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About Breast Implant Surgery in Philadelphia, Pennsylvania
Placement Options
The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or on top of the muscle and under the breast glands (subglandular) with saline breast augmentation. Dr. Bottger prefers in most cases the submuscular placement.
Incision Options
Dr. Bottger offers his patients choices regarding incisions for the insertion of implants. Although any of the three major incisions can be used in most patients, certain anatomic characteristics may favor one approach over another.
Inframammary (in the fold under the breast): An incision, one to two inches long, is made in the fold in the shadow under the breast. Through this incision, a pocket is made usually under the pectoral muscle. The implant is inserted into the pocket and inflated.
This is a very direct approach and is the most requested incision. It can be used in virtually any patient although it may be less optimal in the extremely flat patient with no defined fold. The vast majority of these incisions heal with excellent scars.
Periareolar (around the lower border of the nipple/areola): This incision is made at the margin of the pigmented portion of the areola and the skin of the breast. Pockets for the implant are then usually made under the pectoral muscle. The implants are inserted, inflated, and adjusted for symmetry. This incision produces almost universally excellent scars. The periareolar approach may be less optimal in the patient with a very small diameter areola.
Axillary (armpit): The axillary incision is made through a crease in the armpit. The pocket for the breast implant is usually made under the pectoral muscle. The advantage of this approach is that there are no scars on the breasts. A fiberoptic endoscopic system is used to dissect the pockets under direct vision with a high degree of accuracy.
Umbilical (belly button): An incision is made in the belly button. With a special instrument, a tunnel is made from the incision to behind each breast. The breast implants are rolled up and passed up these tunnels. They are inflated, checked for symmetry, and the incision is closed. Dr. Bottger does not favor this incision for a number of reasons. Mainly, the dissection is done bluntly with no visualization, which creates a greater chance for asymmetric pockets and subsequent implant asymmetry. In addition, lack of visualization interferes with adequate control of bleeding, which can also lead to post-operative problems.
When the breast augmentation surgery is complete, a dressing and elastic bandage is applied for twenty-four to forty-eight hours, followed by a support bra. You can be up and moving around within a day, but strenuous activity and heavy lifting should be avoided for approximately three weeks. There is usually some swelling and possibly some bruising after the operation. Bruising and swelling will usually disappear within a few weeks. It is also normal to experience some degree of firmness in the breasts for a number of weeks following breast augmentation surgery. This, too, should diminish with time.
If you would like to see before and after photos of Dr. Bottger’s patients who have undergone breast augmentation surgery, click here.
Visit our FAQs section to find out more about Breast augmentation.
For more information about breast augmentation surgery and how it can improve your figure, please e-mail or call us today
(610) 520-1929
Contact Us
David A. Bottger, M.D.
Bryn Mawr, PA 19010
Serving breast enlargement patients and other cosmetic surgery patients throughout the Philadelphia, Pennsylvania metro area.