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DONALD J. CAPUANO, M.D.
Plastic Surgeon

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Augmentation Mammoplasty
or
Breast Enlargement

Pre op information

The Operation

Pictures 1

Pictures 2

Complimentary Consult

Other Augmentation Menu Information

Other Augmentation Information

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 purposes.

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 prostheses

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 and activity.

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 after surgery.

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

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