How This Surgery is
Performed (continued)
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The tissue expander is filled approximately one and one-half (1 1/2) times the desired end fill volume. The breast and connective tissues will slowly separate from the underlying muscle for sub-glandular placement or from the chest wall for sub-pectoral placement. Your surgeon may further situate the tissues with manual compression and by pushing the implant to each quadrant of the pocket. This will create an oversized pocket necessary for natural movement of the implant and the breast. After the tissue has been successfully expanded, the expander will be deflated and removed. |
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Dr. Grossman will then insert a long fill tube into an empty breast implant, which will then be rolled up just like the tissue expander was. |
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After the implant has been rolled up it will then be inserted into the end of the endotube. This way the breast implant will be inserted and placed just as the tissue expander was. |
After the breast implants have been positioned inside their respective pockets either under the pectoralis major muscles or as in this depicted case, in the sub-glandular position Dr. Grossman will fill them.
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Using a large syringe in combination with a closed delivery system, sterile saline is then pumped into the breast implant. Your surgeon will take note of the cubic centimeter (cc) amount of sterile saline which will have been determined beforehand for your desired size goal. Your fill tubes may be left in until the last phase of the surgery.
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Dr. Grossman will then possibly elevate you to a sitting position to further determine if more saline is needed in either side, to check for symmetry and placement of the implants. If needed, more saline is pumped in to the implants to create a symmetrical appearance. If the amount of saline is correct, the fill tubes are removed by a gentle, but firm tug on the fill tubes and the implant valve is then self-sealed. All patients have a degree of asymmetry although some may have more pronounced imbalances than others. The diagrams depict posterior-valve (the valve on the back, being up against the chest wall) breast prosthesis, although most commonly-used saline implants (by Mentor or Allergan) have anterior valves (a valve in front of the implant, facing out).
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Your surgeon and his operating room staff will then perform an instrument and sponge check to determine that all items are accounted for and the incision lines is then sutured closed. Dr. Grossman does not feel that a drain is warranted in any of T.U.B.A. cases.
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| You are then dressed with an elastic band above the breasts and a small dressing over the belly button.
You will then awaken and your family or friends will be allowed inside with you. Please visit our recovery
section for what to expect during the healing phase. |
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