OCALA, FL (352today.com) – While breast augmentation surgery is a common practice, it is still considered solely cosmetic by most insurance companies.
At Ocala Plastic Surgery & Dermatology, Dr. Jennel Carreras-Montgomery, MD, a Miami native, has dedicated years to her education and practice.
Her journey began at Boston College, continued with a residency at Baylor University Medical Center in Dallas, Texas, and culminated in a Cosmetic Surgery Fellowship in New York City, where she mastered advanced surgical techniques. Dr. Carreras-Montgomery utilizes her extensive training in body sculpting, mommy makeovers, abdominoplasty, Brazilian butt lifts, and both surgical and non-surgical facial rejuvenation.
“True breast augmentation is usually considered a cosmetic procedure,” she explained. “There are instances where people can be born with severe asymmetries where one breast is much larger than the other or other cases.”
She adds that there are certain syndromes where the breast is not developed at all. In cases like this, breast augmentation can be considered medically necessary. “But honestly, insurance usually considers this a cosmetic procedure, as well,” she said.
Evolution and techniques in breast augmentation
Dr. Carreras-Montgomery says that while medical procedures evolve and improve, some things remain tried and true. She says that’s why the fundamental approach to breast augmentation hasn’t changed drastically. There have been different types of incisions developed, such as axillary (armpit) incisions or umbilical incisions. However, the most common method remains a small incision in the breast or underneath the areola.
Dr. Carreras-Montgomery says implant materials have significantly improved over the years. Both saline and silicone implants are available. Saline implants have remained fairly consistent, except for improvements in the external shell, she says. Silicone implants, on the other hand, have made significant strides.
“We are now in what we call our fifth-generation silicone implants, which basically means we’ve learned from all of our previous mistakes on manufacturing silicone implants and have improved them with every generation. Now we have more cohesive implants, or what people called ‘gummy implants,’ and the shells are more durable, as well,” she said. “Our knowledge about the scar tissue that builds around the implant has also increased, and we have learned that there are certain things that we can do to try to minimize the risk of that happening.”
Safety and risks of breast augmentation
Breast augmentation is a surgical procedure that comes with risks, but it’s also very common. The safety of the procedure starts with the surgeon deciding if you’re a good candidate. This extends to the day of surgery with the anesthesia team.
Postoperatively, there are also risks. But if you follow your surgeon’s instructions, the experts say those are usually minimized.
“Overall, it is still one of the most common procedures that we perform in plastic surgery,” said Dr. Carreras-Montgomery. “But I think it’s very important that the patients understand that that safety relies predominantly on the care team, which includes your surgeon and anesthesiologist. It is very important that patients do their homework and make sure that they have board-certified plastic surgeons performing their surgeries as well as certified anesthesia providers.”
Recovery time and pain management
Dr. Carreras-Montgomery says that the average downtime for breast augmentation is anywhere from four to eight weeks.
“The pain experienced after the surgery can definitely be subjective,” she said. “But I would say that it is more painful if your implant is placed in a sub-muscular position versus a sub-glandular position, which means over the muscle. Also, if you’re going from very little breast tissue and tight skin to a much larger size, that would also cause more pain in the recovery.”
Activity limitations can last from four to eight weeks, depending on your surgeon’s preference.
“I always tell all my patients you can expect to see your final result anywhere from three to six months,” Dr. Carreras-Montgomery added. “This allows the implant to settle and the tissue surrounding the implant to settle, as well.”
Post-surgery limitations include no physical activities like exercising, heavy lifting, pushing or pulling, repetitive movements, and no swimming for four to eight weeks, depending on your surgeon’s recommendations.
Potential risks and complications
No surgery comes without risks.
“The risks of breast augmentation can include pain, bleeding, infection, scarring, fluid collections building around the implant, collection of blood accumulating around the implant,” said Dr. Carreras-Montgomery.
One risk of breast augmentation is also the formation of what is called capsular contracture.
“Our body always forms a capsule which is a thin tissue that separates any foreign object from the surrounding natural tissue, and this occurs in a breast augmentation, as well, around the implant,” she explained. Over time, this capsule can thicken and harden, causing irregularities that can make the breast appear a different shape.
Recently, some cancers have been associated with breast implants.
Asymmetry and migration of the implants are also risks.
Who should avoid breast augmentation?
The safety of this procedure starts with choosing the right candidates. If you have severe medical conditions or a severe cardiac condition that would prohibit you from undergoing anesthesia, you’re not a candidate for the surgery.
“If you’ve had previous radiation to your breast, that can also make you a poor candidate for a primary breast augmentation,” Dr. Carreras-Montgomery explained.
Patients with autoimmune disorders can have a risk of flare-ups due to the stress of surgery, although this doesn’t necessarily preclude them from undergoing the procedure, she added.
The surgical team at Ocala Plastic Surgery & Dermatology say they are committed to delivering exceptional plastic surgery and dermatology services, aiming for beautiful, natural-looking outcomes for their patients. They say they strive to blend surgical skill, artistic perspective, and exemplary care to make sure your experience with them is positive and fulfilling. Their services include a comprehensive array of modern procedures that span both non-surgical and surgical techniques.