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DONALD J. CAPUANO, M.D.
You are interested in information regarding the procedure
for enlarging the breasts known as augmentation mammoplasty.
The procedure involves implantation of mammary implants either
beneath the breast tissue or beneath the muscle of the chest
wall. The Doctor can advise you as to the method which may
be best suited to you.
For your information: It is highly speculative that breast
prostheses can contribute to arthritis or other "collagen"
diseases. The chances of this occurring are less than the
chances of being injured in an automobile accident. There
is also a remote possibility of an "allergic" reaction to
the silicone outer shell of the prosthesis. Silicone has been
used for many, many years in human beings. It is given to
babies in certain over-the-counter medications. It is used
to coat needles used by insulin dependent diabetics as well
as needles used by physicians for patient injections. Pacemakers,
artificial joints, catheters, etc. are all coated with or
make of silicone. The FDA allows the use of silicone for these
A second aspect of "allergy" to silicone involves so-called
autoimmune disease. An example of this is rheumatoid arthritis.
There have been many reports, which are conflicting and confusing.
No conclusive evidence has shown a link between breast implants
and the development of autoimmune disease. Whether the few
patients with this problem would have developed this with
or without implants is not known. Studies are still being
done to ascertain the answer to this complex problem, and
we mention this for the sake of completeness.
For further information see -
comments from the University of Pittsburgh
School of Medicine
the FDA's comments on silicone breast
Breast size is determined by yourself and the Doctor in
the office before surgery. Bring a bra of the cup size you
would like in for sizing. Usually the chest circumference
size (34, 36, etc) does not change unless the augmentation
desired is very large. It is important to discuss size with
the Doctor, as prostheses must be ordered in advance.
This surgery is done as an out-patient under general anesthesia,
and takes approximately 1 1/2 to 2 hours. An incision is
made, usually beneath the breast fold, and after dissection
of the tissue the implant is put into place. Stitches are used, and a big bulky
gauze bandage with Ace wrap is applied. This remains clean,
dry and on for about two days. You are then seen in the
office in follow up and given instructions regarding care
You will be given prescriptions for medications following
surgery to reduce swelling, for infection and for discomfort.
We recommend at least a week and up to three to four weeks
away from work, depending on your job. This should be discussed
with the Doctor and/or office staff for an estimate.
Over two million women have breast implants, and there is
no evidence that implants cause cancer. If a tumor is found
following augmentation, breast biopsies can be done in the
vast majority of cases without injury to the implant. The
surgeon should of course be advised about the implants.
It is also advisable to tell your dentist or oral surgeon
about the implants before having dental work, as antibiotics
should be taken before any procedure.
Many patients ask if having implants makes it more difficult
to detect a breast cancer. In fact, women with implants
tend to be more aware of their breasts and examine them
more frequently. Because the breast tissue is pushed outward
more with implants in place it may be possible for smaller
tumors to be more easily detected.
When having mammograms it is important to tell the technician
about the implants. Special views and techniques are used
for mammography in implant patients, and you should ask
for someone who has experience with this.
We ask that you discuss this surgery with your husband or
"significant other" prior to scheduling surgery. If there
is a conflict between yourself and that person regarding
surgery it may be advisable for both of you to come in
and speak with the Doctor. This may decrease potential problems
Most women's breasts are not equal, and will not be equal
after augmentation. There may be a difference in size, shape,
projection, nipple position, etc. This will not change following
surgery. If there is a major difference before surgery,
attempts can be made to improve this using different sized
implants. The amount of breast tissue, muscle tissue, etc.
can be different as well, which can alter the look after
surgery. Your underlying rib structure can also play a very
important part in equalness after surgery. Without expensive
studies such as CT scans or MRI studies, the chest/rib structures
cannot be exactly determined before surgery. The spine can
also affect results. Curvatures of the spine change the
way implants "settle" into place.
In certain cases, depending on the size of the breast, amount
of sagging, quality and thickness of the muscle chest wall
configuration, skin thickness, amount of fat beneath the
skin, etc., placement of the implants behind existing
breast tissue (above the muscle) may be indicated.
There are many factors to be considered, and many judgments
to be made by Dr. Capuano. We try to make as many decisions
as possible before surgery, but some judgments can only
be made at the time of surgery.
If you are seen in the office regarding this procedure,
the Doctor will discuss with you the operation, the possible
risks and complications of the operation, and the results
that might be expected. There are of course risks involved
with surgery and anesthesia, but complications are rare
in Dr. Capuano's experience.
Dr. Capuano has performed over 1,000 breast enlargement
procedures, and the vast majority of patients are extremely
pleased with their surgical results.
If you have questions regarding this information, or have
questions about any other surgical procedures, call the
office at 585-225-0680.
INFORMATION REGARDING AUGMENTATION MAMMOPLASTY