Plastic surgery is a specialty that is in constant pursuit of improving aesthetic outcomes. Over the past three decades, there have been several advances in the area of breast augmentation that have furthered the field both from a technical aspect and a device standpoint.
Post-operative pain has always been an area of interest for improvement in breast augmentations. The advent of Enhanced Recovery After Surgery (ERAS) protocols has shed light on the importance of multimodal pain control and the benefits of pre-emptive nerve blocks. With the prevalence of the Opioid Epidemic, we have learned that “pain” is not a singular phenomenon. Instead, pain is multifaceted and has contributions from many sources. Muscle pain is best treated with muscle relaxant medications, nerve pain (neuropathic pain) is best treated with targeted medication for nerves, inflammatory pain is best treated with Tylenol, and somatic pain is best treated with narcotics. Historically, physicians have prescribed high-dose narcotics to treat “pain” with very little success. Newer treatment protocols allow surgeons to treat pain on all fronts, which leads to an improved recovery and a substantially lower need for narcotics.
Intra-operative targeted nerve blocks also help to lessen post-operative pain by selectively numbing the specific nerves responsible for “traditional pain” associated with surgical manipulation of tissue.
The popularity of the Dual Plane pocket for placement of implants has led to the use of both the submuscular (under the pectoralis major muscle) pocket and the subglandular pocket (under the breast tissue). The Dual Plan pocket places the muscle partially under the pectoralis muscle and partially under the breast tissue. This pocket can be custom-fit to each patient to maximize aesthetic outcome.
Another important advance in the field of breast augmentation has been the No-touch Technique, which focuses on ensuring that the implant is not directly touched by the operative team nor the patient’s own skin at the time of placement. This leads to less risk of contamination of the implant by a patient’s own bio-flora (bacteria that are always present on the skin). The invention of the Keller Funnel®, allows surgeons to avoid direct contact with the breast implant and has the added benefit of allowing the implant to be placed through a smaller incision without damaging the surrounding skin.
In conjunction with the No-touch Technique, the addition of antibiotic irrigation was introduced in the 90’s by Dr. Bill Adams, MD and has gained popularity. Antimicrobial irrigations have been shown to decrease infection and capsular contraction rates in cosmetic breast augmentation.
As with any surgical procedure, there are always risks associated with those procedures. A key element to undergoing any procedure is to ensure that the surgeon is well qualified. For breast augmentations, a patient should confirm that their surgeon has completed an American Board of Plastic Surgery accredited Plastic and Reconstructive Surgery residency or fellowship. So-called “cosmetic or aesthetic” fellowships are not recognized by the American Board of Medical Specialties and do not ensure rigorous and objective standards to protect patients from surgeons without proper training.
Little Rock Breast Augmentation Surgeon
Dr. David Bauer is a board-certified plastic surgeon at Arkansas Plastic Surgery in Little Rock. He specializes in breast procedures and has the expertise needed to give you the natural and long-lasting results you’re looking for. Contact us today to schedule a consultation!