Breast Augmentation

Overview

Breast augmentation is a surgical procedure that enlarges and uplifts the breasts, and is typically performed on women who have small breasts, or sagging breasts due to pregnancy, significant weight loss, or genetics.

The procedure involves the use of a synthetic implant containing either silicone gel or saline, and the implant is placed beneath the breast's tissue or muscle. The implant is placed into the breast using a small scar around the nipple areola complex, in the armpit, or under the breast. Sometimes longer incisions are necessary if a breast lift is performed at the same time.

Who Is a Candidate?

Typical candidates are women between the ages of 18 and 60 who want their breasts to have a fuller appearance. The operation usually is considered an aesthetic enhancement or cosmetic procedure. In certain rare instances, the procedure can be performed on a young patient to treat breast asymmetry or to correct breast developmental deformities. Silicone gel implants can only be placed in women over the age of 22.

Before the Procedure

Your plastic surgeon will perform a comprehensive evaluation of your breasts, including a detailed history of any personal or family breast problems, pregnancy, and weight loss or gain.

Your breast health, including the most recent mammogram for women over 35, will be thoroughly evaluated.

Some of the specific instructions you’ll receive about preparing for surgery include:

• Smoking cessation
• Medications to avoid
• When to take your prescribed medications
• Proper washing techniques
• Restrictions regarding eating and drinking the night before surgery

Procedure Details

You and your surgeon will discuss your concerns about your current breast shape, and your goals regarding the breast augmentation procedure. Prior to the consultation, you should think carefully about your goals because various augmentation techniques often are combined. Incisions can be made around the nipple and under the armpits, as well as under the breasts.

You and your doctor will discuss:

• The location of the implant (either above or below the pectoralis muscle)
• The implant size
• Type (silicone gel or saline filled)
• Any potential short-term or long-term problems following surgery

The approximate location of the incisions and scars will be outlined directly on your skin with a medical skin marker or on a diagram. 

Finally, your surgeon will perform a careful evaluation of your overall health as well as issues that could cause complications, such as:

• Your blood pressure
• Bleeding tendencies or blood clotting disorders
• History of adverse scar formation after previous surgeries

Type of Anesthesia

Your doctor will recommend the best type of anesthesia for you. General anesthesia or local anesthesia with intravenous sedation can be used.

Where Will the Surgery Be Performed?

A breast augmentation is usually done in a hospital as outpatient surgery, and you must be driven to and from the hospital by a friend or family member.

Immediate Postoperative Recovery

In most cases, patients experience pain for 24 to 72 hours. Some swelling usually occurs in the breast tissue but it resolves within a month of surgery.

Short-term Recovery

Most patients can go out in public within two to four days. In an effort to maintain the softest possible state for the implant, you will have to perform an external breast massage designed to move the implant in its pocket. Vigorous physical activity cannot be resumed until four weeks after surgery.

This includes:

• Running
• Jumping
• Bouncing
• Heaving lifting
• Aerobics

Risks

This is considered major surgery, so you should think carefully about your specific expectations and communicate your goals to your plastic surgeon.

In addition to the risks associated with anesthesia, complications can include:

• Bleeding
• Infection
• Scarring issues
• Postoperative breast asymmetry

Complications with the implant can include:

• The implant’s failure
• Infection
• Issues related to the patient’s reaction to the implant

Overall, breast implants are safe and do not pose a health risk. They are not permanent, however, and you will most likely need additional surgery on your breasts in the future. Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with your prior to surgery.

Anticipated Results

Breast augmentation usually produces a rejuvenated, more youthful, fuller, and attractive breast appearance.