Breast Augmentation In Honolulu, HI

What is a Breast Augmentation?

Breast Augmentation is a surgical procedure that improves the size and shape of a woman’s breasts. It is the most popular cosmetic surgery procedure done in the United States, with over 100,000 procedures performed every year. Breast augmentation is just as popular in Hawaii as it is on the Mainland! The surgery is sometimes done in conjunction with a breast lift to achieve the best results.

There are several decisions that patients must make before having breast augmentation. The following is a list of breast augmentation decisions:

• Manufacturer – There are three breast implants available in the United States: Allergan, Mentor, and Sientra. All three are FDA approved. Sientra is a Brazilian company, and plastic surgeons and their patients have learned, when something goes wrong with a product made by a foreign company, they are not there to help the patient.
• Implant Filler – The outside of all breast implants is a silicone shell. The insides are either saline or silicone. During the implant controversy of 1991, we were unable to use silicone implants for over 15 years. During that time, we used saline implants and discovered there were many problems associated with saline: 1) they tend to ripple; 2) they have a valve, and anything you fill during surgery has the potential to leak, and 3) they have a different feel both to the person wearing them and the person touching them. All in all, Dr. Schlesinger does not like saline implants and typically won’t recommend them to his Hawaii breast augmentation patients. Silicone breast implants are softer to the touch and when the patient lies on her stomach, it does not feel like one is lying on two water balloons. While all implants have the potential to ripple, silicone breast implants ripple less, and since Allergan has a thicker shell, it also has less propensity to ripple. Silicone implants, because they have no valve, can last forever, and because the new silicone filler is no longer liquid but semi-solid, the danger of leakage from breast implant damage has been pretty much eliminated.
• Covering of Implants – There are two types of breast implant coverings: textured and smooth (kind of sounds like Skippy peanut butter, doesn’t it?). Textured implants were invented in 1991 by both Allergan and Mentor. Each manufacturer has a different style of texturing; the theory behind textured implants was that the body would form a scar around each little bump, the scars would not line up and it would keep the implants from getting hard. This, unfortunately, has not proven to be true. Textured implants a) lead to significant rippling on the skin; and b) very often go hard as a rock. Therefore, Dr. Schlesinger is a big fan of smooth implants and they are what all of his Hawaii breast augmentation patients should receive.
• Shape – There are two shapes of implants: teardrop (aka anatomic), and round. Teardrop implants, on the face of it, would be fantastic if they would only stay in place. Unfortunately, they tend to rotate, and no one has ever thanked me for a diagonal breast. All teardrop implants have a textured covering; therefore they not only rotate but also go hard. Round implants become teardrop when they are partially under the pectoralis muscle. The muscle pushes on the upper 2/3s of the implant and the lower 1/3 which is not covered by the muscle bulges; therefore, on profile, they look like a teardrop or anatomically shaped implant and because they are round, no matter how they turn, they are always teardrop. Therefore, Dr. Schlesinger prefers to use round implants.
• Route of Entry – There are five basic routes of entry to place the implant into the breast: 1) through the belly button; 2) an incision below the breast; 3) an incision below the nipple; 4) around the inferior aspect of the areola; and 5) through the armpit. Each route of entry has its pluses and minuses, but Dr. Schlesinger feels that breast augmentations through the armpit give the surgeon the greatest ability to make the position of the implant totally appropriate for the patient while at the same time leaving little to no scar. He has done over 3,000 breast augmentations through the armpit using an endoscopic technique. Although Dr. Schelsinger has tried all other techniques, he has found the armpit to be the most effective route of entry for our Oahu breast augmentation patients.
• Implant Positioning – Breast implants can be placed above or below the pectoralis muscle, and at times partly above, and partly below. Each patient has a different requirement; however, implants below the muscle are always preferred because the implants stay softer, the patient gets a better mammogram, partially subpectoral silicone implants appear to be teardrop and there is less chance of rippling even in most slender women.
• Types of round implants – There are three types of round implants; the difference between the three is base width versus projection.
  • moderate implants are very wide with minimal projection
  • moderate plus implants are in between
  • high profile implants have a narrow base and the greatest projection.

  Dr. Schlesinger prefers the high-profile implant because, once they settle, they give the most breast-like appearance in profile.

• Cup sizes – This is possibly the most difficult category to discuss with Dr. Schlesinger’s Hawaii breast augmentation patients because, unfortunately, there is no standardization in the bra community. Cup sizes A, B, C, and D or D+ tend to have very little meaning today because, at one store, a B is a B and in another store, a B is a C. With this in mind, a patient seeking breast augmentation should go with the visual appearance of an implant in her bra and not worry significantly about which letter is associated with it since one can get a different letter at a different store.

Above are some of the most important decisions the pre-operative breast augmentation patient must make. It is the surgeon’s obligation to point these out to the patient, discuss them at length, give the pros and cons and allow the patient to make an informed decision.

What are the benefits of a Breast Augmentation?

Our Breast Augmentation patients in Hawaii have seen and been able to enjoy the following benefits from their surgery:

• Adjusts the size and shape of your breasts
• Clothing fits better and options are increased
• Corrects uneven breasts (Asymmetry)
• Enhances your appearance and overall silhouette
• Improves your self-confidence

What to expect on the day of Breast Augmentation

On the day of your Breast augmentation, our nurses will make sure you feel fully comfortable, which will include administering general anesthesia, allowing you to sleep throughout your operation. Dr. Schlesinger will then make the appropriate incisions based on what was discussed and insert your implant. Once safely and properly inserted, he will use stitches to close the incisions, and may also tape over them for greater support. A gauze bandage may be applied over your breasts to help with healing.

You can expect the entire surgery to take approximately one to two hours to complete.

Breast Augmentation Recovery

After your surgery, you will be able to return home to recover in a familiar and comfortable environment. You can expect to feel tired and sore for a few days following your surgery, but you’ll be able to start moving around within 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by Dr. Schlesinger, but you can also use ice packs to alleviate any pain or discomfort. There may also be a slight burning sensation in your nipples for about two weeks, but this will subside as the bruising fades.

Within several days, Dr. Schlesinger will remove any gauze dressings and you may be instructed to wear a surgical bra, which should be worn as directed. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear. Breast augmentation recovery can take time, but you should be able to return to work within a few days, depending on the level of activity required for your job.

We encourage you to follow Dr. Schlesinger’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, after which, breast contact is fine as long as your breasts are no longer sore, which usually takes about three to four weeks after surgery. Your scars will be firm and pink for at least six weeks, and in some cases, may remain the same size for several months, or even appear to widen, before eventually fading after a few months.

You should continue with routine mammograms if you are in the appropriate age group, but your mammographic technician will need to perform a special technique to ensure a reliable reading. Routine mammograms can help detect and address any complications early if they occur, and can thus be treated. If you have any questions about your mammograms, please discuss them during your consultation.