Breast Augmentation

How is Breast Augmentation Performed?
Desired Breast Size
Silicone vs. Saline Implants
Incision Site (Armpit, Under the Breast, Areola, etc.)
Placement of the Implant Above or Below the Pectoral Muscle

A woman’s choice for breast augmentation is a very personal one, but also involves several important decisions. Breast augmentation is generally a safe, rewarding procedure when done by a well trained surgeon. Several factors need to be considered including: the desired breast size, type of implant (silicone or saline), the site of the incision and whether the implant is placed above or below the pectoral muscle.

Dr. Edward P. Miranda is experienced in breast augmentation and happily assists each woman in making her own informed decision about each of these questions. In addition, Dr. Miranda will examine each woman in order to best advise each woman about the choices that she has.

Before and After photos are available during your consultation.

How is Breast Augmentation Performed?

Breast Augmentation is generally performed in the hospital under general anesthesia (the woman is completely asleep). Dr. Miranda places the implant underneath the breast itself (either below or above the muscle).

Desired Breast Size

Communication between Dr. Miranda and the patient is critical to attaining excellent results in breast augmentation surgery. Dr. Miranda listens to each woman’s concerns and expectations for size and shape of the breasts. To assist in dialogue, Dr. Miranda suggests that each patient bring in pictures (e.g. from magazines) that show her desired breast size. Dr. Miranda will also show samples of different implant sizes and use them assist in planning for the breast augmentation procedure. Dr. Miranda also recommends bringing in several different types of shirts to assist in the decision process.

Silicone or Saline

Both silicone and saline breast implants have been in use world-wide for decades. Each has advantages and disadvantages. In late 2006, the FDA re-approved silicone implants for use in breast augmentation. Modern silicone breast implants have a soft, very natural feel that many women prefer. Others prefer saline implants which, having been the standard in the United States for the last 15 years, is also a reasonable choice. At the time of your consultation, Dr. Miranda will discuss in detail the advantages and disadvantages of each so that each woman can come to her own, informed decision.

Site of Incision

Dr. Miranda is skilled at each of the major incision sites for the placement of breast implants. The choice of incision site is based on the preference of the woman and also the size and shape of the woman’s breast. There are three major incision sites:

Under the Breast (inframammary, or in the breast crease),
The Nipple-Areolar Edge (where the generally darker skin of the skin surrounding the nipple, or areola, meets the normal skin of the breast), and
Concealed in the Armpit (axillary incision).

There is a fourth incision site: through the navel (umbilicus, or belly-button) but this approach, also called the TUBA (Trans-Umbilical Breast Augmentation) is generally not preferred as it is only compatible with saline implants (silicone implants cannot be used) and creation of the final breast shape is less controlled. Furthermore, even with saline implants, use of the TUBA incisions for breast augmentation will void the implant manufacturer’s warranty because the method risks damaging the implant when it is placed.

At the time of consultation, Dr. Miranda will discuss the advantages and disadvantages of each incision site, particularly in the context of both the woman’s expectations and the shape of her breasts, allowing each woman to make a well-informed choice.

Site of Implant Placement: Above or Below the Muscle

Beyond the site of the incision, there are two major options for implant sits in the body: either in front of or behind the pectoral muscle (“pecs”). Dr. Miranda is experienced in both techniques and will discuss both options with each woman. In either case, the implant is actually placed behind (not within) the actual breast tissue to minimize any interference in normal breast function and sensation. However there are advantages to each site of placement. The amount of existing breast tissue and the overall shape of each woman’s chest are major factors in the determination of whether or not to place the implant above or below the muscle. Placement below the muscle may have the added benefits of minimizing the chance of any “hardening” of the tissue around the implant (capsular contracture). However, placing the implant above the muscle is advantageous in a select group of women. Dr. Miranda and each patient will discuss these issues, allowing the woman to make an informed decision.

Other Breast Procedures Include:

Edward P. Miranda, M.D.
A Medical Corporation

3838 California Street, Suite 404
San Francisco, CA 94118
(415) 379-9015

Info@MirandaPlasticSurgery.com

Board Certified by the American Board of Plastic Surgery