Breast Augmentation Houston
One of the most common cosmetic procedures performed is primary breast augmentation in Houston, The Woodlands, and Conroe, Texas. Dr. Gill is recognized for his natural and elegant breast augmentation results. Dr. Gill and his patient coordinators spend a lot of time during your initial consultation to help identify your goals and concerns. After a detailed history, Dr. Gill will perform a series of measurements known as bio-dimensional planning. This means he determines an implant range that is safe based on your breast dimensions and then the final implant size is determined with his in office sizing process, which involves the use of implant sizers in front of a full length mirror to help give patients a realistic idea of body proportions. He informs his patients that often the patient and their significant other will be the only ones who know the cup size or implant size of her breast, but everyone will notice their breasts in proportion to their body. Hence, the key components of the sizing process is to select an implant that fits their desired body proportion and also fits into the bio-dimensional planning measurements, meaning it is a safe implant choice.
“Choosing to have breast augmentation surgery was a HUGE step for me! I researched for months on line looking at before and after photos of surgeons all across the US. I called several surgeons in my hometown and did not feel comfortable with either the surgical process (performing the surgery in the office rather than a hospital) or the knowledge and compassion from the staff. I saw Dr. Gill’s website and liked what I saw. I called and spoke to Melissa and she spent probably half an hour on the phone discussing anything and everything regarding the surgery and the process. I received referrals and called and spoke with them. I flew halfway across the US to meet Dr. Gill and agreed he was the one to do my surgery. He sat down with me and explained the surgery and what to expect. His staff was wonderful as well making sure there were no unanswered questions! My surgery was a bit unusual as I was from out of state, but they made every effort to take care of me for my stay. My surgery went great, I followed my doctors orders … was a HUGE step for me! I researched for months on line looking at before and after photos of surgeons all across the US. I called several surgeons in my hometown and did not feel comfortable with either the surgical process (performing the surgery in the office rather than a hospital) or the knowledge and compassion from the staff. I saw Dr. Gill’s website and liked what I saw. I called and spoke to Melissa and she spent probably half an hour on the phone discussing anything and everything regarding the surgery and the process. I received referrals and called and spoke with them. I flew halfway across the US to meet Dr. Gill and agreed he was the one to do my surgery. He sat down with me and explained the surgery and what to expect. His staff was wonderful as well making sure there were no unanswered questions! My surgery was a bit unusual as I was from out of state, but they made every effort to take care of me for my stay. My surgery went great, I followed my doctor’s orders and did not have any issues. Dr. Gill is the only plastic surgeon I will use! He is amazing! The evening of my surgery I felt good enough to go out for ice cream and the next day I walked around the mall. I was told this was because I had a great surgeon and I truly believe that! I trust him completely”
Individual results may vary
Dr. Gill will then review the options in breast augmentation. He discusses 5 major choices in breast augmentation:
Individual results may vary
Saline versus Silicone Breast Implants: Many patients feel very comfortable with saline augmentation, as these implants have been FDA approved and on the market for over 20 years. We know they are safe and cause little risk. The downside is that they do not look nor feel as natural as the solid silicone/gummy bear implants. Also, they are more likely to wrinkle or ripple, amore likely to rupture. Hence, over 80% of Dr. Gill’s patients choose the new silicone gel implants. Why? Because they feel and look more natural and are less likely to rupture or wrinkle. We have found very high patient satisfaction with these implants. We also caution patients that the new silicone implants differ from the old silicone implants in that they are a solid gel, not a liquid gel. Hence, they do not leak or stick like the old gel implants did 20 years ago. However, this means that patients need to have an imaging study every 2 years per the FDA to test the integrity of the implant shell.
Above versus Below the Muscle: Dr. Gill has a strong preference for under the muscle breast implant placement for 2 reasons. It looks more natural as an end result and the risk of capsular contracture, infection, and sensation change are much less. In patients who require a breast lift due to the nipple position migrating to or below the level of the breast crease, but who are opposed to a breast lift, Dr Gill may discuss the option of an above the muscle implant placement. His concern with this procedure is that the implant will often cause more sagging of the breast due to the increase in size and lead to a more unappealing result if a breast lift is not considered in the long-term.
Incision Placement: There are multiple options in incision placement, each guided by the patient’s own anatomy and desires. In general, Dr. Gill offers three choices: the axillary, peri-areolar, and inframammary approach:
- Axillary approach: this technique is recommended for patients with no breast tissue and a very tight skin envelope. With the use of a lighted camera, Dr. Gill can see the crease of the breast in detail. This technique works well for a saline implants or small silicone implants.
- Peri-areolar approach: This technique is recommended for patients who have a slight amount of nipple asymmetry and desire a breast lift of less than 2 cm. The incision hides nicely within the natural border of the areola. The downside of this approach is that Dr. Gill feels the sensory nerves to the nipples and the milk ducts are at a higher risk of damage. This means that patients will have a higher risk of sensation change to the nipples, changes in ability to breast feed, and infection/capsular contracture due to milk duct damage.
- Inframammary approach: This is Dr. Gill’s preferred method for primary breast augmentation and revision augmentation procedures. It violates the least amount of breast tissue and therefore decreases the risk of capsular contracture and sensation change.
Smooth or Textured Breast Implants: Dr. Gill prefers the use of Smooth Implants under the muscle and textured implants over the muscle. On top of the muscle, the incidence of capsular contracture has been shown to be decreased with the use of textured implants. However, under the muscle, there is no difference in capsular contracture rates between smooth and textured implants. Therefore, Dr. Gill recommends smooth implants under the muscle as they are more comfortable to the patient in this position.
Round or Anatomic Breast Implants: Dr. Gill prefers the use of round implants in cosmetic surgery as he feels that it does not distort the surrounding breast tissue and anatomy. The anatomic implants can rotate causing malposition and distortion requiring revision surgery. For this reason, he does not generally recommend round implants for primary breast augmentation. Dr. Gill recommends anatomic implants only for breast reconstruction after mastectomy. Since all the breast tissue has been removed, these implants do a better job at filling the void of tissue in the upper pole of the breast. In this case, he feels the benefits outweigh the risk of an anatomic implant.
The easiest way to discuss recovery from a breast augmentation is to give patients a timeline of what to expect with Dr. Gill’s breast augmentation procedure.
Preoperative Period: After you have made a decision to book surgery, our patient coordinators will offer you a surgery date and pre-op appointment date. We always perform routine lab-work and request that any necessary medical clearances be performed prior to your pre-op visit. Our coordinators will help guide you through this process every step of the way.
At the pre-op visit, you will review your choices and plan with Dr. Gill. This is also an opportunity to resize your implants to help finalize your choice. Dr. Gill always recommends bringing the family member or friend who will be helping you during the recovery process. You will sign consents, receive your pre/postop care instructions, and be given prescriptions at this visit. We find this visit helps ease any pre-surgical anxiety and leads to a well-informed patient.
Surgery Day: You will see Dr. Gill will see you about 20 minutes prior to your procedure to perform surgical markings and answer any questions. The primary breast augmentation takes approximately 45 minutes to complete. Dr. Gill will use dissolve-able sutures, a sterile skin glue, soft gauze, and a bra. He also injects a long acting pain medication to assist with any soreness.
Postoperative Period: Patients are typically sore from this procedure for 3-5 days. Patients with a tight skin envelope, where the skin undergoes more stretching may have more soreness. Our patient coordinator will follow-up with you during your first few days to ensure your safe recovery. Dr. Gill will see you back for your first postoperative visit at 5-7 days. He will check your implants and incisions and demonstrate his implant massage, scar cream, and activity level recommendations. He will also discuss appropriate support bras to keep the implant in proper position. Generally, we want patients back to their normal activity by 1 week, with the exception of two things.
- No heavy pectoralis muscle activity as this can result in breast implant migration/displacement
- No swimming, pools, hot tubs, or soaking in a tub, as this can cause bacteria to migrate into your breast augmentation incisions.
You will see Dr. Gill for a 2nd postoperative visit at 3 weeks. He will again check your implant position and incision. Appropriate scar therapy will be discussed. By this visit, the implants have begun to settle and swelling is decreasing. We will then see you for a 3rd postoperative visit at 6 weeks, where we find the majority of swelling is gone, implants have dropped into position, and the incisions have regained the majority of their strength back. After checking your implants and scar, we will discuss bra options, scar management, and return to normal activities. We usually take our initial postop pictures at this visit.
We will then recommend follow-up every 3 months for a year to assess your breast implants for any signs of capsular contracture and follow your incision healing progress.