Breast Augmentation Philadelphia

Breast surgery can enhance your figure and restore your poise and self-confidence. Unfortunately, your breast shape and size can change over time due to pregnancy, weight loss or genetics. Breast augmentation is a surgical procedure in which Dr. Scott D. Chapin can insert a saline filled or silicone gel breast implant behind the breast to increase volume and improve your appearance. As a skilled, board certified surgeon that specializes in breast surgery, he will minimize the appearance of an incision while placing the implant in such a way as to achieve the most natural-looking enhancement possible. It is common for breast augmentation to be performed in conjunction with other procedures such as breast lift, tummy tuck and to be part of a mommy makeover procedure.

Breast Augmentation Can:

  • Amplify the fullness and projection of your breasts
  • Improve the proportion of your figure
  • Balance asymmetrical breasts
  • Boost your self-image and self-confidence
  • Restore lost volume

Our Customized Approach
Dr. Chapin is a nationally recognized breast surgery expert due to his exclusive, cutting edge techniques that produce unparalleled patient outcomes. In your consult, Dr. Chapin will walk you through the key decision points that are outlined below after listening carefully to your concerns and goals. He will make certain that you have a complete understanding of how your new breasts will look and feel to ensure you are satisfied with your decision.

Implant Delivery
The original Keller Funnel™ was created in 2009 to improve the methodology of breast augmentation procedures. The use of the Keller Funnel™ provides exceptional short and long term benefits to breast augmentation patients. This device allows Dr. Chapin to insert an implant in a significantly gentler and efficient way compared to traditional methods. Dr. Chapin is one of the few surgeons in the country to adopt and implement this advanced technique for breast augmentation procedures. The benefits of employing the Keller Funnel for breast augmentation procedures are:

  1. Small incision site: the Keller Funnel™ is designed to allow the implant to be placed in the breast pocket through a smaller incision site. Therefore, the scar is more easily concealed.
  2. Reduction of implant damage: traditional methods of implant insertion involve the surgeon pushing the implant into the implant pocket with a gloved hand. This method can create uneven pressure on the implant contents and outer shell. This unequal pressure can cause short and long term damage to the implant and increase the chance of future complications. However, utilizing the Keller Funnel to insert the breast implant ensures uniform pressure on the implant during insertion, resulting in less damage to the device. This progressive approach reduces the chance of future implant rupture and capsular contracture following surgery.
  3. Decreased implant exposure: the Keller Funnel™ allows the surgeon to place the implant directly into the breast pocket without the implant coming in contact with the skin, which is a potential contaminate. This no-touch technique reduces implant exposure time and decreases the probability of complications associated with the breast augmentation procedure.

Extensive research indicates that utilizing the Keller Funnel™ preserves the quality of the implant, decreases the rate of capsular contracture and other breast augmentation complications.

Implant Material
Dr. Chapin will offer you a wide variety of breast implant options, including the new cohesive gel (aka “gummy bear”) implants and shaped anatomical implants. You can choose between the newer textured cohesive gel, smooth silicone, or saline breast implants. If cohesive gel silicone is chosen then you can choose the shape that complements your figure best. Dr. Chapin will thoroughly educate and provide you with informative data on all your options. Together you will choose the best selection based on your personal preference and his proven methodology to achieve the best possible result. Dr. Chapin will work with you to decide what option is best suited to meet your objectives during your consultation.

Although all three options offer unique advantages and disadvantages depending on a variety of factors, Dr. Chapin highly recommends the textured, cohesive gel silicone implant in most cases. You may have heard of the term "cohesive," "gummy bear," "form-stable” or "highly cohesive" breast implants. Each is a different way of describing an implant that retains its shape and does not leak if the implant were to rupture due to its cohesive molecular makeup. Gel implants are found to be strong, yet they remain remarkably soft and natural to the touch. The textured, cohesive gel silicone offers multiple advantages over other implants for numerous reasons.

5 Reasons to Consider Textured Cohesive Gel Silicone Implants
Longer shape predictability
Over time, saline breast implants can fold and lose their shape creating an unflattering appearance. This ultimately can lead patients to breast revision surgery to correct the problem. Breast revision surgery increases both the costs and the risk of complications to the patient. Saline and liquid silicone implants lose their shape faster than textured cohesive gel silicone implants due to the difference in their respective composition. The new generation of textured cohesive gel silicone implants is firmer than the traditional saline or liquid silicone implants, but is still soft to the touch. Textured cohesive gel silicone implants retain their shape longer and exhibit improved longevity when compared to saline and liquid silicone implants.

Decreased rupture rate
The newest generation of gel silicone implants is comprised of a strong silicone shell that surrounds the cohesive silicone gel filler that is solid yet soft and rubbery. This cohesive silicone gel has been dubbed the name “gummy bear” as its consistency resembles that of a gummy bear candy. Amazingly, this cohesive gel implant will not leak, even if the implant is cut in half.

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This feature is thought to make these implants safer and easier to remove even if there is a tear in the outer shell.

Cohesive silicone gel implants are advantageous in the rare event of implant rupture. Should a saline implant rupture, the implant will typically deflate completely. Although the body harmlessly absorbs the saline, the patient will require immediate implant replacement due to the significant cosmetic discrepancy that is created. A cohesive gel implant on the other hand will retain its shape even if there is a significant tear in the implant shell. Patients with cohesive gel implants who are noted to have a tear in the implant shell (usually noted on MRI) have the option to pursue replacement or simply observe the implant over time. This eliminates the financial and emotional burden of immediate reoperation in the case of implant injury.

Research and testing has shown conclusively that saline implants have a much shorter shell life compared to cohesive gel silicone implants. There is no doubt that cohesive gel silicone implants offer a longer shell life, and consequently minimize the number of reoperations you are likely to require over time.

Decreased capsular contracture
Capsular contracture occurs when the scar tissue around the implant becomes inflamed and creates a thickened, hard shell around the breast implant. Below are the most common capsular contracture symptoms that patients may experience:

  • Breast becomes hardened and loses a soft, natural feel
  • Breast changes in appearance and becomes distorted
  • Feelings of tightening and discomfort

Capsular contracture is an unpredictable complication. Presently, we do not know exactly why capsular contracture may form in one patient and not in another or even why capsular contracture may only occur in one breast and not the other. Capsular contracture may require patients to undergo surgery to remove the scar tissue and exchange the implant. However, there are some proven operative techniques that have reduced the risk of capsular contracture in our patients. The use of textured implants is one way to decrease the risk of capsular contracture. The rough surface of textured implants deters a hard capsule of scar tissue from forming around the breast implant. The use of antibiotic solutions, the Keller FunnelTM and inframammary (under the breast) incision all contribute to a decreased chance of developing capsular contracture. Dr. Chapin routinely employs all of these maneuvers during surgery to decrease this chance.

Decreased migration
Breast implants can migrate or move, medically known as malposition, laterization, or supine shift from their original placement at the time of surgery. If the implant has shifted in the breast pocket the patient may notice a change in appearance of the implant or a change in location of the implant. When laterization has occurred the patient may need to undergo surgery to correct the placement of the implant. Additional surgery causes the patient to endure more costs and risks of complications that can occur with surgery. The risk of laterization can be reduced with the use of textured cohesive gel implants. Textured cohesive gel silicone implants provide a more stable position to the implant over smooth implants, which reduce the risk of the implant shifting over time. Smooth implants have an increased risk to shift out of position because they do not adhere to the tissues and do not have a coefficient of friction that prevents them from sliding around in the pocket. Textured implants help to stabilize the position of the implants, as they are less likely to migrate out of position over time.

Decreased rippling
Breast implant rippling refers to folds or wrinkles in breast implants that are visible through the skin. Typically, rippling is the most noticeable on the bottom or sides of an implant, but may also occur in other areas such as the middle or near the cleavage region. Although rippling can happen to any patient there is research to support what factors increase the chance of implant rippling.

  • Overfilling of the breast implant: this can only occur with saline breast implants as silicone breast implants are prefilled and cannot be “overfilled.” Overfilling occurs when more saline is inserted in to the breast implant than what was recommended by the manufacturer. This can cause the edge of the breast to pull, which can induce a ripping.
  • Underfilling the breast implant: underfilling can also only occur with saline due to silicone implants being prefilled. When an implant is underfilled it leaves the shell emptier than intended, resulting in wrinkling and folds in the implant.
  • Poor tissue coverage: this can occur with saline or silicone breast implants but is most often seen in women with small breasts. It is more noticeable to see rippling in those with small breasts simply due to the fact that there is not as much breast tissue to cover the implant. Those with more breast tissue provide more coverage of the breast implant, consequently lowering the risk of rippling that is visible or felt.
  • Subglandular (over the muscle) breast implant placement: breast implants are most often placed under the muscle for a variety of benefits. However, in rare situations it may be recommended to place the implant over the muscle. Breast implants that are placed over the muscle provide the least amount of coverage for the implant, which increases the chance of visible rippling.

Implant Size
Choosing the size of your breast implants is the most emotional part of the decision making process. Dr. Chapin’s goal is to achieve a look that makes you feel comfortable and this of course is different for each individual. The size of the implant should relatively match the width of your breast. Going too large or too small can cause long-term complications. Your desired look will help determine what size would fit your best. At Chapin Aesthetics we conduct a sizing test during your consultation so that you can see your potential result in the mirror. This will help show you what size would fit your body best and the most accurate representation of your look after surgery. Please keep in mind when surgeons reference breast implant sizes they use cc’s rather than cup size as a measurement tool. Cup size may vary among bra manufacturing companies and therefore is not an accurate way to measure breast volume. Dr. Chapin’s most critical piece of advice when choosing your implant size is that he can get your cup size right and your look wrong and you will be unhappy. If he gets your look right and your cup size wrong you will be thrilled.

Implant Shape
You have the option to choose between the traditional round implants or shaped implants. The shape of your implant will affect your overall look after surgery. The majority of women have round implants, which often gives more volume and upper pole fullness to the breast. Generally speaking shaped implants are ideal for patients seeking a natural look and do not want an abundance of superior fullness. Dr. Chapin has found with his extensive experience that shaped implants are helpful with patients that have nipples located lower on the breast mound and for patients who do not have a large amount of natural breast tissue because they offer more shape inferiorly. However, the best way to determine what shape is best for you is to have a candid discussion during your consultation about what look you are seeking.

Implant Position
There are three options for the breast implant position:

  1. Submuscular breast implant position (behind the muscle): placing the implant under the pectoralis muscle gives a more natural appearance, as the muscle tends to mask the implant and provide a smoother appearance to the upper pole of the breast. Another advantage of placing the implant beneath the muscle is that it is less likely to create a drooping or waterfall effect by stretching out the breast tissue that can occur over time. Also, placing the implant under the muscle decreases the chance of capsular contracture or interference with breast exams and mammography.
  2. Subglandular breast implant position (in front of the muscle and behind breast tissue): the advantage of this placement is that it can increase volume to the area of the breast behind the nipple. However, this placement of the breast implant makes the implant more easily visible and felt due to the lack of muscle covering the implant in the upper pole of the breast. Additionally, there is an increased risk of capsular contracture with the subglandular breast implant position.
  3. Dual Plane (the implant is placed beneath the pectoralis major muscle superiorly but lies directly under the breast tissue inferiorly): although dual plane offers several advantages, many surgeons do not offer this specialized technique. Dr. Chapin is part of the small minority of plastic surgeons that educates patients and performs dual plane implant positioning. Dual plane allows Dr. Chapin to be the most accurate with implant placement and provides the best shaping of the inferior portion of the breast. It allows the breast tissue to ride up relative to the implant so that it does not appear that tissue is drooping off the implant. The patient will still benefit from all the advantages of submuscular position such as decreased visibility and reduced risk of capsular contracture. Also, for patients that present a small amount of breast sag a dual plane is an ideal method to allow the implant to still be placed under the muscle and give a lift to the breast while avoiding the need for a breast lift procedure.

Incision Placement
There are three options for the incision placement in breast augmentation surgery:

  1. Axillary (underarm): an endoscope (lighted camera) is utilized to help tunnel through the subcutaneous fat to construct a pocket behind the breast. This incision site is most often used to place unfilled saline breast implants.
  2. Periareolar (around the nipple): although this incision type can be the most concealed it is linked to an increased risk of breast feeding difficulties than the other incision options because periareolar incision involves cutting through the breast tissue. Other increased risks with this incision type are capsular contracture and a higher likelihood that nipple sensation will be affected.
  3. Inframammary (under the breast): this is the most common incision type today and the incision takes place right under the breast fold. This is an optimal choice because it may cause fewer breastfeeding difficulties than the periareolar incision and capsular contracture as well as allow the procedure to be more straight forward and more precise.

Day of Your Procedure
Your procedure will be performed under general anesthesia at a Bucks County or Montgomery County AAA Certified Facility. On the day of your procedure, Dr. Chapin and his highly trained team will meet with you to review all details and answer any questions before surgery. Generally, breast augmentation takes one hour to perform. You will receive exceptional and comprehensive care following your procedure to ensure your comfort and outcome.

Breast Augmentation Recovery
You may experience the feeling of pressure or discomfort for one to three days after your procedure and although you will be mobile, it may be difficult to lift your arms. Generally, people can return to a sedentary job five to seven days after surgery. Light workouts can be initiated two weeks after surgery and high impact exercise three to four weeks after surgery. Dr. Chapin will provide complete preoperative and postoperative care instructions. He will monitor and advise when patients can gradually resume their daily activities including exercise.

Contact Our Office
Dr. Chapin serves patients from Philadelphia, Bucks and Montgomery counties. To learn more about breast augmentation or to schedule a complimentary cosmetic consultation, contact our office today.

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