Breast Augmentation in Pittsburgh, PA

Breast augmentation is a procedure performed for women who may be dissatisfied with their breast size or who wish to restore lost breast shape and volume. Women choose to have breast augmentation for various reasons, the most common being size. In addition, it is common for women to lose breast shape and volume following pregnancy or weight loss. Breast augmentation surgery can also help correct asymmetrical breasts (a condition when one breast is larger than the other). Pittsburgh, PA plastic surgeon Dr. James Fernau produces gorgeous outcomes using the latest breast enhancement techniques. Dr. Fernau performs a composite breast augmentation, which is a combined procedure including the quick recovery technique. This is paired with fat grafting which allows for perfect remodeling of the breast. Patients can choose between silicone or saline implants for a natural, lasting result. In addition, patients who wish to use an autologous approach may consider a fat transfer to add additional breast volume.

Women considering breast augmentation surgery many times wonder how much time they should allow for the recovery. In addition to postoperative pain, they worry about getting back to work, being able to exercise, and of course, taking care of their family. Dr. Fernau offers his patients a major advantage with the quick recovery technique that allows for a rapid 24-hour recovery from breast augmentation surgery. This technique involves the use of the Keller Funnel 2 for a smaller incision with a faster and more gentle delivery of the implant. We will also administer a long-acting local anesthetic, Exparel, that can help with your pain for 3 – 10 days after the procedure. All of this will be discussed in greater detail during the initial consultation.

At Dr. James Fernau Plastic Surgery, many patients are drawn to breast augmentation procedures because of the following wonderful benefits:

• Customizable shape and size of outcomes
• Ability to balance or even out asymmetry
• Newfound enjoyment of fit and feel of clothing
• Quick, pain-controlled recovery options

Saline Breast Implants: Saline implants have always remained a positive choice for patients when deciding what type of implant to use for breast augmentation. Because these implants are filled with a sterile saltwater solution, any potential leakage does not pose a threat as the body can safely absorb the solution. Saline implants also cost less than the silicone type. One of the disadvantages of saline implants is that in some cases, obvious rippling can appear. This is especially something to consider for women who are thin and have low breast tissue. Those who opt for this type of implant must be at least 18 years old.

Silicone Breast Implants: Silicone breast implants are very popular today and are highly recommended by surgeons for patients who are thin and desire a natural look. Since the FDA validated their safety and efficacy, safety concerns surrounding these implants are today almost no different than that of saline. The silicone shell is prefilled with silicone gel and comes in different sizes, shapes, and textures. Unlike saline implants, in which leakage is absorbed by the body and implant volume appears visibly flat, it is difficult to tell when a silicone implant ruptures. An MRI is required to detect any rupture. Patients considering silicone implants must be at least 22 years old.

Fat Transfer: For patients who desire fuller breasts but do not want an artificial implant to achieve this look, there is also an option known as a fat transfer. In this procedure, the doctor will harvest fat from donor sites of the patient, such as the flanks, abdomen, and thighs, via liposuction. The fat collected will undergo a process of refinement and purification and then be gradually reinjected into the breasts with smaller syringes — so the shape is evenly distributed.

Profile: Breast implants come in a variety of different profiles. The selection is based on how enhanced the breasts’ projection would be, as well as how wide the implant will be on the chest wall in relation to the base width. Since the silicone implants are already pre-filled, the standard profiles come in low, moderate, high, and extra high. Saline implants, however, come in variants that are either prefilled; or the silicone shell is inserted then filled with saline solution up to the patient’s preferred profile.

Shape: The standard shape of a breast implant can either be rounded or tear-shaped. Each shape serves a different aesthetic function as it pertains to the patient’s goals. Rounded implants produce a shapelier curve on the top portion of the breast. The teardrop implants are shaped to copy the natural appearance of the breast, so they will not appear as high.

Texture: Implants are made with either a smooth or a textured surface. In general, smooth implants cost less and are more common. The textured implants were initially conceived out of the idea that it reduces the chances of capsular contracture (the constriction of scar tissue around the implant), although there is no valid claim to this. The textured type is more common with the teardrop shape as the rough texture adheres to tissues helping the implant stay in place.

Placement: The two most common placements are on top of the chest muscle or under it. When the implant is placed under the muscle, a pocket is created within the pectoralis major muscle. A pocket is also created if it is placed in front of the muscle, but many surgeons do prefer the submuscular approach (behind the muscle). This helps to keep the implant in place for a longer period of time and takes into consideration factors such as implant size, weight, gravity, and time. Placing the implant behind the muscle also provides a natural look and provides the implant with the long-term support it needs to stay in position.

Incision Type: There are several standard incision approaches for breast implants. The most common is known as an inframammary incision, which is an incision near the breast fold. The second is an incision made under the areola, which is known as a periareolar incision. A third option is to place the incision within the armpit, known as a transaxillary approach. There is also an incision approach that takes place around the belly button, but this is the least recommended way. It is up to the patient’s desires and the surgeon's recommendation as to what approach is best to take. Scarring is also discussed at this time with each method.

Breast augmentation is an outpatient procedure that may last from an hour to several hours. It is performed using general anesthesia in an accredited surgical facility. All activities must be limited within 48 hours after surgery. There will be bruising and swelling, and a compression support bra will also be worn to help in healing. It is normal to feel tightness around the chest area as the skin adjusts to the breast’s new shape. Most patients can resume normal activities within seven days; exercise should be avoided for 4 – 6 weeks. It takes approximately six months for the breasts to look, feel and function normally in regards to softness, sensation, and final placement.

Implants may last up to 15 years. As long as the implant shows no signs of damage or visible defects, such as breast rippling or a deformity, replacing them is not necessary. What’s necessary, however, is a periodic check of the implants to make sure that they are still intact.

How much does breast augmentation cost?
The costs of breast augmentation depend on the implants that will be used. The average fee for saline implants runs about $5,500, up to $8,500. Add $1,000 or more when choosing silicone implants. Any additional procedures will add up to the fees.

Is there a risk associated with silicone implants?
Negative notions about silicone started back in the early 90s when there were cases of leakage and complications. With today’s advancements in engineering, silicone-based shells are made durable and safe and have been proven so by the FDA. Today silicone is more preferred than saline since they last longer and feel more natural. The rates of reported complications have significantly decreased in the last decade.

Should I receive breast implants or a breast lift?
Breast augmentation is a cosmetic procedure designed to enlarge breasts, while a breast lift is designed to tighten the loose skin of a droopy breast. Both resolve different breast issues. There are cases that the procedures are simultaneously done when it is agreed that a breast lift with augmentation is necessary.

Can I breastfeed with implants?
If you want to breastfeed after augmentation surgery, be sure to tell Dr. Fernau during your consultation. It's usually possible to breastfeed after augmentation surgery, with the right surgical technique and placement. Breastfeeding and pregnancy can alter your results, which is why it is better to wait until your family is complete to have breast surgery.

Can I have my implants removed?
You may decide that you would like to replace or remove your implants. If this happens, Dr. Fernau can perform breast revision surgery. In revision surgery, your current implants will be either replaced with new implants or removed. If you want to have your implants removed, you may need to have a breast lift since larger implants may stretch your skin. For any concerns or questions after your breast augmentation surgery, schedule a consultation at Dr. James Fernau Plastic Surgery to learn more about your options.

Do implants cause breast cancer?
The Food and Drug Administration (FDA) is still investigating a link between breast implants and anaplastic large cell lymphoma (ALCL). This is not breast cancer, but a cancer of the immune system. According to the World Health Organization (WHO), breast implant-related ALCL is very rare and when caught early, it is easy to treat. Dr. Fernau encourages all patients with breast implants to get frequent screenings for breast cancer. You should contact Dr. James Fernau Plastic Surgery if you see any concerns, like swelling or other visible changes.

Breast enhancement surgery with implants is popular for many excellent reasons. This surgery is safe, effective, and creates outstanding aesthetic results. With an abundance of available considerations, you can get the appearance you have always wanted. Dr. James Fernau Plastic Surgery is pleased to offer this proven treatment, and we welcome you to learn more. Contact Dr. James Fernau Plastic Surgery in Pittsburgh, PA, to plan your first office visit with Dr. James Fernau.