Breasts Surgery
BREAST AUGMENTATION

Are you thinking of having breast augmentation? Johnny Chung, MD and Robert Kevitch, MD are Board Certified plastic surgeons in the Lehigh Valley who specialize in breast enlargement. Voted Lehigh Valley's 2009, 2010, and 2011 "BEST COSMETIC SURGEONS" and "BEST SURGEON", you can trust the experience and integrity of our doctors. 

What is Breast Implant Surgery?

Breast augmentation is one of the most popular plastic procedures performed. Women choose breast enlargement for various reasons, but it should not be taken lightly. Breast augmentation is a challenging procedure to perform particularly when attempting to create natural looking breasts.

What IMPLANTS are available to me?

Currently both SALINE and SILICONE implants are available and approved by the FDA for primary augmentation. Our office utilizes implants from all manufacturers: Mentor, Allergan, Sientra. The incision can be placed either around the areola, in the breast fold, or in the armpit. Depending on how much native breast tissue you have, the implant can be placed either above or below your pectoralis (chest) muscle. Dr. Chung specializes in the endoscopic transaxillary technique which leaves "no scars" on the breast. The use of a camera with the axillary approach allows for a precise dissection and proper placement of the implant. This gives the patient a better result versus implants that are placed with blind dissection(no use of a camera).

Where are the Incisions?

Breast augmentation requires surgical placement of breast implants to enhance breast size.  The most common incisions include an inframammary incision (near the crease under the breast), an axillary incision in the underarm area, or a periareolar incision placed at the edge of the areola.  Incision patterns vary based on the type of implant, degree of enlargement desired, patient anatomy, and patient and surgeon preference.

Through the incisions a pocket is created either directly behind the breast tissue or beneath the pectoralis muscle.  The implant is positioned within the pocket and incisions are closed with a layered, non-removable suture in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.  Implant placement, type and size will be determined based on the patient’s breast anatomy, body type, and desired increase in size, as well as our surgical judgment.

The results of breast augmentation are immediately visible.  Over time post-surgical swelling resolves and incision lines will refine.  Satisfaction with your enhanced body image should continue to grow as you experience the fulfillment of your goal for fuller breasts.

Are implants Safe?

Breast implants have not been shown to impair breast health.  Careful review of scientific research by independent groups has found no proven link between breast implants and autoimmune or other systemic diseases in women.  Implants can, however, create subtle or more noticeable changes in the look and feel of the breasts.  Capsular contracture, a condition that causes the natural forming scar tissue around the breast implant to contract, occurs in a variable percentage of patients and can make the breasts feel firmer than normal.

The decision to undergo breast augmentation should be a personal one. As with any cosmetic procedure, breast augmentation will not resolve any of life's major problems, but may help to boost a patient's own body image and self-esteem. All the potential benefits will be discussed with our doctor at the time of your consultation.

Our doctors are currently certified to use Mentor, Allergan, and Sientra silicone implants. For further information on silicone breast implants, please contact our office for a consultation.  

Aesthetic Surgery Associates serves Allentown, Bethlehem, Easton, Quakertown, and the surrounding Lehigh Valley area
Aesthetic Surgery Associates
250 Cetronia Road, Suite 301
Allentown, PA 18104
(610) 437-2378

FAT GRAFTING for BREAST ENHANCEMENT 
    (Natural Breast Enlargement)

Many of our patients have recently inquired about Natural Breast Enlargement with fat grafting. The technique of fat grafting has been around for over 20 years, and the use of fat grafting into the breasts is not new. We currently use fat grafting into breasts mainly for reconstruction purposes only.

What is Natural Breast Augmentation/Fat Grafting to Breasts?

Fat grafting is a process in which fat cells are moved from one area of the body to another and is commonly used in facial and hand enhancement procedures. Very few studies have been done to examine the safety of using fat grafting for breast augmentation. As with any new procedure, patients need to know the level of risk associated with the technique. Fat grafting can lead to long term complications, such as the development of cysts, scar tissue, and tissue calcification. Of particular concern is the development of tissue calcification because it may interfere with accurate detection of breast cancer. This problem may be eliminated as breast cancer detection methods become more sophisticated and techniques are further refined, but as of today, the potential for complications may outweigh the benefits especially with 1 in 8 women being diagnosed with breast cancer. 

Is Fat Transfer into the Breast safe for me?

Below is a news release from both the American Society of Plastic Surgeons and The American Society of Aesthetic Plastic Surgeons:

New York, NY and Arlington Heights, IL (February 27, 2007) – The American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) have announced that fat grafting for breast augmentation is not recommended at this time based on the lack of safety and efficacy data, and amid concerns that the procedure may interfere with accurate detection of cancer. Fat grafting or lipoinjection is a process in which fat cells from one area of the body are transferred to another area of the body, and is commonly used for enhancement of the face or hands. Despite increasing consumer interest in this technique, there is little clinical evidence to suggest that fat grafting for breast augmentation is safer or better than saline or silicone implants, and long-term complications, including tissue scarring and calcification, can obscure or mimic breast cancer during breast cancer screening by self examination, mammography, ultrasound, or magnetic resonance imaging (MRI).
Fat grafting has been around for more than twenty years, but many plastic surgeons have been skeptical of using it for breast augmentation because of safety issues such as distinguishing calcifications caused by fat grafting as opposed to those associated with breast cancer,” said Foad Nahai, MD, President Elect of ASAPS. We advise caution to women seeking fat grafting for this purpose and strongly support the ongoing research efforts that will establish the safety and efficacy of the procedure.
The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons urge consumers considering fat grafting over saline or silicone implants for breast augmentation to proceed cautiously, since the temporary benefits of fat grafting may be offset by low survival rates of the transferred cells (which are frequently absorbed by the body), development of cysts, calcification and tissue scarring, as well as long-term problems with breast cancer detection. Tissue calcification, in particular, can make accurate detection of cancer difficult, since it is difficult to distinguish mammographically between calcifications associated with breast cancer and calcifications associated with fat transfer.
“Patients considering breast augmentation need to know that fat grafting for this indication is not recommended at this time, unless one is part of an ongoing clinical research study,” said Roxanne Guy, MD, President of ASPS. “Even though fat grafting techniques have become more refined and breast cancer detection methods have become more sophisticated with time, creating a great deal of excitement about the potential of fat grafting, we simply need more data before we can recommend that this procedure be generally used to augment breasts.”
More information for women about fat grafting for breast augmentation is available on the websites of The Aesthetic Society ( www.surgery.org ) and ASPS ( www.plasticsurgery.org ).
ASAPS and ASPS recommendations
The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons, in the interest of patient safety, do not recommend fat grafting for breast enhancement at this time. Because there is little clinical evidence available to document efficacy, the societies urge patients to consider the procedure as one undergoing continued evaluation.
About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS) is the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. www.surgery.org .
About ASPS
The American Society of Plastic Surgeons (ASPS) is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. www.plasticsurgery.org

MASTOPEXY

What is a Breast Lift/Mastopexy?
Mastopexy also known as a breast lift is a surgical procedure to reshape and raise sagging breasts without altering the overall volume of the breast. As the years go by, almost every woman notices a gradual deterioration in the size, shape, and firmness of her breasts. Gravity, pregnancy, breast feeding, running, aerobics, weight gain and loss all take their toll. A mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple

Is there scarring involved with breast lift surgery?
The breast lift procedure is performed with either a scar around the nipple only or around the nipple, down the lower half and along the fold below the breast. The results of this operation are usually excellent, you can expect less drooping of your breast, nipples in a higher position, and a fuller shape in the upper half of your breast.

Every effort will be made to make your scars as inconspicuous as possible. Still, it is important to remember that mastopexy scars can be extensive and are permanent. Fortunately, the scars can usually be placed so that you can wear low cut tops without them being visible. Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and your expectations are realistic. 


REDUCTION
Breast Reduction(reduction mammaplasty) removes fat, glandular tissue, and excessive skin, resulting in smaller, lighter breasts that are better-shaped in proportion to rest of the body. Symptoms often related to this condition include problems with posture, breathing, skin irritation, shoulder and neck pain, and painful indentations of the bra straps. Multiple techniques can be used for breast reduction, but the art is determining which technique to use for each individual. 


GYNECOMASTIA
Although rarely discussed, gynecomastia (male breast enlargement) is a relatively common condition. Gynecomastia affects approximately 30 to 40 percent of men. Although there has been some correlation with various drugs or medical conditions there is no known cause Men who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat and glandular tissue from the breast, and in extreme cases excess skin is removed, resulting in a contoured chest that is flatter and firmer.

RECONSTRUCTION
Breast reconstruction is one of the most important procedures that can be performed by a plastic surgeon. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to a natural breast.

The choice for reconstruction is a highly personalized decision that needs to be made at the individual level but with the guidance and expertise of a plastic surgeon. As important as the reconstruction is itself is the relationship between the patient and the surgeon

At the time of your consultation, Dr. Chung will discuss all avenues of reconstruction including tissue expansion and autologous(your own) tissue. Dr. Chung feels that your comfort and confidence in your surgeon makes this difficult time easier to get through

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