- Men's health
- Anesthesia and Pain Management
- Cosmetic Surgery
- Plastic & Reconstructive Surgery
- Gynecology Surgery
- What is Breast Augmentation
- Effects of Breast Augmentation
- Candidates for Breast Augmentation
- Your Consultation
- Breast Augmentation Procedures
- How much increase in cup size can I expect?
- Are silicone breast implants dangerous?
- When will the sutures be removed?
- Do I need to massage my breasts and for how long?
- When can I bathe?
- When can I resume exercise?
- When can I wear my preferred bras or clothes?
- How long will my implants last?
What is Breast Augmentation?
Breast Enhancement or Augmentation Mammaplasty is one of the most popular surgical procedures requested by women of all ages. It involves the placement of an implant behind the breast tissue of each breast or the underlying chest wall muscle. Breast Augmentation gives patients a larger, fuller figure that they desire.
Effects of Breast Augmentation
Breast Augmentation produces pleasing and satisfying results through enhancing the size and shape of breasts that women wish to have. It gives women a more flattering bust line, improving their appearance and boosting their self-confidence with regards to their figure.Those who would benefit the most in this procedure are the women having realistic expectations of improvement, not perfection, in the way they look.
Candidates for Breast Augmentation
Each person has her own opinion on what is beautiful in a breast. Normal breast size, for some, might not be enough, and this procedure offers that change you might want. It is solely your choice if you want to undergo this procedure, and the doctors will be happy to discuss the change in the size and shape of your breasts.
Women who are good candidates for Breast Augmentation have at least one of following characteristics:
- You think your breasts are too small or underdeveloped
- The upper part of the breasts seems empty.
- Your breasts do not have the same size or shape.
- Your breasts do not have the same size or shape.
- One or both breasts failed to develop normally or have an unnatural shape.
- You previously had breast implants and are having problems with them.
- Your breasts have lost volume due to pregnancy, weight loss or aging.
- For breast reconstruction following mastectomy for breast cancer.
Breast Augmentation has been performed since 1962 to over 3 million women. The surgical techniques and breast implants have been continuously refined throughout the years, increasing the safety and reliability of said procedure.
Prior to your breast surgery, the BHMGs Board Certified Surgeon will carefully evaluate your general health status and any pre-existing health conditions that could compromise the outcome of surgery or bring risk to your health. Also, the BHMGs Board Certified Surgeon will get detailed measurements of the physical parameters of your breasts and the quality and quantity of your existing breast tissue to determine the proper choice of breast implant and technique.
The BHMGs Board Certified Surgeon may suggest a breast lift or Mastopexy in addition to Breast Augmentation in situations where there is excessive laxity or drooping of the breasts. If this is the case, Breast Augmentation alone would be insufficient to solve and correct this condition.
A mammogram six months before surgery is required, and photos of your breasts will be taken before and after surgery.
The Breast Augmentation Procedure
Breast Augmentation is done on an outpatient basis in an Ambulatory Surgery Center, and usually under general anesthesia.
A couple of options with regards to the location of the incision will be relayed to you, which would be dependent on the individual variables of your breast anatomy and the type and size of implant that will be used. Not all options are available to every patient. The implant type, pocket placement and incision approach all have relative advantages and disadvantages.
The following are the different type of incisions:
Infra-mammary Incision is made in the fold under the breast.
Peri-areolar Incision is made around the nipple.
Trans-axillary with endoscopic assist Incision is made under the arm.
All incisions are kept short and inconspicuous. The BHMGs Board Certified Surgeon will choose the surgical technique as well as the size and type of implant that will produce the result each individual desires.
Implants can be inserted either under the breast tissue (sub-glandular) or partially under the pectoral muscle (sub-pectoral or sub-muscular). When implants are placed in a sub-muscular position (under the breast tissue and the pectoral muscle), there is less chance of capsular contracture, which is the shrinkage of the tissue capsule surrounding the implant that causes both implant and breast to feel unnaturally firm. Placing implants in a sub-glandular position (directly under the breast tissue) may be advisable in some cases, depending on the thickness and laxity of the breast tissue, and also the ability of the breast tissue to decently cover the implant.
Once the desired pocket has been created, a temporary sizer implant is placed to determine the proper shape and size of the final implant. In this stage, the BHMGs Board Certified Surgeon will evaluate your pre-operative photos and your desired results based on your previous discussions with the surgeon, as well as the photos you may have shown for comparison. The final implant is then chosen, inserted, and properly positioned within the pocket, and checked to insure that your breasts have the shape and size you expected before surgery. Although, take note that there can be no guarantee as to the final cup size of your breasts after the operation.
A local, long-acting anesthetic will be used in the space around the implants to insure minimal pain or discomfort when you wake from surgery. Incisions are carefully closed with multiple layers of hidden sutures and surgical tape. However, in the case of revision surgery on the breast for encapsulation or other problems, drains are never placed. You will then be placed in a soft surgical bra with a supportive wrapping around the chest. You will wake up in the recovery room with minimal pain, or mild to moderate muscular soreness that is similar to a strenuous workout, after the implants have been placed partially behind the muscle.
The BHMGs Board Certified Surgeon will help you in deciding which incision, pocket placement, and type of implant you should have to get your desired results. They will utilize the most advanced techniques in order to minimize your risks, optimize your results, and return you to your normal, unrestricted activities as quickly and comfortably as possible.
After the procedure, patients are placed in a soft surgical bra with a supportive wrapping around the chest. Do make sure someone is able to assist and drive you home and be available to care for you continuously for the first 24 hours. Since no drains are required except in the case of re-operative breast implant surgery, our patients are allowed to shower the day after surgery. Some pain or discomfort might be experienced the first day or two which is easily controlled with analgesic medications. But there should be minimal bruising. Also, tightness in the breast area is normal as your body adjusts to the implants. There is somewhat more discomfort and spasm when the implants are placed below the pectoral muscle. If this occurs, the BHMGs Board Certified Surgeon may prescribe a muscle relaxing medication to control the spasms.
Patients would be able to return to normal daily activities like washing the hair and driving, about 2 to 4 days after the surgery. In the first 2 weeks after the procedure, a bra should be worn at all times, except when showering. Moderate exercises like walking are allowed after the first week. Patients should avoid heavy lifting, tub bathing and Jacuzzi, or swimming for the next 2 to 3 weeks. While vigorous exercises like jogging and aerobics should be resumed in 3 to 4 weeks time. You may return to work in a day or two, but do avoid any strenuous activities for a couple of weeks after surgery.
Your breasts may be appear somewhat swollen after surgery, but within a few weeks, the actual shape and size of your breasts will be apparent so you can begin to wear bras and clothes that you prefer. BHMG suggests for you to get breast examinations at no cost from our office every 6 to 12 months. Continue breast self-examinations monthly, and have mammograms as recommended by your gynecologist or personal physician, which is generally yearly after age 40. We do request that you forward copies of all your mammography results to our office.
Capsular contracture is a process of gradual but aggressive shrinkage of this tissue capsule surrounding the implant. This causes the breast and implant to feel unnaturally firm and often times painful. Capsular contracture is usually progressive, worsening with time, over the course of several months to years. This situation may result in asymmetry of the breasts. The occurrence or severity of this condition varies with each individual. There is no reliable data as to how often it occurs. Asymmetry may also occur as a result of unexpected problems with early healing after implant placement.
When the saline solution of a saline breast implant leaks either through the valve or through a puncture or defect of the outer shell of the implant, it would cause deflation and would require surgical replacement. Most implants are covered by a manufacturers warranty against deflation.
Patients are reminded that sensory changes may occur in the nipples or outer breasts. Also, patients with a very small volume of breast tissue or thin skin before surgery may notice visible wrinkling or rippling of the implants, especially saline, and more commonly when larger size implants are chosen. Another reminder is that there may be delayed wound healing for patients with diabetes, a history of radiation, autoimmune disease, or for smokers. Surgical scars may be unsightly. In order to avoid these problems, a thorough medical evaluation should be done before the surgery.
Breast implants do not affect fertility, pregnancy, or a womans future ability to nurse, there are no evidences found to prove otherwise. It is a fact that not all women may be able to breastfeed even without the implants. If the peri-areolar (nipple) incision is used for the procedure, there may be a greater risk of scarring within the breast or alteration in the ability to breastfeed as compared to the axillary (under-arm) or inframammary (breast fold) incisions, but there is no evidence gathered for it to be scientifically proven.
Breast Augmentation may not be a one-time surgery. It is very likely that additional surgeries and doctor visits will be necessary over the course of your lifetime to maintain the appearance of your breasts after the procedure. This might be because of problems related to the implants themselves, like deflation, capsular contracture, rupture, etc., or because of aging changes, like pregnancies, weight gain, loss of breast tissue, etc., that affect the appearance of the breasts over time.
Health insurance does not cover Breast Augmentation, except in rare cases of congenital deformity or some types of reconstruction. Insurance may not also cover re-operation or additional future surgeries or additional doctor visits if complications arise.
Q: How much increase in cup size can I expect?
A: The size of your breasts after Breast Augmentation will depend on the implant used and the ability of your breast tissues and chest wall muscles to expand with the implant. In general, women with relatively large breasts can go larger than women who have very little breast tissue to begin with, also petite women cannot go as large as women with a larger physique. There is no guarantee as to the final cup size.
Q: Are silicone breast implants dangerous?
A: To date, silicone breast implants are safe devices that do not pose any greater risk of causing disease than saline implants. If there is evidence showing that silicone breast implants could lead to systemic disease, BHMG would never use them. As for now, we would not hesitate to recommend silicone breast implants to a patient if the circumstances dictate that this would be the best choice of implant.
Q: When will the sutures be removed?
A: Sutures will be removed after a week to 10 days.
Q: Do I need to massage my breasts and for how long?
A: Smooth implants, whether saline or silicone, above or below the muscle, must be massaged immediately after surgery to maintain the softness of the breasts. Maintaining a large space around these implants prevents or delays the encapsulation process. Textured implants do not require massage. We will give you detailed instructions if massage is required after the surgery.
Q: When can I bathe?
A: You may shower 24 hours after surgery. Do not immerse your breasts under water or take baths in the tub, pool or ocean 3 weeks after surgery.
Q: When can I resume exercise?
A: You may do walking and treadmill or riding a stationary recumbent bicycle within 2 days. No strenuous upper-body exercises for 2 to 3 weeks following surgery. Avoid any activity that may cause any discomfort.
Q: When can I wear my preferred bras or clothes?
A: The swelling will settle in 2 to 4 weeks. The breasts are not likely to change much in size at that time, but may continue to soften and improve in shape. You can now wear your bras and preferred clothes at this point. You should wear the post-surgical bra given by our office for the first 2 weeks at least.
Q: Will I need additional operations on my breasts in the future?
Q: How long will my implants last?
A: Most implants last for 10 to 15 years. Any type of breast implant is subject to wear and tear and deterioration due to aging over time. Like a heart valve or artificial joint replacement, they are not to be expected to last forever. The implants are covered by a manufacturer's warranty against manufacturing defects, and most companies provide financial assistance for re-operation, and implant replacement at no charge, in the event of implant failure. However, you may incur other financial costs which are not covered.