Breast Augmentation
Breast > Breast Augmentation
Breast augmentation can be a very satisfying procedure for women with small breast, an uneven breast, asymmetrical or empty breast. Age, breast feeding and weight gain and weight loss take its toll on the shape and size of the breast.
Perky full size breast conveys youth beauty and self confidence.
Over the years several new approaches have emerged, along with the availability of different types and shapes of implants.
Some known facts will assist you in your decision of breast augmentation surgery.
When considering breast augmentation, you have several options that you need to decide.
- Type of implant, saline or silicone implants
- Position of implants, above the muscle or below the muscle
- Location of the incision, inframammary, peri-areolar or axillary
- The size of implant. This is ideally determined by your wishes and desired final size
However measurement of your body and the measurement of the breast is the most critical measurements in deciding the size of the implant.
Taking in consideration the laxity of the skin, the amount of breast tissue thickness you already have, are very important factors to consider when choosing the appropriate size of the implant and the profile height of the implant.
It is very important to communicate with your surgeon and discuss all these issues before the surgery for successful results.
Choosing the right surgeon for you is important, a BOARD CERTIFIED PLASTIC SURGEON (AMERICAN BOARD OF PLASTIC SURGERY).
- Breast augmentation can be performed on women, as young as their late teens, once their breasts have fully developed.
- Breast augmentation can be performed in conjunction with a breast lift.
- The implant is placed either under or over the pectoral (chest) muscle. Depending on tissue volume, thickness, and skin characteristics.
- Saline and silicone breast implants are available. The choice of implant type is a patient choice.
- No known illnesses are associated with saline-filled or silicone implants; Many studies have also conclusively shown that there is no relationship between silicone and any disease. They have proven their safety record through many years of use. Breast implants available in the United States have been approved by the FDA after 15 years of scrutiny and scientific studies.
- Implant ruptures, the body will absorb the saline, which is harmless. Saline is salt water. However the implant needs to be changed. Newer silicone implants are filled with more gel like silicone, and most implant failures results in a contained silicone within the capsule.
- Saline implants are available with smooth or textured surfaces.
- Saline implants do not feel as natural as silicone gel implants especially in patients with small amount of breast tissue to cover the implant. Neither implant is guaranteed to last a lifetime. Once you have an implant, you will need another surgery in the future.
Breast implants interfere with mammograms. You may need to be followed by your surgeon.
It is extremely important to notify your mammography physician of the presence of breast implants; additional views are necessary (Eklund Views), and special care needs to be taken to minimize trauma due to pressure.
ALTERNATIVES TO SURGERY
Breast exercises do not increase breast tissue or volume. They may help tone the pectoral muscles.
Bra pad inserts, or padded bra can give the appearance of a full breast.
Hormones and over the counter creams do not increase the breast size.
Fat transfer to the breast is the latest attempt to use your own body fat and transfer to the breast. Fat transfer is very successful in many other parts of the body. The experience accumulated in breast augmentation from the United States, Europe and other parts of the world has shown that fat transfer to the breast for breast augmentation is safe. Fat transfer to the breast is done in small amounts so the increase is small and gradual. There is some fat necrosis and calcifications, but those are easily distinguishable on mammograms, oil cysts do disappear with time.
The issue of the potential of stem cell transfer, since fat contains lots of stem cells, and the question of stem cells transforming to cancer cells is not substantiated in the lab. This is some of the information that has been published up to now.
Fat transfer is gaining more acceptances in the US. Therefore each woman and plastic surgeon must decide based on the information available in the medical literature.
PREPARING FOR SURGERY
Understanding the surgery and what is needed to achieve the best results for your body is critical to your satisfaction.
Communicating with your plastic surgeon is important to achieve the desired shape and size that you wish and fits your body image.
Pictures from magazines can aid in the communications, and are used as a communication tool.
No guarantees as to the final cup size because manufacturers differ in sizing a bra. Only the implant size agreed upon is guaranteed. Or a range of implant sizes.
If the breast is empty and the skin is lax and have lost its elasticity then you may require a breast lift in conjunction with implants. This will add more scars on the breast for the breast lift.
It is very important to follow the preoperative and post operative instructions of your surgeon. This will make your surgery and recovery smoother.
THE PROCEDURE
Saline implants require smaller incision because the implants are folded and inserted then inflated.
A slightly larger incision is needed for silicone implants insertion because they are inserted prefilled with silicone.
You have option of location of the incision :
- Inframammary - in the crease underneath the breast. This scar is not visible unless you are lying down.
- Peri-areolar - a semicircular incision around the inferior part of the areola.
- Axillary - Underarm incision. The incision is larger and can be seen when you raise your arm. The implant is placed with the aid of an endoscope.
Anesthesia
Breast augmentation is usually performed under general anesthesia, but may be performed under local anesthesia with intravenous sedation.
Level of Pain/Discomfort
When the implant is placed above the muscle there is minimum discomfort during the postoperative period. The discomfort may be more if the implant is placed beneath the muscle. Most discomfort can be controlled with pain medications.
The use of pain pump will decrease the level of pain and make your experience pleasant.
PRE- AND POSTOPERATIVE INSTRUCTIONS
It is important to follow all preoperative and postoperative instructions to assure a smooth course and avoid complications.
- Stop smoking, at least 3 weeks prior to surgery and 3 weeks after surgery.
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discontinue the use of alcohol, and stop taking vitamin E and any medications
containing aspirin or ibuprofen (two weeks prior to surgery and three weeks after surgery). - Do not have food (including gum or mints) or drink (including water) starting midnight the night of surgery.
- Have someone stay with you the first 24-48 hours after surgery.
- Do not lift push or pull anything heavy for at least two weeks.
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Dressings – supportive bra will be used after surgery, to wear for four to six weeks after surgery. Do not wear an under wire bra.
- You must sleep on your back with your upper body elevated on two or three pillows for at least the first week to ten days.
- The breasts must not be exposed to the sun or tanning beds or any source of heat, for at least 3 month.
RECOVERY
Healing takes one to two weeks. However every one heals differently.
pain tolerance differs from patient to another and depends on the extent of the surgical procedure.
There is some tenderness and pain the first few days immediately after surgery.
There is some swelling and bruising around the breast. The breast may be numb for few weeks, this will resolve gradually.
RISKS / COMPLICATIONS
Though complications are not common however they can occur. You must fully understand all potential risks and complications before deciding on the surgery.
Complications include bleeding, hematoma (a collection of blood around the implant.), changes in sensation and infection, deep venous thrombosis and Pulmonary emboli, which can be serious complications asymmetry, which may require another surgery, and scarring. Every effort is made to keep the scars as inconspicuous as possible. Most scars fade with time and become barely noticeable. Although scaring is genetically predetermined, and no guarantees or warrantees as to how your scar will look.
Implant failure, deflation and rupture.
Displacement of implant
Interference with sensation
Interference with mammogram
Interference with lactation
The need for further surgery, for complications or undesired results.
You are fully responsible for any further surgery including the surgeon’s fee,
anesthesia fees, facility or hospital fees and implants when indicated.
Capsular contracture, (hardening of the scar around the implant)
NEW YOU…ONLY BETTER
Almost all women report complete satisfaction with breast augmentation surgery.
The full breast conveys youth, health, beauty and self confidence.
Clothes fit better and better body image.
5300 Dorsey Hall Drive, Suite 102, Ellicott City MD 21042
(410) 715-2000