Breast Augmentation

For most people, the decision to have breast augmentation either stems from a lack of self-confidence in appearance or simply wanting to feel better about themselves.

One of the biggest transformations patients feel following a breast augmentation is that they immediately improve their psychological well-being, their confidence in themselves and intimacy with their partners. Breast augmentation surgery is an extremely common surgical procedure and allows patients to achieve their desired aesthetic. The procedure is performed to enhance the size and improve the shape of the breasts using breast implants.

Given the popularity of breast augmentation surgery, Dr. Markarian often receives questions from his patients. He ensures all of his patients are comfortable and informed before booking surgery.

Defining your goals and Choosing the Right Breast Implant

Dr. Markarian always suggests the first step is to have a detailed discussion about the desired outcome of your surgery. This often involves discussing your ideal breast size and shape. You may wish to look at some before and after photos to find a size and shape you like to help you more clearly define your goals. Dr. Markarian suggests meeting with a Board-Certified Plastic Surgeon, who specializes in breast surgeries, to talk through your goals, questions and any concerns you may have. Dr. Markarian advises his patients on the best breast implant based on the:

  • Volume of the implant. His patients often find it useful to try on implant sizers during their consultation to help them decide. Dr. Markarian primarily uses the Mentor volume size system for this and broadly, 150-200cc is necessary for a single cup size increase.
  • Contents of the implant. Patients choose between saline and silicone implants. Saline Implants have a silicone outer shell and are often filled during a procedure with sterile saltwater. These implants tend to be a little stiffer and rounder than saline implants and can cause rippling of the skin. Silicone implants have a silicone outer shell and have silicone gel inside. They are considered the most natural feeling implant.
  • Shape of the implant. Dr. Markarian’s patients choose between round or anatomic implants. Both can provide a natural breast shape, however they different in the projection of the breasts.
  • Position of the implant. Many patients ask whether their breast implants should be over or under the pectoralis muscle. Both placements provide a different shape and projection. Dr. Markarian advises placing the implant under the muscle for two reasons. It is better for your health as it decreases the risk of capsular contracture. Many patients describe their appearance as more natural and their breasts feel more consistent with their natural breasts before surgery.

Dr. Markarian will also assess your breast diameter, overall chest circumference and the volume of your native breast tissue.

Ideal Candidates for Breast Augmentation Surgery

Women consider breast implants for a variety of reasons. For example:

  • Their breasts are different sizes and asymmetrical.
  • They are unhappy with the volume of their breasts and wish to enhance them.
  • They have lost volume due to weight loss, pregnancy, breast feeding or aging.

However, patients considering surgery are also often concerned with whether they are a candidate for undergoing a breast augmentation. This can be for a variety of reasons, including previous ill-heath, worries over recovery time and whether surgery should be postponed until after childbirth. Dr. Markarian has offered some answers to some of these frequently asked questions below.

Would future weight loss cause breast implants to sag?

Dr. Markarian advises his patients to achieve their desired weight goal before surgery. Losing weight prior to surgery reduces patients’ Body Mass Index (BMI) which reduces risks of complications from surgery. It will also allow patients to better understand the aesthetic of their breast appearance at their desired weight.

Are medical tests required prior to breast augmentation surgery?

The pre-operative checks necessary for a procedure depends on the health of the specific patient. For breast augmentation – a short outpatient procedure – Dr. Markarian does not require any significant blood work or other pre-operative studies. Additional preoperative studies, like labs, Xrays, EKG and so on may be necessary depending on a patient’s age and medical history. Dr. Markarian suggests seeking the advice of a Board-Certified Plastic Surgeon and discussing your medical history.

Preparing for a Consultation

Dr. Markarian loves answering patients’ questions and truly believes the best patients are those that are fully informed. He asks patients to bring photographs of breast images to make it easier to identify their desired aesthetic and goals. He also recommends writing down a list of questions patients may have from their research or talking to friends. Dr. Markarian often finds that patients remember a question they were desperate to ask while they are on their way home!

A woman in her 20s is shown 6 weeks post-op from a breast augmentation. 350cc silicone implants were placed under the muscle with a dual plane technique while utilizing a minimal 1 inch incision hidden in the breast fold.

Making the Most Out of Your Consultation

Dr. Markarian’s breast augmentation consultations typically last for 30 minutes. He performs a detailed examination of his patients to carefully assess the different properties of their breasts, including breast width, skin stretch, overall volume, symmetry, and degree of breast droop. He will discuss various implant types and suggest the exact implant that fits your body and matches your goals. Dr. Markarian also utilizes a breast implant sizing system that recreates the exact breast size his patients desire by physically placing an implant sizer between the breast and bra of the patient to demonstrate what it would look like for the patient in clothing.

Dr. Markarian advises any women considering breast augmentation surgery to discuss implant placement, skin incision type, the risks and benefits of the surgery, recovery time and the specific post-operative processes with a Board-Certified Plastic Surgeon. New patients should also ask to see before and after pictures of women with a similar breast size, shape and appearance to themselves and view the result of the surgery at different time frames after surgery. The breast augmentation result immediately after surgery may different from the result 3 weeks or 3 months after surgery.  

Patients ask Dr. Markarian a lot if it is necessary for visit with other plastic surgeons before they move ahead with a procedure. Dr. Markarian encourages his patients to see other doctors so that they have another reference point and may feel more comfortable with their decision.

Achieving a Natural-Looking Result

One of the key concerns of plastic surgery patients is that they will look unnatural following a procedure. This can be easily avoided in breast augmentation surgery. Generally, the more superficial the implant is (when placed above the muscle), the more obvious the implant contour will be and therefore that breast appearance will be more unnatural. Dr. Markarian typically places a smaller diameter implant under the muscle to provide a more natural look.

A woman in her 20s is shown 6 weeks post-op from a breast augmentation using 300cc moderate silicone implants. A dual plane technique was performed with the implants placed underneath the muscle.

Minimize Any Scars

Due to the variety of techniques and incision placements used by plastic surgeons to perform breast augmentation surgeries, patients are concerned about lasting scars from the procedure. Dr. Markarian uses a scar-minimizing technique by placing the implant underneath the muscle and the short incision (less than 1 inch) is hidden within the breast fold.

Generally, any surgical scars that patients’ have may help predict what to expect following a breast procedure. Scars may not settle for up to a year when a final result can be expected. Red and firm scars may fade within a year and become softer and consistent with the skin color of the patient. There are also several scar reduction treatments available, such as laser therapy.

Immediate Results

Patients researching breast augmentation results mention that some breasts look unnatural, stick out too much or are too full at the top of the breast. Immediately after surgery, there is a possibility that patients may have too much upper-pole fullness rather than a natural breast slope. This fullness does drop gradually over several months as gravity takes effect and the skin envelope stretches.

Dr. Markarian always tries to achieve the patient’s desired aesthetic immediately after their procedure, so that they do not have to wait for their implants to drop. He does this utilizing a dual-plane technique to place the implants low.

Consider the Recovery Time

Although Dr. Markarian creates a specific post-operative program for his patients, 6 weeks is generally the recommended recovery time. There may be a variation in recovery time recommendations between surgeons as they may use different techniques and implant locations. Dr. Markarian generally places breast implants below the muscle. He recommends patients do not try to rush recovery as using their pectoralis muscle prematurely can lead to complications such as displacement of the implant to the sides, fluid collection, or an increased risk of capsular contracture in the future.

Many of Dr. Markarian’s patients feel great after three weeks and can begin exercising on a stationary bike. However, to reduce the risk of complications, Dr. Markarian is conservative in his approach to recovery time.

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