If you are unhappy with the shape and size of your breasts or if you want to improve your body proportions, consider breast augmentation in Nashville.
Breast enlargement surgery can increase your breast volume, balance your breast shape, and boost your overall confidence. Our experienced plastic surgeon, Dr. Olivia MaDan, specializes in breast surgery and offers various techniques to achieve your ideal appearance. Call now to schedule a breast augmentation consultation with Dr. MaDan to talk more in-depth about your cosmetic goals and ideal outcome.
A breast augmentation operation in Nashville is a way to enhance breast shape, volume, projection, and overall symmetry. A “primary” augmentation indicates the first or initial surgery of placing the implant device. The procedure is performed as an outpatient surgery, and it takes less than an hour. The incision to place the implant is less than two inches long and can be made in different locations—the most common being in the crease or the fold of the natural breast.
View All Before and After Pictures
To augment the breast, Dr. MaDan uses two primary methods: Implant-based or Autologous tissue. Autologous augmentation would involve liposuction of a particular area, processing the fat, and transferring it back into the breast tissue to enhance the chest. Implant-based augmentation uses an implant (silicone or saline) placed above or below the pectoralis major muscle to increase breast volume, projection, and upper pole fullness.
Use of a breast implant can provide improved height retention and more upper pole fullness compared to fat transfer. Breast implants require routine rupture surveillance and exchange/replacement surgeries in the future. There is no breast implant that is considered a lifetime device. Fat transfer is a permanent method of increasing breast volume. The fat that is transferred establishes a new blood supply and becomes a part of the breast. Fat transfer does not always increase the breast cup size significantly or create a perfectly round, augmented appearance. Some breast enhancement patients in Nashville choose fat transfer as a more natural option as opposed to a prosthetic breast implant.
Most patients seeking breast augmentation in Nashville want to feel more feminine, improve body proportions and overall self-esteem.
When discussing breast enhancement, a crucial first step is for the surgeon to identify and educate the patient on her own natural asymmetries. From there, the patient and surgeon can discuss realistic expectations after an augmentation procedure.
For example, a patient who currently wears size 36D, previously breastfed, and has significant skin laxity is unlikely to achieve the same surgical outcome as a patient who has no skin laxity, never breastfed, and wears 36AA. It is important to remember that breast augmentation is an individualized surgery that is tailored to a specific person and their body.
After your breast augmentation procedure in Nashville, you will experience various stages of healing. For the first few days, you will need to rest at home. This is an ideal time to enlist family and friends to help you with day-to-day tasks, such as eating, bathing, and using the restroom. You will feel tired and sore during this period of time, and Dr. MaDan may recommend a prescription or non-prescription pain medication to help you stay relaxed.
After the initial recovery time, you will need to limit your activities as required by our plastic surgeons. This protects the sutures and helps the tissues heal properly. You may be required to stay at home resting for one to two weeks.
In the months after your breast augmentation, the swelling gradually subsides. If, during this time, your breasts do not look as expected, understand that inflammation can mask the final results. You will also see the incisions start to heal and form a pinkish scar line. The scar will eventually change to a color that is slightly darker than your natural skin tone, but it will not disappear completely.
Many women in Nashville are choosing breast augmentation to improve breast shape and volume. Some women simply want larger breasts to feel more feminine and proportionate. Others feel that their breasts are uneven and wish to achieve a more symmetric, balanced appearance.
No matter what your reason is, the caring and highly-trained staff at BEYOND Collective, along with talented plastic surgeon, Dr. MaDan, are dedicated to helping you achieve your cosmetic goals and feel more confident in your own skin. Call today to set up an initial appointment and learn more about your various breast enhancement options.
Instead of placing silicone or saline implants, fat grafting can be performed to augment the breast. Liposuction is performed on an area of your choosing, the fat is processed and then placed in each breast. The viability of grafted fat varies, and you may require more than one procedure to achieve your desired result. The biggest risks of breast fat grafting is contour deformity and need for multiple procedures.
Breast implants do not counteract gravity. Breast implants do not stop the breasts’ natural aging. Often times, the breast implant can remain in good position, under the muscle, but the breast tissue itself continues to sag, hanging off of the implant. This can cause the “snoopy” deformity. A breast lift, or mastopexy, can often improve this deformity.
Classically, silicone implants have a softer feel compared to saline implants. There is usually less rippling and visibility with silicone implants. New, structured saline implants are being developed which can sometimes fool the experts!
The term “gummy bear” refers to the cohesive nature of the silicone gel. A “gummy bear” implant is one which is highly-cohesive meaning the gel would not budge if you cut the implant in half with a knife. It would resemble the appearance of a “gummy bear” cut in half.
The outpatient augmentation procedure usually takes less than 1 hour. The outpatient augmentation and lift procedure (augmentation mastopexy) takes around 2 hours. With either procedure, you are able to go home the same day. You should be up, walking around the house, but taking it easy the next day and throughout the recovery process.
The procedure causes more of a feeling of “soreness” than sharp pain. The pain may be the worst 1 – 3 days after surgery and consistently improving thereafter. Muscle spasm medication is often more effective than a narcotic at treating breast augmentation pain. Most patients are able to switch to anti-inflammatory medications (Tylenol, Advil) after the first 3 days.
Breast implant size range is best estimated by your individual breast width. We also use an insert sizing system in our office. This allows you to estimate breast shape/size while wearing clothes. With your breast width and desired insert size, we are able to determine the best size for you. It is also helpful to bring photos of what you think is “too big”, “too small”, and “just right”.
All implants have a silicone shell- even saline and structured saline. They are completely latex-free. There is no reliable evidence that any illnesses or allergies are associated with breast implants.
Silicone has a more natural, softer feel. However, monitoring for implant rupture is more difficult with silicone implants. The FDA recommends an MRI within the first 3 years after breast implant surgery, and every other year after that.
Saline implants, while more visible and prone to rippling, are easier to monitor for rupture. If rupture occurs, your body simply absorbs the saline and your breast returns to its pre-operative size.
The structured saline implant gives you less rippling and visibility more similar to a silicone implant, but with the beneficial rupture surveillance of saline. Your body absorbs the saline and the breast returns to its pre-operative size.
There is no exact time-frame that a breast implant will last, but it will not last a lifetime. You can almost be guaranteed to have another surgery by choice or necessity. You may want to have smaller implants later on in life or may be forced to exchange them in the case of rupture or capsular contracture.
Several factors determine the best implant profile. First, we will discuss your ideal outcome: an athletic, more natural look or a round, shelf look with more cleavage. A higher-profile implant usually creates more roundness and cleavage. We will take breast measurements and assess your natural breast tissue in the exam room. The most important measurement is your breast width. This measurement indicates the maximum base width of an implant that can fit on your chest wall. We will also do breast implant sizing using silicone inserts to understand your ideal volume. Once you know the desired volume, our 3D simulation can simulate what that size may look like on you. Inspiration photos can also help understand your breast goals and ideal shape/look. We will also review many before and after photos so you get an understanding of the looks that are possible with different profiles and volumes.
Skin quality and soft tissue envelope are also important factors in selecting volume. A thin patient with a tight skin envelope may only be able to hold a certain amount of implant volume. This can be determined at your consultation to ensure you have realistic expectations of what is possible. With additional breast surgery, like implant exchange, you will often be able to increase size since the soft tissue has already expanded and stretched.
We use multiple methods to help you choose your desired volume. We use a sizing insert system to show you what your desired volume looks like in clothing. The 3D software simulates what your desired volume will look like on you. Another method is reviewing before and after photos of patients with a similar build and starting volume to yourself. Physical characteristics like breast width and soft tissue envelope may be factors that influence/limit what volumes are possible. It is important to know that breast implants are not considered lifetime devices. This means you will require future surgery for exchange or removal, depending on your goals at that time. It is easier to exchange implants for a larger size than downsizing. The soft tissue will stretch or expand to the larger implant. However, it may not tighten or bounce back if a smaller implant is placed. Sometimes, downsizing implants may require a lift to be performed at the same time to remove excess skin that previously stretched with the larger implants.
A silicone implant will feel the most natural and similar to breast tissue. The silicone gel is form-stable while still feeling soft. This minimizes the risk of unnatural-looking rippling and wrinkling. A saline implant (depending on the fill volume) may feel more hard and unnatural. Due to the property differences between silicone and saline, the saline implant has less height retention in the upper pole. The cohesive silicone gel will maintain its shape in the upper pole, giving you more shape and upper pole fullness.
Maximum cleavage can be achieved with the most cohesive gel and a higher profile implant like a full/high or extra full/extra high. When placing implants in the sub-pec (behind the pec muscle) position, we are limited by your anatomy to a certain degree. Some women naturally have a wider space at the midline between the breasts. Releasing too much of the pec muscle from the sternum medially can create a complication called symmastia. In general, your breast footprint (where the breast is located on the chest wall) cannot be changed. Placing an implant does create a lifting effect due to the added volume and projection of the implant. The entire breast position is not altered when a breast lift is performed. This procedure functions to reposition the nipple and tighten the lower pole of the breast by removing excess skin.
The Keller funnel is a useful tool that increases safety during the augmentation procedure. Think of it as a pastry piping or decorating bag; the implant is the icing. With the implant in the funnel, squeezing the back of the funnel propels the implant forward. The funnel is how we can get a large implant through a small, 4 cm incision. The funnel also minimizes the risk of contamination because no one touches the implant with their hands. In essence, the implant goes from its sterile container into the funnel and then into the pocket.
The no-touch technique is a method of handling the implant for optimal safety during the procedure. The purpose is to ensure the implant does not come in contact with the skin or other possible contaminants. Additional measures we employ to maximize safety include nipple shields and antiseptic solutions. The breast is not considered a sterile organ. In essence, it is open to the world (via the nipple), which is how we breastfeed. Thus, the nipple and the breast tissue may have some bacterial contamination. A nipple shield is an occlusive dressing applied during the procedure to decrease the risk of bacteria contamination in the procedure and the implant.
Galaflex or Durasorb are the brand names of internal soft tissue scaffolds made of absorbable, strong suture material. This mesh is usually not indicated for primary augmentation procedures. However, it can be placed for extra support if needed. The mesh is more often used in revision breast surgery. It can correct a double bubble deformity, which is a disruption of the inframammary crease during a prior procedure. Some revisionary surgery requires a total capsulectomy, after which the implant essentially has no support. In this scenario, the mesh can be placed for additional soft tissue support for the implant.
If the implant is not enough to fill out the soft tissue envelope and elevate the nipple to an acceptable position (ideally pointing forward and positioned on the most projecting point of the breast), a lift can be performed in combination to reposition the nipple and remove excess skin from the lower pole of the breast. The “pencil test” is something you can try at home to assess the potential for needing a lift. Place a pencil in the natural fold/crease below your breast. If there is breast tissue holding the pencil against your chest, you may be a candidate for a lift. If there is no tissue (underboob) to hold the pencil in place and it falls to the ground, you are less likely to need a lift.
Our 3D images can simulate your outcome with and without a lift at your consultation. This tool can assist you in your decision-making process for your ideal outcome/look.
Yes, the majority of breast surgery is performed in a certified surgical center under general anesthesia provided by an anesthesiologist. Typically, an IV is placed in the pre-op holding room. You are given IV medications for relaxation and induction of anesthesia. After you are asleep, an airway (LMA- laryngeal mask airway or ETT- endotracheal tube) is placed to assist your breathing during the surgery. When you are awakened from anesthesia, the breathing tube is removed. Some patients may feel like they have a sore throat afterward. This is temporary and usually resolves quickly. It is important to inform your plastic surgeon and the anesthesiologist of any adverse effects of prior anesthesia (including nausea) or family history of problems with anesthesia. Anyone taking GLP-1 medications like Semaglutide is asked to hold the injection/dose a minimum of 1 week before surgery to minimize the risk of aspiration. It is acceptable to resume those medications after surgery.
Yes, the minimum requirement is having someone drive you home from surgery and stay with you for the first 24 hours after anesthesia. Depending on your home situation, assistance may be beneficial if you have young children or other lifting requirements. Driving is acceptable 24 hours after any narcotic pain medication.
Yes, you will be placed in a supportive bra before you are awakened from surgery. You should wear this bra at all times except when showering. The purpose of the bra is to support and protect the tissues as they are healing. No underwire for 6 weeks following the procedure. Usually, the final shape and implant position is ~3 months post-op. It may be beneficial to wait until 3 months post-op for your new bra size to be remeasured.
While the recovery process can be different for everyone, in general, you may feel sore and tight after surgery. The majority of swelling has peaked 72 hours after your procedure. Ice packs and anti-inflammatory medications can be great adjuncts to the recovery process. There is no exercise or intense activities for 2 weeks following your procedure. The biggest risk of the procedure is typically bleeding. Yes, the risk is very low (~4%), but we want to optimize safety and minimize the post-operative risks. After two weeks, light activity is acceptable. The light activity would be defined as a walking, stationary bike, or slow stair mill– nothing high impact or causing excess bouncing like running or jumping—weight restriction of nothing more than 10 lbs for the first 4 weeks following surgery. Upper body exercise should be limited to a minimum of 6 weeks.
We recommend waiting to return to CrossFit exercises, bodybuilding/heavy weight lifting with a barbell (heavy, intense, repetitive upper body exercises) for 3 months to minimize the risk of implant malposition.
Time off from work largely depends on your occupation and desire to return. When you do not need narcotic pain medication and can abide by the restrictions, it is acceptable to return to work. A note can certainly be provided outlining the specific restrictions. Typically, the weight limit is 10 lbs or less for the first month, then 30 lbs or less for weeks four through six. We recommend avoiding intense, repetitive shoulder and upper body workouts like cross-fit style, bodybuilding, or Olympic weight lifting for 3 full months after your procedure. This is to minimize the risk of implant malposition.
Yes, high-risk screening should begin at age 35 for some patients. Routine mammographic screening starts at age 40 and should be performed annually. The mammogram technician should be made aware of your implants as there are certain views needed to displace the implant and allow complete visualization of the breast tissue.
No drainage tubes are indicated with an augmentation.
No. We perform a meticulous three-layered closure to ensure the implant is protected from the outside world. The sutures are all absorbable and do not require removal. We place skin tapes called steri strips to cover the incisions after surgery. These stay on until your first post-operative appointment. After we remove the steri strips, we usually start the medical-grade scar therapy.
It is uncommon to have permanent sensory changes after breast augmentation. It is very common to have temporary sensory changes after the surgery. We have found that most of our primary augmentation patients have more sensitivity during recovery. After things have healed and settled, your nipple sensation most likely will return to normal. The incision/scar itself will always remain numb, like any other scar.
Yes. No breast implant is considered a lifetime device regardless of material–silicone or saline. Generally, the recommended replacement time frame (or removal) is ~10 years. The rupture rate at 10 years is quite low. Implants left in place for many years/decades can develop a calcified capsule/shell that can become hard and painful. If exchange is delayed until this calcification has occurred, the entire capsule is usually removed with the implant. Total capsulectomy is more invasive and has a higher risk than an implant exchange.
The most common complication after breast augmentation is bleeding. The risk is very low, ~4%, and typically occurs during the first two weeks after the procedure. We never leave the operating room if something is bleeding; however, non-compliance with restrictions (like exercising or overexertion) can cause a blood vessel to open up and start bleeding. Bleeding can be a life-threatening complication that is managed emergently. Other less common risks are infection, fluid collection, implant malposition, capsular contracture, permanent sensory changes, BIA-ALCL, BIA-SCC, and breast implant illness.
Yes, any surgical incision will leave a scar. The inframammary fold scar is typically ~4 cm or about 2 inches long. Initially, the scar may appear red, but it will fade and soften over time. We provide you with medical-grade scar therapy to help the scar fade and look the best possible.
Yes, an implant can break or rupture. The most common reason for implant rupture is shell failure. Shell failure can occur if the implant folds upon itself with repeated friction/shearing forces. This can be seen in an underfilled saline implant. The repeated shearing forces of the shell folding on itself cause shell failure.
Saline implant rupture is usually obvious. This type of implant is filled with IV fluid/saltwater absorbed by your body. Your breast implant deflates once the fluid is absorbed, and an obvious volume difference can be noticed. The highly cohesive, 5th generation “gummy bear” silicone implants may not show any outward signs or symptoms of implant rupture or shell failure. This is called a silent rupture. The gold standard for rupture surveillance of silicone implants is an MRI. However, high-resolution ultrasound, like our Clarius L15, can be used in the office to evaluate your breast implants. Although this is not considered the “gold standard”, it can be useful in obtaining more information regarding the status of your implants.
No, it will feel tight after surgery, and you may notice the pressure from your implants with each breath you take. Swelling and muscle spasm will subside, and the pec muscle will relax and stretch, allowing your implants to soften and settle. Immediately after surgery, although it feels tight and sore, you should be able to brush your teeth and wash your hair without causing surgical complications. Shoulder stiffness can occur if you don’t use your normal arm mobility.
Dr. MaDan BEYOND Collective
N/a
Copyright © Dr. MaDan BEYOND Collective, 2024 | All rights reserved.
