Breast Augmentation

Breast Augmentation, or Augmentation Mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:

  • Enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
  • Restore breast volume lost due to weight loss or following pregnancy.
  • Achieve better symmetry when breasts are moderately disproportionate in size and shape.
  • Improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure.
  • Provide the foundation of a breast contour when a breast has been removed or disfigured by surgery to treat breast cancer.
  • Improve breast appearance or create the appearance of a breast that is missing or disfigured due to trauma, heredity or congenital abnormalities.

By inserting an implant behind each breast, we are able to increase your bust line by one or more bra cup sizes. The choice of implant filler, implant size, shape and other features will be determined based on your breast anatomy, body type and your desired increase in size. Your lifestyle, goals and personal preferences, as well your plastic surgeon’s recommendations and sound surgical judgment are also determining factors.

About the Procedure

If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:

  • Increase fullness and projection of your breasts
  • Improve the balance of your figure
  • Enhance your self-image and self-confidence

Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.

Implants also may be used to reconstruct a breast after mastectomy or injury.

What it won’t do

Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation.

Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.

Is it right for me?

Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast augmentation may be a good option for you if:

  • You are physically healthy
  • You have realistic expectations
  • Your breasts are fully developed
  • You are bothered by the feeling that your breasts are too small
  • You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
  • Your breasts vary in size or shape
  • One or both breasts failed to develop normally

Consultation

Your consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have. We suggest you come prepared with your questions on paper so you’re sure not to forget to ask the questions that are important to you.

Questions to Consider:

What is the simplest and safest surgery to help me achieve my goals?
How is the surgery performed?
What is the expected length of operation?
Are other options available?
What results can I expect, and how long do the typical results last?
Where will scars be located, and how noticeable will they be?
Will scars fade over time, and how long will this take?

When you arrive at the office, you will be asked to fill out a few pieces of paperwork. It is very important when asked about medications to put down all medications you take, including any supplements or aspirin-type regimens, since these items can impact your blood clotting and pressure. In addition, you need to be truthful about your use of tobacco and alcohol since this will affect your recovery and incision healing.

Before you see the doctor, a nurse or nurse practitioner will do an initial exam. You may be able to get a number of your questions answered while with the nurse.

Your surgeon will discuss several factors regarding surgery during your initial consultation, including your procedure, location, anesthesia and recovery. In addition, the surgeon will inquire about your concerns, priorities and motivations for pursuing surgery, as well as your fears.

The doctors are sure to address reasonable expectations for the outcome of your desired procedure, and they should explain what is possible and what is not possible.

After your consultation with the physician, you will meet with the practice manager to discuss procedure costs.

Pre-Procedure

There are a number of things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety.

Your surgeon will give you instructions on what medications to stop taking and when prior to your surgery to prevent any unwanted side effects. Medications you shouldn’t take up to two weeks prior to your surgery include, but are not limited to, aspirin and products containing aspirin, alcohol and herbal supplements. Your surgeon may advise you to take Arnica Montana, Bromelain or vitamins A or K for swelling, bruising and to promote general healing.

It is important to remember to only take a supplement or herbal remedy if your surgeon advises it.

Your Pre-Op Checklist

  • Take pictures and make notes to discuss with your doctor. You know what you want, and he knows how to make it possible.
  • Make a list of post-op projects and gather what you need. Stop taking blood-thinning medications and supplements two weeks prior to surgery (aspirin, Motrin, fish oils, vitamin E) and don’t take them two weeks after surgery.
  • Start using anti-bacterial soap in the shower a few days before surgery and following surgery.
  • Remove all fingernail and toenail polish.
  • Fill prescriptions you’ll need, including antibiotics and pain medications.
  • Purchase over-the-counter eye drops and eye gel for overnight (GenTeal seems best and it is found at major drug stores like Walgreens)
  • Pick up Bacitracin for incision areas and Colace to keep your bowels moving during recovery.
  • Clear your calendar for a month post-op.
  • Arrange for caretakers: you, kids, plants and pets need to be taken care of during your recovery. You will not be able to lift, reach, bend over or be too active for some time.
  • Prepare your recovery area so your head is elevated. A recliner works wonders for this. Also stock your recovery area with blankets, water, phone, lotion, tissues, remote control, reading material, laptop, etc.
  • Make a to-do list of things you want to get done prior to surgery and start! You won’t be able to accomplish as much post-surgery. Some items you may want to get done include:
    • Stock up on groceries and easy to prepare meals
    • Clean the house
    • Catch up on gardening
    • Laundry
    • Give the dog a bath
    • Clean the litter box
    • Wash your car
  • Stock up on ice packs, frozen peas and frozen gel packs. You’ll want to use them early and often on your face, neck and ears. It will definitely feel good and keep the swelling down.
  • Pack a receptacle with a lid and towel in your car for the ride home from the hospital just in case you feel nauseous. You may want to add a pillow and blanket, but be sure to set up on the ride home to help with the nausea and swelling.
  • Get your hair and nails done since it will be a while before you can do either.
  • Prepare Power of Attorney for Medical Care and Advance Directives, just in case. Give copies to your doctor and/or surgical center.
  • Breathe and relax! Stress can adversely affect your recovery. Try to remember that you will heal, the soreness will subside and you will look great.

During Your Procedure

Anesthesia: Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The Incision: Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include:

Inframammary Incision

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Transaxillary Incision

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Periareolar Incision

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Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.

Implant Choice: Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon.

Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.

Options for Breast Implants

Saline Implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body.

Silicone Implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket.

A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.

Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available.

Currently Saline implants are FDA-approved for augmentation in women 18 years of age and older.

Currently Silicone implants are FDA-approved for augmentation in women 22 years of age and older.

Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

Inserting and Placing the Implant: After the incision is made, a breast implant is inserted into a pocket either:

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Under the pectoral muscle (a submuscular placement), or
Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)

The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.

Closing the Incisions: Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade.

Results: The results of breast augmentation are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.

Recovery

After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks.

Exercise and normal activity can resume at the direction of your plastic surgeon. Over time, post-surgical swelling will decrease and incision lines will fade.

Recovery is an important part of any surgery, and you must take the doctor’s orders to heart if you want to heal as quickly as possible.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

Risks

The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Risks Include:

  • Unfavorable scarring
  • Bleeding (hematoma)
  • Infection
  • Poor healing of incisions
  • Changes in nipple or breast sensation, may be temporary or long-lasting
  • Capsular contracture, which is the formation of firm scar tissue around the implant
  • Implant leakage or rupture
  • Wrinkling of the skin over the implant
  • Anesthesia risks
  • Fluid accumulation
  • Blood clots
  • Pain, which may persist
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery

Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases.

Other Important Considerations:

  • Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants.
  • Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime.

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