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Cosmetic Procedures

Dr. Conrad Tirre
Conrad J. Tirre, MD, FACS
Plastic, Reconstructive and Hand Surgery
Dr. Conrad Tirre

Conrad J. Tirre, MD, FACS

Plastic, Reconstructive and Hand Surgery

Dr. Conrad Tirre received his medical degree from Saint Louis University and completed his plastic Surgery Residency at the University of Colorado Health Sciences Center. Dr. Tirre then completed a highly skilled and rigorous Hand and Microsurgical Fellowship at the Oregon Health Sciences Center. Dr. Tirre is Board Certified by the American Board of Plastic Surgery,as well as holding his Subspecialty Certificate in Surgery of the Hand.

Dr. Conrad Tirre performed plastic, hand, and complex microsurgery (including limb salvage/reattachment) in Denver, Colorado for more than twenty years. After visiting Hawaii Island for several years with his wife, they decided to join the community full time in 2019. Dr.Tirre was excited to join the prestigious Ali’I Health Center and offer plastic, hand, and reconstructive services to the Big Island.

Dr. Tirre is an active member of the American Society of Plastic Surgeons, and the Northwest Society of Plastic Surgeons. He is a Fellow of the American College of Surgeons and a former Associate Professor at the University of Colorado Department of Plastic Surgery.

Breast Augmentation (Breast Enlargement)

Breast augmentation (breast enlargement) surgery is a very popular surgery.  More than 2 million women have breast implants according to the American Society of Plastic Surgeons.

Many women in Hawaii seeking breast augmentation surgery feel their breast size has changed following pregnancy and are looking to restore lost volume or their breast size is disproportionate compared to the rest of their body.  Other reasons women seek breast augmentation may be breast asymmetry (size and shape difference between the breasts).

Whatever your reason for wanting breast augmentation, you owe it to yourself to share your goals with a board certified plastic surgeon as well as discover the options available to you.  Dr. Tirre and our staff will listen to you and help you achieve an appearance you desire.

What to Expect at your Consultation
Our practice offers an extensive and personalized consultation regarding breast augmentation.  During your consultation, Dr. Tirre will review your options for implant placement, size and shapes, and review information regarding silicone and saline breast implants.  We can also determine if a breast lift (mastopexy) would be required to give you the results you are desiring.

Silicone and saline filled breast implants are available for patients to touch, feel and “try on” during the consultation.  Both silicone and saline filled breast implants are safe and each has its own advantages. Our goal is for every patient to feel confident they will get the best results possible.

Breast augmentation is typically performed under general anesthesia thus maximizing both your safety and comfort during this procedure.  This procedure typically is 2 hours in duration and is done in an accredited outpatient surgery center for your safety and optimum results.

Incision Location
Dr. Tirre may place either a silicone gel implant or a saline (sterile salt water) filled implant through a peri-areolar or inframammary incision (under the breast within the crease).  The incision location will be decided between you and Dr. Tirre prior to your procedure.

Implant Location – under the muscle or above the muscle?
Dr. Tirre will then place the implant either under the pectoralis muscle or the breast gland.  In our practice, almost all breast implants are placed under the pectoralis muscle for some major advantages.

First, placing the implant under the muscle provides extra padding and soft tissue coverage over the upper and middle parts of the implant.  This creates a more natural slope at the top of the implant rather than a more pronounced shelf.  It may also reduce any appearance of wrinkling or rippling of the implant as well.

Secondly, placing the implant under the muscle can make it easier to get an accurate mammogram as there is less distortion of the breast tissue itself.

Drainage tubes are typically not used by Dr. Tirre for breast augmentation.  Incisions are closed with very fine sutures to aid in minimal scarring.  Complete post procedure instructions will be discussed personally with you by Dr. Tirre and all of your postoperative care is included in your breast surgery pricing.

Ultimately, Dr. Tirre will work with you to determine the best location for the incision and placement of your breast implants. He will offer his expertise and guidance in determining the best options for you.

Should I choose Silicone or Saline?
Silicone implants have been available continuously for several decades, however their use became limited in the 1990’s when they were only offered as part of a silicone study protocol.  Dr. Tirre was proud to be a certified silicone study physician during this period and continued to utilize silicone gel implants for breast reconstruction, breast augmentation & lift combination procedures and secondary breast augmentation.

Silicone gel filled (cohesive or gummy bear implants) are the newest generation of silicone implants available.  Silicone implants are less likely to produce visible rippling or wrinkling and typically offer a more natural appearance and feel.

Saline filled (sterile salt water solution) breast implants are available in Dr. Tirre’s office to touch, feel and “try on”.  Saline breast implants offer patients an excellent breast augmentation result as well and Dr. Tirre is comfortable utilizing silicone or saline breast implants.

The decision to have silicone or saline implants is a personal decision based on cost and personal preference.  Dr. Tirre and our staff will work closely with you to answer all your questions regarding each of these types of breast implants.

Breast Augmentation Questions answered by Dr. Conrad Tirre

There are three common approaches (incisions): underneath the breast (inframammary), around the nipple (periareolar), and in the armpit (transaxillary).

A more controversial approach is through the belly button (TUBA, trans-umbilical breast augmentation). Dr. Tirre does not perform the TUBA technique due to the high complication rate and Dr. Tirre does not feel this is the best way for a breast augmentation to be performed.

Dr. Tirre typically uses Mentor saline and silicone (Memory Gel) breast implants.

Breast augmentation surgery fees range from $8700-$9500 depending upon where the incision is made, the size and type of implants. Also, the fee is determined by the degree of difficulty (if one breast is significantly larger than the other, etc.). The fee includes the surgery, implants, anesthesia, O.R. supplies (this includes the facility costs, medical and surgical supplies and surgical personnel), and postoperative care following surgery.  The practice also includes CosmetAssure which is a patient safety medical policy.

We offer several financing options to make breast augmentation as low as $150 per month!  Many other cosmetic surgery procedures are affordable now with low monthly payments.

Dr. Tirre will review your desired goals for breast enlargement prior to surgery and have a specific implant in mind for you.  He will use “sizers” during surgery to allow him to see exactly what the final implants will look like.  By using these “sizers” during surgery, Dr. Tirre is able to maximize his ability to achieve the best size and shape possible.

The recovery period is about one to two weeks. Limited exercise (walking, stationary bike) can be resumed at 2 weeks with approval from Dr. Tirre; full exercise can be resumed at 5 to 6 weeks. Most patients return to work about 5 to 10 days after the surgery if the job performance requires only light duty, such as office work, or sales, etc.

Decreased sensation in breast and nipples (this improves over 1-2 years), infections, bleeding, capsular contracture (making the breast feel firm) and implant leakage.

The breast implant could obscure detection of breast cancer on a mammogram therefore, it is important that you tell the mammogram technician that you have implants and whether they are above or below the muscle when having a mammogram.

If drooping is present, we may not be able to put the breast implants under the muscle unless a breast lift is done.

If the breast implants are above the muscle the chances of rippling being visible is greater. Having the implants are below the muscle minimizes rippling, but still may be noticeable between the breast and under the breast.

Capsular contracture, a condition that causes the naturally-forming scar tissue around a breast implant to contract, occurs in a variable percentage of patients and can make the breast feel firmer than normal. While this condition can be addressed surgically, correction is not always permanent.

No, you do not have to replace the implants unless you have a problem with them. Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants.

Breast Augmentation does not generally interfere with a woman’s ability to breast feed.

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