Breast augmentation, also known as breast enlargement, is one of the most commonly performed plastic surgery procedures in the United States. Using saline or silicone implants, breast augmentation restores volume that may have been lost following weight loss or pregnancy, giving you fuller-looking breasts and increased self-confidence. Breast augmentation does not correct severely drooping breasts; in this case, a better option may be a breast lift with or without breast augmentation.
Saline Breast Implants vs. Silicone Breast Implants
Saline breast implants are filled with sterilized salt water, and can be filled with various amounts of saline to fine-tune the firmness, shape and feel of the breast. If the implant ever leaks, the saline liquid will be absorbed by the body and expelled naturally. Silicone breast implants are filled with a silicone gel that better mimics the feel and movement of natural breast tissue. These implants are pre-made and are larger than a saline implant, requiring a larger incision. If a silicone breast implant leaks, the gel may leak into the implant cavity; since this may not be noticeable, a yearly MRI is recommended to assess the condition and integrity of the implant. Our plastic surgeon will work with you to determine which type of breast implant is best for you.
It is important to understand that implants may need to be replaced over time. The results are not permanent and changes can affect how your current implants look and feel. Weight gain or loss, age, gravity and certain hormonal factors can change the appearance of your breasts. Should any of those occur, a breast implant exchange and/or a breast lift may be considered.
Incisions Used for Breast Augmentation
Several incision options exist for breast augmentation surgery; these options include the periareolar incision, the inframammary incision, and the transaxillary incision.
The periareolar incision is made around the edge of the areola. This approach leaves the least-conspicuous scars, as they are hidden between the coloring of the areola and the breast skin. A periareolar incision may affect a woman’s ability to breastfeed in the future, as it divides the milk ducts. Nevertheless, this approach is still commonly used, as women planning to have more children are advised to postpone breast augmentation.
The inframammary incision is considered the fastest and simplest of the three incision options, involving an incision across the lower fold of the breast. This approach is ideal for patients with fuller breasts that will effectively cover the scar. The shortcoming of the inframammary incision is that scars may be noticeable when lying down.
The transaxillary incision involves an incision in the armpit through which the implants are guided to the breasts. With this option, the scars are on the armpits and not on the breasts themselves. The downside to the transaxillary incision is that the plastic surgeon is operating farther from the breasts, increasing the likelihood that the implants are improperly placed. When performed by a trained plastic surgeon, the transaxillary incision is an excellent option for breast augmentation patients who want the scars hidden on their armpits.
Candidates for Breast Augmentation
Patients considering breast augmentation must be in good overall health. Their breasts may have decreased in size and/or firmness following childbirth or weight loss, are noticeably asymmetrical, or have always been too small. Patients considering breast augmentation surgery are usually unhappy with the small size of their breasts and feel self-conscious when wearing form-fitting tops or swimwear.
Before Breast Augmentation
Before undergoing breast augmentation surgery, your plastic surgeon will examine your breasts, review your medical history, and address any concerns you may have about the procedure. Medical photographs may be taken to compare the size of your breasts before and after surgery. During the examination, the size and shape of your breasts, the location of your nipples and areolas, and other details will be noted; these details will determine the most appropriate breast implant and surgical incision for your body type. Notify your plastic surgeon of all medications you are currently taking, as some may need to be temporarily stopped before the procedure. Patients that smoke will need to stop several weeks before surgery, as it may interfere with the body’s natural healing process. Breast augmentation should be postponed if you are planning to become pregnant or lose weight, as these can unpredictably affect the size of your breasts.
Breast Augmentation Procedure
Breast augmentation is usually performed as an outpatient procedure in a hospital, ambulatory center or office-based surgical suite. Patients are typically given a combination of local anesthesia and intravenous sedation; in some cases, general anesthesia may be used. After the anesthetic has taken effect, incisions are made and the breast implants are inserted. Once the implants have been inserted, the incisions are shut with sutures in the breast tissue and surgical tape, stitches or sutures over the skin. Breast augmentation surgery generally takes one to three hours.
Recovery and Results from Breast Augmentation
The results of breast augmentation are noticeable immediately, and patients usually return home the same day as their procedure. You may experience bruising, swelling, soreness, or pain; these can be managed with painkillers and should subside within a few weeks. If non-absorbable stitches were used, they will be removed a few days after surgery. Regular activity may be resumed within a few days after breast augmentation, although physical activity should be avoided for a few weeks to give the breasts time to heal and adjust to the implants.
Risks Associated with Breast Augmentation
As with all surgical procedures, breast augmentation carries a risk of complications. These risks include adverse reactions to the anesthesia, capsular contracture, infection, and changes in nipple or breast sensation. If you are going for a mammogram, let your technician know that you have breast implants, as they may require a more detailed examination. To minimize the occurrence of complications, always choose a board-certified plastic surgeon for your procedure and follow all instructions closely.
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