Sacramento Breast Augmentation Specialist
Dr. Donald Hause

From his premier Sacramento plastic surgery center, Dr. Donald Hause treats Modesto and Sacramento breast augmentation patients. In the paragraphs below, Dr. Hause describes the options available when considering the breast augmentation procedure.

Saline-Filled Implants:
Saline implants are made of a silicone rubber shell and are inflated at the time of surgery to their appropriate size with saline (0.9% salt water). If they leak (rupture), the body just absorbs the water with little side effect other than the volume is lost (some patients wake up with a 'flat tire'). This is one big advantage of Saline-filled implants. A second advantage is that they come deflated and therefore require a much smaller incision for placement. However, as you will see during your consultation, saline-filled implants do not feel anything like silicone gel or normal breast tissue. This is why we recommend placement of these implants under the Pectoralis Muscle. This is a sculpting technique to hide this implant under the normal soft tissue. In this way, the implant is less visible and feels more natural. They are still not as natural feeling as silicone gel but they are acceptable in appearance and feel for patients with adequate soft tissue (breast and muscle tissue). Another interesting thing about saline-filled implants is that the rate of Capsular Contracture (becoming hard) is about the same for textured and smooth implants.

Because saline-filled implants require a smaller incision, there are 3 standard options for placement of the incision.

1. Trans-Axillary Incision: Placing the incision in the armpit may be considered advantageous because there is no incision on the chest. The most critical part of breast augmentation is placement of the implant in the fold below the breast. Since this incision is the farthest from the fold, it is technically more difficult to place the implant precisely.
2. Infra-mammary Incision: Under the breast fold is the traditional method most plastic surgeons were trained to do because it is straight forward and can be used with all implant types.
3. Peri-areolar Incision: Most surgeons prefer an incision around the nipple, if possible - this is called the peri-areolar approach.

Silicone Gel Breast Implants:
The FDA has concluded that Silicone Gel is safe enough for routine use (patients must be at least 22 years of age, have no active infections, not pregnant, no active cancer). Silicone Gel is far and away the most natural feeling and looking breast implant available. The most noticeable disadvantage of Silicone Gel implants is that they require a larger incision (2 inches) for placement. This is because they come pre-filled from the manufacturer. This fact usually prevents the surgeon from using the preferred peri-areolar incision and necessitates the infra-mammary approach. On the flip side, because they feel so much more natural, it is usually not necessary to place them under the breast muscle. There is much less discomfort and faster recovery after surgery and the breasts do not move when you flex your chest muscles. In contrast, the maintenance of the gel is more involved. The manufacturer recommends routine follow-up with MRI scans (added costs) at various intervals to detect rupture.

Breast augmentation is performed as an outpatient. In this practice, it is performed under general anesthesia. Although some practices perform breast augmentation with sedation and local anesthesia, I believe that it is a much more pleasant experience and can be done more precisely with you asleep. We always see you the following day after surgery. We will give you a port-operative bra at that time. We will see you again in 7-10 days to remove sutures and again at 8 weeks after surgery to make sure the implants are settling well into their pockets and everything is progressing normally.

In addition to the breast augmentation procedure, Dr. Hause also treats Sacramento breast lift and breast reduction patients. Please visit these pages to learn more about Dr. Hause, who serves patients from Sacramento and Modesto.

downloadable documents

• Breast Augmentation Letter