Breast Augmentation

BREAST SIZE IS IMPORTANT TO MANY WOMEN. Some individuals feel that small breasts not only limit their fashion choices, but can also cause dissatisfaction with body image. Breast augmentation to increase fullness and projection of the breasts improves the balance in a woman’s figure and can enhance her self-image and self-confidence. Breast augmentation enlarges a woman’s breasts through the surgical placement of breast implants. In general, it is a cosmetic procedure strictly performed to fulfill your personal desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Implants may also be used for reconstructive purposes to restore a breast that is lost due to mastectomy, injury or for other reasons. In any case, breast implants allow women the choice of fuller, natural appearing breasts and a more balanced figure.

What is a breast augmentation?
Breast augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts. Clinically referred to as augmentation mammaplasty, the procedure is used cosmetically to:

  • Enlarge a naturally small breast, most commonly the result of heredity
  • Restore breast volume lost following pregnancy, as a result of breast-feeding or due to weight loss
  • Achieve better symmetry when breasts are moderately disproportionate in size and shape

Breast augmentation does not however correct sagging breasts. In cases where a woman desires to enhance breast fullness and at the same time improve the position and shape of sagging breasts, a breast lift may be performed in conjunction with breast augmentation.

Breast augmentation is a highly individualized procedure – one that you should choose to undergo to fulfill your own desire for enhanced breast size, not the desire of others. Permanent breast enhancement can only be achieved surgically. There is currently no medical treatment of any kind for breast enhancement with the proven results and satisfaction of breast augmentation.

Adult woman of any age can benefit from breast augmentation to enhance small breast size or restore fullness. However it is recommended that breasts be fully developed prior to breast augmentation. You should also be aware that breast augmentation does not generally interfere with a woman’s ability to breastfeed.

A woman who is motivated by her own personal desire to enhance breast contour is most likely to be satisfied with the results of breast augmentation surgery. Good candidates are defined as:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for improving their body image

Where do I begin?
A consultation with your plastic surgeon is the first step to learn how breast augmentation can enhance your breasts’ appearance and improve your body image. A consultation is designed to fully educate you about breast augmentation in a non-pressured environment and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The options available in breast augmentation surgery
  • The likely outcomes of breast augmentation and any risks or potential complications
  • The course of treatment recommended by your plastic surgeon

Your plastic surgeon will also answer your questions.

Evaluation
Overall health and personal outlook can greatly impact the outcome of breast augmentation surgery. These will be carefully evaluated in consultation with your plastic surgeon. The success of your procedure, safety and overall satisfaction require that you:

  • Honestly share your expectations
  • Fully disclose health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs
  • Be candid about any history of breast cancer in your family and your personal breast health
  • Commit to precisely following all of your plastic surgeon’s instructions

Safety
By making the decision to consult with your plastic surgeon and following all the instructions given, you are taking an important step in helping to assure your safety.

Your plastic surgeon is certified by The American Board of Plastic Surgery’ or The Royal College of Physicians and Surgeons of Canada’. This certification designates surgeons who are specifically trained in plastic surgery of the face and entire body.

My breast augmentation
Your plastic surgeon performs breast augmentation using implants made of medical grade, biocompatible, textured or smooth silicone shells filled with sterile saline solution. Should the implant rupture or leak, the saline is safely absorbed by the body and poses no health hazard. Implants may be pre-filled prior to placement, or slowly filled at the time of surgery through a self-sealing valve. Implant placement, type and size will be determined based on your breast anatomy, body type and desired increase in size, as well as your plastic surgeon’s judgment. Implant manufacturers occasionally introduce new styles and types of implants; there may be additional options available to you.

Breast implants have not been shown to impair breast health. Careful review of scientific research by independent groups such as the National Academy of Sciences Institute of Medicine (IOM) has found no proven link between breast implants and auto-immune or other systemic diseases in women. Implants can, however, create subtle or more noticeable changes in the look and feel of your breasts. Capsular contracture, a condition that causes the naturally-forming scar tissue around a breast implant to contract, occurs in a variable percentage of patients and can make the breast feel firmer than normal. While this condition can be addressed surgically, correction is not always permanent.

You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of a woman’s lifetime. Breast augmentation requires maintenance over time, including regular examinations for breast health and to evaluate the condition of your implants.

A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison. Following the procedure, mammography is technically more difficult. Obtaining the best possible results requires specialized techniques and additional views. You must be candid about your implants when undergoing any diagnostic breast exam.

Preparing for surgery
Your plastic surgeon will carefully explain your breast augmentation procedure. Prior to surgery, you will be given specific instructions that may include:

  • Pre-surgical considerations, diagnostic testing and medications
  • Day of surgery instructions and medications
  • Specific information related to the use of anesthesia
  • Postoperative care and follow-up

In addition, you will be asked to sign consent forms to assure your plastic surgeon that you fully understand the procedure you will undergo and any potential risks or complications.

Possible risks of breast augmentation include bleeding, infection or poor healing of incisions and changes in nipple or breast sensation. Capsular contracture, implant leakage or rupture, or wrinkling of the skin over the implant is also possible and may require a second procedure. All surgery carries risks associated with anesthesia. These and additional risks will be discussed prior to your consent.

It is important to have all your questions answered and it is natural to feel some anxiety about surgery. Discuss these feelings with your plastic surgeon.

What to expect
A brow lift may be performed in your plastic surgeon’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital. The decision for anesthesia will be based on the requirements of your specific procedure and considerations of patient and surgeon preference. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.

Following surgery
Once your procedure is completed, dressing or bandages may be applied to your incisions, and an elastic bandage or support bra will minimize swelling and support the breasts as they heal. Before being released, you and an accompanying family member, friend or caregiver will be given specific instructions that may include:

  • How to care for the breasts following surgery
  • Medications to apply or take orally to aid healing and reduce the risk of infection
  • Specific changes at the surgical site or in overall health
  • When to follow-up with your plastic surgeon

Progress and healing
Initial healing may include swelling and discomfort at the incision sites and in breast tissue overall. Discomfort is common and can be controlled with medication. A support bra may be recommended around the clock for the first week or two. It is important to cleanse the incision sites and apply any ointment as directed. Follow all instructions carefully; this is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready, usually within a day or two of surgery.

Initial wound healing may take 5 to 10 days, at which time any sutures will be removed. You will be ready to return to work and normal activity at this time, if you feel comfortable, so long as you do not engage in any heavy lifting or vigorous exercise. Intimate contact with breasts may resume when healing is more fully completed, usually within 4 to 6 weeks.

Healing will continue for several weeks as swelling resolves, implant position settles and incision lines continue to refine. Incision lines are permanent, although inconspicuously located. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

Results and outlook
The results of breast augmentation are immediately visible. Final results appear gradually over the next few weeks as swelling resolves and breast size and shape settles. Incision lines typically will continue to fade over the next year.

Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. However, your new enhanced breast contour and the freedom to wear the clothes you enjoy without the need for padded bras should bring you added self-confidence whether at the beach or in the boardroom.

Your surgeon, your choice
Choosing to have cosmetic or reconstructive plastic surgery is an important decision; so is selecting a plastic surgeon. Consider these important guidelines:

BOARD CERTIFICATION – Not all physicians who perform plastic surgery or who use the title plastic surgeon are boardcertified in plastic surgery.

The American Board of Plastic Surgery® (ABPS) and The Royal College of Physicians and Surgeons of Canada® certify physicians in plastic surgery of the face and entire body. To be certified by either board, a plastic surgeon must:

  • Graduate from an accredited medical school
  • Complete a minimum of five years of surgical training following medical school, including an accredited plastic surgery residency program
  • Pass comprehensive written and oral exams

PRIVILEGES -Your surgeon should have operating privileges at an accredited, local hospital for the same procedure you plan to have performed – even if that surgeon suggests your procedure be performed in an accredited office-based surgical facility or at an ambulatory surgery center.

Breast augmentation requires surgical placement of breast implants to enhance breast size. The most common incisions include an inframammary incision (near the crease under the breast), an axillary incision (in the underarm area), or a periareolar incision placed at the edge of the areola (the pigmented skin surrounding the nipple). Incision patterns vary based on the type of implant, degree of enlargement desired, patient anatomy, and patient and surgeon preference.
Through the incisions, a pocket is created either directly behind the breast tissue (submammary or subglandular placement) or beneath the pectoral muscle and on top of the chest wall (submuscular placement). The implant is positioned within this pocket and incisions are closed with layered, non-removable sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.
The results of breast augmentation are immediately visible. Over time, post-surgical swelling will resolve and incision lines will refine. Satisfaction with your enhanced body image should continue to grow as you experience the fulfillment of your goal for fuller breasts.