Breast augmentation is a cosmetic procedure that uses implants to enlarge and shape the breasts.

You may be a good candidate for breast augmentation if you feel your breasts are too small, weight loss has changed the size and shape of your breasts, or your breasts have become smaller and lost their firmness following pregnancy. A young woman must have reached full breast development, be emotionally mature, and have realistic expectations concerning the procedure. Your goal should be improvement but not perfection.
Breast augmentation is a day surgery and is done at one of several local hospitals or surgery centers. There will be no stitches to remove and usually no drains. Most patients resume their normal daily activities during the first week following surgery.

Dr. Hackney will discuss the following important aspects of breast augmentation during your consult.

Incision Placement:

Three different incision locations are commonly used to place the breast implants. The inframammary incision is made under the breast just above the natural crease. The periareolar incision is made around the lower edge of the areola (the darker area around the nipple). The transaxillary incision is made within the armpit (axilla). There are several factors to consider when choosing the location of the incision such as the visibility of the scar, potential of numbness of the nipple, or the need to have a breast lift at the same time. Dr. Hackney will help you decide which is the best option for you; however he usually recommends against using the armpit incision because he feels it is more difficult to position both implants evenly so they match.

Breast Implant Location:

The breast implants can be placed either behind your breast tissue (sub glandular) or under the chest muscle (sub muscular). The choice of location depends on how much breast tissue you have. If you have enough thickness of breast tissue over the muscle, then the implant can placed behind the breast tissue. If not the implant is best placed under the muscle.

A pocket is made either behind the breast tissue or under the chest muscle and the implant is inserted.

Types of Breast Implants:

Saline Breast Implants A saline breast implant is filled with a salt-water solution. This breast implant is filled by the surgeon in the operating room. Saline is a natural solution and if the implant is ruptured the body will safely absorb the fluid.

Silicone Implants
A silicone implant is pre filled by the manufacturer with silicone gel. Silicone was the first substance used for breast implants because of its natural feel and movement. Following allegations that silicone gel may cause autoimmune diseases, the FDA restricted the use of silicone gel implants to breast reconstruction patients and other patients who meet certain criteria. Since then multiple independent medical studies have failed to find a link between autoimmune diseases and the use of silicone gel implants.

After years of extensive research with silicone implants, the FDA in November of 2006 approved the use of silicone breast implants for cosmetic patients. To have silicone implants you must be 22 years old and be well informed about silicone implants. For you to make the decision that is best for you, the FDA requires each patient reads and understands a patient information pamphlet about silicone implants. After discussing this information with Dr. Hackney, you may schedule your surgery in 1 to 2 weeks.

Many patients may be candidates for silicone implants. Patients with thin skin and breast tissue may especially benefit from silicone implants as compared to saline implants. To determine if you are a candidate for silicone breast implants, Dallas Dr. Fred Hackney offers a free consultation.

The FDA requires surgeons using silicone implants to be certified in their use. Dr. Hackney has been certified by both USA implant companies to use silicone implants.


Shape of Implant:

Breast implants may be either round or anatomic (tear drop shape). No single implant is right for everybody. Dr. Hackney will discuss the pros and cons of round and anatomic implants, examine you, and recommend which implant would be best for you.

Implant Shell:

The shell of both types of breast implants is made of hard silicone. The FDA never restricted hard silicone, as it is much different than silicone gel. The shells can have a textured surface or a smooth surface. The textured surface was originally designed to decrease scarring, also called capsular contracture, around silicone gel implants. However, saline implants have a low incidence of scarring so the textured surface is less beneficial with these implants.

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To view before and after images of breast lift please click here.

Some patients do not want larger breasts but feel that age, gravity, and child bearing have caused their breast to sag, have less volume, and are less firm. These women may be candidates for a breast lift.

The incisions are made around the areola (the pigmented area around the nipple) from the bottom edge of the areola down to the crease under the breast and in the natural fold under the breast. As the excess skin is removed, the breast is lifted and made firmer. The areola may also be made smaller. Patients are pleased with the restoration of a youthful appearing breast.

There will be no stitches to remove and usually no drains.  You may gradually resume your normal activities during the first week after surgery.

Short Scar Breast Lift

A recent innovation in breast lift surgery is a technique performed by Dr. Hackney that limits the length of the scars. If the nipple only needs to be lifted a small amount, a circumareolar mastopexy may be the best option for you. This technique limits the scar to around the edge of the dark skin around the nipple. The dark skin around the nipple is called the areola. If the nipple needs to be moved higher or the breast made smaller, in addition to the incision around the areola, a vertical incision is made down to the natural fold under the breast. The combination of the scar around the areola and the vertical scar below the areola is called a short scar breast lift.

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To view before and after images of breast reduction please click here.

Breast reduction is the procedure designed to relieve the discomfort caused by large, heavy breasts as well as enhance your over all appearance. Excess breast tissue and skin are removed and the breasts are made smaller and firmer. The nipple and pigmented area around the nipple is reduced and repositioned higher.
You may be a good candidate for breast reduction surgery if your breast are proportionately too large for your frame; your breasts are so heavy they cause back, neck or shoulder pain; there is skin irritation under your breasts or indentations in your shoulders from tight bra straps; or your physical activity is restricted due to the size and weight of your breasts.

The incisions are made around the areola (the pigmented area around the nipple) and from the bottom edge of the areola down to the crease under the breast and beneath the beast in its natural fold. Excess tissue and skin is removed, the nipple is repositioned higher, and the breast is lifted and made smaller. There are no stitches to remove and usually no drains are used. You may gradually resume your activities during the first two weeks after surgery, and should refrain from strenuous exercise for four weeks. Most patients are very pleased with the results of their breast reduction and enjoy the overall improvement in their physical appearance.

In some patients who only require a minor breast reduction, the procedure can be done with the incision limited to around the areola and from the bottom of the areola down to the natural crease under the breast, without the incision in the crease under the breast. This is called a short scar breast reduction.

A relatively new procedure to reduce the breast is the use of liposuction. This has been called the “scarless” breast reduction, however there are small scars less than one-half inch long. Liposuction breast reduction is not appropriate for all patients, and only a few select patients are candidates for this procedure.
During your consultation with Dr. Hackney he can help you decide which type of breast reduction is best for you.

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To view before and after images of male breast reduction please click here.

Several procedures are now available to reduce the size of enlarged male breasts, a condition known as gynecomastia. This condition often occurs in the early teenage years and may persist into adulthood. Dr.Hackney uses tumescent liposuction and ultrasonic liposuction (UAL) to remove the excess breast tissue. The ultrasonic liposuction is especially effective for removing the fibrous male breast tissue. In addition some patients may need a small incision around the inside of the nipple to remove the dense glandular breast tissue under the nipple that can not be removed with liposuction. This is usually performed in a hospital or surgery center. The patient is most often returned home the day of surgery and depending on the extent of the surgery is able to return to usual activities in one to two weeks, and routine exercise in four weeks. A compression garment is worn after the surgery for four weeks to enhance the appearance of a firmer, flatter chest.

For before and after examples of male breast reduction, please click here.

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