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Breast Augmentation

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In general, breasts can impact a woman’s confidence and self-image. If you wish to enhance your breast shape or size, consider breast augmentation at Fox Valley Plastic Surgery. Since 1993, FVPS has performed breast enhancement procedures to help women restore a formerly perky profile, attain shapely curves that just never developed, or even out asymmetrical figures.

Our board-certified plastic surgeons are ready to help you perfect your personal Renaissance. Indeed, women visit us for breast augmentation from places such as Green Bay, Fond du Lac, and Sheboygan. To get started, request your consultation in either the Oshkosh or Appleton office using our online form or contact us at (920) 233-1540. We can apply the non-refundable $100 cosmetic consultation fee towards the cost of the procedure.

What Is Breast Augmentation?

Medically known as augmentation mammoplasty, breast augmentation is a procedure that enlarges small or underdeveloped breasts with silicone gel or saline implants. To begin, Dr. Janssen or Dr. Doubek will make an incision in the skin and create a pocket for the implant under or above the chest muscle. Then, the surgeon will insert the implant, and suture the incision closed. In general, the surgery is usually done under anesthesia and takes one to two hours.

We also perform implant removal, implant replacement, and implant repositioning. As such we determine the pricing for these procedures by the type of implant, the state of the current implant, and if we performed the original surgery. Please call us at 920-233-1540 for a consultation, which will include pricing information.

RealSelf Patient Reviews of David Janssen, MD, FACS

Pricing

A breast augmentation is usually a cosmetic procedure; therefore, insurance does not cover this surgery. A breast augmentation costs approximately $8000, which includes the surgeon’s fee, smooth round silicone implants, the facility fee at the Theda Care Surgery Center, and anesthesia. However, the pricing is subject to change, and will change, if the surgery is done at another facility, if different implants are used, if there are unique circumstances surrounding the surgery, etc.

Cost Breakdown

Usually, there are multiple procedure discounts for cosmetic procedures: 15% off the surgeon’s fee for the 2nd cosmetic procedure, and 30% off the surgeon’s fee for the 3rd procedure. We discount the operating room fee 50% for the 2nd+ procedure, while anesthesia charges by time. Although there are zero interest financing options available through Care Credit and Alphaeon Credit, payment by cash gives a 5% discount.

Because Dr. Janssen highly recommends the use of Exparel® (for an additional $800) to the surgical site to alleviate post-operative pain, we will discuss your expectations for recovery at your consultation.

Also we recommend the use of Strataderm® for optimal healing. Strataderm is a film-forming silicone gel-based wound dressing approved for the use on old and new scars. Depending on the length of the incision, a tube of Strataderm® costs $32-$54.

We can apply the non-refundable $100 cosmetic consultation fee towards the cost of the surgery.

Best Candidates

Because breast augmentation is a very personal procedure, you should do this for yourself and not for someone else. Altogether, ideal candidates for breast augmentation surgery:

• Are physically healthy
• Have realistic expectations
• Have fully developed breasts
• Are bothered by the feeling that their breasts are too small
• Feel dissatisfied with the breasts losing shape and volume after pregnancy, weight loss, or with aging
• Are unhappy with the upper part of the breast appearing “empty”
• Have asymmetrical breasts
• Have one or both breasts that failed to develop normally or have an elongated shape

Please note that a breast augmentation does not correct ptosis or sagging of the breasts. If you have sagging breasts, a breast augmentation will only amplify the dropping. You will need a mastopexy (or breast lift) to correct droopy breasts. In fact we can perform a breast lift along with a breast augmentation or as a separate procedure depending on the desired results of the patient.

Meet Our Surgeons

Dr. David Janssen and Dr. William Doubek combine experience, refined surgical techniques, and artistry to produce beautiful results for their plastic and reconstructive surgery patients.

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Types of Breast Implants

Since there are many different types, shapes, sizes, and brands of implants, we strongly advise you to come to a consultation to see and feel the implants. We will help you “test”  the implants on yourself or with our Vectra 3D imaging system to assist in determining size, which is the most important decision for patients.

Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse, and the body will absorb and naturally expel the saline from the body. Most importantly, saline breast implants provide a uniform shape, firmness and feel, and are FDA-approved for augmentation in women age 18 or older.

Silicone breast implants are filled with silicone gel, so they feel a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. Unlike older versions, a leaking implant filled with silicone gel will not collapse. If you have any concerns with an implant, an ultrasound or MRI screening can assess the condition of breast implants. Finally, silicone breast implants are FDA-approved for augmentation in women age 22 and older.

Brands of Implants

We perform many breast augmentations with US made Mentor® silicone implants because MENTOR® MemoryGel® Breast Implants are available with a smooth surface shell, have a high safety rating, and come in a wide range of sizes and profiles to fit your body.

We also offer US manufactured Sientra® Opus Luxe smooth round breast implants. Like Mentor, they come in many sizes and projections to get the silhouette that you want, and have a platinum 20 year warranty.

Shape of Implants

Round breast implants have a tendency to make breasts appear fuller than form-stable implants. While higher profile options can achieve more projection, round implants with the same shape all over, have less concern about them rotating out of place.

Smooth breast implants are the softest feeling. Because these implants can move with the breast implant pocket, they may give more natural movement. However, smooth implants may have some palpable or visible rippling. Due to safety concerns, we no longer use textured breast implants. Allergan has voluntarily recalled textured implants because those textured implants are six times more likely to cause BIA-ALCL than implants from other manufacturers.

Are you ready to discuss breast augmentation for yourself? Contact Fox Valley Plastic Surgery today at (920) 233-1540 to schedule a consultation.

Procedure

We administer anesthesia for the patient’s comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. The anesthesiologist will recommend the best option.

First, incisions are made in inconspicuous areas to minimize visible scarring. Then, the surgeon will discuss which incision options are appropriate for the desired outcome. Incision options include periareolar, inframammary, and transaxillary. Incisions vary based on the type of breast implant, degree of enlargement desired, patient anatomy and patient-surgeon preference. The surgeon makes the final decision on the type of incision.

After the surgeon makes the incision, he inserts a breast implant into a pocket either under the pectoral muscle (a submuscular placement), or directly behind the breast tissue, over the pectoral muscle (a submammary/subglandular placement). The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, the patient’s body type and surgeon recommendation.

The surgeon eventually closes the incisions with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.

Preparing for Surgery

• Stop smoking one to two months prior to surgery.
• Discontinue all aspirin and blood thinners 10 days prior to surgery.
• Get a baseline mammogram within the 1 year prior to surgery.

Preparing for surgery with a clear, complex-carb rich beverage will keep you strong and enhance your recovery. Drinking ClearFast PreOp prior to your medical procedure is a safe way to speed up recovery time, nourish your body, and reduce post-operative nausea and vomiting. It is available at Hometown Pharmacy on N. Sawyer Street, Oshkosh at $8 a bottle. The recommended dosage is one bottle the night before your surgery during the fasting window, and a second bottle two hours before surgery. Consult with your anesthetist before taking the beverage. We encourage afternoon surgery patients to take this beverage.

Recovery

After surgery, we wrap the breasts in gauze dressings and a compression bandeau bra to minimize swelling and support the breasts as they heal. The implants will ride very high in the chest due to swelling and spasms of the pectoral muscle. Wearing a compression bandeau bra helps keep the implants from riding up. As the swelling decreases, the implants will slowly move down into a more natural looking position, usually within 3-6 weeks after surgery.

Wear a support bra continually for the first week or two. It will be important to cleanse the incision sites and apply ointment as directed. Be sure to follow all instructions carefully.  While it is important to rest frequently during the first week, walk 15-20 minutes four times a day to help to prevent blood clots from forming.

Returning to Work

The ability to return to work at a desk job depends on whether the implant was placed under or over the pectoral muscle, and the patient’s pain tolerance and motivation. When implants are placed over the muscle (subglandular), the patient should take off 2-3 days before returning to her desk job.  The patient can return to her desk job on the next day only if she is highly motivated; as the patient will undoubtedly feel uncomfortable. When the implants are placed under the muscle (submuscular), a patient should not return to work for 5-7 days because the patient may still be using narcotics.

Thin women are more likely to have their implants placed under the muscle to better conceal the implants.  Lifting is absolutely forbidden for the first 7-10 days, so an early return to work is not suggested for patients with active jobs. Avoid strenuous activity for the first two weeks, and lifting anything heavier than 10 pounds in the first 6 weeks.

At your personal consultation, an experienced board certified plastic surgeon will answer all your questions about breast reconstruction. Contact Fox Valley Plastic Surgery today at (920) 233-1540 to schedule a consultation.

RealSelf Q&A with David Janssen, MD, FACS

Breast Implant Replacement

Because breast implants are not designed to last a lifetime, patients should plan for an annual examination to evaluate breast health and implant integrity. Over time, breasts will change due to aging, weight fluctuations, hormonal factors and gravity.

Potential Risks

Smoking increases the risk of having a complication post breast augmentation. As such we strongly urge smokers to stop one to two months prior to surgery and one month post to insure proper healing and an optimal outcome.

Most importantly, patients will sign consent forms to ensure that they fully understand the procedure and any risks and potential complications. Possible breast augmentation surgery risks include:

• Anesthesia risks
• Bleeding
• Blood clots
• Asymmetry
• Infection
• Changes in nipple or breast sensation
• Unfavorable scarring
• Wrong or faulty position of the implant
• Implant leakage or rupture
• The formation of tight scar tissue around the implant (capsular contracture)
• Fluid accumulation (seroma)
• Wrinkling of the skin over the implant
• Pain, which may persist
• Possibility of revision

Breast Implant Safety

The FDA’s longstanding position is that implants are essentially safe as long as women understand they can have complications, including scarring, pain, swelling and implant rupture. However, the FDA has been grappling with how to manage a recently confirmed link to a rare cancer and the thousands of unconfirmed complaints of other health problems.

FDA regulators said it is “impossible” for them to determine how frequently the cancer — a form of lymphoma — occurs because the U.S. does not track the total number of implants on the market. Estimates of the frequency of the disease range from 1 in 3,000 women to 1 in 30,000.

As of July 2019, the FDA requested that Allergan voluntarily recall certain breast implants and tissue expanders from the market. Get more information about breast implant removal here.

Most confirmed cases of the disease, known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), have involved a particular style of implants from Allergan with a textured surface, designed to reduce scar tissue and slippage. But the FDA said it has also received reports of the disease in smooth implants, which account for most of the U.S. market, raising questions about whether the cancer is a risk with both implant types.

The disease is not breast cancer, but a form of cancer that attacks the immune system and usually forms in the scar tissue surrounding implants. It grows slowly. Doctors can successfully treat this disease by surgically removing the implants.

Are Implants Right for You?

Right now, the FDA is not recommending removal of implants unless there are adverse symptoms. Mentor implants are not being recalled because Mentor products are rarely associated with BIA-ALCL.

Other important considerations:

• Breast implants are not guaranteed to last a lifetime, and future surgery may be required to replace one or both implants.
• Pregnancy, weight loss, and menopause may influence the appearance of augmented breasts over the course of your lifetime.
• Breast augmentation requires regular examinations of your breasts’ health and to evaluate the condition of your breast implants.

Consultation

You can now have a VIRTUAL CONSULTATION via Doxy.me with Dr. Janssen. This encrypted telemedicine system is an easy-to-use online tool that allows you to schedule a HIPAA compliant video call with no download required. Please call the office at 920-233-1540 or email us at [email protected] for instructions on how to proceed.

Like an in-office visit, we will usually need your 1) demographics, 2) insurance information (if applicable), 3) area(s) of concern, 4) photos of the area(s) of concern, and 5) complete health history. We’re here for you more than ever.

Next Steps

As experts with many breast enhancement surgeries to their credit, Dr. Janssen and Dr. Doubek look forward to educating you and working with you to make important choices. During a breast augmentation consultation, be prepared to discuss:

• Why you want breast augmentation surgery, your expectations and the desired outcome.
• Medical conditions, drug allergies and previous medical treatments.
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use.
• Family history of breast cancer and results of any mammograms or previous biopsies.

The surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors.
• Examine and measure your breasts, including detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas.
• Take photographs.
• Discuss your options and recommend a course of treatment.
• Discuss likely outcomes of breast augmentation and any risks or potential complications.

Schedule Your Consultation

In order to get a definitive quote for breast augmentation, please call for an individual consult with one of our surgeons.  We can apply the non-refundable $100 cosmetic consultation fee towards the cost of the procedure.  Find out how breast augmentation with Dr. David Janssen or Dr. William Doubek at Fox Valley Plastic Surgery can improve the way your breasts look by calling (920) 233-1540. Our board certified Wisconsin plastic surgeons are helping women from all over the upper Midwest to perfect their personal Renaissance. Request your consultation today.