Generally, breast enlargement is a fairly straightforward procedure for an experienced, board certified plastic surgeon. The procedure increases the breast size and helps women obtain a more shapely figure.
Breast implants work by adding volume to the existing breasts. Whatever breast shape is presented to the surgeon is only made larger. This procedure works very well if the existing breast has a normal shape and width and the only problem is small size.
However, tubular breasts present extra challenges. These small breasts have many variations but share some common features. For instance, tubular breasts are very narrow at the chest wall, have a long, tubular shape with large fleshy areolas and are too far apart, leaving the patient with an unnaturally wide cleavage.
Most women with this condition only know they have small breasts and don't realize the problem is not just size alone. If tubular breasts were treated by simply inserting an implant, the results usually would be very poor and unacceptable. This is because an implant is incapable of stretching, flattening and altering the tubular shape.
To correct tubular breasts, I make an incision along the bottom edge of the areola and reach down to the base of the breast where I make a series of incisions on the undersurface. When finished, it looks like spokes in a wheel. These incisions widen the base of the breast and bring the inner edges closer together, creating a natural looking cleavage. Up to this point, the procedure only widens the base of the breasts; however, the tubularitiy is still not corrected.
My contribution to the operation is making a series of thin shavings at the under surface of the breasts to remove tissue. This will transform the tubular, conical shape into normal, even thickness breasts. A narrow base cone becomes a wider based globe.
If you can imagine the patient lying on her back, the tubular breast looks like a narrow mountain that is too tall. To reduce the height, I remove the bottom of the mountain and allow it to collapse to a lower level which reduces the tubular appearance. Thus, I have transformed a narrow, tall mountain into a wider, flatter mountain.
Once the tubularity is corrected, all that is needed is a breast implant.
I generally place the implant under the chest muscles which creates a smoother, softer and more natural-looking breast.
While many plastic surgeons can use other surgical approaches to making a pocket under the breast, I prefer working through the areola. That gives me direct access and vision to the inside of the breast. Moreover, the incision does not scar badly.
The other pathways for inserting implants from locations like the armpit or from the bottom of the breasts and even from the belly button make it difficult for the surgeon to see and can create more complications. If the surgeon does not have a clear view, he or she can not possibly perform a precision procedure.
Correction of tubular breasts is done in conjunction with breast implants under general anesthesia. This adds an additional one to one and one-half hours to the breast augmentation procedure but does not cause additional discomfort to the patient. Recovery time is seven to 10 days.
Surgery is performed in our surgery center which is accredited by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), a top certifying body which leaves nothing to chance.
The surgical teams consist of a board certified anesthesiologist, certified registered nurse anesthetist (CRNA), registered nurses and operating room technicians.
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