Breast Augmentation
[Augmentation Mammaplasty]
Breast augmentation plastic surgery is one of the most common procedures performed annually by members of the American Society for Aesthetic Plastic Surgery. Women may choose to under go breast enlargement surgery for various reasons. These personal reasons may center around breasts that are perceived to be under developed, or because of differences in the sizes of the breasts or from changes after pregnancy or breast-feeding.
Some women may be happy with
their breasts but just want them made fuller. Often after weight loss, aging or
childbirth a woman's breast volume and shape may change. This too can lead to a
woman to seek a breast augmentation. Breast implant surgery performed by
cosmetic plastic surgeons is the most popular way to improve breast shape and
size. Breast enhancement using breast implants can give a woman more
proportional shape and may improve self-esteem.
Am I a good candidate for
breast augmentation?
One or more of the following
feelings or conditions may indicate that you are a good candidate for breast
augmentation:
•you are bothered by the
feeling that your breasts are too small
•clothes that fit well around your hips
are often too large at the bustline
•you feel self-conscious wearing a swimsuit
or form-fitting top
•your breasts have become smaller and lost their firmness
after having children
•weight loss has changed the size and shape of your
breasts
•one of your breasts is noticeably smaller than the other
How should I prepare for breast
augmentation plastic surgery?
In some instances, your plastic
surgeon may recommend a baseline mammogram before surgery and another
mammographic examination some months after surgery. This will help to detect
any future changes in your breast tissue. Following breast augmentation, you
will still be able to perform breast self-examination.
If you are a smoker, you will
be asked to stop smoking well in advance of surgery. Aspirin and certain
anti-inflammatory drugs can cause increased bleeding, so you should avoid
taking these medications for a period of time before surgery. Your surgeon will
provide you with additional preoperative instructions.
Breast augmentation is usually
performed on an outpatient basis. If this is the case, be sure to arrange for
someone to drive you home after surgery and to stay with you at least the first
night following surgery.
What will the day of breast
implant surgery be like?
Your breast augmentation
surgery may be performed in a hospital or an ambulatory facility.
Medications are administered
for your comfort during the surgical procedure. General anesthesia will be administered at the time of surgery. When surgery is
completed, you will be taken into a recovery area where you will continue to be
closely monitored. Your breasts will be wrapped in gauze dressings or a
surgical bra.
You may be permitted to go home
after a few hours, unless you and your plastic surgeon have determined that you
will stay in the hospital or surgical facility overnight.
How will my breasts look and
feel after the breast implants have been placed?
A day or two after surgery, you
should be up and about. Any dressings will be removed within several days, and
you may be instructed to wear a support bra. Your plastic surgeon will probably
permit you to shower between three and seven days following surgery. Stitches
will be removed in about a week. Some discoloration and swelling will
occur initially, but this will disappear quickly. Most residual swelling will
resolve within a month.
What should I expect during the
recovery process?
At the conclusion of your
breast augmentation procedure, you may be placed in a surgical dressing that
may include a support bra or garment. You should follow your plastic surgeon’s
directions as prescribed. Prior to your discharge, you and your caregiver will
be given detailed instructions about your post-surgical care including drains
if they have been placed, the normal symptoms you will experience, and any
potential signs of complication.
Options for your recovery after
undergoing breast augmentation include:
•Home: When discharged, you
will be released to the care of a responsible adult with safe, licensed
transportation home. The adult may be a family member, friend or hired
caregiver and must be competent to understand your recovery instructions and to
monitor your health. Your caregiver must commit to stay with you at all times
for a minimum of 24 hours after surgery.
•Licensed Recovery Facility: You will be released to the care of a licensed post-surgical recovery facility where nurses or specially trained medical professionals will monitor your health and comfort until you are able to return home and capably care for yourself.
•Overnight Hospital Stay: An
overnight hospital stay may be offered to you or may be recommended. In this
case your surgery will be performed at the hospital where you will stay
overnight. You will be released from the hospital to a capable caregiver to
continue your recovery at home, or to a licensed recovery facility.
You should be walking under
your own strength immediately after your breast augmentation surgery. It
is very important that you walk a few minutes every few hours to reduce the
risk of blood clot formation in your legs.
The first 2-5 days following
your breast augmentation surgery you may feel stiff and sore in the chest
region. Any dressings will be removed within several days, and you may be instructed
to wear a support bra. Your breasts may feel tight and sensitive to the touch,
and your skin may feel warm or itchy. You may experience difficulty raising
your arms. You should not lift, push or pull anything, or engage in any
strenuous activity or twisting of the upper body. Some discoloration and
swelling will occur initially, but this will disappear quickly. Most residual
swelling will resolve within a month.
It is important to follow all
patient care instructions as directed.
When can I expect to resume my
normal activities after my breast augmentation?
While it will take several days
to return to more normal activities after your breast augmentation, it is
important to your recovery that you get up and move around. After breast
augmentation, it is often possible to return to work within just a few days or
a week, depending on the type of activities that are required at your job.
Physical activity should be
avoided for at least the first couple of weeks following surgery. After that,
care must be taken to be extremely gentle with your breasts for at least the
next month.
How Breast Augmentation is
Performed
Individual factors and personal
preferences will help you and your plastic surgeon to determine your
appropriate breast size, the location of incisions, and whether the implants
will be placed on top of or underneath the chest muscle.
What type of breast implants
can be used for breast augmentation?
The implant is placed in a
pocket either directly behind the breast tissue (right) or underneath the
pectoral muscle, which is located between the breast tissue and chest wall. The
size and type of breast implant recommended for you will be determined by your
goals for breast enhancement, your existing body frame, and mass, your existing
breast tissue, and the preferences you and your plastic surgeon
discuss. All breast implants include a solid silicone rubber outer shell,
called a lumen.
Breast implant options include:
•Saline breast implants: Filled
with sterile salt water. Saline implants may be pre-filled to a
predetermined size. Saline may also be filled at the time of surgery to
allow for minor modifications in implant size.
•Silicone filled breast
implants: Filled with soft, elastic gel. All silicone breast implants are
pre-filled and may require a longer incision for implant placement. You must be twenty two years of age or older in order to have this type of implant.
New scientific data on the
safety of breast implants is rapidly being collected. In the future, it is
possible that additional types of filler materials may become available as
advancements take place. Surgical techniques for breast augmentation and breast
implants themselves are continuously being refined, increasing the safety and
reliability of the procedure. Your plastic surgeon will be able to provide you
with the latest information.
Where are the incisions made for
the placement of breast implants?
An incision can be made either
underneath the breast, just above the crease, around the lower edge of the
areola or within the armpit. One of the advantages of a saline-filled implant
is that, because it is filled with saltwater after being inserted, only a small
incision is needed. Often, an incision of less than one inch is made underneath
the breast, just above the crease, where it is usually quite inconspicuous.
Another possible location for
the incision is around the lower edge of the areola. A third alternative is to
make a small incision within the armpit. Once the incision is made, the surgeon
creates a pocket into which the implant will be inserted. This pocket is made
either directly behind the breast tissue or underneath the pectoral muscle,
which is located between the breast tissue and chest wall.
