A saline solution containing the local anesthetic lidocaine and epinephrine (to constrict blood vessels) is infiltrated from the belly button in a tract towards each breast. The breasts themselves are also numbed with the same solution. An incision is then made in the belly button, and a long instrument is introduced through the tract into the breast.
The instruments are then used to develop a pocket either under the breast tissue or the pectoralis muscle. Once an adequate pocket has been developed to properly hold each implant, breast sizers (empty implants) are inserted through a tube into each breast and inflated with air. This is done to check the size of the pocket. The sizers are then removed and any adjustments to the pockets are perfomed.
The implants are then inserted through a tube into each breast and filled with saline. The patient can then be sat up so they can check the size and adjustments can be made as necessary. At the completion of the procedure, the incision is sutured closed and a small dressing is applied. The patient has little-to-no recovery and goes home numb!