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Cosmetic Surgery
AWAKE Breast AugmentationAWAKE Breast Augmentation
AWAKE surgeries are based on the Klein Technique, which uses lidocaine to numb tissue in order to perform surgery. The term AWAKE Breast AugmentationTM is a trade marked term created by Dr. Anil Gandhi.
It has been shown that this technique has an extraordinary and unprecedented safety record when used as directed and has few of the side effects or risks associated with using General Anesthesia. A secondary benefit to using this procedure is that the patient is "awake" so she can participate in her final breast size determination.
In 2008, Dr. Novoa studied with Dr. Gandhi and completed training in AWAKE Liposuction, AWAKE Breast Augmentation and AWAKE Lipoabdominoplasty (Tummy Tuck). Since this date, Dr. Novoa has performed hundreds of AWAKE Breast Augmentation, Liposuction and Lipoabdominoplasty procedures.
In January 2012, Dr. Novoa presented a research paper at the Fifth World Congress of the International Society of Cosmetogynecology (ISCG) and the American Academy of Cosmetic Surgery (AACS). The paper, Tumescent Breast Augmentation Surgery (TABS), is the first and largest research paper discussing AWAKE Breast Augmentation without the use of any sedation. This paper, along with Dr. Novoa's instructional video on AWAKE Breast Augmentation found on YouTube.com, has been recognized nationally and internationally as a reference for AWAKE Breast Augmentation.
The Procedure
  1. Prior to the start of the procedure, the patient is given only Extra Strength Tylenol without any sedative.
  2. To begin the procedure, tumescent anesthesia (lidocaine, epinephrine & sodium bicarbonate) is injected in subcutaneous tissue of the breasts while the patient is "awake" to numb the area.
  3. incisionsOnce the anesthetic has taken effect, inframammary incisions (Figure 1) are made for insertion of the implants. This is the most commonly employed incision and after healing, the scar tends to be well hidden under the new breast crease. The scar, however, will be more visible if the patient is lying down. The length of the incisions depends on the type of implants that are chosen. Typically, saline implants will require a smaller incision as opposed to silicone implants.
  4. After the incisions are made, a surgical tool is used to create subpectoral pockets so that the implants can be inserted.
  5. Once the pockets are created, the implants are inserted under the pectoralis major muscle.
  6. Once the implants are inserted, the patient is placed in an upright position so she can preview the look of her new breasts. At this time, any additional determinations regarding size, placement, or profile of implant can be made. The advantage of saline implants becomes very apparent during this step. Since the patient is awake, she can determine whether to increase or decrease the volume as desired prior to closing the incisions. Saline implants can be adjusted in size in the event that one breast is larger than the other. Silicone implants cannot be incrementally adjusted with the flexibility of saline implants. To compensate for common asymmetry in the breasts using silicone implants, the surgeon must preoperatively estimate the difference in size and insert two different size implants to compensate for the asymmetry during surgery.
  7. After final adjustments have been made, the incisions are closed with Quill™ SRS wound closure sutures.
  8. The patient is then bandaged and supporting garments are placed.
  9. After 30 minutes of observation, the patient is allowed to leave.
Since breast implants come in many shapes and sizes, the type of breast implant that you choose for surgery should be based on your desired change in profile and size goals. Some other considering factors include positioning, surface texture, shape, personal anatomy and personal preference.
Breast implants come in many varieties, including:
  • Implant surface: smooth or textured
  • Implant shape: round or shaped
  • Implant profile: how far the implant protrudes
  • Implant size or volume: size typically ranges from 120 to 850 cc
  • Implant filler: saline or silicone
  • Implant material: "anatomy" of the implant
Click here to see before and after results of AWAKE Breast Augmentation procedure.