Breast Augmentation New York City
Breast augmentation (technically known as “augmentation mammoplasty”) is the use of breast implants to increase the size and/or fullness of your breasts. Women choose breast augmentation when they want to increase the size of their breasts to better balance their body proportions or to enhance their self-esteem. Breast augmentation will also restore breasts that have deflated due to pregnancy, aging or weight loss.
Am I a Good Candidate for Breast Augmentation?
You are a good candidate for breast augmentation if your breasts are fully developed and you are unhappy with the size, shape or volume of your breasts. You may feel that your breasts are too small for your body. You may also have breasts that are asymmetrical or didn’t develop normally.
Ideal breast augmentation candidates must also be in good health, live in New York City (or be willing to travel), and be motivated to follow Dr. Cangello’s pre-operative and post-operative instructions. This includes wearing a support bra while your breasts are healing.
You must also have realistic expectations for the surgery. For the best results, you should be close to your ideal weight and your weight should be stable. You should also understand that breast augmentation does not correct excessively sagging breasts. If you want your breasts to have a perkier more youthful appearance, Dr. Cangello may recommend that you consider a breast lift in addition to breast augmentation.
The Consultation: Creating Your Plastic Surgery Plan
Your breast augmentation journey begins with a consultation with Dr. David Cangello in our New York City office. Dr. Cangello will discuss your medical history and the results that you want from your breast augmentation. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures. You will also need to tell him if you are planning on getting pregnant or breastfeeding.
Pregnancy and breast feeding can cause significant changes to the size and shape of the breasts so if you plan to have children in the near future after having breast augmentation surgery, Dr. Cangello may advise you to postpone surgery in an effort to minimize surgical procedures on the breasts.
Dr. Cangello will ask about your goals for breast augmentation and the look you hope to achieve – including the size, shape and volume of your breasts. Dr. Cangello feels that his approach to breast augmentation is unique in the way he chooses the size of implants to be used. For various reasons, most surgeons err on the side of choosing larger implants at the time of surgery which can result in an “implanted” look. However, Dr. Cangello prefers to create the most natural look possible (unless your prefer something different). To achieve a natural look, the surgeon must be able to visualize in his/her mind what a certain size breast implant will look like once it is placed, given the patient’s chest and breast measurements and the quality and quantity of their native breast tissue. This requires exceptional artistic vision.
For patients that do want a larger more “implanted” look, that is perfectly fine too. Dr. Cangello’s goal is to provide the patient with something she will be comfortable and happy with.
There are many decisions associated with breast augmentation. First, you will need to decide whether you want saline or silicone implants. Secondly, you’ll need to consider whether you want the implants placed above or below your chest muscle. Finally, you’ll need to decide the shape, contour and volume of the implants.
Dr. Cangello will conduct a physical examination. He will look at your body as a whole, as well as your skin’s thickness and the volume of your breasts. Dr. Cangello will recommend the size, shape and placement of implants that will look the best given your height, weight, build, anatomy, current breast size and goals.
Dr. Cangello will answer your questions and explain how to prepare for your breast augmentation, as well as what you can expect in your post-operative care.
Decision Factors for Breast Augmentation
Saline breast implants are filled with sterile salt water. If saline implants rupture, the implant deflates and the saline is easily absorbed by the body. Because saline implants are filled after they are implanted in the body, they require a smaller incision. It is also possible to make small changes to the size of saline implants by using a syringe to insert or remove saline. Saline implants are approved for patients who are 18-years-old and over.
Silicone breast implants are filled with silicone gel and tend to feel more natural. If they leak, however, the implant will not change in size and the silicone gel will not be absorbed by your body. For this reason, silicone implants require regular monitoring by your surgeon. Because silicone implants come pre-inflated, they may require a slightly larger incision and the size cannot be changed. In order to minimize the length of the incision Dr. Cangello uses something called a Keller funnel that assists in placing a silicone gel filled implant through a smaller incision. Silicone implants have a long history of safety. They are approved for patients who are at least 22-years-old.
Breast implants can be placed under the breast tissue (subglandular placement) or under the chest muscle (submuscular placement). This decision is based on your anatomy, your skin elasticity, the size of the implant in relation to your native breasts, and the amount that your breasts are sagging. Breast implants that are placed under the muscle require a longer recovery than implants placed under the breast tissue. The vast majority of the time, Dr. Cangello places the implants in the submuscular position. This creates a more natural look and minimizes rippling because it provides more soft tissue coverage over the implant. In addition, it decreases the risk of capsular contracture around the implant.
Choosing the right implant is critical to the success of your augmentation. You will need to consider the size (measured in cubic centimeters), the shape, and the profile (which is the distance that the implant will project from the chest wall). You will also need to consider how you want your breasts to feel. Dr. Cangello will recommend the implant size and shape that will best enhance your body.
Preparing For Breast Augmentation
Dr. Cangello is committed to achieving the best results possible. During your initial consultation, he will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. You will be advised to avoid ANY nicotine-containing products for at least two to four weeks before and after surgery.
Dr. Cangello will also give you instructions for the days before your surgery. These include stopping certain medications and supplements. You will also be told not to eat beginning at midnight on the day of your surgery.
Finally, Dr. Cangello will explain your post-operative plan. He will give you prescriptions to fill prior to surgery and ask you to find someone to drive you home following surgery.
Where Will the Surgery Be Performed?
Your breast augmentation will be performed at Dr. Cangello’s New York City office. He has a fully accredited (AAASF) state-of-the-art operating room on-site. You are encouraged to ask for a tour of the operating facility when you come in for your consultation.
Types of Anesthesia
Breast augmentation generally takes one and a half to two hours. It is performed using general anesthesia. You will not feel any pain or remember the surgery.
Breast Augmentation Surgery Techniques
Having a positive outcome to breast augmentation depends greatly on the skill of the surgeon, who needs to carefully construct a “pocket” for the implant. This “pocket” may be under the pectoral muscle (submuscular placement) or under the breast tissue (submammary placement).
There are three places for the incision. The incision location is based on your anatomy, the type of breast implant, and the amount of enhancement planned. Incisions can be periareolar (around the nipple), inframammary (on the lower side of the breast, and transaxillary (in the armpit). Dr. Cangello prefers not to use the transaxillary technique as we know that this technique has the highest rate of implant malposition after initial breast augmentation.
Once the “pocket” has been constructed, Dr. Cangello will carefully insert the implant. Saline implants are inserted through a small incision and filled after insertion. Silicone implants come pre-filled and are placed carefully in the breast. Dr. Cangello adjusts the position of the operating table to a “seated” position after he places the implants and before permanently closing the incisions to be sure that your augmentation looks perfect. Once the implants are in place, the incisions are closed with sutures.
Breast Augmentation Scarring
Incisions made around the areola are extremely well camouflaged and often barely visible—if not invisible—several months after surgery. Incisions in the inframammary (under the breast) crease also hide extremely well. They are not at all visible on the breast when in the upright position. If the incision is properly positioned and the incisions are meticulously closed the resultant scar is usually minimally visible in time. Dr. Cangello recommends using Biocorneum which is a liquid form of silicone gel starting two weeks after surgery to help minimize the appearance of the scar. Other over the counter scar creams have proven ineffective and can be expensive. Biocorneum has the added benefit of having SPF 30 in it so that scars don’t become hyperpigmented (darken) from UV or sun exposure. We provide Biorcorneum to our patients. If necessary, Dr. Cangello also has lasers in his office that can be used to improve the appearance of scars in people who have hypertrophic scars or who are prone to poor scarring.
The Recovery Process
You will wake up with a surgical dressing over your incisions. You will also be wearing a post-surgical bra or compression garment. Your breasts may feel achy, heavy or tight following the surgery. Dr. Cangello will prescribe pain medication to keep you comfortable. Your sutures should be removed within ten days if dissolvable sutures are not used.
Following breast augmentation, you should be able to return to work within a few days to one week. If you are physically active at work, or need to lift more than a few pounds, you may need to plant to stay out of a work a little longer. You should discuss this with Dr. Cangello. you should be able to resume normal physical activities within four to six weeks.
Please call our New York City office at 212-644-4416 to set up a consultation and learn how you can benefit from breast augmentation.
Is there anything I should do to prepare for my surgery?Dr. Cangello’s staff will provide you a list of instructions to prepare you for your surgery. For example, you may have to stop certain medications. You cannot use any nicotine products (smoking, patch, gum). You cannot eat or drink anything after midnight the day before your surgery, etc. Aside from following these instructions, one of the best things you can do for yourself is to be well rested. It’s normal to be anxious leading up to your procedure. But being well rested and as relaxed as possible will serve you well in your recovery. You should also try to eat as healthy as possible and get as much protein as possible in your diet. This will help with the healing process. Aside from these things there is really nothing special you have to do!
How do I chose which implants to get?This is a part of the discussion you will have during your consultation with Dr. Cangello. Dr. Cangello will examine you and take measurements of your chest to determine what size and type of implant he feels will be most appropriate for your body type. But he will also ask you what you have in mind in terms of; size that you’d like to be, look that you’d like to achieve, and implant type that you may want based on your research. After you discuss your goals with Dr. Cangello and he provides you information about implant options based on his expertise, together you will come up with a plan for which implants will suit you best.
Are there risks to having surgery?The risks associated with surgery in general, particularly related to complications with anesthesia are extremely low. In general, patients who are healthy have excellent outcomes with this surgery. Issues in the immediate postoperative period that we try to mitigate are infection and bleeding. Dr. Cangello and his staff adhere to meticulous sterile technique in the operating room to keep the risk of infection extremely low. His surgical technique is also meticulous and extremely precise and gentle, so the operative field stays bloodless during the surgery. You will be given detailed post-operative instructions on how you can contribute to minimizing the risks of these complications or any others.
Is it possible to lose nipple sensation?It is possible to lose sensation. However, in the many years Dr. Cangello has been performing this procedure he has never had permanent loss of nipple sensation. Sometimes the nipples actually become hypersensitive. Sometimes women can experience a temporary decline in sensation as some of the nerve fibers that provide sensation to the nipple get stretched when the pocket for the implant is made. However, in these cases, sensation returns within a few weeks to one year.
Will I be able to breast feed with breast implants?Yes you will. There is a slight risk of having difficulty with breast feeding after breast augmentation if an incision around the areola is used. However, the risk is very low. When the incision is made in the breast crease (below the breast) the risk is even lower.
How long will it take to recover?Full recovery in terms of being able to exercise happens in about four to six weeks. Often patients are worried about taking time off from work to have breast augmentation surgery. If you work an office type job that does not require physical labor you can usually go back to work within a few days.
Can I have other procedures done at the same time as my breast augmentation?The answer is yes. It is very common for women to have a mastopexy (or breast lift) at the same time as a breast augmentation. Also many women have an abdominoplasty or tummy tuck as part of a “mommy makeover” at the same time as breast augmentation. Liposuction is another procedure that is commonly combined.
How long does breast augmentation surgery take?The procedure usually lasts between one and a half and two hours. If combined with other procedures, such as a breast lift (mastopexy) it can take longer.
What can I expect right after my procedure? Is it necessary to stay in the hospital?Patients’ experiences vary depending on many things. However, the first few days after breast augmentation you may experience some pain and a slight feeling of tightness in the breasts. Pain usually lasts no more than a few days and you are given a prescription for pain medicine to prevent it. Some patients do not feel the need to even use the pain medicine. Others use it more regularly over the first couple of days. By one week most patients are feeling quite well. The procedure is an ambulatory procedure meaning you go home the same day as your surgery. No hospital stay is necessary.
Why does choosing a Board Certified Plastic Surgeon matter?A surgeon certified by the American Board of Plastic surgery has to undergo rigorous training in the field of both cosmetic and reconstructive plastic surgery. In addition they have to pass very difficult oral and written examinations to verify their proficiency in the field. Unlike surgeons who undergo cosmetic training alone, plastic surgeons also have extensive experience with reconstruction of the entire body. So they are the most qualified to deal with any untoward event that may occur as a result of having breast augmentation. They are also the most qualified to have in depth understanding of the anatomy involved when performing the procedure.