft tissue strain, one should avoid significant weight fluctuations either up or down.  Finally, we can avoid unnecessary damage to the soft tissue by limiting nicotine exposure and tanning.

What type of breast implant is the best choice, silicone or saline?

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During your consultation, Dr. Albright will discuss the differences between salt-water (saline) filled versus silicone gel filled breast implants. For most patients the choice will boil down to the overall comfort level with risks/benefits of the implant fill material.  Here is a brief comparison of saline versus silicone breast implants. For further information check out our blog article on the different types of implants.

1. Breast Implants and Rupture

For saline implants, if the implant were to rupture, your body would slowly absorb the salt-water and you would notice a “deflation” or loss of volume in the affected breast. Conversely, with newer cohesive silicone implants, implant ruptures are often “silent”, meaning you may not be able to see or feel a difference in the implant after a rupture.  The FDA recommends scheduled MRI surveillance of silicone implants to help detect these silent ruptures.  If your silicone implant ruptures, the FDA recommends having it removed with or without replacement.  The recommended MRI’s are not covered by insurance and will have to be paid out of pocket.

2. Breast Implant Cost

‍Saline implants are typically less expensive to purchase than silicone implants (typically several hundred dollars) but may have less extensive warranty coverage.  An exception to the cheaper initial cost for saline-filled implants is the new “Ideal Implant”, which is a “structured”saline-filled implant that is purported to feel more like a silicone implant and has a similar overall cost to silicone implants.

3. Breast Implant Feel

Silicone implants, including gummy bear breast implants, are widely accepted as feeling more “natural” or“breast-like” particularly when squeezed or prodded. However, this is likely an over simplification. The overall implant feel is also affected by implant pocket selection, implant fill characteristics (over-filled vs under-filled saline and more or less cohesive silicone gel), and overall soft tissue coverage.  Dr. Albright typically reserves saline-filled implant use to below the muscle (total submuscular) to minimize any unnatural feel.  Furthermore, he discourages using saline implants in a dual-plane pocket as these implants may migrate more quickly due to a water hammer effect from the saline fluid on the surrounding soft tissue.

4. Breast Implant Weight

The implant fill density (typically grams per cc of volume) is very similar between 0.9% Normal Saline, and cohesive silicone gel.  Both approximate 1g per cc.  Since saline implants come deflated and are filled with salt water during the procedure, they have a range of fill volumes that can be placed and are more adjustable, whereas silicone implants come pre filled and have a fixed volume. But even with these variables, differences between implant weight (at least within the range of most implant sizes) are negligible.

5. Implant Rippling

Every breast implant has the risk for rippling/scalloping/waviness/folding in its shell.  This is why ensuring adequate soft tissue coverage to “hide” the implant is so important. There are certainly differences in overall risk of seeing or feeling these ripples or folds. Underfilled-saline implants are at greater risk than over-filled saline implants.  Less cohesive silicone gel filled implants are at greater risk than more cohesive silicone gel implants.  

Should my breast implants be placed over or under the muscle?

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Implant pocket is the most important determinant of outcome and is described by the relationship of the implant to the pectoralis muscle on the chest.  The “pec” muscle is a flat fan-shaped chest muscle connected to the front of the chest on three sides (collar bone, outside border of the breast bone, and along the ribs near the lower part of the breast).  The muscle is not connected to the chest wall on the side toward your armpit (you can pinch the muscle between your fingers on the side) as it spans over the armpit to connect the chest to your upper arm.  Placing the implant above this muscle is called subglandular or prepectoral.  Placing the implant below the muscle is called submuscular or subpectoral, and can be further differentiated by being completely under the muscle (total submuscular), or partly under the muscle (dual-plane). When an implant is placed below the muscle, the procedure is more painful and you may need more pain medication. However, for most women, the pain is temporary and there is no difference in pain long term. By changing the pocket, you can change the overall breast look as well as the relative short and long term risks and benefits of the procedure.  During your consultation, Dr. Albright will help you decide which implant pocket is best for you.

What is the right size breast implant for my body?

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Although most women worry about specific implant volume, implant pocket and implant dimensions are more important considerations-- especially if you have a particular “look” you are trying to achieve.  To this end, a simple exercise for patients considering breast augmentation is to begin collecting photos of models you like, in clothes/swimsuits/underwear/naked.  You can also view Dr Albright’s B&A gallery online or in the office to get additional examples. Together you and Dr. Albright will figure out what will help you achieve your best look.

Do I need a breast lift with my breast augmentation procedure?

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This is the first question to answer when considering a breast augmentation.  Dr. Albright will assess your breast tissue, the skin of the breast and the position of the nipple to help you decide which of breast augmentation, breast lift, or breast lift with breast augmentation would be best.  The ideal breast augmentation candidate is a patient that desires more breast volume. If you desire to wear a larger cup size, then more volume will be needed. If you are happy with the volume of breast tissue in a bra, but not with the droopiness of the breast out of clothing, then a breast lift is best.  Do you want more volume and need to fix a little breast droop?  Typically, if the nipple position is below the fold of the breast while standing in front of a mirror and you want larger breasts, a lift with an implant (augmentation mastopexy) procedure will likely be needed.

Why do breast implants move/displace over time?

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‍Gravity, muscle contraction, and soft tissue resistance to these forces.

Gravity

All implants will have a natural tendency to displace over time due to gravity.  Implants are weights.  In fact, implants are typically more dense (weigh more given same volume) than breast tissue!  Implant pocket will affect the degree of implant displacement due to gravity.  When the implant is placed completely underneath the pectoralis muscle (the lower part of the muscle is still connected to the ribs near the bottom fold of the breast), the implant will be supported by these muscle fiber attachments and resist downward movement of the implant due to gravity.  Subglandular and Dual Plane Submuscular pockets do not have this lower muscle support and therefore will be more likely to allow implants to move down the chest.  

Muscle Contraction

When an implant is placed underneath the pectoralis muscle and the muscle contracts, the muscle fibers will shorten and create a pressure on the implant.  THe implant will want to go where there is less pressure, and this is typically where there is no muscle coverage.  Imagine squeezing a balloon in your fist, the balloon will be pushed out through the open side of your fist.  Both total submuscular implants and partial submuscular (dual plane) implants are subjected to this force from contracting muscle.  These two implant pockets will tend to push the implants toward the armpits over time.  Additionally, for dual plane implants, where there is no longer muscle support from the bottom side of the breast, and therefore, the implant can also be pushed out from under the breast toward the belly.  This creates a “double-bubble” deformity.  When an implant is placed above the muscle, it is not squeezed by the muscle and actively displaced by muscle contraction.

Soft Tissue Resistance

‍The only thing resisting gravity and muscle contraction is soft tissue (skin, fascia and scar tissue). The skin and fascia of the breast are designed to stretch to allow for possible milk production, and are therefore not ideal counter-forces. Women with damaged skin and stretch marks on the breasts are particularly at risk.   The only remaining soft tissue support is the scar tissue that forms around the implant. When an implant is placed in your body, your body will start to wall it off with scar tissue.  This scar tissue is called the implant capsule.  Patients differ in how robust this scar tissue layer is. Plastic surgeons’ do not have a way to predict how thick or robust this scar tissue will be for patients.  If you happen to produce a thin/flimsy capsule, your implant will be more likely to migrate out of position. Plastic surgeons’ have tried to create a thicker capsules by using textured surfaces to the implants, and a variety of meshes to reinforce the capsule.  Textured surfaces on the implant allow a more intimate connection between the scar tissue and the implant thereby resisting movement of the implant. However, these textured surfaces have been implicated in a very rare type of cancer.  The lone remaining viable option is  to use a mesh to support the implant and resist displacement due to muscle contraction.  Meshes are either biologic or synthetic and all have unique benefits and drawbacks.

Which breast augmentation incision is best for me?

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Dr Albright recommends placing the breast augmentation incision along the lower breast fold (inframammary fold). This affords the best control of implant pocket dissection, a critical step during augmentation.  Additionally this incision is associated with the lowest risk of developing capsular contracture, which is a progressive pathologic thickening of the scar tissue around the implant (the capsule). The most widely accepted cause of capsular contracture is chronic inflammation in the scar tissue around the implant due to bacteria colonizing the surface of the implant.  The bacteria may be encountered during implant placement either through milk ducts around the areola or in hair bearing pores / sweat glands in the armpit (axilla). Accessing the breast pocket through the belly button (umbilicus) or TUBA (transumbilical breast augmentation), has been criticized for difficulty with pocket development, and limits implant selection to saline implants.

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Breast Augmentation
“ I recently had breast augmentation, and I am so pleased with my results. He spent a great deal of time explaining my options, listening to what I wanted, and providing his opinion. I visited other surgeons in the area and didn’t feel any of the others listened or cared quite like Dr. Albright. Not only do I recommend Dr. Albright, hospital nurses said he is the best! ”
Breast Augmentation
“I had a very positive experience. I always felt comfortable and he was very knowledgable and helpful with any questions I had. He helped me understand the procedure at the consultation and during and after the surgery he was available and ready to help if I needed anything. I would highly recommend Dr. Albright and his wonderful staff!”
Breast Augmentation
" All of my life I have been small chested, and when I became a mommy, it only went downhill from there. I didn't know that the smallest "A" could sag and really deflate my confidence. I began working out, and became a Beach Body Coach. I strive to help others feel as confident as possible with exercise and eating right on a daily basis. This became very hard for me to continue to do, when I myself, was lacking confidence in one area. The more chest and arm exercises I did, the more my breasts began to look like "pecks". I came to Dr. Albright for a simple consultation, and left feeling more motivated than ever. His staff was so professional, and despite my want for "cosmetic" surgery, they were very welcoming!! I was in and out at my consult, and also at my second appointment. We scheduled surgery for two weeks later. Everything went great, and I saw Dr. Albright the next day for my follow up. All of the decisions that we chose to make as far as my breast augmentation, were spot on. My recovery time was 4-6 weeks, and I didn't have much pain at all. At 4 weeks, I was cleared to begin working out again, very slowly. This was a quick recovery, and life got back to normal. I would have this surgery all over again, and have already recommended Dr. Albright and his staff to everyone I know!! This was the most convenient, and wonderful experience I could have had with a surgery!!! "
Beach Body Coach
Breast Augmentation
" Dr. Albright spent a great deal of time to explain pros and cons and the best options that would benefit me the most regarding my breast augmentation. The best place to go for honest and open discussions, reality vs misconceptions and the confidence of feeling better about oneself. Highly recommend! "
Diane
Breast Augmentation
" Dr. Albright is a very skilled surgeon and a very kind provider. He spent a great deal of time explaining the breast augmentation options and providing his opinion on which option is the best for me along with why. There was a slight mix up (no fault of his) and he worked to ensure my procedure went on as planned. Throughout he stayed in contact and made me a laugh. I am very pleased with my results and the aftercare I have received. The nurses at the hospital shared how much they like him, too! "
Danielle
Breast Augmentation
" All of my life I have been small chested, and I didn't know that the smallest "A" could sag and really deflate my confidence. I began working out, and with each chest exercise, my breasts began to look more like "pecks". Dr. Albright was very professional, knowledgeable, and believes that his patients should research before making a decision. The staff is so welcoming, and made me comfortable. I went with a small implant, and I would have surgery all over again under Dr. Albright's care! "
Stacy
Alamo Plastic Surgery San Antonio TX | Team - Dr. Albright, Franchesca Espinosa, Juli Albright
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