DR Andrew j. HAYDUKE
Also known as augmentation mammaplasty, breast augmentation involves using implants to fulfill your desire for fuller breasts or to restore breast volume (size) lost after weight loss or pregnancy. It is one of the most common cosmetic plastic surgery procedures performed in the United States and in Dr. Hayduke’s practice. Dr. Hayduke approaches breast augmentation with as much care and planning as fine artists approach the creation of their most cherished work. He works closely with his clients to establish a highly individualized surgical plan custom tailored to their unique cosmetic goals.
If you are dissatisfied with your breast size, augmentation surgery is a choice to consider.
Breast augmentation can:
Implants also may be used to reconstruct a breast after mastectomy or injury.
Breast augmentation does not correct significantly drooping breasts or low positioned nipple/areolas. If you want your breasts to look fuller and to be lifted due to significant sagging, a BREAST LIFT (MASTOPEXY) would be required in conjunction with your breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Dr. Hayduke will assist you in making your decision. If a BREAST LIFT is performed, the diameter (width) of large areolas can be made significantly smaller and more youthful looking. Decreasing the size (diameter) of wide areolas during a BREAST LIFT tends to make breasts look younger.
Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast augmentation may be a good option for you if:
Anesthesia is administered for your comfort and safety during breast augmentation. The importance of anesthesia is frequently overlooked by patients. The choices include general anesthesia or intravenous “sedation” (extremely rare nowadays). The most common choice by far in the United States is general anesthesia. Unfortunately, some old fashioned practices may only offer intravenous “sedation” since they do not actually have a facility accredited for true general anesthesia at their own office (nor do they have the expensive equipment necessary for general anesthesia accreditation). Their in-office surgical facility might be accredited only for intravenous “sedation” and obviously they urge their patients to choose intravenous “sedation”. Please be aware that in today’s modern era of sophisticated anesthesia, anything other than general anesthesia for a breast augmentation should be considered highly unusual.
If the intravenous “sedation” approach to anesthesia is being suggested to you by any office as their first recommended anesthesia choice for your breast implant procedure, we highly suggest that you carefully do your own in depth research on this anesthesia related topic. The importance of your anesthesia choice for your breast augmentation should never be underestimated, in fact, we feel it is just as important as your choice of implant size. Most patients prefer to be totally asleep under modern general anesthesia (not just sedated) for their breast augmentation. Sedation (rather than general anesthesia) is more common in the United States for smaller less invasive procedures such as upper eyelid surgery and dental procedures, etc.
For more detailed information on this very interesting (and frequently overlooked) anesthesia related topic, please visit this link to an online article from The New York Times.
Any incision used will leave a permanent scar regardless of who performs your procedure. Incisions are ideally made in inconspicuous areas and made as short as possible to help minimize visible scarring. All scars, however, are permanent. You and Dr. Hayduke will discuss which incision options are appropriate for your desired outcome and for your unique anatomy. Incision options include:
PERIAREOLAR – around a portion of your areola
INFRAMAMMARY – in the natural skin fold (crease) under your breasts
TRANSAXILLARY – in the hair bearing underarm area totally away from your breasts
PERI-UMBILICAL – via an incision around your belly button (umbilicus)
Incision recommendations will vary based upon the type of implant (silicone vs saline), degree of enlargement desired (size of implant), your particular anatomy, and patient-surgeon preference. For example, patients with very small diameter areolas are generally not good candidates for medium/large silicone implants inserted via a periareolar incision. Simply put, their areolas are not wide enough to safely allow this approach to medium/large silicone breast augmentation. These patients, however, might be better candidates for the inframammary incision or transaxillary incision. Patients with a well formed natural crease under their breasts (known as an inframammary crease) are generally excellent candidates for the inframammary incison – since the incision can be well hidden in this natural crease in most cases. Many factors, including patient preference, are taken into consideration. Dr. Hayduke will help you with your decision making process regarding incision location. Most patients are extremely concerned with incision location placement before cosmetic breast surgery and it certainly deserves careful consideration.
Breast size and shape are important, so be honest and open about your expectations when speaking with Dr. Hayduke. Implant type and size will be determined not just on your desired increase in size, but also on your breast anatomy, skin elasticity, breast width and body type. Many factors including anatomical measurements (measured by Dr. Hayduke himself during your consultation) should be involved in a carefully and properly planned cosmetic breast augmentation. Dr. Hayduke personally takes and analyzes your measurements, including your: inter-mammary distance (separation distance between your breasts), breast width, areolar diameter, sternal notch to nipple distance, etc. Using Dr. Hayduke’s vast experience with breast implants and all this data together with your personal desired size/shape goal, a proper strategic plan can be created for your breast augmentation.
Saline implants are filled with sterile salt water after they are inserted into your breast pocket by Dr. Hayduke. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline implant will collapse and the saline inside the shell will be absorbed. The shell itself, however, will not be absorbed. Saline implants are significantly less expensive than silicone implants. Saline implants can be inserted via slightly smaller incisions (compared to silicone) since they are inserted into the breast pocket while totally empty and then later filled with saline as the last surgical step. Saline implants can also be inserted from distant locations, such as via the armpit incision (transaxillary incision) much more easily than silicone implants. A transaxillary incision (armpit incision) would allow the final scar to be located totally away from the breast itself.
Silicone implants are pre-filled with an elastic silicone gel. The gel feels and moves somewhat like breast tissue. Different degrees of cohesiveness exist among modern gel implants, with some implant manufacturers claiming that high cohesiveness helps maintain implant shape. Most modern silicone gel implants are very cohesive compared to earlier generations of silicone implants. If the silicone implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel may not collapse. MRI screening can assess the condition of silicone breast implants. Silicone implants are by far our patients’ most common choice for both cosmetic breast augmentation and breast reconstruction. Most patients simply prefer the more natural feel of silicone implants over the feel of saline-filled implants.
Implant shapes/types – Breast implants come in many shapes, profiles and types, including: high profile, moderate profile, moderate plus profile, classic profile, tear-drop, highly cohesive, smooth, textured, anatomical shaped, gummy bear, high strength, etc. Competing implant manufacturers (of which their are several) introduce new styles, catchy names, and types of implants all the time – so many options are available. Dr. Hayduke will help you sift through the implant manufacturer’s marketing hype versus the true realities of implant shape/profile/type choice, always keeping in focus your own personal desires and your unique breast anatomy. The most highly advertised “implant of the month” with the most media/marketing hype may not necessarily be the best choice for your own personal breast shape and goals. Media exposure and “hype” regarding a certain “new” type of breast implant usually only reflects which specific implant manufacturers decided to spend the most on an advertising campaign
Implant size – Implant size choice is a very personal decision, ranging from an ultra-conservative barely detectable enlargement to a more significant and dramatic statement. Dr Hayduke understands that implant size choice is frequently very intimidating for clients and sometimes even the greatest source of stress for them before implant surgery. Dr. Hayduke carefully evaluates your personal size preference, body frame, example photos that some clients choose to bring to the consultation, rib cage dimensions, height, weight, shoulder width, skin elasticity, breast width and existing breast volume to help guide you in your decision making. Implant size is indeed a very personal decision and expert guidance is crucial in achieving ultimate success. Dr. Hayduke realizes how intimidating implant size choice may be for new patients and he spends as much time as necessary to help his clients make the right decision. Several visits with Dr. Hayduke may be necessary before a final size decision is made and he always encourages his clients to take their time.
After the incision is made, Dr. Hayduke carefully creates a pocket either:
The method for inserting and specific positioning of your implants will be discussed during your consultation with Dr. Hayduke and will depend upon the type of implant you choose, degree of enlargement desired, your unique body type, amount of existing breast tissue present and your own personal preference. The most common modern day positioning choice is “under the muscle” (partial subpectoral). For those particular patients who specifically request the transaxillary (underarm) approach – Dr. Hayduke uses his own endoscopic transaxillary equipment to meticulously create the pocket under magnified video screen endoscopic guidance. It is more common, however, for patients to request the inframammary (under the natural breast crease) or peri-areolar (around the areola) incision. Dr Hayduke offers all these options to his clients.
Incisions are closed with layered absorbable sutures in both the breast tissue and skin. Staples are not used and the sutures will eventually disappear on their own. External surgical adhesive tape is then applied for a second layer of reinforcement. Over time, the incisional scars usually lighten in color and flatten.
Immediately after surgery, post-surgical swelling masks your new breast contour and size. Although the initial early swelling significantly resolves over the first two to three weeks, please be aware that at least several months of patience will be needed to see the final results. It may take from six months to over one year for your implants to truly settle into their final position. Satisfaction with your new image should continue to grow as you recover and hopefully realize the fulfillment of your goal for fuller breasts.
Breast implant surgery involves many choices. Finding a formally trained and credentialed breast implant surgeon is difficult. Since insurance does not cover cosmetic breast implant surgery, many types of surgeons from different specialties (general surgery, gynecology, otolaryngology, ear nose throat surgery, etc) will try to capture you as a breast implant patient. We feel that the first and most important recommendation is selecting a formally trained PLASTIC SURGEON who is board certified by the American Board of Plastic Surgery (ABPS)
Although it is hard to believe, in the state of California, your surgeon does not need to be a formally trained plastic surgeon or board certified by the ABPS in order to perform breast implant surgery. Board certification is simply not required. In reality, your chosen breast implant surgeon could actually be a gynecologist, general surgeon (gallbladder-hernia-colon surgeon), ear nose throat surgeon, etc. Any licensed medical doctor (M.D) or D.O. (Doctor of Osteopathy) from any specialty can legally perform breast augmentation as long as a patient signs the consent form for the procedure. It is left up to the patient to actually double check if their surgeon is actually board certified by the ABPS by visiting www.abplsurg.org and clicking/tapping on the “is your surgeon certified” tab. It is very easy to be confused by other official sounding boards and certifications posted on ads and websites.
To find out if your potential surgeon holds any board certification in any specialty whatsoever, we suggest you visit www.certificationmatters.org and discover which SPECIFIC board certification (if any) your potential surgeon actually holds. We highly suggest that you choose a surgeon board certified by The American Board of Plastic Surgery if you are thinking of having PLASTIC SURGERY – it only makes sense. Visiting www.certificationmatters.org is also a way to find out which specific specialty your potential surgeon was truly trained in – rather than relying upon slick ads with confusing phrases that may indirectly (and falsely) suggest certification in plastic surgery.
Once you are assured that your potential plastic surgeon meets this very important standard of formal training, then you can determine if they are truly the right breast augmentation surgeon based on your own personal consultation with the doctor and a careful review of the doctor’s past breast implant work. Take your time, do your own research (do not rely solely on advertising or on your friend’s research) and make your choice wisely. Dr. Hayduke is a meticulous, properly credentialed, highly-skilled and artistic plastic surgeon with tremendous experience in breast implant surgery. Equally important is Dr. Hayduke’s ability to truly listen to his clients and work together with them to achieve ultimate success.
Visit Dr Hayduke’s portfolio page to see more before and after photos.