Introduction

Macromolecular hyaluronic acid breast augmentation has become an increasingly popular choice for those seeking to enhance their breast appearance. In New York City, there are several public top - level hospitals that offer this plastic surgery procedure. This article will introduce you to these hospitals, as well as provide in - depth knowledge about macromolecular hyaluronic acid breast augmentation, including its background, procedure, potential complications, and the importance of choosing the right hospital.

Understanding Macromolecular Hyaluronic Acid Breast Augmentation

Background and Popularity

Breast augmentation is a well - requested procedure in aesthetic surgery. Over time, various techniques have been developed, such as using implants, fat grafting, flap surgery, and injectable fillers. Among the available fillers, hyaluronic acid is one of the most popular synthetic fillers globally. It is a glycosaminoglycan biopolymer that the human body can synthesize itself. Macromolecular hyaluronic acid, in particular, has been of interest due to its potential for minimally invasive breast volume enhancement (Trignano et al., 2020).

Macrolane: A Focused Example

Macrolane is a NASHA - based (stabilized hyaluronic acid of non - animal origin) medical implant. It was developed and approved in Europe in 2006 for breast use but was withdrawn from the market in 2011 due to several reported issues. In the United States, it has never been approved by the FDA for commercial use (Trignano et al., 2020). However, understanding its characteristics can provide insights into macromolecular hyaluronic acid breast augmentation in general.

Macrolane's structure includes highly cross - linking to elongate its duration in tissues before absorption. Another feature is that the degradation of the product is isovolemic, meaning that as the product degrades, the remaining hyaluronic acid binds additional water to maintain a constant overall volume (Trignano et al., 2020).

Potential Complications of Macromolecular Hyaluronic Acid Breast Augmentation

Infection

Infection is a possible complication after macromolecular hyaluronic acid breast augmentation. In a study by Ishii and Sakata (2014), the infection rate was reported as 0.08%, which was lower than infection rates observed after permanent implants. Prophylactic antibiotics were not used before injection of macrolane in their study. In cases of infection, early treatment with intravenous antibiotics is often required. In severe cases, aspiration of the hyaluronic acid and pus, wound irrigation, and extended antibiotic courses may be necessary. Surgeons should inject the filler under aseptic conditions and stress the importance of patients returning to the clinic early if symptoms such as pain, redness, and swelling occur (Ishii & Sakata, 2014).

Dislocation of Injected Material

Dislocation of the injected hyaluronic acid can occur, where subcutaneous nodules are identified outside of the injection range. In the study by Ishii and Sakata (2014), four cases of macrolane dislocation were observed. Countermeasures include aspiration of the dislocated material with an 18 - gauge needle and injection of hyaluronidase to dissolve the remaining gel. However, re - occurrences may happen in some cases (Ishii & Sakata, 2014).

Early Degradation of the Gel

The aesthetic result of macromolecular hyaluronic acid breast augmentation may not last as long as expected in some cases. Previous studies have shown that macrolane remains in the breast up to 18 months after injection with volumes of 80 ml to 100 ml per breast. In the Ishii and Sakata (2014) study, with an average injection volume of 30 ml to 40 ml per breast, the aesthetic result was expected to last approximately six to 12 months. Some women may experience early degradation of the gel, leading to a return of the breasts to their pre - treatment size within a few months. Surgeons should explain this potential to patients and recommend appropriate injection techniques to slow down degradation, such as injecting the gel as a single implant under the mammary gland positioned below the nipple (Ishii & Sakata, 2014).

Firm Breasts and Nodules

Some patients may experience firmness of the breasts or the formation of nodules after the procedure. Ishii and Sakata (2014) reported that when they switched from using Restylane SubQ to Macrolane for breast enhancement, the number of patients presenting with firm breasts or nodules declined. Patients should be informed that these are usually transient symptoms and should disappear within three to four months of injection. If the symptoms persist, injection of hyaluronidase may be used to improve the result (Ishii & Sakata, 2014).

Visible Subcutaneous Nodules

Visible or palpable subcutaneous nodules can also occur. In the study by Ishii and Sakata (2014), 1.5% of the surveyed women returned to the clinic complaining of such nodules. For superficial subcutaneous nodules, manual compression may be an effective treatment. For nodules in the deep subcutaneous tissue, aspiration of the gel using an 18 - gauge needle under local anesthesia can be attempted. If there is no improvement after aspiration, hyaluronidase injection can be used to degrade the nodule (Ishii & Sakata, 2014).

Top Public Hospitals in New York City for Macromolecular Hyaluronic Acid Breast Augmentation

Mount Sinai Hospital

Mount Sinai's plastic surgeons have extensive experience in performing breast augmentation procedures. They can help patients visualize how their larger breasts will look using advanced 3D imaging technology. This technology allows patients to virtually try on different sizes of breasts, helping them make more informed decisions about the size and shape that will look best for their body. The hospital offers several options for breast augmentation, including breast implants (silicone and saline) and a fat transfer technique known as Natural Fill®. Natural Fill® is a two - step procedure where fat is removed from the buttocks or abdomen using liposuction and then inserted into the breasts. This approach can provide a more natural - looking and long - lasting result in some cases (Mount Sinai - New York, n.d.).

Columbia University

As one of New York’s best hospitals and a world - class medical center, Columbia University's plastic surgery division has surgeons proficient in multiple areas of specialization, including breast augmentation. Their cosmetic care program offers a comprehensive range of surgical and non - surgical options to improve patients' cosmetic health. The plastic surgeons are at the forefront of clinical and laboratory research in plastic surgery. The division also conducts research related to stem cells, tissue engineering, and the study of bone substitutes, which may have implications for improving the safety and effectiveness of breast augmentation procedures in the future (Columbia Surgery, n.d.).

Weill Cornell Medicine

Weill Cornell Medicine's plastic and reconstructive surgeons are leaders in the field. They are committed to helping patients achieve their desired appearance and enhancing their self - image and confidence. The hospital provides a full range of cosmetic breast surgery options, including breast augmentation with implants. The surgeons prioritize patient comfort at every step of the process, from the initial consultation to post - operative care. They use the latest anesthetics and medications to help patients recover more quickly and heal faster. Weill Cornell Medicine partners with New York - Presbyterian, one of the top hospital systems in New York City and the U.S., which adds to its credibility and resources for providing high - quality breast augmentation services (Weill Cornell Medicine, n.d.).

Choosing the Right Hospital for Macromolecular Hyaluronic Acid Breast Augmentation

Surgeon Experience

When choosing a hospital for macromolecular hyaluronic acid breast augmentation, the experience of the surgeons is crucial. Experienced surgeons are more likely to have encountered a wide range of cases and be able to handle potential complications effectively. You can research the surgeons' backgrounds, including their training, years of experience, and any specializations in breast augmentation. Look for surgeons who are board - certified and have a good reputation in the field.

Hospital Reputation

The reputation of the hospital also matters. You can look at patient reviews, ratings, and rankings to get an idea of the hospital's quality of care. Hospitals with a good reputation are more likely to have strict safety protocols, state - of - the - art facilities, and a comprehensive support system for patients before, during, and after the surgery. Some hospitals may be recognized for their research and innovation in plastic surgery, which can also be an indicator of their commitment to providing the best possible care.

Technology and Resources

Advanced technology and resources can significantly enhance the outcome of macromolecular hyaluronic acid breast augmentation. Hospitals that invest in the latest imaging technology, such as 3D imaging, can help patients make more accurate decisions about their desired breast size and shape. Additionally, access to high - quality hyaluronic acid products and appropriate equipment for the procedure is important. Hospitals with a research focus may also be more likely to have access to new and improved techniques and materials for breast augmentation.

Patient - Centered Care

Patient - centered care is essential in plastic surgery. The hospital should have a team that listens to your goals, concerns, and expectations. They should provide clear and detailed information about the procedure, including the potential risks and benefits. Post - operative care is also crucial, and the hospital should have a system in place to monitor your recovery, manage pain, and address any questions or issues that may arise.

Preparing for Macromolecular Hyaluronic Acid Breast Augmentation

Initial Consultation

During the initial consultation with your surgeon, you should be prepared to discuss your medical history, including any previous surgeries, allergies, and current medications. You should also share your aesthetic goals for the breast augmentation procedure. The surgeon will examine your breasts, take measurements, and provide you with information about the different options available, such as the type of hyaluronic acid filler, injection techniques, and expected results.

Pre - operative Tests

Your surgeon may order pre - operative tests, such as blood tests, mammograms, or ultrasound scans. These tests help the surgeon assess your overall health and detect any potential issues that may affect the surgery or your recovery. The results of these tests will be used to develop a personalized treatment plan for you.

Lifestyle Changes

Leading up to the surgery, you may need to make some lifestyle changes. This may include quitting smoking, as smoking can affect blood circulation and increase the risk of complications during and after the surgery. You may also need to avoid certain medications and supplements that can thin the blood, such as aspirin and fish oil, to reduce the risk of bleeding.

Recovery after Macromolecular Hyaluronic Acid Breast Augmentation

Immediate Post - operative Period

After the surgery, you will be monitored in a recovery area for a few hours. You may experience some pain, swelling, and bruising in the breast area, which is normal. Your surgeon will prescribe pain medications to manage the pain. You will be given instructions on how to care for your breasts, including keeping the incision area clean and wearing a supportive bra.

Short - term Recovery

In the first few weeks after the surgery, you will need to avoid strenuous activities and heavy lifting. You should also follow your surgeon's instructions regarding wound care and follow - up appointments. Most patients can return to work and normal activities within a week or two, depending on the nature of their job. However, it may take several weeks for the swelling and bruising to completely subside.

Long - term Recovery

Over the long term, the results of the macromolecular hyaluronic acid breast augmentation should stabilize. However, it is important to continue following up with your surgeon regularly to monitor the condition of your breasts and address any concerns. The hyaluronic acid filler will gradually degrade over time, and you may need to consider additional treatments to maintain the desired breast size and shape.

Conclusion

Macromolecular hyaluronic acid breast augmentation is a popular aesthetic procedure that offers the potential for minimally invasive breast volume enhancement. However, it is not without risks, and potential complications such as infection, dislocation, early degradation, firmness, and nodules should be considered. In New York City, top public hospitals like Mount Sinai Hospital, Columbia University, and Weill Cornell Medicine offer high - quality breast augmentation services. When choosing a hospital, factors such as surgeon experience, hospital reputation, technology and resources, and patient - centered care should be taken into account. Proper preparation before the surgery and careful management during the recovery period are also essential for a successful outcome.

If you are considering macromolecular hyaluronic acid breast augmentation, we encourage you to further research your options, schedule consultations with experienced surgeons at these top hospitals, and make an informed decision based on your individual needs and goals. Share this article with others who may be interested in learning more about this procedure, and explore related topics such as the latest advancements in hyaluronic acid fillers and post - operative breast care.