projection

Cup Size Dilemma: Local Anesthesia?

Submitted by Liz S Admin on Fri, 08/31/2012 - 00:13

Having the chance to increase a cup size or two is quite invigorating. The problem is, not knowing which breast size would look best. A woman can only imagine what her breasts would look like in a B-cup or a C-cup, but will only see the physical change after the breast implants have been inserted. To make a wise decision and have a satisfying result, it is important to consult with an experienced board certified plastic surgeon before surgery. Use his knowledge and experience to guide you in your decisions. An experienced surgeon will listen diligently and will work to find the appropriately sized implant to safely achieve your desires. An interactive rapport with your breast specialist is important. Inadequate communication is the most common cause of angst and upset from either too large or small implants.

Be sure to know your doctors credentials. Do not assume that the doctor offering breast augmentation is a board certified plastic surgeon. Some may not even have had formal surgical training in a reputable institution. Because of their limited surgical training, access to deliver full anesthetic and surgical procedures may be restricted. Some unscrupulous providers attempt to conceal this deficiency by promoting local anesthesia for breast augmentation. Such marketing schemes are touted as less expensive and more accurate breast implant sizing under local anesthesia so that the awake patient can participate in final implant sizing while on the operating table. 

The purpose of putting patients under general anesthesia is so that they won’t feel any pain during the procedure. A patient is rendered unconscious and the body relaxes. Another type of anesthesia is called local anesthesia and only a part of the body becomes insensitive to pain.  An anesthesiologist is required on site when performing surgeries that require general anesthesia but not local anesthesia. With local anesthesia expense is reduced as there is no longer a need to pay for an anesthesiologist. But is it safe? Without the specialist in anesthesia, the doctor performing the procedure now is responsible for the anesthesia as well as the technical aspects of surgery. It’s very risky in fact when a doctor promotes the use of local anesthesia during breast augmentation. Unfortunately, this downplays the seriousness of surgery. Surgery has inherent risks. 

Not only is pain better controlled by general anesthesia, a stable controlled environment permits the plastic surgeon to focus his efforts to achieving the best aesthetic outcome under safe conditions. Sure it would be great to see the doctor model the breast implants and check them in an overhead mirror, but what happens if something were to suddenly go wrong during the surgery? Would it be worthwhile afterwards? Even under local anesthesia, a patient is still a bit fuzzy in the head. Are they really making a wise decision when choosing their breast implants? It’s almost like drinking and driving which leads to impaired vision and judgment.


It’s risky business when a doctor promotes the use of local anesthesia to improve breast sizing during a breast augmentation.

Q: Saline or Silicone for Someone with Adequate Breast Tissue?

Submitted by Q-A from clee on Fri, 05/13/2011 - 12:07

Getting BA done next month. My doctor usually recommends silicone because most of his patients have an A cup. After my exam, he said I could go with silicone or saline because I'm a full 34B cup. He said I have enough breast tissue so there wouldnt be a difference, and would get the same results.

It will be soft as silicone, and give me good projection. I'm a 34 full B, shooting for a 34 full D.What would you suggest? Also, 450cc or 500cc?Would like fuller, natural feel, look, and movement.

A: You have choices, let your preferred incision guide your implant decision

Let your incision choice and size of implant dictate your type of implant. If you prefer to scar in the areolar complex, then use a saline implant as your areola is not large enough to permit placement of a large silicone implant. If you prefer the inframammary incision, then go with the cohesive get as the feel more natural. Request for them to be place in the submammary position as it is far less painful and you have sufficient breast to adequately prevent ripples even from saline implant to show.

Q: 600cc silicone implants look small on me

Submitted by Q-A from clee on Thu, 05/12/2011 - 03:13

My first ba I had 340cc overs mod profile and was unhappy as they looked too small. I had my 2nd ba 3 months ago and went for 600cc HP silicone under the muscle. I was really gutted to find I still haven't got the desired projection I was after. My surgeon said it's because I have a high rib cage which is why my implants do not project much. Should I consider a ultra high profile saline implant or just accept the fact boobs don't look big on me??? Please help!!! Thanks

A: Sizing an implant to achieve a desired shape and projection can be a challenge

Sizing an implant to achieve a desired shape and projection can be a challenge. The final projection and shape achieved depends on the following: 1) the underlying chest wall supporting the implant. A flat foundation will allow the implant to fully express its projection whereas a tilt to the chest wall will result in loss of or uneven projection to one side. 2) from the underlying shape of the implant. The actual measured dimensions of your implant to the dimensions of your breast envelope is more important than the brand model marketed. 3) the tissue plane of implantation and its resistance to stretch is another major factor on both projection and the visibility of the implant margins. As surgeons, we can only control the selection of the implant model and the tissue plane of insertion. Perhaps you should have another visit (with your surgeon or another experienced opinion) to review the various suitable dimensions of implants to be tried via sizers in the operating room to better approach your goals. Furthermore, submammary placement is more likely to achieve the full implant projection then submuscular placement, however, the implant (especially saline implants) will show ripples and edges in this submammary plane.