Introduction: What is a Breast Augmentation?
Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure designed to enhance the size and shape of the breasts most commonly by inserting breast implants but can also be done with fat transfer. It is important to note that breast augmentation is not a breast lift, and if you have significant drooping breast tissue you may require an augmentation mastopexy to address both volume and the extra skin.
Types of Implants for Breast Augmentation
There are different types of implants available. All implants are synthetic silicone rubber shells filled with a silicone gel or a saline (saltwater) solution. The outer wall of the implant. Implants come in different sizes based on the volume of fill within the implants which can change the base diameter of the implant and they also have different projections.
You and your surgeon will discuss the different implant types and based on what you desire will choose the implant that is most appropriate for you.
Who is an Ideal Candidate for a Breast Augmentation?
- You are not currently pregnant or breastfeeding
- Your breasts are fully developed
- You are bothered by feeling that your breasts are too small or that they are losing shape and volume over time
- You feel that the upper part of your breast appears “empty”
- Your breasts have failed to develop normally or are asymmetrical
- Healthy patients without significant medical comorbidities
- Patients with realistic expectations of what a breast augmentation can do for them
- Non-smokers
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Photographs will also be taken during pre-operative consultation to submit for insurance, to be used in surgical planning and for before and after comparison. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals.
This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure: Breast Augmentation
On the day of surgery, the proposed implant site, the creases under the breast and the incision sites will be marked on your skin either in the pre-operative area of the operating room.
The location of your incision is based on your personal preference, your body type, and your surgeon's recommendation.
A periareolar incision (around the areola) means the scar may be concealed by the color and shape of the areola.
An incision placed in the inframammary fold may be hidden by the breast itself when standing but can be seen when the patient is lying down.
A pocket for the implant can either be made above the muscle (subglandular) or below the muscle (submuscular), this will be based on the patient’s anatomy, degree of enlargement, patient preference and surgeon recommendation.
Once the desired look is achieved, the pocket is closed.
The incision is closed with dissolvable sutures that will be under the skin and you will have either surgical glue or surgical tape over your incisions which take about 1-2 weeks to fall off.
Your surgeon will place either a surgical bra or bandage over the incision, depending on what seems best in your case.
Risks & Complications of Breast Augmentation
As with any surgery, breast augmentation involves some risks and potential complications. The possible risks and complications associated with breast augmentation include:
- Anesthetic risks
- Bleeding
- Infection
- Capsular contracture (formation of firm scar tissue around the implant)
- Changes in nipple or breast sensation
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or other very rare cancers in the capsule around the breast implant, such as breast implant-associated squamous cell carcinoma (BIA-SCC)
- Fluid collection (seroma)
- Implant rupture
- Asymmetries or suboptimal aesthetic results
- Possibility of revision surgery
Recovery after Breast Augmentation Procedure
After a breast augmentation there will be some temporary pain, discomfort, and swelling. Medications will be prescribed to relieve pain. You will wear a contoured elastic garment for extra support around the breasts. You should be able to go home the same day from surgery once you have recovered from anesthesia. Stitches are usually dissolvable and internal. Specific post-operative care regimen to minimize scarring will be discussed with each patient. Strenuous physical activity and heavy lifting over five pounds is discouraged for at least two weeks post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. You will likely be able to resume work in 1 week depending on what kind of job you have and how you are feeling. Full recovery may take a few months as the swelling improves and the implants settle into their final position and you will have follow-up appointments to ensure a positive surgical outcome.
Summary
After a breast augmentation you will have immediate results of larger breasts. The final results may not be evident for a few months however, as swelling goes down and the implants settle into position.
