Our breast augmentation in Seattle surgery is for those who desire larger, firmer, or fuller breasts.
Women who have a moderate sagging of the breasts, which can be resolved through our breast augmentation procedure by adding volume to the breasts, rather than by lifting the skin on the chest.
Women who have lost the firm fullness in breast tissue after pregnancy, breastfeeding, or significant fluctuations in weight.
Women who have breast asymmetry; one breast that is noticeably larger or smaller than the other.
There are three main types of incisions used in our Bellevue breast augmentation procedure. Inframammary (under the fold of breast), peri-areolar (around areola), and trans-axillary (through armpit). All three are possible but the latest research and our own personal experience has taught us that the inframammary incision is the safest and produces the least scarring. The TUBA technique (through the navel) is a highly controversial technique effectively shunned by most qualified plastic surgeons. It has also lost its popularity due to some dismal complications.
The general options include subpectoral (under the muscle) and subglandular (above the muscle). There is slight variation in how these placements are used, based upon the unique physiology of the patient. The subpectoral placement is partially beneath the chest muscle. The subglandular technique can be performed using the subfascial technique, a recent development in breast augmentation surgery. The most popular technique is subpectoral, in which the implants are placed beneath the muscle. We believe there are at least five powerful advantages of this surgical technique:
The only disadvantage of breast implant placement with muscular coverage is for some patients, the new breast may appear temporarily misshapen when the chest muscle is flexed. Most patients do not find this effect troublesome.
Dr. Egrari has access to the three FDA-approved lines of implants. Allergan Natrelle, Mentor, and Sientra. Dr. Egrari is one of the largest user of implants in the United States and finds the Allergan Natrelle line of implants to be of highest quality. He is partial to this brand, as the metrics, profiles and the type of cohesivity that they have is second to none. The implants are either saline or silicone. Almost 98% of the breast implant procedures involve silicone implants, due to the natural feel and weight. With five different profiles, and many sizes, these implants can be custom-tailored to create the most natural look and feel. “Gummy bear” implants are created out of a more cohesive gel, more form-stable, and are known for keeping their shape due to the thicker quality of silicone gel. What’s right for you? The first step is an initial consultation, in which all options will be fully explained to you, and you will have the opportunity to see how the various sizes and shapes will appear on our digital imaging system.
Autologous Fat Transfer (AFT) has become a popular treatment in plastic surgery. Over the past decade there has been a renewed interest in AFT in breast augmentation. In a select group of patients that have excess fatty deposits that can be extracted and purified, and do not want a significant increase in breast size, this procedure may be appropriate. Clinical trials are underway, and we expect find out more about the efficacy of this procedure soon.
One of the most important concepts that must be clearly explained to the patient is “footplate.” All patients have a pre-determined footplate – where the breasts are located on the chest wall. This placement is the result of genetics, and can be impacted by loss of flexibility and strength of aging skin or weight loss. If a patient has a low footplate she will have low breasts after breast augmentation, and a breast lift may be needed to produce the look wanted. A wide cleavage due to a wider breast position may not create a tight cleavage line. All of these issues will be discussed so you get the look you envision, including cleavage appearance.
Plan to take at least one week off work and engaging in social activities. During this time, you will not be bedridden, but should just rest, relax and heal. Most of our patients return to work after one week, and are ready to operate a vehicle again. We recommend avoiding exercise and other vigorous activities for two weeks. At four weeks, you can return to an exercise program that is less strenuous, slowly increasing your actions, and always listen to your body. After six weeks, you should be fully healed and can return to all your normal activities, including vigorous exercise, hiking, running, biking, yoga, and other activities.
The no touch technique is a series of surgical techniques designed to reduce trauma to the tissue and reduce the risk of contamination of implants. We strongly feel that contamination of the implants is a likely reason for hardening of the shell around the implant, called capsular contracture. Dr. Egrari uses the latest and most innovative techniques, including the no touch techniques. First the implants are never used to choose size, and uses specific implants to determine the proper size. The pockets are irrigated with three different antibiotic solutions. The dissection is done essentially “bloodless.” Drains are not necessary. Perhaps one of the most important components of the no touch technique is the use of the Keller Funnel, which allows for a rapid, accurate, and non-contaminating technique for placement of implants in the pocket created in the procedure. The combination of these surgical techniques makes the procedure safer, cleaner, and far less prone to contamination in placing implants. Patient safety is always a priority for Dr. Egrari.
Our tremendous knowledge in using meticulous surgical techniques, our rapid operating time, and our extensive experience have made breast augmentation a fast and comfortable operation. Most patients require only two to three days in which they need pain medication and many patients use only over-the-counter products or none at all. Today, we also offer Exparel, a long-acting medication that blocks pain, with up to 72 hours of comfort.
Capsular contracture, asymmetry, wrinkling and rippling, deflation, dissatisfaction with size, nipple insensitivity, under-breast insensitivity, and the common risks of anesthetic are all theoretically possible. All these are rare and some almost nonexistent. The two that are worth further discussion are capsular contracture and the commitment a patient makes to a specific size or shape, which they later feel is unsatisfactory – too large or too small.
Dr. Egrari’s philosophy is based on body size, and shape, and the artistry in achieving the perfect proportion. He does not feel that extremely large implants are a good decision, as they tend to look false. He feels that using the artistic eye he has developed over almost two decades he can help guide his patients to the most beautiful final look. Beauty is proportion and proportion is beauty. Never is this so true as it is with breast augmentation.
Dr. Egrari spends a considerable amount of time talking to patients about the mathematical dimensions their unique body, and an artistic sensibility that can only be developed through experience – and natural talent. He will guide you to the size and shape that will create the most beautiful outcome – for you. He listens to your vision, and helps you to discover the most effective size and shape for your body contour. His digital Vectra visualization system makes it possible for the patient to see how the implants will look – a significant advantage. He reserves the right to adjust size in the operating room. The entire procedure is performed with the utmost of professionalism and a process that aids in ensuring the patient is left with perfectly-sized, even, and natural-looking breasts.