There are four general types of breast implants, defined by their filler material: saline solution, silicone gel, structured and composite filler. The saline implant has an elastomer silicone shell filled with sterile saline solution during surgery; the silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel; structured implants use nested elastomer silicone shells and two saline filled lumen; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, etc. Composite implants are typically not recommended for use anymore and, in fact, their use is banned in the United States and Europe due to associated health risks and complications.
Both anesthesiologists and registered nurse anesthetists can administer anesthesia. An anesthesiologist is a specially trained physician who will administer anesthesia and monitor your vital signs during surgery. A registered nurse anesthetist has specialized training to do the same.  However, while a registered nurse's services can cost about $300 per hour, an anesthesiologist's services can cost closer to $500 per hour.
Thoroughly research surgeons who meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that the surgeon has experience in the type of surgery you’re wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon’s approach.
The breast augmentation patient usually is a young woman whose personality profile indicates psychological distress about her personal appearance and her bodily self image, and a history of having endured criticism (teasing) about the aesthetics of her person.[2] The studies Body Image Concerns of Breast Augmentation Patients (2003) and Body Dysmorphic Disorder and Cosmetic Surgery (2006) reported that the woman who underwent breast augmentation surgery also had undergone psychotherapy, suffered low self-esteem, presented frequent occurrences of psychological depression, had attempted suicide, and suffered body dysmorphia, a type of mental illness.
After the placement of breast implants, you will still be able to breastfeed. During the surgery, there is not disruption to the normal architecture of your breast. There are not any glands or ducts that are cut during the procedure, as everything is moved to the side so that the surgeon can get underneath the breast tissue and create the space for the implant. This is done with both implants placed under and above the muscle. There so be no issues with breastfeeding after getting breast implants.
Don't be afraid to ask questions. Make a list of questions you want to ask your physician and bring it with you to your Botox consultation. That way you won't forget what you want to ask. Ask how much the treatment will cost, how many units of Botox you will need, how long the he/she has been giving Botox injections, etc. Ask about side effects, risks, and how you should take care of your skin after Botox and how often someone with your skin condition should get Botox.
Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
Be on the same page as your doctor - Make sure both you and your physician are clear about what facial areas you want to treat, how you ideally want them to be fixed, and what the ideal final result may be. Different people have different aesthetics. For instance, if the "frozen face" look is your doctor's definition of successful Botox but you disagree, you better make sure both of you are aiming for the same target or you'll end up with a result your doctor thinks is beautiful but you think is horrific.
Fat transfer breast augmentation has a few important limitations. First, fat transfer is typically limited to approximately one cup size increase in breast size. Second, the transferred fat may be absorbed again by the body. Third, it is more expensive because of the extra time involved in harvesting and processing donor fat as well as possible need for a special vacuum bra device. This option is best reserved for women who desire a modest increase in size without using an implant.
Silicone gel filled breast implants consist of a silicone elastomer (rubber) shell pre-filled with a cohesive, gelatin-like substance that holds together uniformly while still retaining the natural give of breast tissue. Silicone gel breast implants are available in a wide range of sizes to accommodate women with different body types and aesthetic goals. Projections from moderate to high provide you with choices for the amount of projection of the breast silhouette.
Am I happy with my breast size when wearing a bra? A breast lift alone will not significantly change the size of your breasts. It can help your breasts look fuller, rounder, and better in a bra, but if you would like your breasts to be larger or smaller, a breast lift in conjunction with a breast augmentation or reduction may be the right option for you.

From your description, you seem to be a very good candidate for this new technique and should really get the look that you are desiring without implants or any unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast reduction and possible results.  You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.

The correction of capsular contracture might require an open capsulotomy (surgical release) of the collagen-fiber capsule, or the removal, and possible replacement, of the breast implant. Furthermore, in treating capsular contracture, the closed capsulotomy (disruption via external manipulation) once was a common maneuver for treating hard capsules, but now is a discouraged technique, because it can rupture the breast implant. Non-surgical treatments for collagen-fiber capsules include massage, external ultrasonic therapy, leukotriene pathway inhibitors such as zafirlukast (Accolate) or montelukast (Singulair), and pulsed electromagnetic field therapy (PEMFT).[60][61][62][63]


Gently get out of bed as soon as possible after your surgery. When you get up, sit with your legs hanging over the edge of the bed or chair for a few minutes before standing. This will help avoid problems with dizziness, light-headedness and fainting. Do not use your arms or upper body to push yourself out of a bed or chair. You may roll to your side and then sit up or stand up. Have an adult assist you the bathroom the first few times. Always get out of bed to go to the bathroom. Begin to walk as much as possible as soon as you can after surgery. Do take it easy the first few days. Do not exert yourself in any strenuous activity. Avoid strenuous activities that involve arm movement such as raising your arms over your head and lifting with your arms. A balance of rest and reduced activity will speed up your recovery.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.

Placing the breast implants on top of the muscle, which has been the traditional procedure, can result in a slightly higher risk of contraction. This issue is a cosmetic problem, rather than a medical or health issue. Gel/Silicone implants have been placed both above and below the muscle without a significant difference in the rates of having contraction.


Stay still but pay attention - If you are afraid of needles, don't make yourself writhe with discomfort by thinking about them. Set your mind on something random, like monkeys juggling pineapples. The Botox will be over before you know it. Stay still but pay attention and follow your doctor's instructions. He/she will tell you to smile, relax, frown, etc. during the injection process.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.
Now, there is also the of a capsular contracture. A capsular contracture simply means that when you put an implant in a human body, your immune system or your body will recognize the implant as foreign. This is one of the main reasons the implant envelope is made from silicone and no other materials like rubber, plastic, etc. because silicone is the most medically inert substance known to man. Silicone is the least offensive material to your immune system, so your immune system is likely to detect it and say OK yes this is something foreign, but it’s not aggressive so it’s not any threat to us. Therefore, what your body will do is form a capsule around the implant, and that’s the end of the immune response.
There are a few alternatives to breast augmentation with implants. Fat grafting breast augmentation involves harvesting fat via liposuction from another area of your body and injecting it into your breasts. Fat grafting is typically used to improve the appearance of your breasts after surgery to treat breast cancer, to correct a congenital breast deformity or to even out any imperfections occurring after breast augmentation with implants, such as wrinkles or ripples. The long-term effects of fat grafting to a normal breast are not fully understood, and the degree of augmentation possible via grafting is only modest at best. For these reasons, fat grafting for cosmetic breast augmentation is still considered experimental by many plastic surgeons.
We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.
After surgery, patients should be prepared for the cost of any pain medication they will take during recovery. These costs are not typically included in the overall cost of surgery. At my practice, we provide homeopathic medications as part of our total surgical package. Your surgeon can explain to you any prescription or homeopathic medications you may be prescribed and discuss their cost.
She advises me that there are many conspiracies around botox- staying up right for more than two hours, is false for starters. ‘The solution takes 20 minutes to settle in your muscles, so I do advise you to stay upright for then, any longer wont make a difference’. She does however advise me not to undertake exercise that’s too strenuous or hot following the treatment (fine by me) and to carefully wash my face when I get home, not scrubbing or rubbing too hard.
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