Information about Breast Augmentation for patients who contact Dr. Medalie
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1 Information about Breast Augmentation for patients who contact Dr. Medalie Thank-you for contacting me through the internet. Below is some information regarding breast augmentation. Please also note the pictures at the bottom which are real patients of mine with different size implants. I will try and answer several of your potential questions. I typically see patients on Tuesday afternoon or Wednesday mornings (and sometimes afternoon). Consultation fee is $65 for anyone who contacts me via the internet. This fee is refunded if you proceed with surgery. To schedule a consult, please call my office at the number listed below my name. If you decide at that consultation to proceed with the surgery, I would be able to perform the surgery almost certainly within 1 month of the consultation. Some of the planning depends on how flexible you are with your schedule. The fee for the surgery depends a little on where it is performed (which depends a little on your location and schedule), but is roughly $ for saline filled implants and $ for silicone filled implants (this includes the cost of the implants, anesthesia, facility fee and all post-operative care). The rates are variable because I operate at four different surgery facilities. Prescriptions for pain medicine and antibiotics would be extra, depending upon your insurance company, and I recommend that all of my patients buy some sports bras for the immediate post-operative period. We also offer financing through companies recommended by the American Society of Plastic Surgery (please call my secretary at the number below my name for more information about financing). Alternatively you can her at Vrowan@metrohealth.org. The procedure is usually done under general anesthesia in an outpatient setting. Operative time is roughly 1hour. The implant can either be placed through an incision following the lower edge of the areola (the pigmented portion of the nipple), in the crease of the armpit or through an incision in the crease of the breast. I am comfortable using any of the three locations for the incision and will base it upon the patient s anatomy and wishes. The implant can be placed either below the breast tissue or below the muscle. In most patients, I prefer to place the upper part of the implant below the muscle, to prevent feeling or seeing the implant where the chest skin is the thinnest. Initially, the breasts are somewhat firmer from swelling, but they will soften over the next four to six weeks. Following breast augmentation, it is necessary to move the breast over the implant, several times daily (implant displacement exercises), to keep this space large and the implant moveable. Implant size is an individual preference and will be discussed with me in my clinic. The saline implants are filled with saltwater. The FDA has recently approved silicone implants as well, and these have a cohesive gel interior which does not leak liquid if the implant ruptures. The silicone gel implants cost around $1000 more than saline. Their advantage is most noticed in thin patients (the gel feels better and has less visible rippling). Their disadvantage is that the incision is several times larger than the incision required for saline implants. It is also recommended by the FDA that you have an MRI every three years to determine whether the silicone implant has ruptured. I will discuss this in more depth in clinic. You can also log onto the Mentor or Allergan implant manufacturer web sites for more information. If there is a post-operative complication such as implant rupture, some of the cost is actually covered by the implant manufacturer and the implants are replaced for free for the first ten years. You must be aware that there is no such thing as a benign procedure and nothing man made lasts forever. If you live to be 100, there are bound to be changes in the shape and feel of the implants (and almost certainly rupture). If you are unhappy with the results of the surgery because of implant malposition or asymmetry, I typically will attempt to repair such a problem without charging you a surgeon's fee (Of note, I am quite careful in my consultations to point out any pre-existing breast asymmetry that may not be corrected by implants alone.) Problems with bleeding or infection are not your fault and will typically be covered by me (not including facility or anesthesia fees over which I have no control). I have never actually had an implant related bleeding or infection problem so am gratefully a novice in that arena. Recovery is variable, but most patients are off narcotic pain medicine in 2-3 days and able to return to work in 7-10 days with Motrin for pain relief. I recommend no heavy exercise for 3 weeks following the surgery. Risks of the surgery include infection, bleeding, anesthesia, nerve injury to the breast or nipple, chest wall injury, blood clots in the legs, breast implant malposition, implant rupture, implant asymmetry, poor cosmetic result and requirement for further surgery.
2 I would be more than happy to see you in my clinic where I can also show you more pictures of my patients and explain the procedure in greater detail. I also encourage you to visit my web pages at Loveyourlook.com, Lookingyourbest.com and at this site (my main web site) to see pictures of some of my breast procedures. Thanks again and I hope to see you soon. Sincerely, Daniel A. Medalie, MD Assistant Professor of Plastic Surgery MetroHealth Medical Center and Case Western Reserve University phone: cc implants -5 3, cc implants 5 4, 130
3 300 cc implants 5 9, cc implants 5 4, cc implants 5 7, 125
4 350 cc implants 5 6, cc implants 5 6, 125
5 390 cc implants 5 1, 115
it is normal to show up on the morning of surgery and still be unsure of the fi nal size implant we will choose with you.
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