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Breast Augmentation - Breast Implants
205-871-3361
About Breast Augmentation
Breast Augmentation has been the most popular plastic surgery procedure among women for decades. Breast Enhancement surgery can improve a woman’s image in clothing, swimwear, and overall figure. Breast Augmentation Mammoplasty is the surgical procedure to enhance the appearance of the breast with implants. These implants are surgically placed by creating a submuscular pocket for the implant. Dr. Howard does not prefer implant placement in the sub-glandular (on top of the muscle) position due to the un-natural appearance and the increased risk of capsular contracture (hardening of the implants).
Breast Augmentation Gallery
Best Candidates for Breast Implant Surgery
Breast Augmentation Incisions
Types of Breast Implants
The Breast Augmentation Consultation
Breast Augmentation Surgical Procedure
Breast Augmentation Recovery
Breast Augmentation Risks
Breast Augmentation Cost
Breast Implant Warranty Information
Breast Augmentation Revision Surgery
Best Candidates for Breast Implant Surgery
Dr. Paul Howard has helped women from ages 18 to 75 improve their overall physical image with cosmetic breast surgery. The best candidates for Breast Augmentation Surgery will be healthy and a non-smoker. Women should be of legal consenting age to have any surgical procedure. Prospective patients should also not be pregnant and should wait until at least six months following pregnancy to consider any cosmetic surgical procedure. Women considering Breast Implant Surgery should desire the surgery for themselves personally and not at the request of a spouse or boyfriend.
Breast Augmentation Incisions
There are a variety of incisions available for breast augmentation. Dr. Howard pioneered the use of the endoscope for the trans-axillary (arm pit) incision in the early 1990s and has been a world leader in trans-axillary breast augmentation. Dr. Howard prefers the trans-axillary 
incision due to its decreased visibility, allows for a small incision (approximately 1 1/2 inches) and less invasion to the breast tissue. The armpit incision is completely safe and has a reduced risk of loss of nipple and breast sensation. It is a plastic surgery myth to believe this incision has an increased risk of nerve damage. In the hands of an untrained surgeon, any surgery has increased risks. Dr. Howard has never had a patient with decreased nipple sensation or permanent nerve damage as a result of the trans-axillary incision. The
trans-axillary incision is only available when using saline implants. The FDA requires a larger incision (approximately 5.5cm) for the surgical placement of silicone implants such as the infra-mammary incision (placed in the crease underneath the breast). The peri-areola incision (around the nipple) is also an available option for breast augmentation using saline implants, but has an increased risked of loss of nipple sensation and hyperpigmentation.
Types of Breast Implants
There are currently two different types of breast implants available for Breast Augmentation: Silicone and Saline. Saline implants are the most common and popular choice, they can be used for any surgical incision, and have a life expectancy of around 10 years. Some common disadvantages of saline filled breast implants are rippling, loss of volume due to the age of the implants, and deflation. Saline implants are made of a silicone shell and are filled with sterile saline water during the breast augmentation surgical procedure.
Silicone gel filled breast implants were re-approved by the FDA in 2006. Silicone gel filled breast implants are gaining popularity due to a more natural feel and longer implant life. The FDA requires a specific incision length for the surgical placement of silicone filled implants. A disadvantage to silicone filled implants is the FDA recommendation the patient has an MRI periodically since silicone implant failure is not always visually detected.
Dr. Paul Howard uses Mentor Breast Implants. Mentor offers exceptional warranties on all their products.
The Breast Augmentation Consultation with Dr. Paul Howard
Dr. Howard and his staff are committed to providing you with the information you need to make an informed and educated decision about your plastic surgery procedure. During your initial consultation, Dr. Howard will speak with you personally about Breast Augmentation surgery, your expectations, and his professional recommendations to achieve the desired result. During your confidential consultation, a complete medical history will be documented, photos will be taken for your medical record, and you will be able to view Dr. Howard’s portfolio of breast augmentation photos. Additional information will be provided to you regarding surgical preparation and recovery.
Breast Augmentation Surgical Procedure
Dr. Howard performs all of his breast surgeries under general anesthesia at the Birmingham Surgery Center in Homewood, a fully accredited surgical facility. Most breast surgeries last approximately one hour unless additional procedures are required to achieve the desired look. Patients are allowed to go home following surgery. Patients will have a surgical bra and dressing placed on them in the operating room. Patients should not remove this bra and dressing until instructed by Dr. Howard. Most patients will have their first post-operative visit with Dr. Howard 2 or 3 days after surgery.
Breast Augmentation Recovery
Your recovery after breast implant surgery will include mild to moderate pain and discomfort. This will be easily controlled with the prescriptions given to you by Dr. Howard. Most patients find sleeping in a recliner or elevated using a few pillows allows them to more easily get in and out of bed and reduces swelling of the surgical area. Dr. Howard recommends the patient expect to be off work for one week following surgery and refrain from physical activity for almost 2 weeks following surgery. Patients with small children should get a friend or relative to assist with childcare, due to the inability to lift or carry them. Dr. Howard does allow his patients to walk on a tread-mill one week following surgery. Patients should avoid sun exposure to the surgical incision for six months following surgery. Patients should drink plenty of fluids following surgery and maintain a healthy, low sodium diet.
Breast Augmentation Risks
Breast Augmentation is a surgical procedure that involves a general anesthetic. Although complications are infrequent, all surgeries have some degree of risk. All of us at Paul S. Howard, MD will use our expertise and knowledge to avoid complications in so far as we are able. If a complication does occur, we will use those same skills in an attempt to solve the problem quickly. The importance of have a highly qualified medical team and the use of a certified facility cannot be overestimated.
Common Risks:
Infection & Inflammation – A superficial infection may require antibiotic ointment. Deeper infections are treated with antibiotics. Development of an abscess usually requires drainage.
Hematoma – Some post-operative bleeding into the pocket containing the breast implant occurs in 2-3% of women. If the bleeding has been minimal, the body will absorb it with time. Marked swelling, however, usually requires surgical removal of the blood.
Capsular Contracture- Capsular contracture is the most common side effect of breast implants. During surgery, a pocket is created for the implant that is somewhat larger than the implant. A fibrous membrane, called a capsule, then forms around the device. Under ideal circumstances, the pocket maintains its original dimensions and the implant “rests” inside, remaining soft and natural. For reasons that appear to relate to the individual characteristics of the patient, the scar capsule shrinks in some women and squeezes the implant, resulting in various degrees of firmness. This contraction usually begins to form within 6 weeks following surgery and can occur in one or both breasts. Many studies have shown tobacco use and heavy alcohol consumption to be linked to capsular contraction. A surgical revision would possibly be advised to re-create the pocket by removing the capsular scar.
Implant Deflation or Rupture – If, for any reason, the valve or implant shell fails, the saline will leak and be excreted by your body. This causes no medical harm, but requires replacement of the implant in a secondary procedure. The rate of saline implant leakage is quoted at about 1-2% over many years. Breast Implants have basic warranties covering implant replacement and financial assistance of up to 10 years.
Rippling and loss of implant volume- In some thin women, the breast implants may present visible wrinkling or rippling. This usually occurs on the outside of the breasts near the arms. This area of thin skin and the lack of breast tissue sometimes exposes the implant surface producing a rippling effect of the skin. This is not a medical condition and can often be corrected by replacing the saline breast implants with silicone gel implants.
Breast Sensation –Small sensory nerves to the skin surface are occasionally cut when the incision is made or interrupted by undermining of the skin during surgery. The sensation in those areas gradually returns – usually within 2 to 3 months as the nerve endings heal spontaneously.
Breast Augmentation Cost
Dr. Howard’s breast implants prices using Saline filled breast implants is $4700.00. This price increases by $800 for the use of Silicone filled breast implants for a total cost of $5500.00. These quotes include the Operating Room (facility fee), Anesthesia, Implants, Garments, Dr. Howard's professional fee, and all pre and post-operative appointments. The cost for prescriptions is not included (antibiotics and pain meds after surgery).
Breast Implant Warranty Information
Breast implants come with a standard warranty. Dr. Howard uses Mentor Breast Implants. Mentor has a standard implant warranty, and an optional extended warranty the patient may purchase within 45 days after surgery. The details of the standard warranty and the extended warranty are as follows:
The Mentor Standard Advantage:
This warranty is free of charge to all patients who are implanted with Mentor saline-filled implant products. And here are the details:
*Lifetime product replacement policy
*For 10 years, and up to $1200 financial assistance for opertating room, anesthesia, and surgical charges
*Free Contralateral (opposite side) implant replacement upon surgeon request
*Non-Cancelable terms
The OPTIONAL Mentor Enhanced Advantage:
This optional warranty is available for saline-filled breast implant products and, to be eligible, must be purchased for an enrollment fee of $100 with 45 days from implantation. The Enhanced Advantage replaces the Mentor Standard Advantage allowing for a total financial reimbursement of up to $2400. Here's what's included:
*Lifetime product replacement policy
For 10 years, and up to $2400 financial assistance for operating room, anesthesia, and surgical charges
*Free contralateral (opposite side) implant replacement upon surgeon request.
*Non-cancelable terms
For more warranty information regarding Mentor Breast Implants, please click here.
Breast Augmentation Revision Surgery
With the new silicone implants now approved by the FDA, many women who have saline implants are deciding to exchange their implants. In addition, many women with first generation silicone implants often desire to exchange their implants to either the new silicone or saline implants. The average life of saline breast implants is 10 years. Although Dr. Howard has numerous patients who have saline implants over 10 years of age and still look great, many patients decide to upgrade their breast implants for a variety of reasons.
Dr. Howard's existing patients receive special pricing for Breast Augmentation Revision Surgery such as replacing implants due to age, size, or to exchange type of implant. Call the office for details.
205-871-3361
205-877-PAUL
800-734-LIPO