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TX Health Magazine Discusses Breast Augmentation with Richard Reynolds, M.D.

TX Health Magazine Discusses Breast Augmentation with Richard Reynolds, M.D.

TX Health Magazine Discusses Breast Augmentation with Richard Reynolds, M.D.

What is the first step for someone seeking augmentation?

The first step is to speak with a plastic surgeon about options. The reason the person is seeking augmentation will help determine her options. Options to consider include placing the implant above or below the muscle and what kind of implant to use, whether it's silicone or saline, textured or smooth, anatomic or round. There are benefits  and drawbacks to each of those that they should discuss with their surgeon.

How would you work with someone who just wants to increase their size?

I would talk to the individual to find out more about their motivation for an augmentation. Why is she interested in having an augmentation and I would make sure her expectations are realistic and that she's a good candidate for the procedure. We'll make some measurements regarding her symmetry, size and breast measurements. From those measurements and after discussing the desires of the patient, we'll devise a plan together.

How does someone decide whether they want the implant beneath the muscle or above?

All implants form a fibrous capsule around them because it's a foreign body. Sometimes this becomes more evident with time, but the majority of time it's not noticed by the patient. Putting the implant below the muscle decreases the possibility of this problem. Sometimes putting it above the muscle will get a better result, but this is only done with silicone implants. Putting the implant above the muscle increased the chance of waviness or rippling from the implant and this is the main reason I usually place the implant under the muscle.

What type of procedure is easiest in terms of placing the implant?

The majority of patients are best served with the incision in the crease underneath the breast. It usually heals well and is hidden after the surgery. It also minimizes the possibility of change in sensation of the nipple or areola. It allows the surgeon the most precision in placing the implant and usually produces a maximal result. However, if some skin needs to be removed to correct droopiness or ptosis of the breast, then a periareolar approach with a possible vertical extension may be best.

What are the best options as far as breast reconstruction?

There are several options for breast reconstruction. The best choice, if it's possible, is to do an immediate reconstruction at the time of the mastectomy. The general surgeon makes an incision to remove the breast, but most of the breast envelope is left in place. A plastic surgeon can put something in that envelope to keep it expanded temporarily or to put a permanent implant or the patients own tissue in that skin envelope. If this isn't possible, or if the patient is going to receive radiation, it is usually better to wait.

Some general surgeons are very good about discussing the option of immediate breast construction with patients. If we work with the general surgeon at the time of the mastectomy, we usually design the incision together. The general surgeon removes the breast and then the plastic surgeon will fill that breast envelope with either tissue from the abdomen, the back, an expander, an implant or a combination.

What is your greatest joy in the work that you do?

My greatest satisfaction comes from my patient's satisfaction as a result of the surgery, whether it's cosmetic or reconstructive. It usually makes a significant difference in their life and in their self-esteem. Plastic surgery procedures are usually procedures that patients request and after the procedure are happy that they made the decision to have it done.

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