Breast augmentation, or augmentation mammoplasty, is the insertion of implants to increase breast size. I however think of augmentation as more than that. It is an opportunity to artful improve breast aesthetics.
In order to achieve this, it is critically important to understand the issues which affect breast appearance, and it is these factors which are under appreciated by patients and plastic surgeons alike. In fact, I taught a course at the ASAPS (American Society of Aesthetic Plastic Surgery) which, in part, explained these factors.
In evaluation of a patient, the underlying torso shape critically impacts not only breast appearance but also has implications on implant selection and ultimately outcomes. Whether its peaking (pectus carinatum), depression (pectus excavation), undulations, or asymmetries, these conditions must be considered during the planning and execution of breast augmentation. The consequences and nuances of these issues are not considered in present day software which some plastic surgeons use to computer image breasts and attempt to “show” patients what their breasts will “look like” after surgery. This would be misleading and is why I choose not to use these imaging options presently. I have actually been asked on occasion by these software manufacturers to participate in software development because of my expertise and vast experience. The computing capabilities to factor in all these considerations is just not there yet to predict reliable outcomes.
Nevertheless, I have a thorough comprehensive evaluation process which patients really appreciate. Together with the patients’ input, we arrive at the proper plan.
The results speak for themselves and many of these can be seen on the website. The seven characteristics we review during consultation include 1) choice of saline or silicone 2) choice of smooth or textured surfaces on the implant 3) shape of implants; either round or shaped 4) anatomic location of placement; whether above (subglandular or prepectoral) or below muscle (submuscular/retropectoral), 5) incision locations (axillary, periareola, or inframammary fold), 6) the base diameter or the implant (or footprint), and finally, 7) the projection of implant.
I have general philosophies about these choices, and although each patient is different, I will share some basic facts here with you that I have learned through observation from over 25 years of doing this surgery.
- Saline ripples more than silicone gel
- Silicone gel generally feels more natural and looks more natural
- Saline implants age the surrounding breast over years more than silicone gel implants
- Gravity influences over time (years) cause saline implants to subtly migrate lower and more lateral than silicone gel
- Smooth implants placed under muscle DO NOT have an increased rate of capsular contracture when compared to textured surface implants
- Certain textured surface implants may be linked to a lymphoma or (in very rare instances) lymphoma like reaction known as BIAALCL (breast implant associated anaplastic large cell lymphoma)
- Round implants are the most versatile because together with space manipulation/creation, they can be made to look round or naturally shaped
- Textured shaped implants are generally firmer to touch than smooth round implants
- Submuscular placement of implants allow for better, more accurate breast surveillance by self-exam, physician exam, or mammogram, ultrasound or MRI
- Subglandular implant placement leads to more rippling, capsular contracture, and overlying breast tissue atrophy over time
- Inframammary fold approach to insertion allows for the most precise release of pectoralis muscle, implant space/pocket creation and implant placement
- Transaxillary implant augmentation and transumbilical augmentation have the highest re-operation rates
In conclusion, although surgery and recovery are generally fairly simple, it’s the planning which sets the tone for the outcomes. The results can be amazing!
We take pride in what patients say about us
Dear Doctor Spiro and staff, I just wanted to take the time to thank you for an amazing job. You and your staff are all such a pleasure to be around. Breast augmentation is not something I’ve always thought of doing but it has been one of the best decisions I’ve ever made!!! The results are even better than I imagined. Having a Doctor and staff like yours has made this such a great experience, I would recommend you to anyone!!! I feel very lucky to have had you as my unbelievably talented surgeon. Thank you again from the bottom of my heart.
Since under-going breast augmentation surgery, I have a new quality of life that I never thought possible. I have so much confidence and now look forward to wearing a bikini. I finally feel like a woman with breasts that match my body and no longer feel uncomfortable or insecure in clothing. Dr. Spiro pointed out details that only an artist and talented surgeon could see that other surgeons missed. I was told I had constricted breast anomaly, something that was never brought to my attention by any of the four surgeons I consulted before meeting Dr. Spiro. I knew he was my guy. He was able to correct it and give me the most beautiful, natural looking breasts. I am so happy every day when looking at the outcome. Dr. Spiro and his staff are the most professional and friendly medical team I have ever encountered. My expectations were consistently surpassed with each office visit. I love Dr. Spiro and his staff for what they have done for me and highly recommend his services to everyone. It’s impossible to find better than the Dr. Spiro experience!
Since high school I have wanted to have an augmentation. I struggled with self-consciousness even in my adulthood. Dr. Spiro was recommended to me from my gynecologist and I am so thankful to her. Upon my arrival to the office, my heart was racing. I was greeted with a friendly staff, especially Marybeth the nurse and then finally Dr. Spiro. He immediately made me feel comfortable and thoroughly answered my long list of questions. I never felt rushed and knew immediately i was in good hands. Thank you Dr. Spiro for giving me amazing results. This has been an experience I wouldn’t change. To anyone on the fence with their decision, I say you live once, do what’s going to make you feel good about yourself and trust in Dr. Spiro!
All I can say is “I Love My Body!” I had an abdominoplasty and breast augmentation with Dr. Scott Spiro and had impeccable results. Dr. Spiro’s skillful artistry as a plastic surgeon completely surpassed all of my expectations. Thirteen years after having two children, my body was seriously sagging. I have been a Fitness Specialist for over 25 years and knew exercise and eating healthy would never tighten my stretched out skin. My results with Dr. Spiro were remarkable! I feel like I have my 25 year old body back and I am almost 50 years old! I would highly recommend him as your plastic surgeon!
When I finally decided to go through with the surgery I was excited, but also very nervous. A friend of mine recommended Dr. Spiro and said he was the best. He promised I would not be disappointed, and he was completely right! The entire staff, Dr. Spiro, and even the anesthesiologist were so nice, caring, and knowledgeable. One of the things that made me feel most comfortable is that Dr. Spiro and his staff actually listened! Everyone truly had my best interest at heart. Dr. Spiro gave me the most natural breast augmentation when it comes to both look and feel. I honestly couldn’t have imagined things any better.
The level of talent Dr. Spiro possess’ and the attentiveness of him and all of his staff helped to make my post op experience as pleasant as I could have hoped. The pain wasn’t bad and it didn’t last long. My incision was very small and well placed. The scar is pretty much unnoticeable, and that’s even before using the scar cream he recommends. I am so happy with my decision. It has really boosted my confidence. Dr. Spiro you are a true artist!
The best doctor I had my breast augmentation with Dr. Spiro two and half years ago. I felt compelled to write this review after this much time because during those years not a day has gone by where I have not thought about how that surgery changed my life. It didn’t just transform my body so beyond my expectations and what I even thought was possible, it completely gave me my confidence back. Not to mention it was one of the easiest and painless procedures which I was not expecting. Dr. Spiro and along with his staff are exceptional and writing this review is the very very least I can do for what he has done for me.