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Breast Augmentation In Richmond,Va
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What Is Breast Augmentation?
An Overview By Richmond Breast Augmentation Expert Dr. Lynam
Silicone implants come in also various, we call levels of cohesiveness, so those implants can be very firm and that’s known as a gummy bear implant or they can come very fluid and that’s more of a standard implant. I prefer one that’s in between which we call a soft touch. So it has the benefits of being a little bit firmer but it’s still very, very natural and it’s very soft. And so that’s really a newer … in fact, that is the newest cohesive level of implant sold by one of the manufacturers that I use.
The saline implants, again, I like them, I use them very often. They have the benefit that when they pop, they just deflate so it’s pretty simple. There’s no test, there’s no MRIs, there’s no studies. And the implants that I use are smooth and round and a newer implant that’s also on the market that is smooth and round is called the Ideal Implant. And again, they named it the Ideal Implant. It was created by a plastic surgeon because they wanted something that was very similar to silicone and how it felt and how it was shaped but was made with saline so when it did pop, it just would dissolve in the body and it would be very natural and you would have no problems. And that’s a very nice implant. I’m using more and more of them. And those are the general implants that we have on the market in the United States today.
Breast augmentation is the most common cosmetic surgical procedure in the United States. The most frequent reasons women choose to undergo breast enlargement include the following:
- Improved self-esteem
- Improved breast shape and symmetry
- Improved balance and total body proportions
- Improved breast contour
- Increased size
- Restored shape and size following pregnancy
What To Expect During Your Initial Consultation
But you’re going to do some online research. We know that. When you come into the office, you’re likely going to have some pictures. And if you don’t, I do think pictures are a great thing to have because if you can find someone who you like their result, and your body is very similar to that person in the picture, then that’s going to help me.
Sometimes people come in and say, “This is a picture, this is the implant, this is the incision,” and they really have done a lot of homework. And it makes my job easy because they’re able to just show me what they want and explain what they want because one person says, “I want to look just average. I want to be kind of an average augmentation, or I just want to be a full C cup. That’s what I want.” But it’s different for every person, so having some images that you really like that is a body type similar to yours really helps me.
What we’re really gonna try to do in the consultation is measure you, examine you and really try to listen to you to find out what you want because everybody wants a little something different. And if I’m a good listener, I’m going to be able to take that information that you give me and with the pictures you’ve shown me and be able to help you select the implant that best suits your needs.
Am I Good Candidate For Breast Augmentation?
During your on-site consultation with Dr. Lynam, your goals, the breast enlargement (breast augmentation) procedure, and the routine post-operative healing process will be explained in detail.
Furthermore, all of your questions will be answered. You will also be sized with different implants until you find the desired size that is a right fit for you. Your medical history will also be reviewed to ensure you are a healthy candidate for surgery.
Breast Augmentation Video Testimonial
Frequently Asked Questions?
So we use these, what we call bio-dimensional profile of each individual to determine what implant best suits their frame. And once we have those measurements taken, what we do is we look at the implants that we have available, whether they’re silicone or saline. Implants come in, we call it, different profiles. So they have different widths and different amounts of projection. So, we can choose something that’s kind of more like a pancake or very flat, and that’s okay for somebody who wants a very, very small breast. Or we can choose something that’s more like a beach ball, that really sticks out and has a lot of prominence. And for some people, that’s exactly what they want. So by choosing the proper profile to what the patient’s desires are, we really can meet everyone’s individual needs.
When we talk about who is a great candidate for silicone implants, those are usually candidates who have a very thin amount of soft tissue. Again, most all the implants placed in my office are placed below the muscle, we call subpectoral breast augmentation. Occasionally, we do put them above the muscle for very specific indications, very specific reasons, such as a bodybuilder, someone who competes in the athletic bodybuilding competition. They can’t have that implant under the muscle.
The second is what we call the periareolar, which is on the lower typically edge of the pigmented nipple areola skin junction. It’s usually a crescent smiley face incision and that heals very well too.
The third which is one that I really like, I think its great, is called the trans axillary or the armpit incision. And it’s again about one and a half inch incision in the armpit and use a special camera system to make a pocket under lighted magnification. The benefit of that in my hands are that we use a camera system, a bright light and everything is magnified and we use very precise instruments and can create a very nice pocket in a very nice position to implant with no visible scar on the breast.
Some of the concerns about each individual scar are really as follows. The periareolar scar has the highest rate of losing nipple sensation and it has a higher rate of what we call capsular contraction, which is the hardness or firmness of the implant which you really don’t want. Periareolar has a highest risk of that and for that reason it’s low on my list of selected incisions.
The inframammary or the breast fold really is the go to for larger silicone implants or patients that have complex anatomy because it really gives you the best visualization of the pocket and lets you really manipulate the tissue the most. So it’s really the gold standard.
The trans axillary or armpit is not offered by a lot of surgeons because the equipment is more technologically advanced, it’s fairly expensive and it is a more, really a more difficult procedure to perform so most surgeons don’t learn it and don’t offer it. It is something that I’ve done for literally almost 20 years now, so it’s something that when somebody comes to my office and says, “Oh, everyone in town says you can’t have a trans axillary incision.” It’s really because the doctor doesn’t know how to do it, but it really is an excellent, superb procedure for the right patient.
So we can go above the muscle. The key elements are you have to have enough soft tissue to cover the implant, because if you don’t, you’re going to see the edges, and you’re going to see rippling and wrinkling. It’s really a fallacy for some women who come in and say, “I read online that I might not need a breast lift if you just put the implant above my muscle.” I think that’s a fallacy, I don’t think that’s a real procedure, and I think it really is doing something inappropriate for the patient, because as soon as you load that soft tissue with an implant, which is more weight, it’s just going to stretch that skin, and it’s going to, what we call bottom out, where you’re going to have a very bottom heavy breast, it’s going to be a poor shape.
And we know factually, that whether it’s subglandular, or now, some people try to say, you can put an implant subfascial, really, really hard to do, not a very good operation, and it still has the same problems, and for many patients that much, much, much higher rate of capsular contracture. And if you have a really hard, painful, misshapen breast, you’re going to need a revision, and I always tell people, you’d rather do it right the first time, then to have to come back and try to fix something a second, or third, or fourth time.
Breast augmentation is a very safe procedure that is completed using saline or silicone implants to enlarge and enhance your breasts.
Silicone Implants – Pros and Cons
Richmond Silicone Implants By Dr. Lynam
Again, most all the implants placed in my office are placed below the muscle. We call subpectoral breast augmentation. Occasionally, we do put them above the muscle for very specific indications, very specific reasons, such as a bodybuilder, someone who competes in the athletic bodybuilding competition. They can’t have that implant under the muscle because their pectoralis muscles need to be activated and very big and large, and when they flex, the implant would shift too much. But your average workout girl can certainly have implants under the muscle, which is what I generally prefer. The reason we prefer that is it does add some padding. It’s going to add about a centimeter and a centimeter and half a thickness. It also blends the edges of the implants in, so it’s a more natural look.
The other benefit is it also holds the implant against the chest wall, so the implant has some support. If the implant is literally just under your skin, it’s going to really feel the effects of gravity quickly and end up maybe looking like a rock in a sock. Of course, that’s not what you want for your breast augmentation. So silicone implants are a little bit lighter than saline implants. The benefit, they have much less rippling and wrinkling than most saline implants. And for women who don’t have a lot of soft tissue coverage, they really feel and look more natural.
Having an augmentation does not affect your ability to breastfeed in the future. Most patients do not have permanent loss of nipple sensation or loss of breast sensation following surgery.
Dr. Lynam offers minimally-invasive breast augmentation, using a transaxillary (armpit) incision and a small camera called an endoscope for improved visibility.
Implant Options – Which is best for you?
1) Saline Implants:
The saline implant has an excellent track record and often has the lowest reported rate of capsular contraction. Dr. Lynam prefers smooth, round, saline implants.
One benefit of saline implants is that when they eventually rupture, the sterile salt water leaks out and you know when to replace the implant without the need for an MRI. Saline implants cost less than silicone implants and can feel just as natural as any other implant.
The often-discussed rippling or wrinkling of saline implants can be decreased with proper implant selection but is more common than with silicone implants.
Find more information on saline breast implants here: https://www.breastimplantsbymentor.com/breast-implants/saline
2) Silicone Implants:
Silicone implants were the first breast implants developed and used. Currently the newer cohesive gels (Gummy Bear Implants) and improved outer shell technology make silicone implants the number one implant used worldwide.
Dr. Lynam prefers smooth, round implants.Dr. Lynam is well-versed in all the variations of silicone implants and will recommend what is best for your particular body and soft tissue envelope.
Silicone implants are lighter and softer than saline implants and have less tendency to wrinkle. The FDA recommends a breast implant MRI intermittently to determine implant integrity. Ultrasound is a newer less expensive option to determine implant rupture.
Find more information on silicone implants here: https://www.natrelle.com/augmentation
3) The Ideal Implant®
Structured Breast Implant is a new type of implant designed by a plastic surgeon. It combines a natural feel with the safety of only saline inside, for peace of mind. With IDEAL IMPLANT, you can look in the mirror and be confident your implants are intact.
The Ideal Implant has some of the lowest reported rupture rates of all breast implants, which makes it an excellent choice for those concerned about silicone gel leakage.
Find more information about Ideal Implants here: https://idealimplant.com/
Why To Choose Dr. Lynam For
My practice is called Richmond Surgical Arts. Again, a little bit about my background. I went to dental school, and part of dentistry is very artistic. It’s sculpting. It’s manipulating materials. It’s having an eye for colors and shades. So I really think of myself as an artist.
When I switched professions and ended up in plastic surgery, it’s really ideal because we’re sculpting it and manipulating all areas of the body. And I really love the fact that I can manipulate tissue and manipulate patient’s appearance and do so with a very artistic eye. It really is something that really makes me happy every day.
And sometimes the chest wall itself is slanted or crooked, and that’s because some people have scoliosis. Some people, I joke, just have a big heart and their left side of the chest is just pushed out a little bit more. So there’s so many things that we can look at, and I measure it and evaluate. And what that means is that I’m going to adjust things as I see fit, to try to improve your symmetry. And that means that we sometimes don’t use the same implants. Sometimes we’ll use a 325 on one side, and a 350 on the other side. Sometimes if we’re using a saline implant, we’ll have a fill of 350 on one, and 365 on the other. And we’ll manipulate those volumes, and sometimes implants, to help improve your symmetry.
And I think that’s really a key important thing because some docs just say, “Hey, we’re throwing in 350s,” and you get one on each side. And the problem with that is that breast augmentation will magnify a breast asymmetry. So I’d like to try to improve it from the start, not try to explain something later to a patient, “Oh, oh, we should have done this, we should have done that,” because really, you have one chance to do it right. So let’s plan accordingly.
Breast Augmentation – Day Of Surgery
Breast Aug – What To Expect On Your Day Of Surgery –
Richmond’s Favorite Plastic Surgeon Dr. Lynam
Most of our patients, we’ve had them clean their skin the night before surgery and then the morning of the surgery with a special cleaning compound that we talk about in our preoperative visit. You can anticipate to have your driver, who’s going to drive you to the surgery center, be there about three hours for a breast augmentation. The surgery center typically gets you there about an hour before your surgery time. Then I’ll come and mark you right before surgery, draw some blue lines on you. Your surgery generally takes about one hour for breast augmentation. Then you’ll head to the the recovery room. They’ll give you a Popsicle, something cool to drink, monitor your vital signs. After about an hour, you’ll go home.
We believe that by maintaining a large pocket surrounding your breast implants, you can lower the risk of capsular contraction. These exercises will become part of your daily routine. Vigorous exercise routines may resume 4-6 weeks following your breast augmentation. You may return to work in one week.
The best way to determine if you are a good candidate for the procedure is to schedule a free consultation at our office. Here, you will learn the reasonable expectations for the goals you wish to achieve.
Recovery After Breast Augmentation Surgery
Breast Augmentation Recovery – What To Expect – Richmond Plastic Surgeon Dr. Lynam
So the first day after surgery, you’re going to be wrapped up in a big what we call double ACE wrap. It’ll be tight, it’ll be sore, and you’ll remove that after 24 hours. You’ll look in the mirror and your implants are usually high and tight. Why? Because we put them under your breast muscle, the pectoralis major muscles. So the implant is under your muscle and that muscle is going to spasm. It’s kind of be like a Charley horse, so it’s pretty sore. Occasionally, there are some people where implants are perfect the next day, but that’s far and few in between. So the first day muscles are sore. It’s a squeezing sensation, kind of like you’ve been to the gym and did a hundred extra pushups when you usually do one pushup, so it’s pretty sore.
The next really big area I would say is a week. The next week you’re going to get better every day. Every day gets a little better, a little easier. Most people stop their pain medications within three or four days. We’re really utilizing an approach to try to decrease the amount of narcotics people use, and so we have some special medications that we use to help minimize narcotic usage and that decreases… Actually, it improves your speeds to recovery, decreases kind of the feeling lethargic and tired because some of those medications just don’t make you feel good. So after about a week, you’re back driving a car probably three or four days. In a week, you’re probably able to walk on a treadmill. You might be walking around your neighborhood, but that’s really all you should be doing at a week.
At a month, you’re really able to do much, much more. You’re probably doing a stair climber, cycling, running. You’ll be wearing a sports bra to help keep those breast implants in position and not really bounce up and down because that still might be a little sore. In a month, you’re really doing most normal activities with the exception of pushups, pull ups or bench pressing. We don’t want you to really activate those pectoralis muscles for about two months. The reason is they’re pretty strong and they can push the implant to an unfavorable position, which you don’t want. You don’t want your implant to pop out the bottom. You don’t want it to pop out the side. So after about two months, you can get back to the gym and start doing more vigorous chest muscle exercises.
When Can I Start Working Out Again After Breast Augmentation?
The third week, yeah, you’re probably on a bicycle, you’re on a treadmill, and you’re doing a moderate amount of exercise. The key is if it hurts, don’t do it. The fourth stage I really tell people is think of this, you’re really only healed 10% a month. So one month, you’re 10% healed. At four months, you’re 40% healed. You can probably do anything you want. But during that time frame, from one month to four month, you really have to be careful. And depending upon the surgery we’ve done, you just have to limit the exercise that activates that muscle.
For breast augmentation, you can’t use your pecs for really at least two months. For a tummy tuck, same thing, can’t really use the abdominal muscles for two months. You really want to let those muscles heal before you overdo it and cause some problems that you would regret.
Care & More About
When it comes to incisions, I mean, the closure of the incision is not something I take lightly. We do it very precisely. All of your sutures are tucked underneath the skin. In fact, we actually use three to four layers of sutures. So there’s not just one layer, but they’re all underneath the skin. We usually have some special material placed over your incision line, it’s an antibacterial product. You’ll remove that after 24 hours, and then we actually start you on typically a silicone scar gel, which helps improve the quality of your scar in the long run.
All implants fail eventually, so all implants need to be replaced eventually. So if you’ve had your implants for three years or seven years or 10 years, we know they start to fail. And so it might be something you now say, “Okay, this information’s out there. I’ve had my implants for 10 years and I want to replace them.” And this can be a very straightforward, simple process. We can replace same size, a little bigger. We can do some other things that if you want them done at the same time. Maybe a little lift if you now feel you need a little bit of a lift. But it can be done safely, effectively, and in a controlled manner. And we don’t want anyone to panic. But it is something that if you have these textured implants, you may be considering replacing them at this point in time.
And then we’re going to talk about other ways to place the implant. I am a huge fan of a device called the Keller Funnel. It was developed by Dr. Keller, plastic surgeon, and it’s basically a sterilized single use, slippery… It’s a slip-and-slide for breast implants. You put it in the big end, like a cake icing bag, you put the small end in, squirt it in, so no one touches your implant, the implant has no trauma to it, it doesn’t… It just slides right in. And there are several studies that are good studies showing a decreased risk of capsule contracture with the Keller Funnel.
The other thing is what we irrigate, or what we wash out your breast pocket with, prior to implant insertion. There’s several different formulas. There’s some really new exciting materials that I’m working with that are very safe, and I’m really excited to tell people that caps contracture can really be decreased by using appropriate surgical technique, appropriate implant placement, and then washing the pocket out with specific materials that we know are super safe and work fantastic.