Breast Augmentation

Surgery of the breast is one of the few areas in which Dr. LeTard has chosen to specialize. Dr. LeTard combines his experience with the most recent techniques to offer his patients the very best individualized care possible. Just as every woman's breasts are unique, their breast surgery needs to be individualized specifically for them. Dr. LeTard spends and extensive amount of time with each patient planning their surgery. This individualized approach includes determining the size of the breast implants, the location of the incisions (through the armpit, around the nipple, or under the breast), the shape of the implant, and the location of the implant (under or over the pectoralis muscle). It is this type of personalized attention that allows Dr. LeTard to help achieve the optimum result for each patient.

Dr. LeTard has a long history of commitment and dedication to breast augmentation. He is fluent with the use of a variety of breast implant types and shapes. In addition, Dr. LeTard is also adamant about proving that saline implants are safe. During a patient's consultation, Dr. LeTard discusses different options of breast augmentation and determines an approach which will offer them the best results. Dr. LeTard's philosophy is to learn what his patients whish to achieve, educate them about breast implants and what is possible, and then use the varied techniques in his repertoire to accomplish this.

For women considering breast augmentation, an important early step is to become educated about the procedure. There are many areas of importance which Dr. LeTard wants his patients to be well acquainted with.

Your individual needs can be assessed and discussed further with Dr. LeTard through a no charge consultation. A careful analysis of each patient's unique needs is an important step in breast augmentation.

Selection of Implant Size

Determining the appropriate implant size is one of the critically important steps in breast augmentation. An implant that is too small or too large produces an unsatisfactory result. Dr. LeTard believes that the best and most natural results are achieved by selecting an implant that is proportional to a woman's anatomic features. During each consultation, Dr. LeTard devotes much time to this process and together with his patients finds an appropriately sized implant to help them achieve their desired results.

Location of Incision

There are several places where an incision can be placed for breast augmentation: in the axilla (armpit), under the areolas, or under the breasts. While Dr. LeTard is fluent in the use of all of these approaches his preference is to insert implants through the areola. His reason for this approach is that after the scar heals, it fades so it is not as noticeable.

Location of implant placement

Breast implants can be placed either under the breast tissue and over the pectoralis muscle or under both the breast tissue and the pectoralis muscle. The vast majority of patients who undergo breast augmentation today have implants placed above the muscle. The reasons for this include a more natural shape. The natural breast is on top of muscle. There are some patients with little tissue. In that case, they need to go under the muscle and there are some patients that want the implant under the muscle. Dr. LeTard goes over all your options.

If you would like more information about Breast Implants and would like a personal consultation from Dr. LeTard, please call our office at 865.693.4150

Recovery

Recovery from breast augmentation, as with any surgery, is a gradual process. Some patients recover more quickly while others may be a bit slower. In general, the recovery following the procedures is not difficult. The typical patient will experience some pain and discomfort and use pain medication for 2 to 3 days following surgery. Depending upon the patient's occupation, most patients will return to work 3 to 4 days after surgery. After 1 to 2 weeks patients can resume non-impact lower body exercise. Four weeks after surgery they can resume impact exercises and 6 weeks following surgery they can resume upper body exercise.

Results

While patients will of course see results immediately after surgery, there is always swelling that develops. During the first week after surgery, the breast and surrounding area are swollen and the implants appear high. Over the course of several weeks the swelling subsides and the tissues stretch to accommodate the implant creating a more natural apperance.

Complications

As with any surgery, complications can develop following breast augmentation. Forunately complications are unusual. Some of the complication which can occur following augmentation are: bleeding; infection; capsular contracture; and deflation. Dr. LeTard will discuss these with you in detail.

Follow Up

In order to ensure each patients' care and well being, Dr. LeTard sees his patients frequently in the postoperative period and continues to follow their progress for an extended period following a breast augmentation procedure. Should a question or concert arise, please call our Plastic Surgery Consultants office at any time.

Breast Implant Exchange and Breast Implant Revision

Breast Augmentation is the second most popular plastic surgery procedure. According to the American Society of Aesthetic Plastic Surgeons, over 360,000 are performed annually. Much of this popularity is due to the high satisfaction women have with the results. Surveys find the satisfaction among women with breast implants to exceed 90%. Some women, while pleased with their augmentation elect, for various reasons, to exchange their implants.

One out of eight women with breast implants will have more than one surgery on her breasts. Over time a woman's breasts change and her aesthetic taste may vary as well. Many women who have an implant exchange do so because they want larger implants. In fact, 34% of secondary breast implant procedures were specifically to increase size. Another increasingly common reason for breast implant exchanges is to replace gel implants with saline implants. There are actually many reasons why a woman may undergo a breast implant exchange or revision breast surgery. Aside from a change in size, these include treating an implant deflation (for saline breast implants), treating an implant rupture (for silicone breast implants), capsular contracture, improving implant position, and breast shape as well as reducing rippling.

Changing Breast Implant Size

As mentioned, this is among the most common reasons women choose to have a breast implant exchange. Over the course of a woman's life her breasts change and there are times when she may wish for fuller, or smaller, implants. While most women elect to have larger implants, there are also women who choose smaller implants as well (though much less frequent). In most cases, the surgery to change the size of the breast implants is more straight forward and easier to recover from than the initial surgery. The reason for this is that the pocket (the space around the breast implant ) is already created. For exchanges to larger implants, the pocket may be expanded. It unusual, but for exchanges to smaller breast implants, the pocket may need to be partially closed. In either case, it is usually less painful and easier to recover from than the original breast augmentation.

Breast Implant Deflation

Saline breast implants can leak. When this occurs, the saline slowly leaks out and the implant deflates. Because saline is the bodies natural fluid, this does not pose a health risk. However, the affected breast will get smaller as the fluid is absorbed. The treatment for this is to replace the implant. It is quite helpful for this reason for women to keep records regarding their breast augmentation. Specifically, they should receive a card at the time of surgery which states the make, model, and size of the implants. Treatment involves removing the ruptured implant and replacing it with a new one. The opposite breast does not require treatment unless the implants have been in for a considerable amount of time, in which case it may be prudent to exchange that implant as well, or if the patient wishes to change size.

Breast Implant Rupture

Silicone implants differ from saline in that if they leak or rupture the body does not absorb all of the silicone the way saline is absorbed. Rather it generally remains in place. Some feel that the rupture can contribute to problems local to the breast such as capsular contracture. The general view is that when there is a known, or suspected, gel implant rupture, the treatment of choice is to remove the ruptured gel breast implant and replace it with a saline implant.

Capsular Contracture

Capsular contracture leads to a hardening of the breast after augmentation. There is always a scar tissue capsule that forms around an implant. It is the body's response to a foreign object. While this capsule typically remains soft, it can contract causing the breast to feel firm. When this occurs, it may result in one or both breasts becoming only slightly hard. Alternatively, it can cause the breast to become very hard and visibly distorted. If there is only a slight hardening of the breast, treatment may be observation. When the breast is very hard, re-operation is considered. Capsular contracture is a frustrating condition for both patient and surgeon. There is no definitive understanding of why this occurs nor can it be predicted to whom this will occur. It occurs less often in the submuscular position. For this reason, when it occurs in a patient with subglandular implants, Dr. LeTard will often recommend treating the scar tissue and moving the implants to a submuscular pocket. When a patient with submuscular implants develops capsular contracture, Dr. LeTard will usually treat this by releasing the scar tissue (a procedure called capsulotomy) and/or removing scar tissue (a procedure called capsulectomy).

We offer the following different breast surgeries:

Breast Augmentation - Breast augmentation can enhance your appearance and your self-confidence. Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a woman's breasts are fully developed prior to placement of breast implants. Saline implants are FDA approved for augmentation in women 18 years of age and older. Silicone implants are FDA approved for augmentation in women age 22 and older. Click to view images.

Periareolar Lift - A periareolar breast lift is a cosmetic surgical procedure that enhances the appearance of a female's breasts. A periareolar breast lift, is performed on women who have experienced breast sagging as a result of pregnancy, breastfeeding, aging, and gravity. A periareolar breast lift procedure refers to a special technique used in mastopexy surgery that has less scarring than other breast lift procedures.  This procedure may be performed with or without implants.   Click to view images.

Breast Lift - As women age, their breasts may sag somewhat. This can be exacerbated by pregnancy or nursing. In these situations, many women enjoy beneficial results from a breast lift or "mastopexy." In this procedure, the skin of the breast is tightened to return the breast to a more youthful shape, firmness, and position. Sometimes an implant is placed as part of the procedure to increase breast volume. Peri Areolar Lift Dr. LeTard specializes in this unique procedure. The incisions are made around the nipple to lift the breast. Dr. LeTard performs this surgery with an implant or with out. His technique leaves minimal scarring. Short Scar Mastopexy In Dr. LeTard's short scar mastopexy, the incisions are made around the nipple and extend down to the underside of the breast. This is for the patient that needs a little more lift than a peri areolar lift. Full Mastopexy In Dr. LeTard's full mastopexy, the incision is made around the areolar and down to the underside of the breasts and under the breast. This procedure is for women who have a lot of loose skin due to weight loss or pregnancy. There are a lot of options in breast lift surgery, and Dr. LeTard will work with you to choose the right approach that will create the best results. During your consultation, Dr. LeTard will discuss recommendations for the type of incision to use and the possible benefits of including an implant as part of the procedure. The procedure is performed in our AAA certified surgery suite. Medication is administered by our ACLS certified CNA/RN to minimize discomfort during the procedure. Most patients have very little pain following the surgery as well because long acting local anesthetic as administered as part of the procedure. Most patients return to work about a week after surgery or sooner if there is no lifting. There may be some bruising for a week or so and some swelling for a few weeks following surgery. Click to view images.

Breast Reduction - Women with large, pendulous breasts may be unhappy with their appearance and experience a variety of problems caused by the excessive weight. Breast reduction is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body. Breast reduction can be performed for cosmetic improvement or relief of physical symptoms. Many women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort. Click to view images. Dr. LeTard specializes in a variety of breast reduction techniques. Dr. LeTard specializes in a variety of breast reduction techniques. Dr. LeTard tailors the procedure to the particular patient's body type and needs. The Surgery Techniques for breast reduction vary, but the traditional procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. He then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. Occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars. After your Surgery After, surgery, you'll be wrapped in an elastic bandage or a surgical bra over gauze dressings. You may feel some pain for the first couple of days-especially when you move around or cough-and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain. The bandages will be removed two days after surgery, though you'll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your stitches will be removed in one week. If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. Getting back to Normal Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for two weeks. Dr. LeTard will give you detailed instructions for resuming your normal activities. Most women can return to work (if it's not too strenuous) and social activities in about two weeks. But you'll have much less stamina for several weeks, and should limit your exercised to stretching, bending, and swimming until your energy level returns. You'll also need a good athletic bra for support. You may be instructed to avoid sex for a week or more, since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for about six weeks. A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, please don't hesitate to call your doctor. Your New Look Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. Dr. LeTard will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops. Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You'll be rid of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better. However, as much as you may have desired these changes, you'll need time to adjust to your new image-as will your family and friends. Be patient with yourself, and with them. Keep in mind why you had this surgery, and chances are that, like most women, you'll be pleased with the results.