Augmentation mammaplasty or breast augmentation is a procedure which uses an implanted device (breast implant) to enlarge the size of the breast.  This is a purely elective procedure performed for aesthetic reasons.                                                                    

   The breast implants are constructed as a silicone shell which is filled with sterile saline after insertion.  Implants have been in the media a great deal over the past few years.  Different types exist.  The FDA is currently evaluating the safety and efficacy of all breast implants.  The product information provided by the manufacturers further explains this.  Currently, only saline filled mammary implants are available in an unrestricted fashion in the United States.  Silicone gel filled implants are available as part of research study groups and are currently being reviewed for more widespread approval by the FDA.

    Many decisions need to be made in planning augmentation mammaplasty.  Dr. Bass will provide an extensive explanation of the issues involved during a detailed consultation.

More information about breast implants can be obtained from the following websites: www.plasticsurgery.org   and www.fda.gov.

Breast Cancer

   There is no evidence that the incidence of breast cancer is increased or decreased after augmentation mammaplasty.  Implants are placed behind the breast tissue allowing normal examination of the breast by you and your doctor.  The exam will feel different after augmentation and you must become accustomed to your new normal exam.  In mammograms of women with implants, parts of the breast tissue cannot be seen because of the implant.  A special mammogram is required which provides additional views.  These mammograms require a radiologist experienced in reading mammograms in patients with implants.  Mammograms for patients with implants may be more expensive than routine mammograms. 

In addition, Dr. Bass will follow you yearly to evaluate the status of the implants.  If you are not able to see Dr. Bass, another plastic surgeon should evaluate the implants yearly.

Silicone

    Any foreign material will have some interaction with the body which we will never completely understand.  The best studies available at this time do not demonstrate an association between silicone and systemic disease in the body.  Any effects of silicone are minimized by use of a saline implant with a solid silicone shell as used in many medical devices but no silicone gel which can migrate more easily into body tissues.  This is discussed in more detail in the manufacturers disclosure form.  

Surgical Technique

    The operation can be performed under local anesthesia with 
sedation or general anesthesia depending on the surgical approach selected.  Incisions can be placed around the nipple (circumareolar), in the crease under the breast (inframammary) or in the armpit area (transaxillary).  I perform this procedure in the office or at the ambulatory surgery facility of a hospital.  Endoscopic techniques are used to help improve the precision of the dissection.  Rather than forceful blunt dissection, I use dissection under direct vision, dissection using endoscopic visualization or a balloon technique to gently stretch tissues apart to create the pocket for the breast implant.                                         

Research by Dr. Bass Relating to Breast Surgery

“Breast reconstruction: The role of the plastic surgeon in breast cancer.”  American Cancer Society, Queens Chapter.  New York, New York.  March 1996.

Atraumatic balloon dissection technique (mammaplasty, abdominoplasty, browlift).” Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.

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