Breast Augmentation In Honolulu, HI

What is a Breast Augmentation?

Modern breast augmentations have come a long way since they were invented in Houston, Texas in the early 1960s. The quality of the implant has also improved tremendously. There are two basic types of implants: silicone and saline. Each has its purpose, and in the hands of a well-trained, Board Certified Plastic Surgeon, one or the other will be used correctly to get the best possible results. Breast implants are used for either purely aesthetic reasons or in breast reconstruction. Dr. Schlesinger does not perform breast reconstruction, but we are fortunate in Hawaii to have several excellent reconstructive breast surgeons.

S. Larry Schlesinger, MD, FACSs Technical Skill, and Experience

• Surgical Experience: More than 30 Years in Hawaii & 19,000 procedures
• Former President of the Northwest Society of Plastic Surgeons
• Visiting Professor of Surgery, University of Oklahoma
• Hawaii Medical Association Physician of the Year 2000-2001
• Board Certified by the American Board of Plastic Surgery since 1985
• First in his class in medical school
• Member of the American Society of Plastic Surgeons

Positioning of Implants

Implants can be placed above or below the pectoralis (chest) muscle. 98% of the time, Dr. Schlesinger prefers going below the pectoralis muscle because:

A) It gives an extra layer of covering over the implant, therefore making the implant less obvious.

B) It is common knowledge in plastic surgery that implants under the muscle tend to stay softer over time.

C) The pectoralis muscle originates on the humerus (bone of the upper arm) and inserts on the clavicle (collar bone) and the sternum, therefore, with the implant underneath the pectoralis muscle, the breast appears to originate in an unbroken line from the collarbone to the nipple, whereas if you go on top the muscle, the breast implant appears to start much lower, giving it a less natural look.

D) Mammography of the breast is made easier if the implant is behind the muscle because the radiologist sees the muscle density and knows that all the breast tissue is above this muscle density and the implant is below.

Like most plastic surgeons in the U.S., Dr. Schlesinger goes partially subpectoral, cutting a small strip of pectoralis muscle off the fifth rib. He feels if the implant is completely subpectoral, this does not give a natural, or teardrop shape to the breast.

Size of Implants

Dr. Schlesinger has no difficulty getting large implants, even up to 800cc, through a relatively small incision throughout the armpit using the Keller funnel. The funnel also allows for a no-touch approach. The implant travels from a sterile box into a sterile funnel, then into a sterile subpectoral pocket below the breast tissue. The number two reason for breast implant hardening is the implant is inserted while touching the skin, thus dragging bacteria with it into the subpectoral pocket. Skin bacteria does not cause infection, however, it does cause the body to form a thick capsule around the implant, therefore leading to hard breasts.

Ultrasound After Capsular Contracture

Once the body has formed a tight scar circumferentially around an implant, it is called a capsular contracture. There are three known treatments for this surgery to remove the capsule, Accolate by mouth to decrease the immune response leading to a softer breast S. Larry Schlesinger, MD, FACS wrote the original article on Accolate), and ultrasound of the breast. In our practice, Accolate plus ultrasound has shown great success in non-surgical intervention. We highly recommend this to go along with Accolate as a first line of defense once capsular contraction occurs.

What are the Benefits of Breast Augmentation?

Breast Augmentation is one of the most popular cosmetic procedures in the world and has a multitude of advantages. Some of the benefits our Hawaii breast augmentation patients have seen include:

• Achieve a rounder breast shape
• Clothing fits better (i.e. shirts, dresses, bikini tops)
• Improved cleavage
• Larger breast volume
• More self-confidence
• Provides more fullness in the upper portion of the breasts
  

What to expect on the day of Breast Augmentation

Dr. Schlesinger does all of his transaxillary breast augmentations using an endoscope, just like a gynecologic belly button or arthroscopic knee surgery. Because he has a camera inside and under the breast and muscle and he operates using a monitor, any excessive bleeding is easily stopped. Endoscopic breast augmentations lead to less bruising, less hard breasts, less swelling, and quicker recovery.

The entire surgery will take approximately 2-3.5 hours.

Breast Augmentation Recovery

Breast augmentations are most often done in surgery centers and rarely in hospitals. 99% of all patients go home with a caregiver the same day after surgery. Hospital stays are not typically necessary. You should arrange for a family member or friend to be able to provide a ride for you and be able to stay with you during your initial recovery to help you with basic tasks. Take it easy for three days to prevent excess bleeding. You can typically drive after 3-4 days after surgery.

• After one week, you can take long walks.
• After 2 weeks, you can go swimming.
• After 3 weeks, you can work out at the gym.
• After 4 weeks, you can go running.

You will need to wait about seven days before you shave under your arms or use deodorant as it could irritate the healing tissue. Full recovery is normally at one month; meaning full physical activity with no restrictions occurs about a month after surgery. Also around the same time, you feel like the implants are emotionally and physically a part of your body, and not something foreign. You should be able to return to work within a week or so, with desk jobs that require minimal mobility in about five days, and more physically demanding jobs in 9-10 days.