A Best Friend's Guide to Breast Augmentation

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A Best Friends Guide
to
Breast Augmentation
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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What you need to know before having a breast
augmentation.
Considering a breast augmentation is a big deal.
Have you always thought about a breast
augmentation, but had limited opportunities to
learn about the options, benefits and risks?
Well.. weve got you covered.
With this guide, well introduce you to the
everything else you need to know about breast
augmentation How To Choose a Plastic Surgeon,
Breast Implant Sizes and Types, Breast Incision
Placement, Risks, Recovery and more.
Were here to guide you through this journey.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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Who are we exactly?
We are a board-certified female plastic surgeon
team located in Nashville, Tennessee. Our goal is
to be both attentive to the needs of our patients
and to help each patient realize their dreams. We
want to ensure that each patients experience,
from the initial consultation through surgical
recovery, is as pleasant and smooth as possible.
We want to facilitate the best education and
support for all women interested in plastic
surgery, whether you become a patient of ours or
not.
If youd like to learn a little more about us,
feel free to check us out here!
We are, Dr. Mary Gingrass and Dr. Melinda Haws
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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A Breast Augmentation is one of the most popular
plastic surgery procedures in the United States.
Having breast implants can help accentuate the
feminine figure and bolster a womans
selfconfidence. It is our goal to answer any/all
of your questions and create a comfortable
atmosphere for you.
THE BASICS
A breast augmentation is a surgical procedure
that enhances the shape and size of a womans
breasts using breast implants. Women choose to
have breast augmentation surgery to enhance the
contours of their body, to correct loss of breast
volume following pregnancy, to make their breasts
symmetrical, and for other individual reasons.
Breast augmentation surgery requires research,
careful consideration, and a basic understanding
of what will be involved even before your first
consultation. Being prepared is the best way to
ensure a successful procedure and a happier
you. Now that you have some background, its time
to move forward and dive deeper into what you
need to consider when having a breast
augmentation. Keep in mind throughout your
research, expectations must be realistic to avoid
disappointment and should be carefully discussed
with your surgeon. This leads us to the first and
most important part of your journey Choosing
the Right Surgeon.
Well.. weve got you covered.
Were here to guide you through this journey.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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SELECTING A PHYSICIAN

• The single most important factor in achieving the
  results you desire is selecting the best
  physician for your surgery. Choosing the right
  surgeon is a responsibility that should not be
  taken lightly. Never let yourself be pressured
  into making uneducated decisions. Instead, do
  your own research and check your surgeons
  training and experience prior to your first
  consultation.
• Youll want to research and verify your
  surgeons
• Plastic surgery specialty
• Plastic surgery board-certification
• Years of experience and training
• Hospital privileges
• Surgical facility/office and ensure they are
  accredited by a national or state agency

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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PLASTIC SURGERYCERTIFICATION
There are many ways to find a qualified
physician. Referrals from friends or family
members whove had a breast augmentation is
always a great place to start.

• In addition you may also contact a number of
  respected professional organizations, such as
• The American Society of Plastic Surgeons (ASPS)
• The American Society for Aesthetic Plastic
  Surgery (ASAPS)
• Your local medical society

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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REALSELF.COM
Since its founding in 2006, RealSelf has created
the world's largest community for learning and
sharing information about cosmetic surgery,
dermatology, dentistry, and other elective
treatments. Their extensive collections of
reviews, photos, and doctor QA make RealSelf the
most trusted resource for those who are looking
for help beyond the beauty counter.
Dr. Gingrass and Dr. Haws are proud to be Top
Doctors on RealSelf, which is a recognition
awarded to less than 10 of doctors on RealSelf.
This status is earned by achieving high patient
satisfaction, getting favorable feedback on their
expert answers, and investing time in answering
patient questions.
They are also honored within the RealSelf 100.
These 100 doctors of RealSelf are recognized as
the most influential board-certified aesthetic
doctors on social media and are recognized for
providing valuable insight for consumers who are
looking to make informed and confident decisions
about their health and beauty.
We recommend browsing and interacting with the
community on RealSelf as an additional resource
when considering a breast augmentation.
Dr. Mary Gingrass Dr. Melinda Haws
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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• In addition to learning about your plastic
  surgeons certification and experience, the
  following are questions you should ask your
  plastic surgeon during your initial consultation
• What are the risks and complications associated
  with having breast implants?
• How many operations should I anticipate over a
  lifetime after having a breast augmentation?
• How will my breasts look if I choose to have the
  implants removed without replacement?
• What shape, size, surface texturing, incision
  site and placement site are recommended for me?
• How will my ability to breast-feed be affected?
• How can I expect my breasts to look over time?
• What are my options if Im dissatisfied with the
  cosmetic outcome of my breast augmentation?
• What alternate procedures or products are
  available if I choose not to have breast
  implants?
• Do you have before and after photos I can look at
  for each procedure, and what results are
  reasonable for me?
• We recommend bringing pictures of breasts that
  you like the day of your consultation so we can
  have a better idea of your expected outcome.

QUESTIONS FOR YOUR PLASTIC SURGEON
These questions and your initial consultation
will help you assess your plastic surgeon and
ensure that you feel comfortable with him or her.
Youll want to make sure that your surgeon takes
time to answer your questions and that they speak
to you in a patient, respectful manner.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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THE BREAST AUGMENTATION PROCEDURE
From start to finish, well discuss exactly what
happens during your breast augmentation
procedure. It is important to understand the
process and have a realistic expectation of how
long the procedure takes as well as what is
involved in the surgery, recovery, and potential
risks. Though it is always important to continue
to ask your plastic surgeon questions about your
procedure, understanding the process beforehand
will help guide you and give you peace of mind.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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At The Plastic Surgery Center of
Nashville, each breast augmentation patient is
unique. It is important for us to make
personalized recommendations based on each
patients vision and goals. To learn about the
process of the breast augmentation procedure,
follow the steps!
Step 1 Anesthesia In a hospital setting, breast
augmentation surgery is performed with general
anesthesia for your comfort. Step 2
Incisions Your plastic surgeon will begin making
the surgical incision along the crease on the
underside of the breast or around the areola. An
incision made underneath the breast is called an
Inframammary Incision, while an incision made
around the areola is called a Periareolar
Incision. Incisions vary based on the type and
size of breast implant, the individuals anatomy
and recommendations made by your plastic surgeon.

BREAST AUGMENTATION SURGERY
Image provided by ASPS
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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Step 3 Inserting and Placing the Breast
Implant After the incisions are made, your
plastic surgeon works through the incision,
creating a pocket either A) behind the breast
tissue, over the pectoral muscle (a
submammary/subglandular placement) or B) under
the pectoral muscle (a submuscular placement) to
accommodate the breast implant. The method for
inserting breast implants depends on the type and
size of the breast implant, your particular body
type, and your plastic surgeons
recommendations.
BREAST AUGMENTATION SURGERY
Image provided by ASPS
Step 4 Closing the Incisions Once the breast
implants are inserted, the incisions will be
closed using sutures, bandages, tape, and/or
gauze for support and to assist with healing.
Over time, the incision lines will mature and
become less noticeable. The breast augmentation
surgery will require an hour to two hours to
complete. Step 5 After Surgery Your plastic
surgeon and attending staff will strictly monitor
your progress. You may feel tired and sore for a
few days after breast augmentation surgery, but
you should be mobile in one to two days. Gauze
and surgical dressing will be removed within 24
hours, at which time you may change to a sports
bra. Any sutures that do not dissolve on their
own will be removed in 7 days. During the first
two weeks, your nipples may experience a burning
sensation. This will subside as swelling
decreases. Swelling after breast augmentation
surgery may persist for three to five weeks with
implants placed under the breast gland. In breast
augmentation where the implants are placed under
the muscle, swelling may persist significantly
longer, approximately three to five months.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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BREAST AUGMENTATION RECOVERY
It is vitally important that you follow all
patient care instructions provided by your
plastic surgeon. This will include information
about wearing compression garments, taking an
antibiotic if prescribed, and the level and type
of activity that is safe. Your surgeon will also
provide detailed instructions about the normal
symptoms you will experience and any potential
signs of complications. You should be able to
walk without assistance immediately after breast
augmentation surgery. It is important to walk a
few minutes every few hours to reduce the risk of
blood clot formation in your legs. Most patients
will be able to return to work a few days after
breast augmentation surgery, depending on the
amount of activity their job requires. During the
first two to three weeks, your breasts will be
very sensitive to direct stimulation. If your
breasts are no longer sore after three to four
weeks, breast contact should be fine. No heavy
lifting, pushing, or pulling with the upper body
is recommended for at least two weeks after
breast augmentation surgery. We discourage any
activity that causes an increase in your heart
rate or blood pressure for the first two
weeks. After breast augmentation surgery, the
surgical scars will appear pink and firm for six
weeks. The surgical scars may appear to widen or
remain the same size for several months. They
will eventually fade, though they will not
disappear completely. View our Recovery Timeline
next.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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RECOVERY TIMELINE

• The First Week
• Any surgical dressings will be removed within 24
  hours. You may be instructed to wear a sports
  bra.
• You will be permitted to shower 24 hours later
  after surgery.
• If you have external sutures, they will be
  removed in about a week. If your surgeon used
  tissue glue or tape, it will be removed in 7
  days.
• You may be able to return to work within a few
  days to a week, depending on the nature of your
  job.
• You should refrain from lifting, pulling, or
  pushing anything that causes pain and limit
  strenuous activity.
• Two Three Weeks
• You should minimize excessive physical activity
  for at least the first two weeks after surgery.
  After that, take care to be extremely gentle with
  your breasts for the next month or two. Your
  breasts will also be sensitive to touch for the
  first two to three weeks.
• Long-term
• To promote a safe and healthy outcome, its
  important to return to your plastic surgeon's
  office for follow-up evaluation at prescribed
  times and whenever you notice any changes in your
  breasts. Do not hesitate to contact your plastic
  surgeon when you have any questions or concerns.

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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POTENTIAL RISKS

• At our cosmetic surgery practice we perform
  breast augmentation surgery often, and usually
  achieve excellent results. Yet, as with other
  types of surgery, there are a number of potential
  risks.
• Capsular Contracture One of the more common
  complications following breast augmentation
  surgery is called capsular contracture, which
  occurs when the capsule or scar around a breast
  implant tightens, causing a womans breast to
  feel abnormally hard. The condition is treatable.
  
• Excessive bleeding or infection
• Oversensitive, under sensitive, or numb nipples
  are infrequent but possible complications.
• Leaking breast implants If a saline breast
  implant leaks or breaks, the implant will drain
  completely within a few hours and your body will
  absorb the salt water harmlessly. If a silicone
  gel-filled implant breaks, you may not detect the
  leak if the scar tissue around the breast implant
  remains intact. If the scar tissue does break or
  tear, however, the silicone gel may migrate into
  the surrounding tissue. If a saline or silicone
  implant breaks, you will require a second
  operation to replace the leaking implant. If your
  implant breaks, contact your plastic surgeon.
• Mammography complications Though current
  evidence does not show a link between breast
  augmentation surgery and breast cancer, breast
  implants can alter the way a mammography is
  performed in order to detect breast cancer.
  Trained radiologists will need to perform special
  displacement techniques as breast implants may
  obscure breast tissue on some views.

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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FORGET THE CUP SIZE
Are you hoping for large or small implants? Do
you want a little boost or a dramatic change in
your bust size? When choosing implant size
there are a few factors you want to consider, and
cup size is not one of them. First well take
into consideration the amount of natural breast
tissue you have. Women with more breast tissue
can use a smaller implant to achieve a larger
result. Your body shape and size is another
factor that will help us determine the best sized
implant for your augmentation.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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TRYING ON SIZERS
Once you figure out your desired results, the
next step, to best visualize what the end result
will look like, is to try on sizers. Implant
sizes depend on how much fluid or gel is in the
implant. The smallest size available is 125cc,
which is often used to correct asymmetry.
Patients typically choose a size between 300cc
and 400cc for breast enlargement. While trying
on sizers, your plastic surgeon will be able to
help you with your decision and fit you with the
best implant size for you.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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LIFT OR AUGMENTATION OR BOTH?

• What you need to remember is that augment means
  to add to, or make bigger.
• A breast augmentation will make your breast
  bigger.
• A mastopexy is a breast lift or breast tightening
  procedure that tightens up a breast that has a
  loose skin envelope.
• The two procedures are by no means mutually
  exclusive in fact, we perform combined breast
  augmentation with a mastopexy or lift quite
  frequently.
• During your consultation, we will first assess
  your goals do you want a larger breast or a
  higher, tighter, firmer breast? Second, we will
  recommend what we believe is the best way to
  proceed in order to achieve your specific goals.
  The use of other patients before and after
  pictures will be used to give you an idea about
  what can be reasonably achieved on our part as
  well as help us better understand your
  expectations.

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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SILICONE VS. SALINE
SILICONE

• Available to ages 22 and higher
• 900-1,200 more expensive than saline
• More natural feel, because it has a closer
  consistency to normal breast tissue
• Larger incisions and scars, because it is
  inserted full size
• Difficult to detect rupture requires medical
  imaging (MRI or ultrasound)

SALINE

• Available to ages 18 and higher
• 900-1,200 less expensive than silicone
• More unique look and feel in some patients, but
  in others, there is no noticeable difference
• Smaller incisions and scars, because it is filled
  once inside the breast
• Easy to detect rupture, because it develops a
  flat tire look body will absorb the harmless
  solution

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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SHAPES TEXTURES
Many patients are surprised to learn that
implants are available in different shapes. Two
main shapes are available round and teardrop.
Round is the most common type used and is a
popular choice since it provides optimal lift and
plenty of cleavage. Some women prefer teardrop
however since this implant shape tends to have a
more natural look. With round implants smooth or
textured can be used since the implant can rotate
in its pocket without changing the shape of the
breast. With teardrop implants we generally
recommend a textured implant to keep the implant
from repositioning or moving inside of the
capsule. One of the biggest complications from
breast augmentation surgery is a condition called
capsular contracture. This occurs when the thin
tissue capsule surrounding the implant becomes
hard and tightens. This can cause the breast to
feel hard and in extreme cases even distorts the
shape of the implant. Rather than having a smooth
outer surface, textured implants have an outer
layer that is textured (kind of like a rubbery
sand paper). This textured surface clings to the
capsule, reducing the rate of capsular
contracture especially in subglandular
augmentations. In patients with sufficient
breast tissue and with a submuscular placement,
you cant feel the difference between a textured
and a smooth implant. In patients with less
breast tissue, you may notice the thicker shell
of the textured implant. Talk with your surgeon
about whether textured or smooth implants will be
most beneficial for you.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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GUMMY BEAR IMPLANTS

• We also offer the highly cohesive gel implants
  (also known as gummy bear implants). While they
  do have many advantages, there are a few
  potential drawbacks to this popular implant
  choice. Gummy bear implants are more expensive
  than silicone and saline implants, but they have
  the following benefits
• In the event of a rupture, these implants will
  keep their shape
• The integrity of shape minimizes the chance of
  gel leakage
• They pass the feel test because they squish
  when pressed against another person (as in a hug)
  as opposed to providing resistance like saline
  implants
• They seem to hold their shape for a much longer
  time than other implants
• The gel is so thick that it won't run or slosh
  around inside the implant
• The folds and rippling associated with saline and
  silicone implants are less likely to occur

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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HOW MUCH DOES IT COST?
At the Plastic Surgery Center of Nashville,
breast augmentation pricing ranges from 5,500 -
6,700, and breast lift pricing ranges from
5,700 - 7,000. A breast augmentation with a
lift ranges from 7,700 - 9,300. These are
all-inclusive prices that cover the surgical and
anesthesia fees, the implants and all follow-up
office visits.
HOW DO I AFFORD IT?

• We aim to make plastic surgery accessible to all
  patients and accept the following financing
  options
• CareCredit
• Alphaeon

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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ARE YOU READY?

• Consider the following points when deciding
  whether or not to undergo a breast augmentation
• I am doing this for myself, not for anyone else.
• My family and friends are supporting me, not
  pressuring me.
• I understand and accept all potential risks
  associated with cosmetic surgery.
• I recognize that there are no guarantees and that
  additional procedures may be necessary.
• I am physically and mentally fit to experience
  this change in appearance.
• I am financially able to afford the costs of
  surgery.
• I will be able to give myself the proper time to
  recover.
• I trust my surgeon, and I am comfortable with
  office staff.

Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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SMART RECOVERY
Our care and compassion does not end with your
surgery. We work to serve you through a
comfortable recovery as well. Breast augmentation
is about an hour-long surgery and involves a
short one-to-two-week recovery. Breast
augmentation does not require an overnight
hospital stay, but you should avoid work and
other normal activities for at least one
week. After your surgery, we will provide you
with in-depth post-operative care instructions
that you are responsible for following. You will
be advised to book a follow-up appointment with
your doctor, but if you have any other questions
or concerns, do not hesitate to contact us
immediately.
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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THATS ABOUT IT
We hope youve enjoyed reading A Best Friends
Guide to Breast Augmentation! We hope you will
share it with anyone you know thinking about
breast augmentation so they are well educated
about the procedure. Again, we want to
facilitate the best education and support for all
women interested in plastic surgery, whether you
become a patient of ours or not. Please give us a
call if you have any further questions or
comments, wed love to be of assistance. And good
luck on your journey!
CONTACT US The Plastic Surgery Center of
Nashville Dr. Mary Gingrass Dr. Melinda
Haws 1915 State Street Nashville, Tennessee
37203 Phone [phone] www.nashvillesurgery.com
2016 The Plastic Surgery Center of Nashville
Mary Gingrass, MD Melinda Haws,
MD www.nashvillesurgery.com
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