This issue is intrinsically related to the surgeon and the patient’s preference. Briefly, through the nipple, the implantation process is carried out through an incision located in the front of the breast which can be counseled with the natural irregularities of the nipple. Nevertheless, sometimes the wound healing process occur in such a way that the scar may become very obvious. Also, through this approach, glandular breast tissue has to be divided to access the pocket under the breast or under the muscle. This potentiates the exposure to a contaminated field that could affect the final outcome by a possible infection and capsular contraction. Through the arm pit, this is another potential contaminated field due to its higher concentration of bacteria than other areas of the chest except the nipple. In addition, the creation of the pocket is so poorly controlled from this position that implants in the submuscular plane requires endoscopic techniques. Through the belly button, the incision is made in the belly button, then a rod or dissector is inserted and advanced superiorly towards the breast creating a subcutaneous tunnel which allows for a tube to be inserted through. Finally, a deflated saline implant is placed in position through this tube and full saline insufflation is performed. Silicone implants cannot be deployed using this method. Finally, the inframammary approach offers easy and non-contaminated access to the pocket allows a precise deployment of the implant and provides an incision that is easily counseled. Medilaser, Cosmetic Surgery and Vein Center uses this approach to provide its patients with the best and safest technique.
There is no question that local anesthesia is safer than general anesthesia. In order to provide the highest safety profile related to elective cosmetic surgery, local anesthesia must be part of the equation. This basic concept results from understanding the main difference between general anesthesia and local anesthesia. The former, puts patients to sleep into a state of “coma” requiring assisted breathing through a ventilator (artificial breathing machine). In order to tolerate such an invasive device, the patient has to be fully paralyzed with medications that blunt spontaneous movements. Therefore, patients are not only comatose but also completely paralyzed. On the other hand, the latter local anesthesia plus oral sedation, is a technique where patients are set into a sleep to snore while the surgical area is numbed to allow its dissection and manipulation. The amount of sedation is determined by the patient’s response to initial doses and to their absorption rate through the intestine. This allows the body to achieve gentle peak levels of medications necessary to achieve clinical sedation without the abrupt peaks of intravenous techniques. This is one of the reasons Medilaser, Cosmetic Surgery and Vein Center has such a high safety record where no emergencies have been reported. Furthermore, patients quickly recover from surgery without enduring the effects related to the reversal from general anesthesia: severe pain, rigors, nausea, hypothermia (low body temperature), weakness and poor inspiratory effort (potential reintubation). In recovery room, after their breast surgeries, our patients rest comfortably and are able to move their arms to a full range without added pain. Thus, patients can be discharged without the necessity to be admitted overnight for further management. Nevertheless, patients are required to return to their first post-operative visit after one or two days.
Healthy individuals who want to enhance the shape and size of their breast and have realistic expectations are probably a good candidate for the procedure.