Liz S Admin's blog

Going under the knife. Where to cut?

Submitted by Liz S Admin on Sat, 09/15/2012 - 10:29

There are various kinds of plastic surgery that can be performed. Ranging from abdominoplasty (“tummy tuck”) to rhinoplasty (“nose job”), but one of the most popular ones, especially among women, is breast augmentation.

Deciding on what type of breast implants to use is not the only difficult decision to make. Plastic surgery after all is a surgical procedure that requires making incisions on the skin. Scaring is typical after an incision is performed and it is unavoidable. Deciding where an incision will be done will determine where the scaring will be located. In a breast augmentation, the three commonly performed incisions are the infra-mammary incision, the peri-areolar incision, and the trans-axillary incision.

The infra-mammary incision is an incision that is done in the breast fold, which is the crease under the breast where it meets the chest. This is the most common incision in that it offers the plastic surgeon direct visual access making it easier to place the breast implants. Both silicone and saline breast implants can be inserted through this incision. If using silicone breast implants, this incision is preferred, especially if they are large sized ones.

The peri-areolar incision is done on the lower border of the nipple, where it will be hidden between the darker colour of the nipple and the lighter colour of the skin. Both implants can be inserted, but the size of silicone implants may be restricted depending on the border and size of the areola. This incision also gives the plastic surgeon direct visual access.

The trans-axillary incision is an incision done in the armpit. The scar can be noticeable when a woman wears sleeveless clothes. Saline breast implants are preferred over silicone breast implants when this incision is done. It is very hard to position large silicone breast implants and there is no direct visual access for the plastic surgeon. Small silicone breast implants are a better option when using this incision.

Regardless of the incision that is made, a scar will follow. It is an unavoidable end result of a breast augmentation but after obtaining the desired breast size, shape, and look, the scaring will be forgotten with time as the new breasts will steal the spotlight.

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.