Breast augmentation surgery: Subglandular Placement

Ever wonder what exactly happens during a breast augmentation procedure? Well, this is a step-by-step account of what happened during one typical breast enhancement procedure, featuring a periareolar incision and subglandular placement of implants. The physician performing the procedure was Dr. Behnaz Yazdanfar at Toronto Cosmetic Clinic.

The surgical room is cleaned and sterilized thoroughly. After the patient is placed under general anesthesia, the chest area is isolated and sterilized. Sterility is vital to prevent infection. A diluted solution containing lidocaine is injected into specific areas of the chest to minimize bleeding. An incision is made partially around the edge of the areola from 3 to 7 o’clock. Because it is ideal for the resulting scar to be as discreet as possible, the incision should be placed right in the area where the areola meets the paler skin on the rest of the body.

Gently pushing the areola and nipple aside, space is made in the breast tissue to accommodate the implant. Then, to ensure that the positioning and the created space are adequate, a “sizer” is inserted and filled with fluid to the desired volume (a sizer is an empty implant shell). At this time, any odd indentations appearing in the breast, particularly in the inframammary fold, are also corrected. It is important that the size fit correctly before the real implant is placed.

Once this is completed, the sizer is removed and the cavity is wiped with gauze to ensure there is no bleeding. Minor bleeding is stopped with a cauterizer. An antibiotic is administered in the cavity and the implant is inserted. In this case, the implant was a round cohesive gel type.

Again, the positioning of the implants is checked to ensure optimal results. A subcuticular stitching technique is performed using monocryl dissolvable sutures to close the incisions. Once they are dressed, the actual procedure is completed and the patient is taken to another room for recovery.

Inventory of the instruments and gauze is taken intermittently throughout the procedure.

Dr. Behnaz Yazdanfar has performed hundreds of breast augmentation procedures in her professional career.