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Ask the Doctor: November 2008

Question: What are the least invasive procedures for breast augmentation?

Answer: Breast augmentation in this day and age should be a minimally invasive surgery. Why would anybody want a large incision on their breast or axilla(armpit)? For the longest time physicians were taught that you needed maximum exposure to all surgeries. The scar was thought of later and the line “it heals pretty well” was always used to tell the patient that the scar was going to be long and obvious.

What patients may not know is that depending on the implant, incisions may be anywhere from about an inch for silicone implants to about one third of an inch for saline implants. Minimally invasive breast augmentation, which is another word for camera-assisted augmentation, is not new. It has been pioneered for about 15 years but what has changed is the relative size of the cameras. They are now down to a quarter of an inch and in fact can go smaller resulting in smaller and smaller incisions. However the limiting step is the actual implants and their respective diameter. The silicone implant can be squeezed through about a one inch incision because they come pre-filled with silicone gel. The saline implant however comes empty and can be squeezed to about one third of an inch and then filled to the desirable volume with saline once inside the breast.

Endoscopic breast augmentation was first used to do the surgery trans-axillary, but it still left about a one to one and a half inch scar. A new procedure called PEBAM uses a miniaturized camera system and surgical tools that allow the trained surgeon to do the surgery with one third of an inch incision. It can also be used to do the surgery through the umbilicus (belly button), placing the implants under the pectoralis muscle.

The less invasive the surgery, the less pain, quicker recovery, and most importantly, the less scarring and visible signs of surgery the patient will experience. These new techniques are usually performed by board certified plastic surgeons who have great experience in the art, form and function of the breast as well being able to handle any complications that may arise.

Typically breast augmentation done with the PEBAM approach allows the patient to resume activities the next day and resume unrestricted activities in a few weeks.

Ayoub Sayeg, MD is a board-certified plastic surgeon currently in private practice in Troy, MI.

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*Advice found within this article is for informational purposes only and should not replace the advice or recommendations of your physician.