Breast Augmentation

Cosmetic breast surgery, or breast augmentation, is a successful way to enhance the breasts, producing a larger and fuller bust. The goal is to augment the breasts for natural-looking, enhanced results. Either saline or silicone gel implants can be used for enhancement.

During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance.

Because breast enlargement surgery is a highly personal decision, you'll want to take time to discuss all of your concerns and desires, including your desired breast size. Show your doctor breast augmentation photos to help him/her determine which breast implant size will best achieve your preferred results.

He/she will also explain the different options available to you, including incision type, location of the implant, type of breast implant, and whether a breast lift may 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 request to view breast augmentation before and after photos of the doctor's recent patients. 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.

The breast augmentation procedure consists of making an incision, creating a pocket in the chest/breast area, and placing a breast implant.

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

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

Both silicone gel and saline breast implants can be used to augment the breasts. Silicone breast implants are comprised of a cohesive gel, and saline of a saltwater solution. Each of these types of breast implants has its benefits, and the ones that you select will depend on your preference, your body, and the doctor's recommendation.

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.

Breast augmentation 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.

Most breast enhancement 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.

Breast augmentation 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 can be somewhat relieved by pain medications.

When you wake up you will feel tired, sore, and stiff. It is important to take the medication prescribed to you by your doctor.

In spite of the initial discomfort that accompanies surgical breast enhancements, most women report that the soreness they experience is well-worth their results.

Your breasts will be wrapped with gauze bandages as well as a tighter bandage for protection and support after breast implant surgery. You also may have drainage tubes coming out of the incision for several days post op breast augmentation, to help drain some of the excess fluid.

Someone will need to drive you home after surgery, 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.

• 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.

Breast augmentation notably increases the size of the breasts, and can increase body proportion. Clothes may fit better, and you may also experience an increase in confidence and self-esteem.

Breast augmentation makes the breasts larger for the life of the implant. Remember, larger breasts can begin to sag faster than smaller breasts, and augmented breasts can do this as well. So it is possible that you may require surgery in later years to correct sagging if you choose to have large implants.

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

In general, the best candidates for breast enhancement surgery are:

• 18 years of age or older (only in rare cases will teen breast augmentation be performed)
• 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 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.

Some of the more common possible breast augmentation risks include: postoperative infection, hematoma (a blood clot in the breast tissue requiring evacuation during a subsequent surgical procedure), and interference with mammogram readings.

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 on the breast, 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 breast pain. Although research has not found conclusive evidence correlating breast implants with these symptoms, further studies have been requested by the FDA.

To ensure that you are not a statistic of breast augmentation gone wrong, make sure that you select a competent plastic surgeon highly-trained and qualified to perform breast surgery. That said, be sure to discuss your chance of experiencing any of the above breast implant problems during a consultation.

A detailed description of the complications, along with further readings can be found at www.fda.gov/cdrh/breastimplants/breast_implant_risks_brochure.html.

It is critical to select a physician who is adequately trained and experienced in breast augmentation procedures. See our Physician Locator feature to find a surgeon in your area, including detailed profile information for many of the listed doctors.

1. How long have you been performing breast augmentation surgery?
2. What is the total number of augmentation procedures that you have performed?
3. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
4. What breast implant incision, location, and type do your recommend? And, is a breast lift necessary, in addition to augmentation?
5. Please explain the risks associated with the procedure, including: capsular contracture, infection, nipple sensitivity, rippling, rupture, and symptoms of immune system disorders.
6. What is the percent of patients who experienced any of the aforementioned risks?
7. In the event that a second procedure is needed, does the original cost cover the additional expense?
8. Is there a warranty on the implants?
9. Where will the procedure be performed?
10. Who will be assisting you during the surgery? What are their qualifications? Will the surgeon perform the entire surgery?
11. What type of anesthesia will be used, and who will administer it?
12. Will you provide references of patients who have had the same procedure? (The doctor should have a list of references available.)
13. Will you provide before and after breast augmentation pictures of your past patients?
14. What are the guidelines and recommendations for selecting augmentation breast sizes?
15. Can I observe the exact procedure I am having before I decide to have the surgery? (Either on videotape, or ask to view one in real life.)
16. What should I expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
17. How will the breast implants affect the way my routine mammograms are performed?
18. Do you offer patient financing?

1. How long has the surgeon been doing breast augmentations?
2. What is the total number of augmentation 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 breast lift in addition to augmentation.)
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 breast 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 breast implants affect the way your routine mammograms are performed?
20. Do you offer patient financing?

• 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 during your menstrual period.

With iEnhance.com's information on patient financing options, money no longer has to be the barrier between you and your new image. By filling out our online application you can quickly learn if you qualify for breast implant financing.

Please review the following articles for more information on this procedure:

• Breast Augmentation: A.J.`s Story
• The Laser Bra
• Modern Approaches to Breast Asymmetry

• Dr. Blome - Columbus, OH
• Dr. Taranow - New York, NY
• Dr. Hall - Leawood, KS
• Dr. Jonov - Lynwood(Seattle), WA
• Plastic Surgery Specialists - Greenbrae, CA
• Dr. Koch - Buffalo, NY

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.

At iEnhance, find information on top plastic surgery procedures such as breast augmentation, liposuction, facelift, tummy tuck, BOTOX ® Cosmetic, eyelid surgery, thermage, rhinoplasty; as well as teeth whitening, porcelain veneers, and other cosmetic dentistry procedures. Locate a plastic surgeon, cosmetic surgeon, cosmetic dentist, or specialist today!