Aesthetic Plastic Surgery Blog | Dr. Linderman

There are four incision location for breast augmentation. Most surgeons will have their own preferences for one or two incisions. The most common location is the Inframammary Fold Incision located in the crease on the undersurface of the breast. It provides direct access for implant placement. It can be well hidden in an individual with a well defined crease. The next most commonly employed incision is the Periareolar Incision which is curved along the lower edge of the areola. This tends to give an excellent scar and provides good access except for patients with small areola. The Transaxillary Incision is placed in the armpit and avoids any scar on the breast. Correct implant placement can be more difficult and access is more limited should bleeding occur. The last and most infrequently employed incision is Periumbilical or around the belly button.

My personal preferences are the Inframammary and Periareolar Incisions which I find adaptable to almost all breast types. By limiting the incision length to 3 centimeters, scarring is minimal. There is no greater incidence of sensory loss with the periareolar incision.

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Following cosmetic breast augmentation surgery, patients may experience areas of decreased or loss of sensation. These are usually temporary and sensation usually returns within 3-6 months of the time of surgery. Complete loss of sensation or numbness of the nipple is very unusual and occurs in a very small percentage of cases. Some patients may have temporary hypersensitivity of the nipple areola area that disappears in a short period of time. Of the commonly used incisions for breast augmentation – inframmary, periareolar and axillary -- there is no greater incidence of sensory alteration with any one particular approach... Breast sensitivity can increase or decrease in reaction to altering the size of the breasts. Larger implants can stretch the nerve supply, which may affect sensitivity. Woman of smaller breast size frequently have more sensitivity than woman with larger breasts.

Changes in breast and nipple sensation after breast augmentation are not uncommon. But, most often they are temporary. To learn more, contact an experienced and qualified cosmetic surgeon today.

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No there is rarely any significant bleeding in breast augmentation. The implant pocket is created with electrocautery with typical blood loss of less than an ounce. By employing a soft touch technique with gentle tissue handling and retraction, pain in breast implant surgery is reduced and recovery is rapid.

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Since its development in the early 1980s, the applications and indications for liposuction have expanded greatly. Body areas will vary in fat distribution and quality. Some areas may have more fibrous fat and may be more effectively removed with ultrasonic liposuction. Examples include chest and love handles in men and hips and back rolls in women. Liposuction may be used for fat removal in the neck, back, upper arms, flanks, bra rolls, axillary breast rolls, abdomen, thighs, calves and ankles. All areas have slightly different risks and results. Evaluation of skin quality, elasticity and overall fat volume are thoroughly evaluated in determining the final result. Ankle liposuction when indicated can result in high patient satisfaction. In other patients, the results may be minimal with prolonged swelling. Surgeon experience and fine technique produces predictable results.

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Body contouring is an area of plastic and cosmetic surgery, which deals with the improvement of patient’s figures and shapes utilizing techniques such as fat removal, excision of excess skin and augmentation or volume increase. With the advent of bariatric surgery, an increasing number of patients are presenting with problems related to extreme weight loss. Procedures employed in body contouring surgery include excisions such as tummy tuck, body lifts, a thigh lifts, arm lifts and breast lifts. Problem areas with excess may be treated with liposuction alone or in combination with a skin excision. Patient requesting increase volume may be treated with implants such as breast augmentation or fat injection. To find out more visit Body Contouring.

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I am frequently asked by patients undergoing breast augmentation if they can breast-feed should they become pregnant. The surgical procedure of breast augmentation does not affect a woman’s ability to breast-feed but is it my recommendation that patients not breast feed with breast implants. A small number of women will develop mastitis with breast-feeding and I believe this increases the risk of development of capsular contracture and breast firmness. The cause is most likely due to a low-grade infection around the implants. Certainly patients have breast fed their children with no adverse effects but I prefer to error on the side of caution. This is an extremely personal decision that patients must balance the rewards against the risks.

Following breast augmentation, pregnancy can have unpredictable results on overall breast shape and volume. The increase in size may cause stretching and thinning of the breast skin. Loss of overall volume and breast sagging are common sequelae following pregnancy. Hereditary influences, skin quality and overall weight gain may a major role in the effects of pregnancy on breast tissue. Some women may have several pregnancies and have minimal changes to the shape and size of their breasts. However most women will experience some volume loss and possible ptosis. The majority are ideal candidates for breast augmentation and or breast lift surgery. With over 30 years of experience, Dr. Linderman can help breast volume and shape after pregnancy.

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The incidence of breast implant deflation after saline breast augmentation is less than five percent over a ten-year period. Deflation may begin with softening of the implant with eventual partial or total loss of volume. This is not an emergency. Patients should notify my office and arrangements will be made promptly to replace the deflated implant. It is preferable to replace the implant within a couple weeks of deflation, as less surgical dissection is required. Often this can be done under local anesthesia with mild sedation.

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A seroma or collection of fluid occasionally occurs after a procedure such as an abdominoplasty. In this procedure a large cavity is created from removal of excess skin and fat. Liposuction is often performed. Fluid may collect from small lymphatics that are cut and this fluid may persist even after drain removal. This collection will usually resolve with repeated aspirations done as an office procedure. Occasionally a drain must be replaced. The overall incidence can vary from 5-10%. Treatment should not affect the cosmetic improvement of the tummy tuck.

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