Breast Augmentation in Omaha, NE

Breast enlargement is accomplished by placing an implant (either saline or silicone) underneath the chest muscle or less commonly just beneath the breast tissue. The choices for incisions include the armpit, the crease underneath the breast or on the lower edge of the areola. The areola is the darker skin which surrounds the nipple. All of these incisions typically heal very well and are usually inconspicuous after healing is completed. Scientific evidence has demonstrated that placement of the implant beneath the muscle of the chest wall has many advantages. It is generally accepted that implants placed under the muscle have a greater chance of keeping the breast soft and less chance of visible wrinkling. This approach usually makes mammography easier to perform and therefore more accurate.

Recovery following breast surgery is generally swift. You will need an adult with you for the first 24 hours after surgery. If you live outside of Omaha, we will ask that you spend the night at one of the neighboring hotels offering discounted pricing for our patients. You will wear either a wrap around your breasts or possibly a post surgical bra. This will be up to the discretion of your surgeon. You will be given appropriate medications to control discomfort after surgery and you will be placed on an antibiotic for a few days after surgery. You will likely also receive a medication for control of postoperative nausea. On the day after surgery you will return to our office for a visit. Your wrap may be taken off on that day and your surgeon or the physician’s assistant will examine you.

Following breast augmentation, there’s always the potential for breast implants to shift and every effort should be made to avoid this problem. In the post-operative period, we recommend that patients sleep on their back for four to six weeks following surgery.

Sleeping on the abdomen or side in the early post-operative period has the potential to cause shifting of breast implants and should therefore be avoided. Sleeping on the back is difficult for some patients and they often move to their side without knowing it. For these reasons, we recommend that patients sleep in a recliner.

After six weeks, we allow patients to resume all their normal activities without restrictions.

This is a very common question asked by women considering breast augmentation.
Many women indicate they are under the impression that implants need to be replaced every 10 years. This is not true. The myth that implants need to be replaced every 10 years probably came from the testimony provided by physicians during the approval process for silicone implants in the early ’90s.

The question asked several times to the testifying doctors was “How long will these implants last”? And the answer often was “We are not sure, but we believe they should last at least 10 years”. The number 10 was accepted by many as the life span of the implant. The accurate answer is the implants will very likely last much longer.

It is difficult to give an exact percentage, however considering there are at least 3 implant manufacturers and each implant manufacturer has a silicone line.

A saline line, textured implants, smooth implants, round implants, teardrop implants all with varying shapes. Consequently, there are thousands of different variations and each one would have a specific lifetime. The best way to think about it would be that in the first 10 years they probably won’t leak. In the second 10 years, they might leak and in the third 10 years, they probably will leak.

How Old is Too Old for Breast Implants? We frequently see women in their fifties who request breast augmentation. In the vast majority of these patients, breast augmentation can be performed without any difficulty. It’s important to realize that as we get older changes occur our bodies. Many women in their fifties have had multiple pregnancies. In many cases they have developed loss of breast volume and associated breast sag. For these reasons many of these patients will need breast lifts at the time of their breast augmentation.

In addition, as we age we frequently develop other health problems. It’s therefore important to have an appropriate medical evaluation before proceeding with surgery. This might include an EKG and laboratory studies.

Even when these issues are considered, patients who have undergone breast augmentation in there fifties report high satisfaction rates. In today’s world, fifty is still considered young.

Implant placement relative to the pectoralis major muscle continues to be a source of controversy. Although the majority of plastic surgeons prefer submuscular placement there is still a large group of plastic surgeons who feel strongly about subglandular placement. Each group can make convincing arguments regarding their position of choice. It’s safe to say both approaches have advantages and disadvantages.

In the context of these discussions we feel that every patient needs to be considered individually. Each patient has unique anatomic findings that effect the decision to place the implant under or over the muscle. The aesthetic goals of the patient are equally important and have a significant impact on the decision as well. The vast majority of patients are striving for larger breasts with a natural look. They want balance, harmony, and proportion with the surrounding structures.

The majority of breast implants are placed in a submuscular position. There are several advantages to this approach. These include more soft tissue coverage which results in fewer visible folds, creases, and ripples in the implant. This is especially important in women who have thin skin and minimal breast tissue who want saline implants. Another advantage of submuscular placement is a lower incidence of capsular contracture. This phenomena results in hardening and distortion of the breasts. Patients can also have significant pain with capsule formation. Capsular contracture can occur with the implant in either position but the incidence is higher when the implant is placed on top of the muscle. For these reasons, submusclar placement gives a more natural look in most cases.

Placement on top of the muscle should be considered in female body builders who have large muscles which can distort the implant during contraction. In women with breast sag, implants can be placed on top of the muscle to avoid a breast lift and scarring.

Every patient should be considered individually. It’s important that you meet with a board certified plastic surgeon who can help obtain your aesthetic goals.