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Breast Augmentation in Los Angeles and Beverly Hills
Breast Augmentation with Any Implant Through Any Incision
Dr. Hughes can perform breast augmentation or breast enhancement with any available implant through any incision.
He performs breast augmentation through the belly button (transumbilical augmentation, TUBA). This approach allows breast augmentation to be performed without any scars on the breast. The scar is hidden inside the belly button. Dr. Hughes achieves fantastic results with this technique four or five times a day. Few people have the training to perform this type of breast augmentation, and that is the primary reason why many surgeons perform augmentation through other incisions.
BEFORE & AFTER GALLERY
Dr. Hughes can perform breast augmentation or breast enhancement with any available implant through any incision.
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Dr. Hughes also performs augmentation through the armpit (transaxillary)). This incision also allows for placement of implants without any scars placed on the breast. The scar is placed in the natural underarm crease, making it virtually undetectable.
He also performs breast enlargement through the most common incisions made under the areola (infraareolar) or in the fold of the breast (inframammary fold). Whatever you as the patient want, Dr. Hughes can deliver.
He performs breast augmentation both above the muscle (subglandular) and under the muscle (submuscular), and he offers saline and silicone implants in a broad array of types and profiles.
During the consultation, Dr. Hughes will discuss your unique anatomical details, and he will suggest an approach and an implant for you. If you are confused or undecided on breast augmentation, Dr. Hughes will make everything about your surgery clear and formulate a plan just for you.
If you have a particular way you would like your procedure performed, Dr. Hughes has done it for other patients.
IMF (inframammary) Incision
The inframammary incision is placed underneath the breast within the breast fold. This is the most common approach to breast augmentation, because it is technically the easiest method to perform. The incision is made, the inferior border of the pectoralis major muscle is identified, and the pocket is dissected. It may be necessary to use this incision for larger implants or gummy bear implants, which are more difficult to mold due to its higher molecular cohesion. Saline or silicone implants can be placed through this incision.
The periareolar incision is performed for women who may not have a well defined inframammary fold or who are not good candidates for the transumbilical or the transaxillary approaches. The incision can be made at the top of the areola or at the bottom of the areola. The areolar size must be large enough to allow placement. This may be a limiting factor in women with smaller areolae who want larger silicone or gummy bear implants.
The incision generally heals well as it is placed in a natural pigment transition zone. A property executed periareolar breast augmentation should have no impact on breast feeding or lactation as the ducts should not be disturbed. The plane of dissection runs parallel to the ducts and not perpendicular.
Sensation is always a concern with any form of breast augmentation. The incision may compromise small portion of the cutaneous sensitivity to the areaola and nipple. In addition, the rates of infection and capsular contracture may be higher for this approach due to the proximity to the bacteria present in and below the nipple areolar complex.
Once again, this all comes down to weighing the risks and benefits for each individual and Dr. Hughes is an expert at helping you understand all of these elements.
Transumbilical Breast Augmentation
This method involves making a hidden incision in the hood of the belly button (umbilicus). The great thing about this approach is the no one will know you had this done. Despite the naysayers, this technique allows for very precise pocket dissection. Most surgeons have never been trained nor have they performed this method and have no expertise or knowledge with regard to the procedure. Dr. Hughes offers all alternatives to breast augmentation so that each patient can have what each patient wants. This method has an extremely low rate of hematoma and infection. This method can be used for saline breast implants.
Transaxillary Breast Augmentation
This route involves making an incision in the armpit (axilla). From this point a tunnel is created underneath the pectoralis major muscle and the implant is inserted through this tunnel. This procedure can be performed bluntly or under direct or endoscopic visualization. Both saline and silicone implants can be placed through this method. The rates of infection and capsular contracture may be higher for this method due to bacterial translocation from incision.
- Article 1: The History of Breast Augmentation in the US
Article 2: The Evolution of Saline and Textured Implants
Article 3: Silicone Implants and Implant Controversies
Article 4: Evaluation of the Breast Augmentation Surgery Patient
Article 5: Determining Implant Size and Incisions in Breast Augmentation: Inframammary and Infraareolar
Article 6: Incisions and Approaches to Breast Augmentation: Transaxillary and Transumbilical
Article 7: Capsular Contracture in Breast Augmentation
Article 8: Complications of Breast Augmentation
Continue on to Dermal Matrices in Breast Augmentation Articles available:
Part I: Types of Dermal Matrices in Breast Augmentation
Part II: Dermal Matrices in Breast Augmentation
Part III: Complications of Dermal Matrices in Breast Augmentation
Part IV: Dermal Matrices in Breast Reconstruction
Part V: Dermal Matrices in Breast Augmentation Summary
OR View Other Scholarly Articles by Dr. Hughes Related to Breast Augmentation
Breast Augmentation with Implants and Variants
PREPARING FOR SURGERY
- STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, second hand smoke and cigarette replacements, such as nicotine patches or gum, in the perioperati ve period. While you should ideally stop smoking for 2 weeks before and after your surgical procedure, YOU MUST NOT SMOKE FOR A MINIMUM OF 24 HOURS BEFORE AND 24 HOURS AFTER SURGERY.
- TAKE MULTIVITAMINS: Start taking multivitamins twice daily to improve your general health once you have scheduled your surgery.
- TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice dai ly to promote healing.
- START TAKING AN IRON SUPPLEMENT: A good iron supplement, such as Feosol Spansules, is required starting one week before surgery and four weeks following surgery. Bowel movements may appear darker than usual as a result. Feosol is available without prescription.
- DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
- LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.
- FILL YOUR PRESCRIPTIONS: You will be given prescri ptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.
- CONFIRM SURGERY TIME: We wi ll call you to confinn the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at (310) 275-4170.
- PRESCRIPTIONS: Make sure that you have filled the prescriptions you were given and set the medications out to bring with you tomorrow. Make sure to have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery they wi ll have that infonnation readily available.
- CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase II I.
- EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
- SPECIAL INFORMATION: Do not eat or drink anything! Ifyou take a daily medication, you may take it with a sip of water in the early morning.
- ORAL HYGIENE: You may brush your teeth but do not swallow the water.
- CLEANS ING: Shower and wash the surg ical areas again with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase Ill.
- MAKE-UP: Please do not wear moisturizers, creams, lotions, or makeup.
- CLOTHING: Wear only comfortable, loose-fining clothing that does not go over your head. NO TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.
- CHECK IN/PREPARATION: Surgery Time:
- You should plan to arrive 45 minutes earlier than your scheduled surgery time. Patients less than 18 years old must be accompanied by a parent or legal guardian. When you arrive at our office on the day of your surgery, give the receptionist the phone number of the pharmacy you would like us to call for any spec ial medications Dr. Hughes and associates might prescribe.
- CARETAKER: Someone must spend the first night after surgery with you.
BREAST AUGMENTATION POST-OP INSTRUCTIONS
- The first week you will need to rest frequently. You need to walk around the house every 2 hours as tolerated. Avoid stairs if possible.
- For the first week post-op, sleep on your back with your head elevated.
- Avoid picking anything up greater than 5 lbs for 4 weeks.
- DO NOT EXERCISE FOR 4-6 WEEKS.
- You may not drive the first week or while you are taking pain medication. After that it will depend on your ability to handle a car without causing any discomfort. You should wear your seatbelt at all times.
- Do not engage in sexual activity at least 4-6 weeks after your surgery.
- No smoking. This will interfere with your healing.
- Eat light the first 24 hours, clear liquids advancing to a regular diet as tolerated.
- If you have persistent nausea stick to a bland diet until it subsides.
- Avoid foods that can cause a lot of gas. This can cause abdominal distention and undue discomfort. Small frequent meals are best.
- The pain medicine may cause constipation. Drink plenty of fluids. You may take any over the counter laxatives or stool softeners as needed.
- It is normal to have numbness over the surgical sites for several weeks or months.
- Do not use a heating pad or ice around the surgical sites. It could cause a burn.
- You may shower on postoperative day 2.
- It is normal to see dried bloody drainage on ABD pad.
- Do not remove surgical tape under breasts.
- Take your antibiotic until it is completed. Antibiotic should be taken with food at each dose.
- If the pain medication is a narcotic it should be taken as prescribed. Do not take any Tylenol while on pain medication. The medication we prescribe may already have Tylenol in it.
- Do not drink alcohol or drive a car while taking pain medication.
- The pain medication may cause nausea and should be taken with food at each dose.
- You may resume your regular medication after your surgery except for Vitamin E, Fish oil and Aspirin (wait at least 5 days post-op).
- If you take aspirin or coumadin check with the doctor to see when you may resume them.
CALL THE OFFICE IF YOU HAVE:
- A temperature greater than 101.5 degrees.
- Excessive bleeding from the incision.
- A sudden increase inn drainage, pain, or swelling around the incision site or the surrounding area.
- If you have persistent vomiting.