Breast augmentation is one of the most popular surgical procedures performed at The Plastics Atelier. It involves using breast implants to increase breast size, restore volume lost after pregnancy or weight loss, or improve breast symmetry.

At our Omaha practice, our focus is on achieving a natural, beautiful, and proportionate result that aligns with your personal aesthetic goals and body frame.

Choosing the right implant is a critical step. During your personalized consultation with Dr. Hall, we will review the best options for your anatomy, activities, and aesthetic goals.

Implant material (silicone or saline)

Implants can be filled with a cohesive, "gummy bear" like silicone gel. Silicone implants mimic the feel of natural breast tissue better than saline and maintains their shape well. The risk of rippling is also lower with more cohesive silicone implants. Implants may also be filled with saline. In the event that a saline implant were to rupture, the contents would just be absorbed by your body.

Pocket selection

There are two locations or “pockets” that can be used during breast augmentation and it relates to the implant position relative to the pectoralis major muscle. Implants can be placed either above the muscle in the “subfascial pocket” or under the muscle in a “dual plane” pocket.

1. Subfascial pocket (Above the Muscle): Typically less discomfort compared to under the muscle, although both are relatively easy recoveries. A subfascial pocket with produce a more augmented or rounded appearance, especially in the upper breast, because there is less tissue coverage over that portion of the implant. One benefit to the subfascial pocket is having minimal to no animation deformity after surgery. For patients who frequently participate in activities that significantly contract the pectoralis major muscle (chest fly, bench press, push ups, etc this is often a better pocket choice).

2. Dual plane pocket (Under the Muscle): This pocket provides more tissue coverage over the upper portion of the breast compared to a subfascial pocket. This result is a smoother transition between the upper chest and the breast, resulting in a more natural appearance of the upper breast. Using a dual plane pocket does come with some animation deformity after surgery when you are participating in activities that activate the pectoralis major muscle which is resting on the implant.

About the surgery

The surgery is performed under general anesthesia and takes approximately 1 hour to complete. A small incision is made typically under the breast in the infra-mammary fold. A precise pocket is the developed for the implant. Next, sizers are used to ensure the implant selection is optimized and the pocket is adequately dissection prior to inserting the final implants in using a “no-touch” technique to optimize sterility and reduce the risk of capsular contracture. The incisions are then closed with absorbable sutures and a surgical dressing is applied.

Recovery and Results

You will need to have someone drive you home on the day of surgery and stay with you for the first 24 hours after surgery. For patients who live more than 1-2 hours away, we may ask you to make accommodations to stay in town overnight the day of surgery. All patients are seen the day after surgery to ensure you are healing appropriately and that you are comfortable.

• Initial Downtime: Plan for around 2 days of rest. You will experience soreness, swelling, and possibly some minor bruising. Most patients describe it as just the skin and chest being very tight, more so than sharp discomfort. That tight sensation starts to lessen around 1 week when the breasts start to soften. Patients typically do not require any narcotic pain medications for this surgery.

• Activity restrictions and recovery period: Normal activities of daily living can be performed as soon as the day after surgery. We do not want you driving or operating machinery if you are taking narcotic pain medications. We ask that you not participate in strenuous activities of any kind for at least two weeks. After two weeks, we do allow you to start some light cardiovascular exercise if you wish (i.e. walking on treadmill), but we do not want you participating in activities that can affect the implant/pocket location as it is healing (sleeping on your chest, jumping jacks, running, etc). After 6 weeks, the pocket is generally stable enough for you to participate in any and all activities and you are released from restrictions at this point. You will wear a specialized surgical bra for several weeks to minimize swelling and support the implants while the pocket is maturing.

• Summary: Most patients are pleasantly surprised by how easy the recovery was and that they had very minimal discomfort.

Results

While you will notice an immediate size change, the final, soft, and natural shape will emerge as the swelling subsides and the skin adapts in response to the additional breast volume, which takes at least 3 months. The resulting scar lines will fade over time and often are almost imperceptible.