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Richmond Breast Augmentation

Breast Augmentation – Dr. Burton Sundin & Dr. Reps Sundin, Virginia

Surgical procedures that enhance the shape and size of a woman’s breasts, called Breast Augmentation or Augmentation Mammoplasty, have become one of the more popular cosmetic surgical procedures in the US. According to new statistics by The American Society of Aesthetic Plastic Surgeons, more than 355,000 breast augmentation surgeries were done in the United States last year; more than liposuction and tummy tucks.

At Virginia Institute of Plastic Surgery, our breast augmentation patients are usually women who feel their breast size is too small. In other cases, they may wish to balance a disparity in the size between their breasts or they may wish to change the shape of their breasts due to pregnancy, nursing or age. In other cases, after bouts with cancer and radical mastectomies, they may wish to attempt to return their appearance to that from before they were ill. For a smaller number of breast augmentation candidates, they may be trying to correct the appearance of an earlier mammoplasty.

View Our Breast Augmentation Before and After Photos

Dr. Burton M. Sundin finds that his breast augmentation patients have a high degree of satisfaction with the process and the end results. Managing the patient’s expectations is a large part of the success of a procedure of this kind and Dr. Sundin takes great care to counsel and advise his patients regarding what kind of implants they select, the size of the implants, and, of course, how their appearance will change once the surgery is complete.

Breast augmentation patients who come to the Virginia Institute of Plastic Surgery want two things: they want their breast augmentation to look and feel natural and they want the risks to be minimized. As with any surgery, there are risks and so it is important for you, the patient, to understand all the basics of what having a breast augmentation entails and be able to make an informed decision about your care.

Below, we have broken the important information into sections. Please read them carefully – Dr. Sundin will answer all of your questions during your visit to Virginia Institute of Plastic Surgery. Be sure to consult your spouse, family members and friends. We welcome your call anytime at 804-290-0909.

Breast Augmentation Testimonial

Breast Implant Surgery Preoperative Evaluation

Dr. Sundin usually begins the preoperative evaluation by letting you tell your story. The preop evaluation is important for the doctor because it allows him to understand what the most important factors are for you in considering breast augmentation and what anxieties you may have. By following an established procedure, Dr. Sundin can map out an appropriate solution for you – one that makes sense for you based on his many years of experience and, most importantly, based on your desired outcome.

During the preoperative evaluation, Dr. Sundin will also evaluate your general health and examine your breasts and the surrounding tissue and musculature. This allows him to get an accurate picture of your particular starting point. He will also take measurements of several important aspects of your body, chest, shoulders, and breasts – this will help him perfectly match the implant size and diameter, and the type of implant that is right for you. You and the doctor will discuss your goals and desired breast size. While many patients arrive in our medical offices with a particular cup-size in mind, Dr. Sundin is dedicated to helping all his patients understand why focusing on cup-size can be misleading and the more proper way to guide the patient is by focusing on the appearance the patient desires.

Types of Breast Implants

Today, all breast implants contain one of two different kinds of fillers: saline or silicone-gel. In either case, the outer shell of the implant is composed of silicone. Silicone gel filled implants have recently been approved by the FDA for use in all patients. Because saline is a common substance in every human and the risk of capsular contracture is lower, saline-filled implants are the most common type of breast implant done today.

Breast implants are either smooth or textured. The shapes are round, moderate-profile, high-profile, or anatomical. Across the spectrum of patients who elect to have augmentation mammoplasty, the majority of patients select round and smooth implants. Should Dr. Sundin recommend anatomic implants, you will find all of these implants are textured. The textured surface helps keep these implants fixed in place. Round implants are most popular because there is less risk of implant malpositioning. Dr. Sundin will review all of the pertinent information surrounding each type and how this might apply to your specific breast augmentation procedure.

Because implants are not sized as C, D, or DD cup sizes, you and Dr. Sundin will need to look at all of the various sizes of implants. Implants are sized according to volume in cc’s (milliliters). There is a broad range of sizes, but most women chose implants in the 250cc to 400cc range, depending on the desired outcome. Larger implants are available.

Many patients find that donning a surgical bra and trying various sizes of demonstration breast implants is the best way to judge relative sizes and shapes. Dr Sundin will have you try various sizes of implants using this technique. He may have you take some sizers home so you can evaluate the effect in various clothing. You may want to bring swimwear or a tight fitting tank top or shirt to your consultation. This will enable you to see how you might look with various sizes of implants.

Dr. Sundin will also counsel those patients whose main complaint is the shape and position of their breasts about the pros and cons of having a breast lift procedure done at the same time as the breast augmentation. In some cases, the high-profile breast implant can eliminate the need to have this done and this will be fully explained.

Breast Augmentation Risks

Any surgery carries a risk of complication from bleeding or infection or, even more remotely, a reaction to the anesthesia. Conscientiously following the doctor’s recommendations, both before and after any surgery, will greatly reduce your risk

Although breast augmentation does leave permanent scars, the scars will almost always be covered by your bra or bathing suit. Additional risks could include a temporary or permanent loss of feeling in your nipples or breasts or an oversensitivity of the breast tissues and/or nipples.

A small percentage of women experience a post-operative condition called capsular contracture which is when the scar tissue around the implant tightens. This can range from mild to severe. As the scar contracts, it can cause the implant to feel firm to the touch or demonstrate visible abnormalities. The risk for capsular contracture is greater when silicone gel implants are used.

It is important to remember that breast implants are man-made devices. In this sense they are subject to mechanical failure. Implants are initially covered by the manufacturer’s warranty, but there is risk of the implant failing outside of the warranty period. If this happens, the implant has to be replaced. There is a cumulative 1% per year risk of failure.

In Dr. Sundin’s experience, complications are rare, but each will be discussed fully with you prior to surgery so that you have a complete understanding of what this procedure may entail.

Planning Your Augmentation Mammoplasty Surgery

Because everyone has a different idea of what size and shape will be appropriate for them, it is important to listen to Dr. Sundin and ask as many questions as you can before making your decision. Taking extra time at this juncture of the decision-making process is never an error.

During your initial visit to Virginia Institute of Plastic Surgery, Dr. Sundin will thoroughly examine your breasts and discuss with you the variables that may affect the procedure, such as your age, your health, your physical profile and your risk factors, the size and shape of your breasts, and the condition of your skin. Typically, Dr. Sundin requests that every patient come in for a follow-up consultation visit to confirm the patient’s plans and to gauge the patient’s comfort level. In addition, the surgeon will also be sure to check the patient’s overall health to make sure no changes have occurred and will also explain the surgical procedure in great detail and make recommendations as to what type of surgical approach he recommends for you.

In addition, your surgeon will also discuss where your breast augmentation will be done and the various anesthesia choices that are available. Dr. Sundin always has time to discuss your anxieties and concerns as well. You will also be directed to have someone drive you home from the surgery and to have people around for the first couple of days after the surgery should you need help around the house.

Preparing For Your Breast Augmentation Surgery

Dr. Sundin may require you get a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications, including various natural teas and aspirin.

Although most patients are surprised at the minimal discomfort they experience after their surgeries, it is quite common to feel sore for a couple of days. Dr. Sundin will prescribe pain medication and antibiotics after the surgery and encourages you to take both as they will help you relax and be comfortable as you begin to heal. It will be helpful to have a friend or family member help you manage things around the home for the first few days.

Where Your Surgery Will Be Performed

Your breast augmentation will be performed at one of the accredited surgery centers that Dr. Sundin is affiliated with. The procedure is typically done on an outpatient basis, for cost containment and convenience. Hospital admission is rarely needed. If you feel like you need extra help, Dr. Sundin can recommend a specialized nurse who can assist in postoperative care.

Types of Anesthesia

Breast augmentation is usually performed under general anesthesia, which means you’ll sleep through the operation. In selected patients – particularly when a smaller incision is being made – Dr. Sundin may use local anesthesia combined with a sedative to make you drowsy and relaxed. In either case, you will feel minimal or no discomfort during the surgery.

Breast Augmentation Surgery

Augmentation mammoplasty usually takes 1 to 2 hours. Breast augmentation techniques vary, but the most common procedure at Virginia Institute of Plastic Surgery involves making a small incision in the crease beneath the breast. This is called the inframammary approach. Other incisions are possible, including those in the armpit (axillary) and those around the nipple (peri-areolar), but these can be more visible and have other drawbacks. The inframammary incision is hidden well beneath the breast and is designed to leave the most inconspicuous scar possible. Although most scars do fade with time, no scar will ever truly disappear. Dr. Sundin will place you on a postoperative scar treatment regimen utilizing a silicone ointment and massage.

Through a small incision, Dr. Sundin will insert the breast implant under the muscle and breast tissue. Dr. Sundin almost always will recommend that the implant be placed beneath the muscle, but, there are some circumstances where placing the implant beneath the breast tissue itself can be beneficial. Once the implant is positioned correctly, the incision is closed with stitches. These stitches are placed beneath the skin to optimize the scar and prevent a “train –track” appearance. Post-surgery you will wear a surgical bra for additional support during the recuperative process.

Patients who have elected to have breast lifts done at the same time as the breast augmentation will naturally experience a lengthier surgical procedure. A breast lift or mastopexy is a much more extensive procedure in which the breast is literally reshaped and excess skin is removed.

Along with the stitches, surgical tape and gauze bandages may be added for additional support of the sutures and to give the patient greater comfort. You will be asked to continue to wear the surgical bra for upwards of two weeks or more depending on your healing time and discomfort. You may also be asked to wear a “breast band” to keep the implants in good position. You will be asked to avoid under-wire bras for three months. The swelling and bruising will subside in ten days to two weeks.

After Breast Augmentation Surgery

If your breast skin is very dry following surgery, you will be instructed to apply moisturizer several times a day. Be careful not to tug at your skin in the process and keep the moisturizer away from the suture areas. If you have any other issues during the recuperative process, you should contact Dr. Sundin at Virginia Institute of Plastic Surgery as once.

Another common concern is some loss of feeling in your nipples and breast skin caused by the swelling after surgery. This lack of sensation usually reverses as the swelling subsides over the next six weeks or so. In very rare cases, it can last a year or more, and occasionally, the loss of sensitivity may be permanent. This is uncommon with straightforward breast augmentation without simultaneous breast lifting procedures.

Getting Back To Normal

Healing is a gradual process and everyone’s progress is different. You will probably feel like getting up and around in a day or two. Most breast augmentation patients can return to work in a few days depending on the level of activity required. Your breasts and chest muscles may be quite sensitive for two to four weeks, so Dr. Sundin will recommend avoiding contact. Once the pain has subsided, it is okay to begin to return to normal activities. If you have any unusual symptoms or other concerns, you will be instructed to contact Dr. Sundin.

Each patient will be given detailed instructions for resuming their normal activities. Every patient is asked to not lift anything heavy over their head for 3 to 4 weeks regardless of the procedure. In addition, you may be instructed to avoid sex for a week or more and to avoid strenuous sports for about a month. After that, you can resume these activities slowly and as your level of discomfort and your stamina permits.

Ongoing health examinations for patients who have had elective breast augmentation likely will include mammograms using special techniques for these women as opposed to the more standard digital breast exam. Some patients may require breast exams to include ultrasound studies for better visualization of the internal tissues and this will be explained by Dr. Sundin fully prior to your procedure.

In addition, the patient will be counseled about post-operative breast implant massage. When the breast augmentation is done behind the pectoralis muscle, these patients exhibit less signs of capsular contracture, if they embark on a regimen of vigorous massage of the entire breast and the implant area. This helps to minimize the risks to the tightening of the scar tissue and keeps the breast implant from becoming “fixed” during the healing process.

Your New Look

At the Virginia Institute of Plastic Surgery, Dr. Sundin makes every effort to deliver a satisfying cosmetic result with each breast augmentation procedure. Initially scars can be red or bumpy, but gradually, over time, most scars become less obvious, and fade to less noticeable flat, white lines. Initially following breast augmentation surgery, there is some swelling and brusing, but this ultimately resolves. How faithfully the patient adheres to Dr. Sundin’s pre- and post-op recommendations will greatly improve the patient’s healing. Good nutrition, smoking cessation, and limiting alcohol intake are all very important in the perioperative period.

At Virginia Institute of Plastic Surgery, your satisfaction with your breast augmentation surgery is likely to be greater if your expectations are realistic and your understanding of the procedure and risks is full. Dr. Sundin’s vast experience with patients just like you helps him guide you to a successful breast augmentation result. We welcome your questions and look forward to meeting with you about your breast augmentation surgery soon. Call us for a consultation today.

Some content provided by the American Society of Plastic Surgeons.



Plastic surgery in
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Our ultimate goal is to achieve an end result which is as natural as possible and to provide you with excellent medical care.We look forward to meeting you soon.

Sincerely, Dr. Burton M. Sundin & Dr. Reps B. Sundin

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