Dr. Silberblatt
offers a complete range of breast procedures and services.
To learn more about a particular procedure, click on a topic
below:
Breast augmentation is a surgical procedure used
to increase the size and/or alter the shape of a woman's breasts
through the use of an artificial implant. Women may
choose to have this operation either as a reconstructive technique
following breast surgery, to balance different sized breasts,
or to enhance the contours of the body. Whatever the specific
purpose, women who undergo breast augmentation can expect
larger, firmer, and more visually satisfying breasts.
(click image to enlarge)
Breast augmentation surgery begins with an incision, made
either in the crease of the breast, the armpit, or the perimeter
of the areola (the dark skin surrounding the nipple). The
placement of the incision will vary according to body type
and the specifics of each procedure. Dr. Silberblatt enters
through the incision and creates a pocket, either underneath
the breast tissue or under the chest wall muscle. The implant
is placed in either location, centered directly behind the
nipple. Finally, the original incision is sutured.
(click image to enlarge)
Once the incisions have been closed and taped, the breasts
are wrapped and supported by a gauze bandage. Patients are
fitted with a surgical bra that provides support for up to
several weeks. Postoperative fatigue, soreness, and discomfort
may be greatly reduced through medication. Swelling
gradually subsides and becomes undetectable in a month's time.
Stitches are removed within seven to ten days.
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No woman who has two breasts that are exactly equal
in size and shape. However, if your breasts are dissimilar
enough for the difference to be noticeable in clothes, then
the insertion of different sized implants can be helpful in
both enlarging the breasts and minimizing size differences.
The best way that Dr. Silberblatt has found to do
this is to use implants that can be adjusted after surgery.
A special valve is left under the skin through which saline
can be injected or removed as desired. A patient
can thus decide just how large she wants each breast to be
(within the confines of the limits for the chosen implant).
The most common disadvantages in using these implants are
that the valve must eventually be removed (under local anesthesia
and at a minimal added cost) and the possibility of mechanical
problems with the valve (punctures, valve migration, etc.).
Complications of this nature are rare and most patients have
been very happy with the results. The ability to have
some control over the ultimate size of each breast is important
for many patients.
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Breast reduction surgery almost always
helps women with their back, neck and shoulder pain, provided
that the weight of her breasts is indeed the cause of these
ailments. Medical insurance usually does cover this
procedure although recent trends in managed care have made
pre-approval more difficult. Self-serving insurance companies
find breast reduction an easy a procedure to deny as cosmetic.
It is not cosmetic when more than a pound of tissue is removed
from each side.
Over the last 15 years European and
South American plastic surgeons have developed ways to try
and limit the amount of scarring after a breast reduction.
The typical operation done for the past 40 years
leaves a scar that extends from the middle of the chest, under
the breast to the underarm and from the middle of this scar
up to and around the areola (an inverted T). The modified
operations leaves a scar only around the areola and can extend
it down to the fold under the breast if needed. These new
operations also seem to preserve more sensation to the breast,
maintain a better blood supply to the nipple and are similar
in reliability for keeping nipple sensation and the potential
for nursing. These operations can be done on any
sized breast and can also be used to lift sagging breasts.
Occasionally, in very large, pendulous breasts, an additional
small transverse scar under the breast will be necessary later
but the scarring is still markedly less that with the older
operation.
Patients undergoing this surgery are
among the happiest of all of Dr. Silberblatt's patients with
the results. Unfortunately, since the procedure takes
between three and four hours to do, the costs are substantial.
Operating room, anesthesia and surgeon charges come to at
least $8000, sometimes more.
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Although removal of a cancerous tumor
and irradiation of the breast is an option for some women,
removal of the entire breast is still necessary in many cases.
An important part of recovery for many women is the reconstruction
of their operated breast. Placement of a balloon
type device under the muscle and skin followed by filling
of the implant once a week for about 10 weeks and subsequent
replacement of this balloon with a final implant is one method
of reconstructing a breast. It has the advantage of being
done as an outpatient in two operations each of less than
an hour’s duration. It's disadvantages are that filling
and stretching of the skin take over two months and the implant
can sometimes become hard and not match the other side too
well.
The other major option is to use the
fat of the tummy under the belly button to recreate the breast
mound. The major advantage is that there is no implant
and the fat looks and is shaped more like the opposite breast.
The major disadvantages include a much longer operative time
(usually four hours or more), hospitalization of a few days,
a longer recovery time and possible problems such as hernias
and lumps from fat necrosis. Nevertheless, this is the option
that, when available, will usually provide the best appearing
reconstructed breast.
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