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Breast Augmentation

 Breast Augmentation Surgery Information, Procedures and Photos provided by PlasticSurgery.com. Read about breast implants, breast asymmetry or breast lift surgery.

breast augmentation, enlargement, enhancementBreast Augmentation is a surgery designed to enlarge the breasts. This surgery is frequently sought by women who are unhappy with the small size of their breasts, sometimes after pregnancy or weight loss.

If you're considering breast augmentation, the following information will provide you with a good introduction to the procedure. For more detailed information about how this plastic surgery procedure may help you, we recommend that you consult a plastic surgeon who is board certified or has completed a residency program that includes instruction in this procedure.
 
  • What are some of the most common benefits of breast augmentation?
  • What will happen at the initial consultation?
  • How is breast augmentation done?
  • How long does the surgery take?
  • Do I have to stay in the hospital?
  • How much pain is there?
  • What can I expect after surgery?
  • What is the recovery period like?
  • What is the long-term outcome like for most people?
  • How long do the results last?
  • Ideal candidate:
  • Possible complications:
  • Risks:
  • Costs:
  • Choosing a doctor:
  • Questions to ask your doctor:
  • Be sure to:
  • How do I finance this procedure?
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     What are some of the most common benefits of breast augmentation?
    This plastic surgery procedure is usually quite successful at making the breasts larger and fuller. The results may not look exactly like “natural” larger breasts; implanted breasts tend to be a bit more round and less saggy than natural breasts of the same size. Most women find these differences to be an improvement.
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     What will happen at the initial consultation?
    During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Because this is a highly personal decision, you’ll want to take time to discuss all of your concerns and desires, including how large you want your breasts to be.

    Show your doctor pictures of breast sizes you like. He/she will be able to determine which size implants will achieve your preferred size. He/she will also explain the different options available to you, including incision type, location of the implant, type of implant, and whether a breast lift might also be beneficial.

    Your doctor should also explain the anesthesia he/she will be using during your procedure. You should tell him/her about any medications you currently are taking, and any health conditions you have. Be sure to ask all the questions you have about the surgery, and ask to see photos of the doctor’s recent patients, before and after surgery. Also ask for, and follow up on, patient references.

    Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to Ask Your Doctor below.
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     How is breast augmentation done?
    Breast augmentation consists of making an incision, lifting the breast tissue, creating a pocket in the chest area, and placing an envelope containing a soft, natural feeling implant material underneath.

    An incision may be made in any one of the following places: the crease below the breast, around the areola, under the armpit, or, very rarely, through the navel.

    The implants can be placed either under the chest muscle or directly under the busts. Placement considerations include the anatomy of your busts, soreness after surgery, exercise activities (upper body strength and conditioning sports such as weightlifting, tennis, volleyball and others) and interference with mammograms.

    Although several implants are available at the present time, the implant being used for nearly all breast augmentation surgeries is made of a silicone rubber sack filled with a saline solution. Under certain conditions, such as reconstructive surgery, silicone gel implants can be used instead. Silicone gel filled implants are only offered on a limited basis, under approved studies, due to questions about silicone implants correlated to autoimmune diseases. For further information navigate to the following sites: http://www.fda.gov/cdrh/breastimplants/indexbip.html
    McGhan Medical

    New to the market are saline filled adjustable implants. These are similar to the standard saline filled implants with the addition of a small connector tube through which the doctor can adjust the size via injection. If you decide after the procedure is performed that you want to change the size of your chest, the doctor can simply make an injection under the skin of the breast to where the end of the tube is located, and either drain saline fluid from, or increase the saline fluid in the implant. This implant has the disadvantage of requiring a second incision (and scar) to remove the injection port in an additional surgical procedure. Not all surgeons offer this type of implant. Your doctor will discuss the choice of implant, and review with you the size changes that are possible with the operation.

    Most likely, the anesthesia you receive will be general, although some doctors use a local anesthetic along with a sedative. Anesthesia type should be discussed with your doctor during the initial consultation.
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     How long does the surgery take?
    Breast augmentation surgery usually takes about one to three hours to complete. The length of the procedure varies according to the technique used, the placement of the implants, the patient’s anatomy, and type of anesthesia used.
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     Do I have to stay in the hospital?
    Probably not. Most breast augmentation surgery is performed in a surgical suite as an outpatient procedure; you’ll be able to return home within a few hours of the surgery.
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     How much pain is there?
    This plastic procedure stretches the tissues, and can be painful. This is especially true when the implants are placed under the muscle and in young women who have never had children. The pain is greatest within the first 48 hours, but improves with each day and is somewhat relieved by pain medications.. In spite of the initial discomfort, most women report that they are very satisfied with the results of the surgery.

    When you wake up you will feel tired, sore, and stiff. It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.

    Your surgeon may prescribe an antibiotic and an anti-inflammatory medication to be taken after the surgery. It is a good idea to have these prescriptions filled beforehand.
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     What can I expect after surgery?
    Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support. You also may have drainage tubes coming out of the incision for several days, to help drain some of the excess fluid.

    It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.
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     What is the recovery period like?
    Your scars will be pink for several weeks. After several months they will begin to fade. It is critical that you review post-procedure care with your doctor. Following his/her instructions carefully will help ensure you have a speedy, healthy recovery. Also keep in mind that:
    • Rest is important to the healing process, so do it as much as possible following your procedure. Drink plenty of fluids, and be sure to take the doctor's prescribed medications.
    • For at least 3-5 days, you should try to keep arm extension to a minimal. Elbows should not be raised higher than the armpit. The tissues will heal more quickly if you avoid stretching and separating muscle/tissue surrounding the breast implants.
    • Most likely, you will be able to resume calm, quiet work within a few days of your surgery. You should still avoid physical exertion for several weeks, depending on the advice of your doctor.
    • After several days, the gauze dressing will be removed. You may be required to wear a support bra to help your breasts form and maintain a pleasing, balanced shape. You may or may not be able to shower, depending on where your stitches are.
    • The stitches will come out within a week to ten days, but swelling may continue, gradually subsiding over several weeks. With the swelling, your breasts may seem hard and unnatural, but eventually they should soften to a more natural feel.
    • You will probably be able to resume exercise and normal physical activities within a month or two, when the soreness has subsided. Recovery varies from patient to patient and depends upon the technique, type of implant, and site of placement that the doctor uses, as well as the level of activities in your daily routine. Ask your doctor for more specific information.
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     What is the long-term outcome like for most people?
    This plastic surgery procedure reliably increases the size as well as possibly balancing body proportions. Clothes may fit better, and you may also experience an increase in confidence and self-esteem.
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     How long do the results last?
    Enhancement makes the breasts larger for the life of the implant. Remember, also that larger breasts sag faster than smaller breasts, and augmented breasts do this as well. It is possible that you may require surgery in later years to correct sagging if you choose to have large implants. Gravity, unfortunately has no exceptions. A study by Scott Spear, M.D. gives some information about how long breast implants last. This study can be found at www.plastic.org/info/HowLongDoSalineImplantsLast.html
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     Ideal candidate:
    In general, the best candidates for breast augmentation are:
    • 18 years of age or older
    • Not currently pregnant or nursing
    • In good physical health
    • Psychologically stable
    • Wanting to improve their appearance
    • Realistic in their expectations
    • Having this surgery for the first time
    The above is only a partial list of the criteria that your plastic surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate for breast augmentation.
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     Possible complications:
    Some of the more common possible complications include postoperative infection, hematoma (a blood clot in the breast tissue requiring evacuation of the blood clot during a subsequent surgical procedure); implant rupture, deflation or leakage; capsular contracture, calcium deposits, changes in nipple or breast sensation, interference with mammogram readings, shifting of the implant. A detailed description of the complications along with further readings can be found at www.fda.gov/oca/breastimplants/bitac.html.
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     Risks:
    There are several concerns regarding breast augmentation: the surgery itself, the implants, breast cancer, and the risk of anesthesia. The risks involved with breast augmentation have received a lot of attention, but neither cancer nor arthritis have been shown to be caused by breast implants. All operations carry some risk and the possibility of complications can include (but are not limited to) infection, unsatisfactory results, excessive bleeding, adverse reaction to anesthesia, and the need for second or sometimes third procedures.

    We recommend you read the specific complications outlined in the Food and Drug Administration Infomation for Women Considering Saline-Filled Breast Implants(courtesy of McGhan Medical Corporation and FDA). To obtain this information, read the online bulletin or contact the McGhan Medical Corporation, F.D.A. Consumer Information Line at (800) 532-4440 or your surgeon. There is no known association of breast implants with breast cancer in human beings, and in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. (Breast implant type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.)

    Other side effects specific to breast augmentation include:
    • capsular contracture: occurs when the scar or area around the implant begins to tighten, causing the breast to feel hard.
    • nipple sensitivity or loss in sensitivity: usually disappears after several weeks, but for some this is permanent.
    • rippling: indentations, often caused when the implant moves.
    • rupture: when the breast implants tear and/or leak. This may require a second operation to replace the implant.
    • symptoms of immune system disorders: some women have reported having symptoms such as joint pain swelling, fever, fatigue, or pain. Although research has not found conclusive evidence correlating breast implants with these symptoms, further studies have been requested by the FDA.
    Many times patients will not be aware of complications until days or months after the procedure has been performed.
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     Costs:
    Costs for this procedure vary, depending on the doctor, the location, technique used and the difficulty of the specific case. The national average of 1999 surgeon fees for breast augmentation was $3,142 (Source: The American Society of Aesthetic Plastic Surgery). Regional averages: New England states: $3,949; middle Atlantic states: $2,820; north central states: $2,936; south central states: $2,739; and mountain/Pacific states: $3,248. These fees do not include anesthesia, operating room facility, hospital stay and other related expenses.

    In most cases, health insurance policies do not cover the cost of this plastic surgery procedure.

    Use our payment calculator to see what your monthly payments might be if you financed this procedure.

    Apply now
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     Choosing a doctor:
    It is critical to select a physician who is adequately trained and experienced in breast augmentation procedures. We strongly recommend that you consider choosing a surgeon who is board certified by the American Board of Medical Specialties. See our Physician Locator feature to find a surgeon in your area, including detailed profile information for many of the listed doctors. Also read How to Select a Plastic Surgeonfor a more detailed discussion on choosing the right doctor.
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     Questions to ask your doctor:
    1. How long has the surgeon been doing breast surgery?
    2. What is the total number of procedures that the doctor has performed?
    3. Has the plastic surgeon ever had his/her malpractice insurance coverage denied, revoked, suspended? (No)
    4. Does the FDA approve the implant the doctor will be using? (Yes)
    5. What procedure is the doctor recommending and why? (Discuss different incision types, location of the implant, type of implant, and whether the doctor recommends a lift in addition to enhancement.)
    6. Please explain the risks associated with the procedure, including: capsular contracture, infection, nipple sensitivity, rippling, rupture, symptoms of immune system disorders (see Risks section for detailed explanations.)
    7. Percent of patients who experienced any of the aforementioned risks?
    8. In the event that a second procedure is needed, does the original cost cover the additional expense?
    9. Is there a warranty on the implants?
    10. Where will the procedure be performed?
    11. Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
    12. What type of anesthesia will be used, and who will administer it?
    13. Will the doctor provide references of patients who have had the same procedure? (The doctor should have a list of references available.)
    14. Will the doctor provide before/after photographs of breast augmentations he/she has performed?
    15. What are the guidelines and recommendations for selecting the implant size?
    16. Can you observe the exact procedure you are having before you decide to have the surgery? (Yes, either on videotape or ask to view one in real life.)
    17. What should you expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
    18. Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
    19. How will the implants affect the way your routine mammograms are performed?
    20. Do you offer patient financing?
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     Be sure to:
    • Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
    • Tell your doctor about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription)
    • Carefully follow any instructions your surgeon gives you regarding eating and drinking, smoking, and vitamins.
    • Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
    • Arrange for someone to drive you home after surgery.
    • Try to schedule surgery at a time other than your menstrual period.

    The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.
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     How do I finance this procedure?
    Did you know that 29% of all Americans have considered having an elective procedure? Of those, 60% would schedule a procedure immediately if financing was available. With iEnhance's patient financing options, money no longer has to be the barrier between you and your new image. By filling out our on-line application you can qualify for a loan in as little as 30 seconds.
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     Related Articles
    Please review the following articles for more information on this procedure.
  • Making the Right Choice
  • Enhancement Procedures to Fit Your Needs
  • Modern Approaches to Breast Asymmetry
  • Best Reduction Method for Women of Color
  • Reconstruction After Mastectomy
  • Reduction
  • Modern Approaches to Asymmetry
  • The best candidates for enlargement
  • The best candidates for a lift
  • Short Scar Reduction and Lift Surgery
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