The Breast Augmentation Specialist, Dr. Douglas S. Steinbrech
Breast Augmentation Surgery
Cosmetic enlargement of the breasts is performed to enhance the fullness of the chest when it is lacking due to genetics, pregnancy, extreme weight loss, or diseases like breast cancer and their treatment. By placing biocompatible prostheses (implants) composed of silicone gel or a saline solution, women can experience a more feminine appearance that fulfills their aesthetic desires. Enlarged breasts can increase a woman’s self-confidence and add to her sex appeal. Patients may also enjoy the added benefit of better-fitting clothing.
Dr. Steinbrech can increase the breast size by one or more cups, enhance the look and feel of the breasts, and improve asymmetry. Breast augmentation surgery, medically termed augmentation mammoplasty, is one of Dr. Steinbrech’s top requested surgeries at his New York City practice. He is an expert at creating natural-looking breasts that are proportionate to a woman’s frame.
Breast Augmentation: A Fully Customizable Surgery
Implant Type – Silicone or Saline
The two main options for a breast enlargement surgery are silicone implants and saline implants. Both types of modern implants are safe for cosmetic use and have been approved for use in augmentation and reconstruction procedures. Silicone implants are composed of two forms of the material: a cohesive silicone gel that mimics the feel of breast tissue encapsulated within a silicone shell. The exterior shell texture may vary depending on which of the five FDA-approved silicone implants is used. While silicone breast implants are available in a wide variety of sizes, individual implants cannot be altered.
Saline implants are another popular option in women seeking to enhance their breasts. The exterior material is similar to that of silicone implants, but rather than being pre-filled with a gel, implants are inflated with a sterile salt water, or saline, solution once in place during the procedure. Because of this technique, surgical incisions are smaller in saline breast implant surgeries. For a time, saline breast implants replaced silicone breast implants, which were taken off the market in the 90’s by the FDA. However, silicone gel implants have since been approved for breast augmentation surgery and are considered to be even safer than previous versions. Even with medical advancements, saline implants are still the slightly safer option in the case of a rupture as the body can safely absorb the saline solution. Unfortunately, they are also more likely to create a rippling effect under the skin. Compared to silicone implants, saline implants also tend to feel firmer and less fixed to the chest (“bouncier”).
Implant sizes are based on volume and measured in cubic centimeters, also known as “ccs”. As a point of reference, one cup size is approximately 100-150 ccs. Implants can range in size from 150-800 ccs, but most hold approximately 400 ccs of material. Because the elasticity of the skin has limits, further enlargements may require additional surgeries.
When considering which implant size to choose, it’s important to take into account that the breasts should appear natural amongst the other features of the body. Breast implants that are too large will suggest obvious surgical modification, while implants that are too small will not significantly impact a woman’s breast size. Patients can attend their consultation with an existing size request, or consult with Dr. Steinbrech’s in determining which size would best suit their aesthetic ideals.
Dr. Steinbrech discusses Breast Augmentation
Breast augmentation requires underlying tissues of the breasts to be accessed through surgical cuts, which can be created in different areas of the general breast region and even the navel. However, Dr. Steinbrech’s preferred incision sites are in the underarm, around the areola, and under the breast. Because there are many factors that determine incision placement, such as the shape of the breasts and their specific characteristics as well as the type of implant selected for the surgery, the best options will be discussed at the breast augmentation consultation.
Breast Implant Placement
After the incisions have been made, the implants can be placed within the chest in one of two preferred locations: under the muscle or over the muscle. In submuscular pocket placement, the breast implant will be inserted below the pectoralis major, also referred to as the pectoral muscle. This approach generally provides the patient with the most natural-looking breasts because more of the body’s natural tissues lay overtop of the synthetic prosthesis. In patients with a naturally smaller breast size prior to breast augmentation, this surgical approach is particularly advantageous. Submuscular placement also provides better support for the implant and reduces the risk of capsular contracture, a condition that occurs when scar tissue surrounds and compresses the implant, causing an uneven or irregular appearance.
The second surgical option during breast augmentation is to place the implant between the existing breast tissue and the muscle, known as a subglandular placement. This technique is considered a bit less invasive than the submuscular placement and recovery time may be less. Implants in this position may also produce greater cleavage and feel a bit softer to the touch. However, this is not a good choice for women with thin skin or insufficient breast tissue as rippling or visible implants may result.
Both placement options are safe and reliable, but depending on a woman’s body type, the requested implant size, and the overall musculature of her chest, Dr. Steinbrech may suggest the best approach.
Breast Augmentation Consultation with Dr. Steinbrech
The initial doctor-patient meeting, or consultation, is an important first step in the breast augmentation process. Dr. Steinbrech will introduce himself to the patient and ask about what goals she wishes to achieve through surgery. After learning about how a woman hopes to enhance her shape, the doctor will perform a physical examination of the breasts to assess existing soft tissue and skin elasticity. He may take measurements of the patient’s anatomy. Plastic surgery aims to be the perfect marriage between art and science, providing patients with their ideal physique, while remaining within the parameters of what is healthy for their body.
During the consultation, patients will have the opportunity to view more before-and-after photos of former patients. The doctor will also explain what specific limitations a patient may face and if her aesthetic goals are realistic. He will discuss the surgery in detail and help the patient decide between each different option available during the procedure. The doctor can answer any questions she may have and go over concerns about the surgery or recovery. During the appointment, Dr. Steinbrech will also address potential risks and complications of the procedure. The consultation is a great first step in preparation to undergo breast augmentation and provides one the opportunity to learn more about the doctor.
Preparing to Undergo Breast Implant Surgery
While many of Dr. Steinbrech’s patients are from New York City, surrounding suburbs, or the tristate area (New York/New Jersey/Connecticut), others travel from other states or countries to undergo breast augmentation with him. Area patients should arrange for transportation back to their home or hotel in advance. For out-of-town patients, travel and hotel reservations should be planned ahead of time to ensure the most comfort recovery possible.
Any prescriptions written by Dr. Steinbrech should be filled prior to the surgery so antibiotics or pain medications are available as needed. Because anesthesia tends to make patients sleepy in the days following a procedure, clean, comfortable bedding should be prepared for a comfortable rest. Extra pillows may assist in elevating the upper half of the body while in a lay-down position. Plenty of drinks, snacks, and even meals must be available in the home or hotel room so patients can eat regularly for energy and to take their medications. It is recommended that patients either hire a caretaker or have friends or family available to help care for them for two or more days postoperatively. A list of suggested supplies is as follows:
- Baby wipes for hygiene as showering will be difficult or not recommended for a short time
- Antiseptic wipes to keep the incision or drain areas hygienic
- Hand sanitizer as it is more convenient than taking trips to a sink
- Pill organizers and a notebook to divide doses and write down when pills are taken to ensure the safest management of infection and pain
- Lightweight ice packs to keep pain and inflammation at bay
- Reading material or movies to cure boredom as there will be several days of downtime
- The doctor’s contact information in case patients have any questions or concerns following the procedure
The Breast Augmentation Procedure with Dr. Steinbrech
Patients will arrive at the doctor’s office or another outpatient surgical setting at their appointment time. They may be asked to complete paperwork, which is common for both cosmetic and medical procedures. Before the surgery begins, the doctor may use a surgical marker to create a blueprint of the procedure on the skin, marking the incision sites and areas the new breasts should expand to. Dr. Steinbrech may take some time to go over details of the surgery and answer any questions a patient has, and he will take “before” photographs to compare to the final results once the breasts have healed.
The breast augmentation is performed under general anesthesia and requires about two hours to perform. The skin of the breasts and surrounding tissue will be thoroughly disinfected to prepare for access to underlying tissues. As previously mentioned, incisions may be created on the underside of the breast where the tissue creases, around the areola, or in the underarm. These locations will eventually show scarring, but scarring will be minimal and well camouflaged. The doctor will use different surgical devices to stretch the skin to accommodate the size of the implants. If saline implants were selected during the consultation, they will be inserted into place and filled to size. Silicone implants will not require this additional step as they are prefilled with gel. After the implants have been placed either under or over the chest muscle and secured in place, the incisions are closed with stitches.
Patients will be fitted with breast bandages for compression or to conform to the new breasts and support their new size and shape. A medical bra may also be provided to wear throughout the healing process. In some cases, surgical drains may be placed to release fluids that can accumulate in the surgery site.
Breast Lift Surgery – A Separate Procedure
While breast augmentation is an excellent way to add fullness to a woman’s frame by increasing the volume of the breasts, the placement of implants will not substantially change the position or lift of the breasts. Another surgery called breast lift, or mastopexy, is performed to adjust the angle and location of the breasts on a woman’s chest. After fluctuations in weight or pregnancy, and with age, the breasts will naturally begin to sag. While the appearance of lowered breasts is completely normal, some women prefer a perkier look or experience pain due to the weight of pendulous breasts.
A breast lift is not part of breast augmentation surgery, but they can be performed in conjunction with this procedure upon request. During the breast lift portion of the surgery, an anchor-shaped incision is made on each breast. Dr. Steinbrech removes extra skin, moves the nipple to a natural-looking location on the newly reshaped breasts, and closes the incisions with stitches.
Patients can expect to be sore and swollen for the first couple of days after the surgery. Pain medication and ice packs will help manage the worst of the discomfort. By keeping the upper body elevated while sitting or lying down, swelling will be minimal. In patients who require drainage tubes, the area must be kept clean and cared for. The doctor can provide instructions to caretakers and patients before discharging them home.
Movement will increase daily and the body will adjust to the modifications. Total recovery time from breast augmentation varies from one patient to the next, but most are able to return to work and light activity with about a week after the procedure. Any sutures used to close the incision are removed after the first week to ten days.
Breast augmentation patients will be asked to massage the breasts for the next year – more frequently for the first three months following the procedure, and less often after that time – to promote a supple, natural feeling of the breasts. This at-home technique also helps to prevent capsular contracture and the formation of scar tissue. In patients who undergo breast lift in conjunction with implants, massage may not be the ideal healing technique as it does help the breasts adjust to a lower position. In some implant types, it will not be recommended. Dr. Steinbrech will provide clear and concise instructions individually tailored to each patient’s treatment.
It can take months or even years for a patient’s body to heal completely, but results are easily enjoyed in a few short months. Much of the internal changes that take place to accommodate the surgical additions are unnoticeable and follow a regular course of healing. The breasts will feel normal again with the implants functioning like they are a part of the body in about two to four months.
Breast Augmentation Complications
The risks and complications associated with breast augmentation surgery include infection, injury to the patient’s own breast tissue, capsular contracture, implant rupture or rejection, changes in nipple sensitivity, and changes in milk production in women who breastfeed. The likelihood of any of these occurring is minimal, and Dr. Steinbrech takes precautions to prevent issues during the surgery and healing process.
If patients experience postoperative problems or have any concerns during their recovery phase, they should schedule a follow-up visit with Dr. Steinbrech at his New York City practice.
Male Breast Augmentation
While breast augmentation surgeries have traditionally been performed on female patients, Dr. Steinbrech also offers this procedure to male patients. In transgender women who were born males and seek a more feminized look, he can accommodate the procedure to their changing body type. Other men seek to maintain and emphasize their masculine appearance through the addition of pectoral implants, which is the male equivalent to breast augmentation surgery in women. More information on these two specific surgeries is available during a scheduled doctor-patient consultation.
Breast Augmentation FAQs for Dr. Steinbrech
Is the placement of breast implants painful?
Patients recuperating from any medical procedure generally experience some discomfort, and breast augmentation is no different. The location of the incisions and the breast tissue affected during the surgery may cause some inflammation and pain for the first one to five days postoperatively, but Dr. Steinbrech controls discomfort by using drainage tubes at the surgical site to keep swelling and fluid accumulation to a minimum, and he provides a post-surgical bra or special bandages for the patient to wear to support the new breasts. In addition to this, the doctor recommends icing and prescription pain medication to ensure comfortable healing, and sitting and lying in an elevated position to lessen swelling. Most residual soreness will not last beyond a few weeks following the surgery.
Do breast implants feel synthetic to the touch and inside the body?
Many patients are pleasantly surprised with the natural feel of breast implants, especially when the silicone models are chosen and placed under the breast muscle. The silicone gel provides a natural breast feel, and the patient’s own breast tissue will be positioned overtop of the implants.
How can breast augmentation patients avoid complications?
By following the doctor’s instructions on avoiding strenuous activities, massaging the breasts, maintaining good hygiene, and taking medications as prescribed, patients can help to prevent most negative consequences from occurring. In certain cases, there are unavoidable complications, like implant rejection that even the most diligent patients can experience. If a woman notices that her breasts feel abnormal or she feels unwell, she should contact Dr. Steinbrech’s New York office right away.
How long after breast augmentation can regular or strenuous activities can be resumed?
Typically, those who have undergone the implant procedure can return to their normal activities at the two-week mark. It may be around six weeks before patients are cleared for activities like exercise, sexual activity, or any other actions that may cause strain to the body or interfere with the healing of the breasts. Dr. Steinbrech customizes each treatment plan, so directions may vary from one patient to the next.
About Dr. Steinbrech – A New York Board Certified Plastic Surgeon
Douglas S. Steinbrech, M.D., F.A.C.S., an expert in facial and body plastics, uses a conservative, minimally-invasive approach in his surgeries. Through a rigorous eight-year training program at New York University in General Surgery and Plastic and Reconstructive Surgery, the doctor has developed the most comprehensive understanding of human anatomy in modern medicine. He was also trained in Plastic and Reconstructive Surgery at the prestigious NYU Institute of Plastic and Reconstructive Surgery. Aside from his numerous patients, the doctor is also trusted by industry professionals. Dr. Steinbrech was chosen as one of America’s Top Plastic Surgeons by the Consumers’ Research Council of America. Dr. Steinbrech is active in peer-reviewed publications and has presented his research at several national conferences.
To schedule a surgical consult with Dr. Steinbrech, call (347) 983-9560 or fill out the Contact Us form.