Breast Augmentation

Breast augmentation is one of the most commonly performed cosmetic operations in America currently. Each year many women seek Dr. Okamoto’s advice about this subject. Four main questions must be discussed and resolved for every consultation.

Where are the Incisions Made?

First, the potential location for the incisions for inserting the breast implants will be discussed. There are four choices: belly-button, armpit, underneath the breast and the areolar edge. Dr. Okamoto will explain why his favorite approach is through the margin of the areola, but the other incisions will be discussed as well.

Where is the Implant Placed?

Second, a decision must be made whether to install the implant above or below the main chest muscle, the pectoralis major. Almost always, under-the-muscle placement will be emphasized, but there are some occasions where above-the-muscle could be more appropriate.

What are the Types of Implants Available?

Third, the advantages/disadvantages between implant types will be thoroughly evaluated. This is the time to discuss virtues and problems for silicone vs. saline implants and textured vs. smooth implants. Although Dr. Okamoto can obtain and install any FDA-approved implant available in the U.S.A. and is quite willing to consent to any reasonable request, he will thoughtfully explain why he prefers to use saline smooth-walled implants currently.

What Size Should I Be?

The fourth decision during the breast augmentation consultation is to determine the most appropriate size for your breasts. Plastic surgeons recognize that many different methods exist in making this determination, each with its specific advantages and disadvantages. Sometimes more than one method is utilized to make the final choice. For example, some surgeons measure breast and chest dimensions and use this information as the primary factors to make a decision. Others give their patients sample implants to stuff under their bras and allow them to make the final choice on this basis. Dr. Okamoto uses the foregoing methods at times, but usually prefers to rely upon having the breast augmentation candidate peer through a book of full-busted women and pick the particular woman that is closest to her desires. This method gives him a visual image of how much fuller she would like to be. On the day of surgery, a preliminary implant, known as a “sizer”, which is the approximate size of the permanent implant predicted for the patient, is installed into the breast pocket as a first step. Each sizer has a variable range – e.g. a 350 cc sizer can be filled with 330 to 400 cc’s of fluid. As the sizer implant is filled, attention is focused on the expanding size of the breast. When it is deemed to be close to the size of the image that the patient has chosen, the amount of fluid installed into the sizer is noted. This quantity is used to choose the appropriate size of the permanent implant. Although this is the method usually applied by Dr. Okamoto, he is open-minded about other options. On some occasions a patient asks for a specific size of implant, which is honored when possible.

Results Gallery

The next step in the consultation process is to discuss the risks and complications of the operation, particularly those special considerations that are related to the implants.

Finally, questions for recovery time and back-to-work predictions as well as any other inquiries are answered. In general, most women with relatively sedentary jobs can return to work in about a week, but since most breast augmentations are under-the-muscle, it will take 6-8 weeks for this muscle to fully heal.