Since opening his practice in 1998, Dr. Rapaport has steadily gained a reputation for his expertise. In particular, he is known for endoscopic placement of implants via the underarm. This approach prevents scarring while allowing for accurate and natural results. He is also gaining a local reputation for his ability to correct less than optimal augmentation results obtained elsewhere.

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Dr. Rapaport recommends that his patients select saline implants, as they have been demonstrated to be safe and provide very high satisfaction rates, both short- and long-term. Breast augmentation surgery requires several important choices on the part of the patient, including the size of the implants, the positioning of the implants (on top of or under the pectoralis muscle), and the location for the small breast augmentation surgical access scar.

When Dr. Rapaport consults with a patient, he takes the time to go over the details in depth with each individual. First, he provides each patient with size options, with the help of viewing many before and after photographs. In addition to the patient's goals, breast size also depends on the patient's individual anatomic considerations, including skin laxity and chest diameter.

With regard to breast implant position, he generally recommends positioning them under the pectoralis muscle for three reasons. First, when the muscle covers the top part of the breast implant, breast augmentation results appear more natural, with less likelihood of an implant edge or rippling showing through. Second, with the implant placed under the muscle, there is a reduced likelihood of capsular contracture, or hardness, developing over time. This is believed to be due to the massaging action of the muscle on the scar tissue surrounding the implant after the procedure. Finally, the submuscular implant position allows for a better view of the breast when a mammogram is obtained.

While scars created on the border between the pigmented skin of the areola and normal skin usually heal nicely, this can never be guaranteed. In fact sometimes it can heal in a slightly unsightly fashion. Scars can be improved but never erased. Problems relating to scar quality are more prominent with people with more pigment in their skin particularly Asians, Hispanics, lightly pigmented African Americans, Mediterranean's (with olive skin).

The photograph illustrates an Asian woman who had breast augmentation done elsewhere through the areola. This is an example where the surgeon may well have done nothing wrong except to decide to place the scar in this location. This is partly the reason why Dr. Rapaport feels so strongly to place the implant the underarm when possible. That scar is placed in the natural skin fold and is usually an inch or less when saline implants are used. It is an area where permanent problems with pigment or scar thickness are truly and extremely rare.

He usually gives patients at his Manhattan practice the choice of where to place the scar. It can be placed either in the underarm, under the breast itself, or at the lower border of the areolus (the pigmented skin surrounding the nipple). Many patients, when given the option, prefer an underarm scar because it allows them to avoid leaving any mark on the breast. Dr. Rapaport performs this procedure using an endoscope. This means that instead of bluntly tearing the lower border of the muscle, and risking implant malposition due to incomplete muscle division, the muscle is precisely divided under direct visualization, allowing for precise breast implant positioning and control of any bleeding.

There are many other details to which he pays particular attention to help minimize the risk of problems. These include the use of powder-free gloves by all members of the operating room team (shown to reduce the risk of capsular contracture, or hardness, after surgery), and an extremely meticulous sterile technique.

He has been performing endoscopic breast augmentation surgery using saline implants at his New York City practice since the procedure was developed in 1993, and he has vast and successful experience with it. It is for these reasons that he has been referred some of the more complicated and challenging breast augmentation problems by fellow local physicians. Dr. Rapaport is also specially trained to perform breast revision surgery and to correct breast asymmetry.

To learn more about this procedure, please contact our office today.

For many women, chronic neck and back pain due to large, heavy breasts makes reduction surgery a necessity. Dr. Rapaport is well known for his expertise in breast reduction and reconstruction. He sees many women with overly large breasts who feel self-conscious and embarrassed as well as physically uncomfortable.

This surgery is a reconstructive/cosmetic procedure during which the breasts are made smaller, lighter, and more proportionate to the body. While it is a relatively complex operation that can involve significant scars, Dr. Rapaport is among the best at minimizing scarring. He regards the procedure as reconstructive as well as cosmetic and spends a significant amount of time educating his patients as to all the factors involved in the proposed surgery.

To learn more about this procedure , please contact our office today.

 

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