Many Choices Are Available For Women Who Want Bigger Breasts

There's no doubt that breast augmentation is certainly one of the most popular cosmetic surgeries. More and more women are electing to have this surgery in order to enhance their breasts, making them larger and fuller, correcting asymmetry (one breast larger than the other, or not lined up evenly on the chest), or even correcting congenital defects such as tubular breasts.



Breast Augmentation Can Make Breasts Bigger, Improve Shape and Correct Uneven Breasts

What is such good news is the number of options available for women of all ages. In our San Antonio surgical center, Dr. Robert Young has performed thousands of breast augmentation procedures with both saline and silicone breast implants. So many, in fact, that he is widely referred to as the "breast doctor" of San Antonio! Over the years, he has seen many changes in the implants themselves, as well as the methods used for insertion and placement of the implants. He was an early pioneer of minimal incision techniques which included armpit incisions that were much smaller than earlier methods.
With the introduction of silicone implants and the subsequent ten year ban, Dr. Young became one of a small group selected by Mentor to perform closely monitored clinical trials of the silicone implants in order to study their safety. Once the FDA found that silicone implants passed the rigorous standards for safety, silicone implants evolved into those that contained cohesive gel silicone which tended to stay together, decreasing the chances for migration into the body if there were rupture. The next generation of even more cohesive implants, referred to as "gummy bear" implants make the selection even greater.

Each type of breast implant, whether saline or silicone, usually has many choices of shape (round or anatomical), as well as width and projection. These options afford a women choices that will address almost any body type or size desired.

And, in addition to the implants themselves, there have been several different methods of insertion used over the years. From large incisions made under the breast, to areola (around the nipple) incisions and endoscopic transaxillary (under arm) entry points. Some physicians have explored other areas such as through the belly button (TUBA or transumbilical breast augmentation) and even performing breast augmentations where the patient is under twilight anesthesia (awake sedation).

The incision methods most preferred by Dr. Young is the underarm or areola because he feels it gives his patients the best result. Scars are minimal and located so that after appropriate healing time, they are usually not very noticeable. Although the TUBA technique can be more problematic (harder to place the implants in order to achieve good symmetry and placement), and more prone to revisional surgery, Dr. Young will review all of your options and help you make an informed decision on what is best for you.


Breast Augmentation surgery has evolved into one of the most popular procedures with an excellent record for safety and patient satisfaction. Dr. Young is a Board Certified Plastic Surgeon with over 30 years experience helping the women of San Antonio achieve the breast enhancement they desire. Visit Dr. Robert Young at his San Antonio office and AAAASF accredited outpatient surgery center for a private consultation regarding your breast augmentation surgery.

Dr Young's Thoughts on Awake Surgery

Local anesthesia for surgical procedures is not always the best choice. Often times the operating physician is giving sedation medication and using local anesthesia without an Anesthesiologist in order to save money. I think it is much safer to use an Anesthesiologist to give the patient the proper level of comfort during the procedure, as well as to monitor their level of consciousness. If you are feeling pain during the procedure the physician will often stop short of getting you a successful result. A few hundred dollars more for a Board Certified Anesthesiologist is definitely worth the safety and success of a several thousand dollar procedure.

Check out what MSNBC has discovered on the topic:
http://on.msnbc.com/awakesurgery

I'm afraid of anesthesia...is the "awake" method good for me?

by Robert N. Young, M.D.

Board Certified Plastic Surgeon

We've seen a new trend in Cosmetic Plastic Surgery...promotions of "Awake Breast Augmentations".  It is talked about as something new, but in actuality, surgeries performed under "local anesthesia", or "twilight anesthesia" have been around for many years.  Whether it is a good choice for patients is being hotly debated.

Because Breast Augmentation has become such a popular procedure, and is more readily talked about by society, some feel it has become somewhat frivolized.  It is easy to forget that this is still a major surgical procedure. While endoscopic (minimal incision) techniques have made the surgery less invasive and easier to recover from, the procedure is best done under general anesthesia with a Board Certified Anesthesiologist. "Twilight anesthesia" can be dangerous without an anesthesiologist present.

There is quite a bit of debate recently about practitioners who are advertising "awake" surgeries.  These are usually performed by physicians who are not Board Certified Plastic Surgeons, and may not even be Plastic Surgeons at all.  Sometimes they are Dermatologists, General Surgeons, or even Family Practitioners who elect to perform the surgery under local anesthesia because they do not have  privileges in a hospital or certified surgery center to perform those procedures. In my Surgery Center, all anesthesia is administered and monitored by Board Certified Anesthesiologists who are experienced in Cosmetic Plastic Surgery.  I feel this is best for my patients, and myself, as it allows me to concentrate on my area of expertise, which is the surgery itself.

My Surgery Center is fully certified by the AAAASF and meets strict standards to perform surgical procedures. Sure, the surgery costs a little more, but it is worth having the extra standards and safety factors. That's why doctors are credentialed and surgery centers are certified. If we didn't adhere to these standards we would be cheaper also. So when you get a fee quote that is cheaper because it is under local anesthesia in an office back room, be careful of what you are asking for.

Board certification by an ABMS member board provides assurance of a physician’s expertise in a particular specialty and/or subspecialty of practice. Professional organizations, such as the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery (ASAPS) require that members be Board Certified within their specialty.

Some advertisements even go so far as to state that you'll be awake enough during your procedure to pick the size of your breast implants (this would only be possible with saline implants which are inserted and then filled to the desired size) during your surgical procedure itself!  If you have had sedation you are going to feel woozy and wobbly.  I don't think you would be coherent enough to make this selection during surgery!

We recommend that you ask questions that will ensure that you are well informed concerning the qualifications and experience of your surgeon and the types of anesthesia that you are offered.  Here are questions generally recommended:

• Are you Board Certified? 
• If so, what specialty board?
• Are you licensed to practice surgery in this state?
• How many breast augmentation surgeries do you perform each year?
• How many years have you performed breast implant procedures?
• Where is my procedure performed?  
• Is the surgical facility accredited?
  
• Who administers anesthesia during my surgery?
• Is the person who administers my anesthesia Board Certified in this specialty? 
  
• What are my options for anesthesia?
  

When you come in for a consultation visit with me, I will make recommendations based on my extensive experience as first a reconstructive and then cosmetic plastic surgeon. I invite you to ask questions regarding various surgical methods, anesthesia, recovery and any other questions you may have so that you can make an informed decision about your surgery.  You may contact my office at 210-496-BODY (496-2639) or e-mail me at nubody@dr-youngforever.com.