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Breast Augmentation

Dr Zukowski and his staff at the Zukowski Center are renowned worldwide for being the best in FFS Facial Feminization Surgery. Based in Chicago America, Mark Zukowski is recognized within the transgender community as being the best.Breast augmentation is a procedure that will make an individual feel like a true woman and is as close as you can get without an SRS.  There are a number of different choices as it relates to either silicone or saline breast implants, and typically this is a decision that is very personal.  Silicone was king during my training and early practice, but with the silicone moratorium in 1992, one went for a period of years where silicone could not be used except for investigational purposes.  Silicone gel over the years has evolved to a much thicker substance.  These days it’s akin to cutting a gummy bear in half; you really can’t squeeze the middle out.  Some people feel that silicone is more natural feeling than saline.  The reality is that, when implants are placed under the muscle in the non-genetic female chest with heavier muscles and heavier skin, it’s very difficult to discern between a saline and silicone implant.  My practice tends to run about 50/50 in terms of a choice between silicone and saline.  The implants are typically placed thru either a periareolar or inframammary incision.  There is also an approach thru the armpit.  However, this approach is always done in a blind fashion, and it is certainly easier to damage the nerve as well as it is difficult to get a precise placement of the implants in a more central location.  When one looks at the non-genetic female chest, you see that the breasts are typically farther off center.  To be able to get a nice, natural result, it is important to get the breasts as close together as possible.  This is extremely difficult thru an armpit incision, and unless that incision is placed properly and closed properly, it can stretch and be very visible especially in a strapless top or in a circumstance where one is picking up their arms.  Typically, the nerve comes in from the 4 o’clock position on the right breast and the 8 o’clock position on the left breast.  During the submuscular dissection one has to be careful in these regions in order to minimize any damage to the nerves.  Typically, sensitivity is initially decreased, and it returns to normal with time.

Dr Zukowski and his staff at the Zukowski Center are renowned worldwide for being the best in FFS Facial Feminization Surgery. Based in Chicago America, Mark Zukowski is recognized within the transgender community as being the best.I prefer a periareolar approach because this approach is very straightforward especially with saline implants, and also one can, depending upon the size of the areola, get a rather large silicone implant in place.  In only rare instances are implants placed on top of the muscle because with time they look like “stuck on” grapefruits.  A submuscular approach typically is one that provides the greatest barrier between the implant and the tissue.  We used to think that implants lasted forever.  We now know that is a procedure that certainly you can anticipate having redone at least one time again in your life.  We now say that implants last approximately 10 years before they may leak or become firm enough to want them replaced.  All American implant manufacturers will guarantee for a lifetime the implants – meaning that if one leaks or ruptures the implant is replaced at no charge.  In the first 10 years, there is typically an amount ranging from about $1200.00 to about $3000.00 that is paid toward a secondary operation.  Salt water implants are typically a silicone bag that has a special port, and the salt water solution is filled at the time of the operation.  The advantage to a salt water implant is that you can correct the asymmetry and unequalness between two breasts much better than you can with silicone implants.  Silicone implants come in the smallest incremental size of a 25cc difference.  Breast augmentation is a very gratifying operation in terms of one’s femininity.  There are also all sorts of textured coatings that can be placed on the implants and all types of profile projections of the implants.  This is something that you want to talk about in depth with your plastic surgeon in order to arrive at the best implant size for you.

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