Breast prosthetic augmentation has emerged as a prominent cosmetic procedure in New York City. Many women seek this surgery to enhance their physical appearance, boost self - confidence, and address various concerns such as breast asymmetry or loss of volume. In this article, we will explore the post - operative case high - definition photo collections of the top - ranked experts in breast prosthetic augmentation in the Big Apple. Along the way, we'll discuss the leading surgeons, the different types of procedures, and the results patients can expect.
Leading Surgeons in New York City for Breast Augmentation
New York City is home to some of the most skilled and renowned plastic surgeons in the world. Let's take a look at a few of them.
Dr. Adam R. Kolker
Dr. Adam R. Kolker is a double - board certified plastic surgeon in New York City. His education and training span prestigious institutions like Harvard Medical School, New York University, and the University of Melbourne in Australia. As an associate clinical professor of surgery at the Mount Sinai School of Medicine, he stays at the forefront of plastic surgery advancements.
Dr. Kolker is well - known for his work in breast augmentation. He emphasizes that true artistry in breast augmentation means that "beautiful" should be more important than "size". He tailors each procedure to the individual woman's aesthetic goals, taking into account her body type to achieve a proportionate and natural result. His patient testimonials are a testament to his skill, with many patients expressing their gratitude for the life - changing results of their breast augmentation surgeries. For instance, one patient, N.S. from New York City, said, "I could not believe my eyes. Dr. Kolker had done something all other surgeons had told me was not possible. He made the impossible, possible I could not believe it took a possibility and turned it into my reality! I will forever be thankful to him for correcting my asymmetrical breasts and making me so happy."
Dr. David Hidalgo, MD, FACS
Dr. David Hidalgo is among the top - ranked plastic surgeons for breast augmentation in New York according to the Newsweek's 2024 ranking. With his expertise, he offers patients high - quality breast augmentation procedures. He has a wealth of experience in handling different cases, from simple augmentations to complex revisions. His patients can expect personalized treatment plans based on their specific needs and desires. Although detailed post - operative photo collections may require a visit to his office or official website, his reputation in the industry suggests that the results are likely to be outstanding.
Dr. Alan Matarasso, MD, FACS
Another respected name in New York City's breast augmentation scene is Dr. Alan Matarasso. He is a highly qualified plastic surgeon who has made significant contributions to the field. His approach to breast augmentation combines technical precision with an artistic eye, aiming to create natural - looking and harmonious results. His post - operative cases likely showcase his ability to achieve a wide range of aesthetic goals, from subtle enhancements to more dramatic transformations.
Types of Breast Augmentation Procedures
There are several types of breast augmentation procedures available, each with its own set of advantages and considerations.
Implant - based Breast Augmentation
Silicone Breast Implants
Silicone breast implants are a popular choice for many women. They are filled with a silicone gel, which gives them a more natural look and feel compared to saline implants. Mount Sinai plastic surgeons often recommend silicone implants for patients who want a result that closely mimics the texture of natural breast tissue. These implants are made of a silicone outer shell and filled with a thick, silicone gel that holds its shape even if punctured or leaks. According to data from the field, silicone implants are less likely to ripple and are more suitable for patients with less natural breast tissue, such as thin women or those undergoing breast reconstruction.
Saline Breast Implants
Saline breast implants consist of a silicone outer shell filled with a sterile salt - water solution. In the rare event of a rupture or leak, the solution is easily absorbed by the body. These implants are FDA - approved for use in patients over 18. Saline implants are round in shape and are ideal for patients who desire a more dramatic result. They may also result in less visible scarring as they are filled after placement, allowing for a smaller incision. For example, some women who want a very full and round appearance may opt for saline implants.
Fat Transfer Breast Augmentation (NaturalFill)
Developed and perfected by Mount Sinai surgeons, NaturalFill is a fat - transfer technique for breast augmentation. It involves two steps. First, the surgeon removes fat from the patient's buttocks or abdomen using liposuction. Then, the removed fat is immediately inserted into the breasts to increase their size. This method has the advantage of using the patient's own fat, reducing the risk of allergic reactions and the need for future surgeries related to implant complications. However, it also has some limitations. Significant volume loss may occur, and multiple procedures may be required to achieve the desired result. It is most suitable for patients who desire a moderate increase in breast volume or want to regain fullness lost after weight loss or pregnancy.
Pre - operative Consultation and Patient Assessment
A crucial part of the breast augmentation process is the pre - operative consultation. During this phase, the surgeon carefully assesses the patient to ensure a successful outcome.
Establishing Patient Expectations
Surgeons like Dr. Kolker understand the importance of having an open and honest conversation with patients to establish realistic expectations. Some patients may want a modest increase in breast size, while others may desire a more substantial change. It's essential for the surgeon to explain that implant - based surgery is a process that may require further surgeries in the future to address complications or maintain the aesthetic form. For example, if a patient has unrealistic expectations of achieving a very large breast size that is not proportionate to her body, the surgeon will gently guide her towards more achievable goals.
Clinical Examination
The clinical examination is comprehensive and focuses on various aspects of the patient's body. Surgeons assess the body habitus to ensure that the augmentation will be proportional. They measure the medial fold (subcutaneous and breast tissue) thickness to determine the best plane for implant insertion. If the overlying tissues are too thin to support the implant, a subpectoral implant may be preferred. The sternal notch to nipple distance, breast width, breast height, and breast projection are also measured to plan the appropriate size and shape of the implant.
Operative Procedure and Techniques
The operative procedure for breast augmentation involves several key steps and different techniques.
Marking the Breast Footprint
Before the surgery, the breast footprint is marked while the patient is in an upright position. This helps the surgeon accurately plan the placement of the implant and ensure symmetry. For example, if there is pre - existing breast asymmetry, the markings will take this into account to achieve a more balanced result.
Anesthesia and Antibiotics
Implant augmentation is typically performed under general anesthesia. A single dose of antibiotics is given at the induction of anesthesia to prevent infection. This is a standard practice to reduce the risk of post - operative complications such as infection.
Incisions
- Inframammary Incision: This is the most common incision used worldwide. It provides good access to both subglandular and sub - pectoral pockets with minimal violation of the breast parenchyma. The length of the scar can vary depending on the size of the implant, and care is taken to ensure that the scar remains hidden in the infra - mammary fold after implant insertion.
- Periareolar Incision: This is preferred when a mastopexy is planned concurrently, such as in cases of tuberous breasts. However, it can be challenging for small areolae or areolae with indistinct margins. There is also a concern for a higher rate of capsular contracture and altered nipple sensations due to the risk of bacterial contamination when incising through the areola.
- Transaxillary Incision: This approach avoids scars on the breast. It involves placing an expandable implant through a small incision in the armpit followed by inflation. It is best suited for smaller, non - ptotic breasts, but placing larger implants can be more challenging due to the remote access.
- Transumbilical Incision: This newer approach also offers remote access and avoids a scar on the breast. A subcutaneous tunnel is created above the plane of the rectus fascia to access both the subglandular and subpectoral pockets for tissue expander placement. However, it does not allow for secondary procedures in the future.
Choice of Pocket Plane
- Subglandular Plane: An implant placed in the subglandular plane has less morbidity compared to the submuscular approach. However, it may carry a risk of implant visibility and palpability, especially in thin patients. It is suitable for patients with good medial fold thickness and can avoid muscle animation associated with subpectoral placement. Although some studies suggest a higher risk of capsular contracture, other research has found no significant difference between the two approaches.
- Subpectoral (Submuscular) Plane: This plane involves dissecting the pectoralis muscle. It provides better coverage of the implant and can reduce the risk of implant visibility. However, it may cause more post - operative discomfort and muscle animation.
- Dual Plane Approach: The dual plane approach, described by Tebbetts, involves placing the implant partially behind the pectoral muscle and partially behind the breast. This provides good muscular cover of the upper pole of the implant while allowing for adequate lower pole expansion, making it a preferred option over the total submuscular approach in some cases.
Post - operative Complications and Management
Although breast augmentation is generally a safe procedure, there are potential complications that patients should be aware of.
Bleeding/Hematoma
There is a 1% risk of bleeding or hematoma after breast augmentation. If this occurs, re - operation and washout are usually recommended to prevent further complications and ensure proper healing.
Infection
The ideal infection rate is less than 1%. Surgeons take multiple precautions during the surgery to reduce the risk of infection, such as changing gloves before handling the implant, washing the instruments and implant pocket with antiseptic/antibiotic solutions, and using prophylactic antibiotics at induction. If an infection does occur, it is typically treated with antibiotics, and in severe cases, the implant may need to be removed.
Capsular Contracture
The rate of adverse capsular contracture requiring operation is 10% at 10 years. Capsular contracture occurs when the body forms a scar capsule around the implant, which can tighten and distort the breast shape. Treatment options may include non - surgical methods such as massage or, in more severe cases, surgical removal or revision of the capsule and possibly the implant.
Implant - related Complications
- Implant Palpability/Visibility/Wrinkling: This is more commonly seen with smooth implants and those placed in the subglandular position. Patients may notice that the implant is more visible or can be felt under the skin, or that there are wrinkles on the surface of the breast.
- Implant Rotation: This is a complication specific to anatomical implants. If the implant rotates, it can change the shape of the breast and may require surgical correction.
- Implant Loss: The goal is to keep the implant loss rate below 5%. If the implant becomes infected or there are other serious complications, removal of the implant may be necessary.
- Silicone Leakage: In the case of silicone implants, if a rupture occurs, the silicone gel usually remains within the capsule (intracapsular rupture) and can be removed when the implant is taken out. However, in some cases, the silicone can spread outside the capsule into the breast, surrounding tissues, or axillary nodes, forming silicone granulomas.
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA - ALCL)
BIA - ALCL is a rare type of T - cell non - Hodgkin lymphoma related to breast implants. As of April 2020, there have been 800 confirmed cases worldwide with 33 deaths attributed to ALCL. It is most commonly associated with textured implants. The most common presentation is a large spontaneous seroma around the implant, often occurring more than a year after surgery. Diagnosis involves triple assessment, including clinical examination, breast ultrasound and/or MRI, and aspiration of the fluid or biopsy of the mass. Treatment usually involves removal of the implant with en bloc total capsulectomy for early - stage cases, while advanced cases may require systemic chemotherapy.
Breast Implant Associated Illness (BII)
BII is a controversial term used to describe a variety of symptoms experienced by women with breast implants, such as fatigue, chest pain, hair loss, chronic pain, body odor, anxiety, brain fog, sleep disturbances, or depression. Although there is no conclusive evidence of a direct link between implants and these symptoms, some epidemiological studies suggest a higher incidence of autoimmune disorders in women with silicone implants. There are two main theories to explain these symptoms: psychological and immunological. Patient management involves compassionate consultation, a detailed discussion of symptoms, clinical examination, and appropriate imaging to rule out implant - related complications. Some patients may benefit from explantation, but the outcome is not guaranteed.
Benefits of Viewing Post - operative Photo Collections
Post - operative photo collections of breast augmentation cases offer several benefits for both patients and the medical community.
For Patients
- Realistic Expectations: By viewing high - definition photos of actual patients, potential patients can get a better understanding of what is realistically achievable through breast augmentation. They can see the range of results, including different implant sizes, shapes, and the overall aesthetic outcome. For example, a patient can see how a certain size implant looks on a body type similar to hers, which helps in setting more accurate expectations.
- Surgeon Selection: Photos can be a valuable tool in choosing a surgeon. Patients can assess the surgeon's skill and aesthetic sense by looking at the quality of the post - operative results. If a surgeon's photo collection shows natural - looking, well - proportioned breasts, it may indicate a high level of expertise. For instance, if a patient is interested in a more subtle augmentation, she can look for a surgeon whose portfolio includes such cases.
For the Medical Community
- Education and Research: Photo collections can be used for educational purposes, such as teaching medical students and residents about breast augmentation techniques and expected outcomes. They can also contribute to research efforts, allowing surgeons to analyze long - term results, complications, and trends in the field. For example, researchers can study the prevalence of certain complications based on the photos and patient records.
- Quality Improvement: Surgeons can use their own post - operative photo collections for self - assessment and quality improvement. By comparing different cases over time, they can identify areas where they can improve their techniques and patient care.
Conclusion
Breast prosthetic augmentation in New York City is a complex and highly specialized field. The ranking of experts is based on their skill, experience, and the quality of their post - operative results, which can be seen in the high - definition photo collections. Patients considering breast augmentation should carefully research and choose a surgeon who understands their goals and can provide a safe and successful procedure. It's important to have realistic expectations, be aware of the potential complications, and follow the surgeon's pre - and post - operative instructions.
If you're interested in learning more about breast prosthetic augmentation or seeing post - operative case high - definition photo collections, we encourage you to schedule a consultation with a reputable plastic surgeon in New York City. Don't hesitate to ask questions, view the surgeon's portfolio, and make an informed decision about your breast augmentation journey.
