BEST BREAST AUGMENTATION
A National leader in breast surgery
Dr. Ary Krau is well known in Miami as a plastic surgeon that provides women with the beautiful breasts they desire, with less scarring, and a sexier shape. Dr. Krau is one of the country’s busiest breast augmentation surgeons — he currently performs over 1500 breast augmentation procedures in Miami per year.
How Patients Rank Dr. Krau
“You have to be meticulous and have a feel for what you’re doing,” says Dr. Krau. His attention to detail, personal approach and closely knit office staff has South Floridians and others flocking to his practice. “Our practice is growing dramatically because our satisfied patients recommend us to their family and friends.”
Many women desire to augment their breast volume because they’ve lost their intrinsic volume due to pregnancy, weight loss, or aging; others simply wish to increase the current size of their breasts and/or improve their shape. Patient satisfaction is, generally, extremely high. However, not all breast augmentations are the same. The results will vary not only by which implant is chosen, but to a great degree, the technique used by the surgeon.
AM I A CANDIDATE FOR BREAST AUGMENTATION?
You may be a candidate for breast augmentation if you:
- desire larger, fuller and sexier breasts
- have asymmetrical breasts
- experienced a change in breast size as the result of breastfeeding
- are in good physical and psychological health
- do not have a medical condition or health problem that could impair your healing
- understand the risks and possible complications
- have reasonable expectations of the results
- desire cosmetic improvement, not perfection
TYPES OF BREAST IMPLANTS
Dr. Krau uses saline and memory gel implants, as well as the recently approved “gummy bear” silicone implants. There are pros and cons to each of the types of implants. The type of implant that is selected can play an important role in the final outcome.
SALINE IMPLANTS
For example, saline implants are not pre-filled, so they can be placed through a slightly smaller incision; also, by the nature of their filling, the body will immediately absorb the saltwater solution in the unlikely case that the implant leaks or ruptures.
SILICONE (GUMMY BEAR) IMPLANTS
On the other hand, silicone implants are pre-filled by the manufacturer, and thus require a slightly larger surgical incision for placement. In addition, because the silicone gel is fairly cohesive, it can be difficult to detect a leak and rupture. However, Dr. Krau does not feel that this is a factor as silicone has been universally established to be safe. Many women find that silicone implants more closely mimic the look and feel of natural breasts when compared to saline implants. In fact, nearly nine out of 10 of Dr. Krau’s breast augmentation patients select silicone implants because they create a more natural feel as well as a more natural-looking result.
Silicone implants come in round and teardrop shapes. Teardrop implants, also known as anatomically-shaped implants, mimic the sloped curve of a natural breast. Round implants add fuller projection on the upper portion of the breast, a look that many of Dr. Krau’s patients prefer.
Dr. Krau will help you weigh your options and decide the type, shape and size that is best for your breast augmentation goals and body type. As one of South Florida’s leading breast surgeons, Dr. Krau has a reputation for excellence. Every year, hundreds of women put their faith in him to deliver beautiful and natural-looking results. As you can see from our before-and-after photo gallery, Dr. Krau settles for nothing but the best surgical outcome.
MENTOR BREAST IMPLANT SIZING KIT FOR PATIENTS
When it comes to breast augmentation, size truly does matter. Depending on your body’s size and structure – and, of course, your own goals and reasons for having breast enhancement – the size of the implant can have a significant impact on your overall satisfaction with the procedure. Choosing the right implant size can also eliminate the need for additional surgery to “swap” implants for a different size in the future. Size is a personal taste and Dr. Krau lets the patient choose when it comes to breast implant size.
To get a much more accurate idea of a wider range of implant sizes, the volume sizing kit by Mentor is the way to go. Available in Dr Ary Krau’s office, the kit allows you to “try on” 24 different volumes, ranging from 150cc-775cc so you can feel confident in the implant size you’re choosing. What’s more, the kit allows you to use a different sizer for each breast so you can see how implants can help you “even out” the natural size differences that may exist between the left and right sides.
WHAT ARE THE INCISION OPTIONS FOR BREAST AUGMENTATION?
After selecting your implants, you and Dr. Krau will make decisions about the incision location to use during surgery. The type of implant that you select may influence the incision type Dr. Krau recommends. There are three incision options available for breast augmentation surgery:
- Transaxillary – This incision is located under the arm, in the armpit area. Although this leaves the least visible scarring, it is typically only used to insert saline implants that can be filled after insertion.
- Periareolar – This incision approach involves making a circular incision around the outer edge of the areola. A periareolar incision is generally well concealed, but is not necessarily an appropriate treatment option for women who are concerned with changes in nipple sensation or their ability to breastfeed, due to the location of the incision near the nipple and, thus, near the underlying nerves and milk ducts.
- Inframammary – This is a horizontal incision that’s placed underneath the natural fold of the breast. The inframammary incision pattern may be visible when the patient is wearing a bikini and lifting her arms.
WHAT ARE THE IMPLANT PLACEMENT OPTIONS?
Breast implants can be placed over the chest muscle and under the breast glandular tissue (subglandular placement) or under the chest muscle (submuscular placement). The former placement option is less invasive in that it leaves the chest muscle intact, but it might not be a suitable treatment option for women who have thin skin and little body fat that does not properly cover and support the implants.
BREAST AUGMENTATION PROCEDURE DETAILS
Breast augmentation is an outpatient procedure performed under general anesthesia. Typically, surgery does not exceed more than one hour. Dr. Krau performs surgery in a state-of-the-art, fully accredited surgical center. Your safety is our top priority during surgery, and you will be monitored at all times while you are in our care.
To begin, Dr. Krau will make the surgical incision in the pre-determined location. Then, he will create a small pocket for the implant and carefully insert it within the pocket. Next, he will close the incisions with absorbable buried sutures and place an elastic bra to help hold the breasts in the correct position during recovery.
If you’ve elected to have combination breast augmentation-breast lift, the procedural details will vary slightly. Learn more about Dr. Krau’s signature breast lift with implants procedure.
After your procedure, we will monitor your vital signs and ensure that you’re recovering nicely from the anesthetic effects. You will then be released into the care of a companion, who should escort you home or back to your hotel (if you are an out-of-town guest). We have an on-site recovery suite available as well, in case you would like to stay overnight with our team.
SHOULD I COMBINE AUGMENTATION WITH A BREAST LIFT?
Many of Dr. Krau’s breast augmentation candidates desire bigger, fuller breasts that are also perkier and more youthful-looking. Some women prefer for their breasts and nipples to sit at a higher position that mimics the way they looked 10 or 20 years ago (or simply reflects the perkiness they have always desired). If this describes your needs, you may be a candidate for combination breast lift with implants, a procedure in which the breast mound is recreated higher on the chest and supplemented with shapely implants. Breast lift with implants is a great option for women whose breasts appear shapeless and saggy after pregnancy, nursing or weight loss, or because of genetic factors. Dr. Krau uses a breast lift method he personally developed that lends itself to better shape that is longer-lasting with fewer and superior scars.
RECOVERING FROM BREAST AUGMENTATION
Some breast augmentation patients recover more quickly than others. The most important thing to remember during recovery is to rest your body and avoid any strenuous movement (including bending and lifting) which could make recovery more difficult.
During the first few days of your recovery, you may experience minor discomfort, which can be controlled with oral pain medication. You will also have some swelling and bruising that will gradually subside. Your breasts may initially sit a bit high on your chest, and gradually “settle” into place as you recover.
All of Dr. Krau’s breast augmentation patients — including those who fly in from out of town for their surgery — receive excellent surgical follow-up care. Dr. Krau will personally meet with you to check your healing progress, remove your sutures and let you know when it is safe for you to return to work, exercise and other everyday activities. Your first follow-up visit will occur within 24 hours of your surgery.
Most women are able to resume light activity as soon as they feel ready. More strenuous activity, including lifting children and aerobic exercise, should be avoided for about three weeks, or until Dr. Krau clears you.
BREAST AUGMENTATION COST AND FINANCING OPTIONS
Dr. Krau believes his patients are entitled to excellent value for their money. He prides himself on offering breast augmentation at a competitive, affordable price. Breast augmentation cost ranges from $4,500 to $8,500, depending on factors such as the type of implants used and whether a lift is incorporated into the surgery.
To help you attain your breast augmentation goals, we offer several financing options, including CareCredit and MyMedicalLoan.com. Learn more about breast augmentation financing.
WHAT ARE THE RISKS OF BREAST AUGMENTATION?
One of the topics that will be discussed at length during your surgical consultation is the possible risks. As with any surgical procedure, there is some degree of risk, due to the unpredictability of the human body. A surgeon can do everything “by the book” and the outcome may still be less than desirable. However, when the procedure is performed well by a qualified plastic surgeon, the risks decrease significantly.
Dr. Krau is proud of his very low rate of complications and low revision rate. He credits his low rate of complications to his extensive experience and top-notch team. His rate of capsular contracture is extremely low: less than two percent, which is significantly lower than the national average, which approaches 10 percent.
Occasionally, minor complications can occur that do not affect the results. In very rare cases, complications such as infection, capsular contracture, symmastia or implant rupture may necessitate medical attention and possibly implant revision surgery.
In rare cases where a breast augmentation patient does develop a complication (e.g., recurring capsular contracture, symmastia or rippling), Dr. Krau can manage the problem with an innovative biomaterial called acellular dermal matrix. ADM materials are skin grafts from which the cells have been removed. When placed, the patient’s own cells are able to grow into the ADM’s framework of tissue, eventually replacing the skin graft. According to Dr. Krau, ADM “makes the unsolvable {cases} solvable” and provides great outcomes with low complication rates.
WHAT SETS DR. KRAU APART ON BREAST AUGMENTATION
BREAST IMPLANT PLACEMENT TECHNIQUES
There are three planes in which breast implants can be placed: submuscular, subglandular and subfascial. The submuscular plane is the one I most often recommend. Placing implants behind the muscle provides additional support and coverage for the implant. Additionally, the tendency for excessive scarring to occur, a condition called capsular contracture, is minimized when implants are submuscular.
It is important to realize, however, that not all submuscular techniques are the same. The technique used can have a profound effect on the results achieved, both short-term as well as long-term. When placing the implant behind the muscle, it is critical that the surgeon preserve the fascial coverage over the muscle. This fascial framework lends support to the implant. If disrupted, this lack of support can lead to bottoming out where the implants have dropped too low with loss of upper pole fullness.
ATTENTION TO DETAIL & BREAST AUGMENTATION CONSIDERABLE EXPERIENCE
I have been to numerous conferences and seen many videos of respected surgeons performing this operation. Many release the muscle along with its fascial framework. I strongly disagree with that approach. Many of those implants will eventually sit too low and require a revision.
The amount of muscle that is released to prepare the pocket for the implant is also critical. The pectoralis major muscle is partially released from its origin in order to make room for the implant, as well as allow it to sit in an ideal position. That muscle needs to be released completely along the fold of the breast. If that area is not released, the implant will wind up sitting too high. No amount of post-operative massage or waiting will result in that implant settling to the desired position.
The muscle also needs to be partially and smoothly released off the lower part of the breastbone. Not doing so will result in a wide gap between the breasts and eventually lead to lateralization of the implants. This is not an uncommon finding after breast augmentation. Many surgeons are perhaps hesitant to release the muscle in this area, afraid of over release and resultant symmastia. With proper technique, visualization and experience, the muscle can be accurately released so as to achieve a close cleavage without the risk of symmastia.
An appropriate combination of antibiotics also needs to be used to bathe the pocket in which the implant is placed. This has been shown to drastically decrease the incidence of capsular contracture. If a periareolar incision is chosen as the access incision, then a nipple shield should be used to prevent contact of the nipple with the implant upon its insertion. The way the surgeon handles the breast tissue through which the implant is introduced also is important. Improper dissection of the breast tissue can lead to indentation and contracted scars.
The subglandular pocket, although I rarely use it, is a common plane for implant placement. It is beneficial in women who have adequate breast tissue for coverage, are body builders, or have tubular breast deformity. In these patients, textured implants should be used, as smooth-walled implants in front of the muscle carry a high capsular contracture rate. Subglandular placement is sometimes used in women who otherwise would require a lift. This, however, is not a good solution, in that the subglandular placement will lead to further stretching of the breast and eventually exaggerate the sagging.
The subfascial plane is rarely used, but is actually quite a viable choice. There is a potential space between the muscle and the breast tissue. This space can be used for implant placement. It has the advantage of not affecting the muscle yet still having adequate support for the implant. The capsular contracture rate is as low as that of the submuscular plane. However, it lacks the additional coverage that the muscle provides. Adequate breast tissue for coverage is also required for this approach.
Although breast augmentation sounds like a straightforward procedure, there are numerous nuances that should be followed in order to achieve the ideal desired results.
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YOUR BREAST AUGMENTATION CONSULTATION
The consultation is an opportunity for you to have some one-on-one time with Dr. Krau. It’s always a good idea to come prepared with questions you may have about breast augmentation, and to bring photo examples of your desired outcome.
During the breast augmentation consultation, Dr. Krau will determine whether you are a suitable candidate for surgery. He will perform a physical examination of your chest, noting qualities like your skin elasticity and amount of natural breast tissue. He will also inquire about your breast augmentation goals and ask you to describe your ideal results.
Your consultation is a great time to show Dr. Krau the photos you’ve compiled, or to review some of his before-and-after photos with him. Dr. Krau will explain the procedure in detail and answer any questions you may have. If you decide to schedule surgery, you and Dr. Krau will need to make some important decisions about your treatment plan.
BREAST AUGMENTATION FAQS
- What is “natural breast augmentation,” or analogous fat transfer to the breasts?
- Am I good candidate for natural breast augmentation?
- What type of results can I expect from breast augmentation surgery?
WHAT IS “NATURAL BREAST AUGMENTATION,” OR ANALOGOUS FAT TRANSFER TO THE BREASTS?
For women who desire subtle breast enhancement, natural breast augmentation, also called analogous fat transfer to the breasts, might be a good treatment plan. With natural breast augmentation, Dr. Krau takes fat cells from an area of the body that typically has an ample amount of fat (e.g., abdomen, hips, thighs), purifies them and injects them into the breasts. The main limitation is that the breasts can only be enhancement by about one cup size, with this technique.
AM I GOOD CANDIDATE FOR NATURAL BREAST AUGMENTATION?
Generally, if you are in good overall health, have an ample amount of excess fat in another area of your body, desire sculpting throughout the fat-harvest area and desire subtle breast enhancement, you might be a good candidate for this technique. Please schedule a consultation with Dr. Krau to establish candidacy.
WHAT TYPE OF RESULTS CAN I EXPECT FROM BREAST AUGMENTATION SURGERY?
Initially, breast implants sit relatively high on the chest wall. Over the course of a few months, they settle into a more natural position. Once your body has healed, swelling has resolved and implants have settled, you can expect shapelier, more voluminous breasts, often with a greater degree of cleavage.
SCHEDULE A BREAST AUGMENTATION CONSULTATION
If you’re ready to learn more about breast augmentation with Dr. Ary Krau, please contact his South Florida office to schedule a consultation today.