Dr. Gary Motykie is an experienced plastic surgeon providing innovative and advanced cosmetic surgery treatments for patients in Los Angeles, Beverly Hills, and surrounding communities. He is board certified by the American Board of Plastic Surgery. He is the recipient of the Physician’s Recognition Award 2009 from the American Medical Association.
Dr. Motykie has also been included in the list of “America’s Top Plastic Surgeons” for the last 7 consecutive years from 2006 to 2013 by the Consumer Research Council of America. He is an experienced cosmetic surgeon in LA for procedures of the body, breast and face, such as tummy tuck, breast implants, and facelift.
Breast augmentation is an effective way to enhance breast size in case a woman is unhappy with the size of her breasts. Smaller breasts may occur due to genetic factors, or in some cases a woman may lose breast volume following a pregnancy, breastfeeding, or major weight loss. In all such cases, placement of artificial implants underneath the breast tissue can enhance the size of breasts as desired.
How is it performed?
Breast implant procedure is performed usually under general anesthesia. The procedure begins with the surgeon making an incision at a pre-determined location, which could be the breast fold, the belly button, the armpit, or the areola. Through the incision, the surgeon will place the silicone or saline breast implant. The placement can be done under the chest muscle or below the breast tissue.
The choice of implant, the location of the incision and the placement of implant will be decided prior to the surgery during a consultation between the patient and the surgeon. A surgeon who is experienced in breast implant plastic surgery will be able to create the most appropriate treatment plan to match the needs of the patient.
FDA has approved two types of breast implants, which include silicone gel based implants and saline solution based implants. The outer shell for both types of implants is made of silicone elastomer, which is a highly biocompatible material. Choice between silicone and saline implants can be made by the patient.
A surgeon will usually be able to provide both saline and silicone implant options. However, some surgeons may have a preference for either silicone or saline implants, based on their personal experience. In reality, both silicone and saline implants have their own perceived advantages and disadvantages. Both implant types are accepted widely among breast augmentation patients.
The patient should be candid during pre-op consultations and explain her needs and aspirations about breast implants to the surgeon very clearly. This will help the plastic surgeon to recommend the most appropriate implant type and size. The surgeon will also evaluate the patient’s medical condition, family history, and anatomical features to give appropriate advice.
Discreet photographs will be taken during the pre-op visit to maintain a medical record, and will also be helpful at the time of surgery. The pre-op breast exam will include evaluation of the nipple position and breast mound, shape of the chest wall and assessment of any breast disproportion.
Breast Implant Placement
The breast implant pocket can be placed in three ways:
- Above the chest muscle and below the breast mound
- Below the chest muscle
- Partly below the chest muscle and partly below the breast mound
Different surgeons may have different opinions regarding the ideal placement of implant pocket. However, any preference among these methods has not been determined scientifically till date. In some cases, the patient’s breast anatomy may prompt the cosmetic surgeon to decide on a particular placement method.
Location of the incision for breast enhancement plastic surgery may be chose by the surgeons as per their expertise and past experience with a particular implant placement approach. The incision is usually about an inch in length, but it may be slightly longer in case of silicone implants. Common locations for the incision include the following:
- Under the armpit
- Below the areola
- Within the breast fold
- Through the belly button
In each of these cases, the goal is to place the implants with minimum difficulty and achieving inconspicuous scarring.
Once the incision has been made in the pre-decided location, a breast pocket is created in the targeted position. This is followed by the insertion of an implant sizer in the pocket, which is positioned behind the nipple. The goal is to minimize the tissue invasion so that the patient has quicker recovery and low risk of complications.
When the final shape and size of the implants is determined, the sizers are removed and replaced with permanent breast implants. Once the cosmetic surgery procedure is completed, the incisions will be closed, and compression wraps will be placed on the breasts.
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