Procedure
Breast augmentation is a type of surgical procedure in which the size and shape of the breasts are enhanced through saline or silicone implants.
Depending on the size and type of implant chosen, as well as your desired outcome and body type, the procedure may be performed in one of three ways:
- Inframammary Approach – An incision is made in the fold beneath the breast, allowing the implant to be positioned beneath the pectoralis muscle.
- Periareolar Approach – The implant is inserted through a smaller incision around the base of the areola.
- Transaxillary Approach – An incision is made high in the armpit to avoid visible scarring on the breast, and the implant is inserted with the aid of a camera through a tunnel made from the armpit to the breast.
Generally we prefer the inframammary approach as the scar hides well within the natural breast crease, changes in nipple sensation are minimized, and revision rates are the lowest.
Anesthesia
Typically a breast augmentation procedure takes 1 to 1.5 hours and is performed under general anesthesia. This is an outpatient procedure.
Recovery
Normal daily tasks may be resumed immediately, with the ability to perform non-strenuous work (no lifting greater than 10 lbs) in 5 to 7 days. No strong pushing, pulling, or repetitive upper body movements for 3 weeks. Most patients are able to return to work in 3-5 days.
- Swelling/Bruising will be moderate-to-significant for 4 weeks, with mild swelling lasting 2 to 3 months (depending upon the extent of the procedure). The breasts will be sensitive to physical contact for 3 to 4 weeks.
- A support garment may be worn immediately following the procedure, and as needed for up to 6 weeks.
- Resume exercise only at 1/3 intensity after 2 weeks and 2/3 intensity at 4 weeks. Limit exercise to low impact activities at 1/3 of normal duration, repetitions, amount of weight, and pulse rate. Full intensity workouts, including high impact activities (running, yoga, horse back riding, high-impact aerobics) can be resumed at 6 to 8 weeks.
- Scar fading and improvement will occur gradually over time, with the first stage of scar tissue forming in the first 6 to 8 weeks. Scars will mature and fade further over a period of 6 to 12 months.
- Other possible side effects include temporary soreness, swelling, a change in nipple sensation, and bruising. The breasts will be sensitive to stimulation for a few weeks.
When Will I Start to Notice Results From My Procedure?
While results from breast augmentation are immediate, in the first few weeks following your procedure, your breasts will appear slightly full with a slight outward (convex) curvature to the upper portions. This fullness regresses as the lower portion of the breast skin envelope stretches from the weight and gravitational effect on the implant over time. Once the stretching in the lower portion of the breast is complete (up to 6 months), the upper pole profile of the breast becomes straight or slightly concave.
Duration of Results
Implants may require removal or replacement at some time in the future, though the time frame for these types of changes is usually years or decades. The type of implants chosen can also have an effect on whether or not you may need them replaced or adjusted in the future. We will discuss expectations for each type of implant and procedure during your initial consultation in order to help make the right choice for your needs.
Medication and Follow-Up Visits
Pain medicine may be prescribed and should be taken immediately following your procedure.
Two initial office visits will be scheduled at 5 to 7 days and 10 to 14 days. You should expect 4 to 5 follow up appointments in the first 3 months, and then yearly after that.
Risks
As with any surgical procedure, there is a very small chance of complications. While these risks are rare, they can include infection, asymmetrical results, implant rupture, and a change in the sensitivity of the nipples or breast skin. In a small percentage of cases, there is the chance for capsular contracture, a tightening and hardening of scar tissue around the implant. We will do everything we can to monitor your condition following the procedure in order to minimize these risks.
How Much Does Breast Augmentation Cost?
A breast augmentation typically costs between $6,200 to $7,800, which includes surgical fees, implants, anesthesia and operations room costs.
Silicone VS Saline Implants
There are many factors to consider when deciding on breast augmentation surgery. One of the most important decisions to make is whether to opt for silicone or saline implants. Each alternative offers a variety of advantages and disadvantages. Generally we prefer to use the new cohesive silicone gel implants. They have the advantage of being much softer and natural feeling, and had been proven to be as safe or safer than saline implants.
About Silicone Gel Implants
Silicone implants have a feel that is similar to breast tissue and are pre-filled with silicone gel. They collapse less when held upright compared to a saline implant, but do require a slightly larger incision. These types of implants are made up of a cohesive silicone gel, which provides a natural shape and does not leak. We will be happy to go over the different silicone implant options available to you, including the new Mentor and Allergan implants, during your consultation.
About Saline Implants
Saline implants are typically inserted through a slightly small incision and then filled to the correct size with sterile saline solution. If a saline implant happens to rupture, the body will be able to safely absorb the saline over the course of a few days.
The implant shell can then be replaced with either another saline implant or exchanged to a silicone gel implant. Saline implants tend to be more visible and palpable than silicone implants, and tend to feel less natural in the breast.
Procedure Timeline
Initial Consultation
During your first office visit, our doctors will:
- Review your medical history as well as your expectations about breast augmentation.
- Examine your breasts and provide you with more information tailored to your specific needs.
- Allow you to try on breast sizers to simulate results and guide in preoperative planning.
- Discuss surgical fees.
At your consultation, you should feel free to ask any questions or address any concerns regarding breast augmentation. Whether you decide to undergo the surgery is completely your decision, but our surgeons will advise you about your options and the expected results. As long as you are in good health, age is not a restriction for augmentation mammoplasty.
Before Your Augmentation Mammoplasty
For the best possible results, the doctors at Boulder Plastic Surgery believe nutrition plays a major role. That is why we employ a three-phase healing program so that your body recovers more quickly. Our program involves:
- Removing any supplements and medications that could interfere with the anesthesia or cause more bleeding about a week before the surgery.
- Giving patients nutrients that will detoxify the anesthesia or other medications as well as diminish pain and inflammation.
- Providing patients with healing nutrients to support a speedy recovery.
Before the surgery takes place, patients may also undergo routine laboratory tests such as blood counts/blood chemistries, an electrocardiogram for those 50 and over, and a pregnancy test if applicable. These important tests check for any abnormalities that could negatively affect the anesthesia or surgery.
The Day of Surgery
Before you move to the operating room, you will be asked to sit up briefly so that your surgeon is able to make small marks in the armpit and/or beneath the breasts to guide them during the procedure. You may be asked to bring in photographs of your desired results to aid in surgical planning. Augmentation mammoplasty is performed under a general anesthetic and typically takes anywhere from 45 to 90 minutes.
Incisions will be made depending on which approach is best for each individual patient. Those incisions are closed with dissolving sutures that do not require removal. After the procedure, you will be transported to a recovery area and observed for a few hours. Once that observation period is complete, you are able to leave with a person who will drive you home and remain with you the rest of the night following the surgery.
After Your Augmentation Mammoplasty
Our doctors want you to be as comfortable as possible after your surgery, which is why we recommend that you take any pain medication with a small amount of food. To decrease swelling and discomfort, it is also recommended that patients apply ice packs for the first 48 hours.
Any bandages that you received at the time of surgery may be taken off the next morning. You may shower after 48 hours. In the first few weeks after your surgery, the upper portions of your breasts may look full with a slight outward curvature. As the lower portion of the breast skin stretches, the fullness will regress.
Patients may also notice a small amount of bruising in the armpit or under the breast, which should subside within one to two weeks. If you notice any of the following symptoms following your surgery, notify your surgeon:
- A temperature of 101 degrees or above.
- Extreme swelling or tenderness in the breast.
- Redness along the incision lines or elevated breast temperature.
Most patients will return to normal activities within 48 hours and many return to work within 3-5 days.
Testimonials
“I am very pleased with the results!” – KG
“What can I say? You’re awesome! Thanks to you and your staff for taking good care of me and for always being so welcoming.” – CM
Thanks to Dr Rouch and BPS for such a great surgery experience
by Joan Heron
Category: reviewsI am very glad that I had my procedure done at Boulder Plastic Surgery. I am also very glad that Dr Rouch was my surgeon. He is naturally warm and personable. It is obvious that he really loves his work. When I made an appointment to ask about a surgical procedure that I felt uncertain about, he immediately began a relaxed conversation with me about what he was seeing and what my options might be. He was so at ease that I began to feel at ease and I made my decision. Having surgery at Boulder Plastic Surgery was a high- quality experience. Everyone who was part of my care was responsive and supportive, giving me the information that I needed to make a good recovery. My thanks to everyone involved. Special thanks to Lana for helping me with wound care. It made all the difference. I felt very taken care of by Dr Rouch who was responsive and supportive from start to finish. I really appreciate his skills, his kind demeanor and his thoughtful reassurances. He is a great surgeon. After my surgery, a close friend said, "You look like yourself, but better." I am very happy with my experiences at BPS.
The Best Aesthetician, Heather!
by Carol Semple
Category: reviewsI have been going to IV Seasons Skin Care for over 20 years. From the beginning I have always received top notch skin care and friendly, professional treatments from everyone! For the last 9 years I have been seeing Heather. Heather brings the art of skin care to a whole new level. Her expertise in designing exactly what is right for your skin is beyond compare. She listens to your needs and treats your skin with the utmost professionalism. I trust her advice and the procedures and products she recommends. On top of that, she is super friendly and a joy to work with. If you're looking for the best aesthetician around, I'd highly recomment Heather! Everyone thinks I look 10 years younger than my actual age. Thank you Heather and thank you IV Seasons Skin Care!
Love Love Heather
by Valerie
Category: reviewsI have been seeing Heather for over three years and have been going to the Clinic for over six years. Heather is the ultimate professional. She listens to any concerns I may have and makes recommendations to help me achieve the best skin results. We have a great time together and I love seeing her. The products made especially for the clinic are fantastic and they are always happy to provide trial samples to make sure you are pleased with them. Thank you Heather and look forward to seeing you next month!
8 years of positive and high impact treatments with Heather
by Kimberly
Category: reviewsHeather’s treatments have transformed my skin and appearance. 8 years ago having never done professional skin care, I went in for a free initial consult with Heather. She gradually introduced me to quality skin care and treatments. She takes your lifestyle and goals and develops a high impact, personalized plan for you. No cookie cutter recommendations or high pressure. Genuinely, Heather cares about my personal progress and helps me reach my goals. My skin immediately transformed. And I am still keeping up the facials and peels. My before and after is amazing! Thanks Heather! Finally, I should mention that over the years, she has done many extractions and teen facials for my teens and now continues caring for their skin in their 20’s. Heather cares about her clients and I feel very lucky to have found a rock star skin care expert!
Say Yes to Dr. Maxhimer!
by Linda Connelly
Category: reviewsThere are so many amazing things that I want to convey that I am afraid I won't do this review justice. Dr. Maxhimer and Claudia are a dream team. They are so good at tag-teaming and keeping each other up to date on patient needs and progress that it boosted my confidence in my results during each weekly visit. I had quite a bit of work done - abdominoplasty, blepharoplasty, breast lift and augmentation. Claudia's ability to understand where I was at and what I was feeling at each stage of recovery was so helpful. She was ready with whatever I needed, anticipated each question, but let me ask it anyway, and helped me transition from post-op to healed with such ease that honestly, I was sad at the thought of not having our weekly chats anymore. She is a gem! I have had a substantial number of surgeries in my lifetime - all non-elective, so while I was not scared of surgery, I was very nervous for the outcome. I should never have been concerned. Dr. Maxhimer is smart and super down to earth. He has a sense of humor, he treats you like you are his friend, and he cheers right along with you as you start to see the results during recovery. He is encouraging by nature, so easy to talk to, and I needed that when contemplating massive overhaul at 52! I am now at week 7 post-op and feel amazing. I am so impressed with their servant hearts, their incredible skills and the results that I would not hesitate to recommend Dr. Maxhimer to anyone looking for a surgeon. If I could have a pre-op call with any prospective patient, I would say this: Say YES to yourself. Say yes to Dr. Maxhimer and let he and Claudia take you under their wing for a few weeks of your life. You will not regret it.
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