Breast augmentation consultations are increasing in frequency as we reach the summer months. Many patients wish to undergo breast augmentaiton in the early spring so that they can be ready for swimwear in the summer. Patients always ask how soon they can go back to the water after breast augmentation. Patients are allowed to shower two days after breast augmentation, but swimming, bathtubs, and jacuzzis, are not allowed until 4-6 weeks following surgery.

www.drbriandickinson.com

Mastopexy Augmentation and Abdominoplasty

Mastopexy augmentation and abdominoplasty when performed in combination can be quite a powerful combination to overall total body aesthetics.

During mastopexy augmentation or simultaneous breast lift and breast augmentation, a breast implant is placed as in a standard augmentation and at the same time, the nipple areola complex is elevated to a much higher position on the chest. When this is performed alone, the result can restore a youthful appearance to the breast.

When an abdominoplasty, or tummy tuck, is performed at the same time, the contour of the abdomen can be significantly improved which even further improves the aesthetic proportion of the breast.

Many patients are very happy with this combined procedure. We see many patients around the holiday season who wish to undergo simultaneous mastopexy/augmentation and abdominoplasty as the holiday season offers an opportunity to rest and recover in Newport Beach, California.

www.drbriandickinson.com

Breast Augmentation Recovery-Breast Augmentation in Athletes

Breast augmentation is common in female athletes who perform high volumes of cardiovascular exercise such as running, swimming, biking, etc. It is also common to see atrophy of the breast with competitive bodybuilders who are consistently lean for competitions. It is quite common for these women to come into our office and say, "Dr. D. I want to be able to return to my previous cup-volume.....or......Dr. D. I just want to be able to wear a strapless dress again."

The next question to follow is......."How soon can I return to working out after my breast augmentation?"

This is the simple 4 week rule.

Week 1: Walking is O.K.

Week 2: OK to return to the gym. Low impact cardio is fine such as exercise bike. Isolated arm exercises are O.K.

Week 3: OK to return to running. Patients should wear two support bras while running.

Week 4: Unrestricted gym activity is OK. Pilates and Yoga OK at week 4 as well.

Tuberous Breast Surgery. Breast Augmentation

Breast augmentation can be a very effective tool to correc the tuberous breast deformity. Tuberous breasts are not simply underdeveloped breasts. Tuberous breast characteristics iclude a widened, enlarged, puffy areola unusually wide spacing between the breasts, minimal breast tissue, higher than normal breast fold, and narrow base at the chest wall.

Correction of the tuberous breast often involve placement of a breast implant, lowering of the inframmary fold, and often scorring of the breast parenchyma below the areola.

The photo above demonstrates an approximately six month follow-up for surgery for tuberous breasts.

www.drbriandickinson.com

Strattice for Recurrent Capsular Contracture?

Capsular contracture and recurrent capsular contracture is a challenging problem for both the patient and surgeon. Acellular dermal substitutes have been used for rippling, implant and inframammary fold malposition. It may be that an additional benefit of acellular dermal matrices is to reduce the recurrence of capsular contracture.

I have found in certain cases of recurrent capsular contracture for Strattice to have been helpful as an interface between the access incision and the breast implant. It maybe that this interface serves as a mechanism to prevent capsular contracture.

http://www.drbriandickinson.com/

Mastopexy Augmentation

More frequently, I am seeing patients in my office who have had large implants for quite some time and now want their implants exchanged for smaller implants and would also like their breasts lifted. These operations are typically challenging.

As one reduces the size of the breast or changes the shape of the breast, it is important to respect the blood supply of the nipple areola complex. For example, this patient had a prior mastopexy augmentation via a superior crescent incision in the submuscular position. Therefore, one needs to be cognizant of the remaining blood supply when attempting to raise the nipple areola complex.

This patient underwent bilateral capsulectomy, bilateral removal of saline implants for Mentor smooth round high profile silicone gel implants, and mastopexy via an oblique pattern. I have found that the vertical, oblique, pattern provide excellent projection while removing excess skin. I have found that many women appreciate the breast projection that these patterns in combination with the high profile implant provide.

www.drbriandickinson.com

Breast Augmentation. Bra Sizing.

The breast augmentation consultation can often bring anxiety to the patient as there are many questions to be addressed or discussed. These variables can range from topics pertaining to the patient (medical conditions, height & weight, bra size, pre-operative breast shape); surgeon (preference for above vs. below the muscle, incision choice); or implant (saline vs. silicone, smooth vs. textured, profile).

Determining bra size in breast augmentation consultations creates a common frame of reference for the physician and patient to discuss post operative bra size. The first step in the physical examination is observation. In the observation step, both the patient and I stand in front of the mirror and with the same perspective identify any asymmetries between the breasts.

Breasts are more often than not asymmetric with either a discrepancy in breast volume, breast fold position, nipple position, shoulder height, and chest wall asymmetry. After this step of the physical examination we proceed to pre-operative bra sizing.

Bra Sizing: The BasicsThe size of a bra is determined by two factors: 1) The Band Size & 2) The Cup Size.

The Band Size

Step 1. The band size of the bra is relatively a fixed number determined by the circumference of a woman’s chest. This number can be measured with a measuring tape in inches, just beneath the breasts, in the crease where the band of the bra would be placed.
Step 2. Add five to the number of inches determined from this measurement. For example, if the measured number is 27” then if you add the number 5, the result is 32. Therefore the band size of the bra necessary is 32. If the measured number were 28” adding 5 would result in a 33 band. One quickly realizes when bra shopping that there are no odd number band sizes, so one would try on a 32 or 34 band bra to see which fit best. In this scenario, the 32 bra would be worn on the last of three clasps and a 34 bra would be worn on the first of three clasps.The band size is relatively consistent in women of adult age as the bony ribcage has completed growing. This number will change to a small degree if a woman gains or looses weight around the chest where the band of the bra would normally be placed. The so called “bra fat”.2)

The Cup Size

I have found the “Size Me Up” system designed by Edward Pechter in Valencia, CA to be the best system for determining cup size. In the “Size Me Up” system, the dome of the breast is measured by starting the measurement from where the breast begins on the side of the chest, passing over the nipple and finishing towards the sternum where the breast ends. The resulting measurement is then compared on the “Size Me Up” chart to determine the cup and bra size.One point I have learned is that the “cup volume” or “measured breast dome” increases depending upon the band width. That is, a “C” cup represents a smaller volume breastfor a woman with a small ribcage (i.e.32 band size bra, C-cup) than a woman with a larger ribcage (i.e. 36 band size bra, C-cup).

In my experience, the best manner in which to predict the post-operative cup size is to determine the pre-operative bra size measurements and base diameter of the patient. The post-operative cup size can be predicted by using these measurements with the volume per base diameter of the breast implant.While the prediction of post-operative cup size is not exact, I find this step to be helpful, as it facilitates a common frame of reference between the patient and surgeon.

www.drbriandickinson.com