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Breast
Augmentation (Breast Enlargement) |
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Many
women choose to have their breasts enlarged
in order to satisfy their own desire for
a fuller bustline. Your breasts may not
have developed to a size that meets your
expectations, or one breast may be significantly
smaller than the other. You may have been
happy with your breasts in the past but
feel that they look different now. Often,
after weight loss, childbirth or as a
result of aging, the breasts lose volume
and their shape changes. Breast augmentation
can enhance your breast size and shape,
and give you the more proportional figure
that you always wanted. If you have questions
or concerns during your recovery, or need
additional information at a later time,
you should contact your surgeon. |
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Am
I a good candidate for breast augmentation?
One
or more of the following feelings or conditions
may indicate that you are a good candidate
for breast augmentation:
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You are bothered by the feeling that your
breasts are too small.
· Clothes that fit well around
your hips are often too large at the bustline.
· You feel self-conscious wearing
a swimsuit or form-fitting top.
· Your breasts have become smaller
and lost their firmness after having children.
· Weight loss has changed the size
and shape of your breasts.
· One of your breasts is noticeably
smaller than the other.
Your Personal Consultation
During
the consultation, you will be asked about
your desired breast size and anything
else related to the appearance of your
breasts that you feel is important. This
will help me to understand your expectations
and determine whether they realistically
can be achieved. |
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How
will my plastic surgeon evaluate me for
breast augmentation surgery?
I
will examine your breasts and perhaps
take photographs for your medical record.
I will consider such factors as the size
and shape of your breasts, the quality
of your skin and the placement of your
nipples and areolas (the pigmented skin
surrounding the nipples). If your breasts
are sagging, a breast lift may be recommended
in conjunction with augmentation.
You
should come to the consultation prepared
to discuss your medical history. This
will include information about any medical
conditions, drug allergies, medical treatments
you have received, previous surgeries
including breast biopsies, and medications
that you currently take. You will be asked
whether you have a family history of breast
cancer and about results of any mammograms.
It is important for you to provide complete
information.
There
is no scientific evidence that breast
augmentation increases the risk of breast
cancer. The presence of breast implants,
however, makes it more technically difficult
to take and read mammograms. This may
be a special consideration for women who
perhaps are at higher risk for breast
cancer because of their family history
or other reasons. Placement of the implant
underneath the pectoral muscle may interfere
less with mammographic examination, but
other factors may also need to be considered
with regard to implant placement. Your
plastic surgeon will discuss this with
you. If you are planning to lose a significant
amount of weight, be sure to tell your plastic surgeon. He or she may recommend
that you stabilize your weight prior to
undergoing surgery. If you think that
you may want to become pregnant in the
future, you should mention this to your
surgeon. Pregnancy can alter breast size
in an unpredictable way and could affect
the long-term results of your breast augmentation.
There is no evidence that breast implants
will affect pregnancy or your ability
to breast-feed, but if you have questions
about these matters, you should ask your
plastic surgeon.
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Your
Surgical Experience
The
goal of your plastic surgeon and the entire
staff is to make your surgical experience
as easy and comfortable for you as possible.
How
should I prepare for surgery?
Following
breast augmentation, you will still be
able to perform breast self-examination.
If you are a smoker, you will be asked
to stop smoking well in advance of surgery.
Aspirin and certain anti-inflammatory
drugs can cause increased bleeding, so
you should avoid taking these medications
for a period of time before surgery. Your
surgeon will provide you with additional
preoperative instructions.
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| Breast augmentation is usually performed
on an inpatient basis. Be sure to arrange
for someone to look after you following
surgery and to stay with you at least
the first night following surgery. |
What
will the day of surgery be like?
Your
breast augmentation surgery will be performed
in a hospital.
Medications are administered for your
comfort during the surgical procedure. When surgery is completed,
you will be taken into a recovery area
where you will continue to be closely
monitored.
Your breasts will be wrapped
in gauze dressings or a surgical bra.
You may be permitted to go home after
a day.
How
will I look and feel initially?
A
day or two after surgery, you should be
up and about. Any dressings will be removed
within several days, and you may be instructed
to wear a support bra. Your plastic surgeon
will probably permit you to shower between
three and seven days following surgery.
Stitches will be removed in about a week.
Some discoloration and swelling will occur
initially, but this will disappear quickly.
Most residual swelling will resolve within
a month.
When
can I resume my normal activities?
After
breast augmentation surgery, it is often
possible to return to work within just
a few days or a week, depending on your
job. Vigorous activities, especially arm
movement, may be restricted for two to
three weeks. Sexual activity should be
avoided for at least the first week following
surgery. After that, care must be taken
to be extremely gentle with your breasts
for at least the next month.
How
Breast Augmentation is performed
Individual
factors and personal preferences will
help you and your plastic surgeon to determine
your appropriate breast size, the location
of incisions, and whether the implants
will be placed on top of or underneath
the chest muscle. An incision can be made
either underneath the breast, just above
the crease, around the lower edge of the
areola or within the armpit. The implant
is placed in a pocket either directly
behind the breast tissue (right) or underneath
the pectoral muscle, which is located
between the breast tissue and chest wall.
What
type of implants will be used?
In
1992, because further studies were needed
to establish the safety of breast implants,
the Food and Drug Administration decided
that silicone gel-filled implants would
not be generally available for cosmetic
breast enlargement. Currently, women undergoing
breast augmentation receive both silicone
gel and saline-filled implants which consist
of a silicone shell filled with either
silicone gel or sterile saltwater.
New scientific data on the safety of breast
implants is rapidly being collected. In
the future, it is possible that additional
types of filler materials may become available.
Your plastic surgeon will be able to provide
you with the latest information.
Where
are the incisions placed?
Often,
an incision of less than one inch is made
underneath the breast, just above the
crease, where it is usually quite inconspicuous.
Another possible location for the incision
is around the lower edge of the areola.
A third alternative is to make a small
incision within the armpit. Once the incision
is made, the surgeon creates a pocket
into which the implant will be inserted.
This pocket is made either directly behind
the breast tissue or underneath the pectoral
muscle, which is located between the breast
tissue and chest wall.
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Understanding
Risks every
year, many thousands of women undergo
successful breast augmentation surgery;
however, anyone considering surgery should
be aware of both the benefits and risks.
I
understand that every surgical procedure
has risks, but how will I learn more so
that I can make an informed decision?
The
subject of risks and potential complications
of surgery is best discussed on a personal
basis between you and your plastic surgeon,
or with a staff member in your surgeon's
office.
Some
of the potential complications that may
be discussed with you include reactions
to anesthesia, blood accumulation that
may need to be drained surgically and
infection. Although rare, an infection
that does not subside with appropriate
treatment may require temporary removal
of the implant. Changes in nipple or breast
sensation may result from breast augmentation
surgery, although they usually are temporary.
When a breast implant is inserted, a scar
capsule forms around it as part of the
natural healing process. The capsule may
sometimes tighten and compress the implant,
causing the breast to feel firmer than
normal. Capsular contracture can occur
to varying degrees. If it is severe, it
can cause discomfort or changes in the
breast's appearance. In such cases, more
surgery may be needed to modify or remove
the scar tissue, or perhaps remove or
replace the implant.
Breast
implants are not lifetime devices and
cannot be expected to last forever. If
a saline-filled implant breaks, its contents
are harmlessly absorbed by the body within
hours. A definite change in the size of
the breast is clearly noticed. Rupture
can occur as a result of trauma to the
chest, but more commonly it occurs spontaneously
with no apparent cause.
Surgery
will be required to replace the implant,
if desired. If you are at an age when
mammographic examinations should be conducted
on a periodic basis, it will be important
for you to select a radiology technician
who is experienced in taking x-rays of
augmented breasts. Additional views of
your breasts will be required. Your plastic
surgeon, in some instances, may recommend
other types of examinations such as ultrasound
or magnetic resonance imaging. It is possible
that the presence of breast implants could
delay or hinder the early detection of
breast cancer. Some women with breast
implants have reported problems including
certain connective tissue and immune-related
diseases. Women without implants also
have these disorders, so the key question
is whether breast implants increase the
risk of developing the conditions. Several
large studies have been completed that
provide reassurance that women with breast
implants do not have a significantly increased
risk for these diseases.
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Results
of Breast Augmentation
Breast
augmentation will make your breasts fuller
and enhance their shape. You will find
it easier to wear certain styles of clothing.
Like many women who have had breast augmentation,
you may have a boost in self-confidence.
How
long will the results last?
Except
in the event of implant deflation requiring
surgical replacement with a new implant,
the results of your breast augmentation
surgery will be long lasting. However,
gravity and the effects of aging will
eventually alter the size and shape of
virtually every woman's breasts. If, after
a period of years, you become dissatisfied
with the appearance of your breasts, you
may choose to undergo a breast "lifting"
to restore their more youthful contour.
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Maintaining
a Relationship with Your Plastic Surgeon
You
will return to my office for follow-up
care at prescribed intervals, at which
time your progress will be evaluated.
I will encourage you to schedule routine
mammographic evaluations at the frequency
recommended for your age group. Please
remember that the relationship with your
plastic surgeon does not end when you
leave the operating room. If you have
questions or concerns during your recovery,
or need additional information at a later
time, you should contact your surgeon. |
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