Breast Enhancement, Augmentation, Implants, Prosthesis: Cleveland, Ohio

Breast Enhancement

Dr. Michelow excels in breast surgery. He has an additional 18 months of fellowship training is surgery of the breast beyond the traditional plastic surgery training. Dr. Michelow has collaborated on a book with Dr. Carl Hartrampf, Jr. entitled: Breast Reconstruction with Natural Tissue.

Aesthetic surgery of the breast includes several options to enhance the appearance of the breast. Together with Dr. Michelow, you will decide which option or combination of options, work best for you.

A breast augmentation will enlarge the size of the breast. This is achieved with the use of implants. In an older person with sagging breasts, a "breast lift" together with implants will provide for a more youthful breast contour.

View Before & After Photos of Breast Enhancement.

Breast Augmentation

Generally, a breast augmentation is performed as an outpatient procedure in a surgical center. It is typically performed under general anesthesia for your maximum comfort. Prior to your surgery, Dr. Michelow will discuss your implant options with you: silicone or saline implants.

Silicone implants have recently been reintroduced to the market by the Federal Drug Administration (FDA). Many women prefer silicone to saline implants because silicone implants have a more natural feel.

No matter which type of implant you choose, Dr. Michelow will individualize your implant choice.

During your consultations with Dr. Michelow, he will discuss the location of your incisions. Briefly, your choices are as follows:

	Advantages	Disadvantages
Incision
Periareolar¹	Well-hidden scar.	Occasional Nipple / areola numbness.
Inframammary²	Direct access to breast.	Scar may be noticeable.
Axillary	Scar hidden in armpit.	Implant may ride up and be too high.
Umbilical	Hidden scar.	More challenging procedure.

Implant Location
Subglandular³	More breast projection.	Step-off onto implant in thin patient.
Submuscular⁴	More natural shape.	Movement with muscle activity.

Implant Surface
Smooth	Less wrinkling.	Capsular contracture may occur.
Textured	Less capsular contracture.	Ripples may be noticeable.

Implant Shape
Round	Enhanced cleavage.	Capsular contracture may occur.
Anatomical	Natural look.	Rippling may be noticeable.

Notes:

¹Periareolar incision. Breast implants are placed through an incision at the lower perimeter of the areola—the dark skin around the nipple. This usually resolves in a well-hidden scar but can result in nipple or partial breast numbness.

²Inframmaray incision. The incision is placed under the fold of the breast. Some surgeons believe this provides the most precision in placing the implant. There will be a short, visible scar in the breast crease.

³Subglandular placement of implants: The implant is placed above the pectoral muscles and under the breast tissue. This location provides an advantage for patients with mild pre-operative sagging but who do not want to have a breast lift. This technique may result in a "step off" because the implants are placed close to the surface. The implant can also be unnaturally high or rounded and the there is a chance of hardening or wrinkling developing.

⁴Submuscular implant placement. The implant is placed below the pectoral muscle and the overlying breast tissue. There is less risk of implant visibility and less interference with mammography.

Breast Lift or Mastopexy

Weight loss, age and pregnancy can all contribute to droopy and saggy breasts. A breast lift can restore a more youthful appearance. Dr. Michelow will tighten the underlying breast tissue, tighten the breast skin and move the nipple areola complex to a more natural point of projection.

An enlarged areola can also be reduced in size. An implant can be added to increase breast size.

You will see an immediate improvement after surgery, however, like other cosmetic surgeries, your breast contours will become more natural over several weeks following surgery.