Breast enlargement is performed in people who wanted bigger and
differently shaped breasts. Augmentation may also be used as part
of breast reconstruction after masectomy. Augmentation is achieved
via the insertion of
breast implants — saline
filled plastic bags — behind the breasts. In the past, silicone
implants were used because of a more natural look and feel. However,
their use has become controversial and now they are used only in
the context of research studies.
The decision for a woman to seek augmentation of the breast is a
very personal one. Most women seeking breast augmentation have a
positive body image yet believe that their breast size is not consistent
or in harmony with their overall body physique. Reasons for seeking
breast enlargement include failure of the breast to develop fully,
breast volume, shape asymmetry and for breast fullness lost following
pregnancy or breast feeding. The goal of an aesthetic breast augmentation
is to achieve a proportional and natural appearance. Breast tissue
is not altered by a breast enlarging procedure.
How is a breast augmentation performed?
Breast augmentation can be performed under local or general anesthesia
as an inpatient or outpatient. Surgery length varies depending on
the type of and number of implants and how it is placed. The location
of the incisions for placing the implants varies. Periareolar incisions
(incisions made around the areola) are usually well concealed after
healing but may lead to problems with breast feeding. Transaxillary
incisions are made under the arm and are visible after healing.
However, this approach rarely interferes with breast feeding. An
inframammary incision is made under the breast in the breast fold
(where the chest wall meets the breast) and is visible after surgery.
However, this approach usually allows for successful breast feeding.
The implant is placed either between the chest wall and the pectoralis
muscle (that sits behind the breast) or behind the breast tissue,
in front of the pectoralis muscle. There are many kinds of implants
and the best one for you should be discussed with your surgeon.
After the implant is in place, the incisions are sutured. More Breast Augmentation Facts...
What is the recovery period like after a breast augmentation?
Short term recovery depends in part on the type of anesthesia used.
Recovery from general anesthesia may involve nausea and vomiting,
shivering (called rigors) and disorientation. Recovery from local
anesthesia is usually easier. Immediately after surgery, your breasts
will be sore and swollen. You will have bandages, sometimes a drain
(to drain excess fluid), and compression garmets. You will need
to wear a supportive bra twenty four hours a day for several weeks.
Your surgeon may recommend that you ice your breasts for the first
two days to reduce bruising and swelling. Drainage of fluid and
crusting is normal. Your surgeon will instruct you on proper wound
care. Drains are usually removed at your first follow up visit a
few days after surgery. Depending on the kind of augmentation performed,
pain can be significant and pain medications will be prescribed,
as well as antibiotics. Swelling of your breasts and surrounding
tissues is normal. You should be up the first day after surgery
but most patients do not return to work for about a week. However,
individual healing can vary, making it difficult to predict exactly
when you can return to normal activities. Activities such as lifting
your arms above your head and heavy lifting should be avoided in
the first few weeks. Strenuous activities, including sexual activities,
should be avoided for several weeks to months, depending on how
the healing is progressing. Rushing the recovery process can actually
slow healing time. More Breast Augmentation Facts...
What are the risks with a breast augmentation?
There are multiple risks associated with breast augmentation. It
is critical to understand these risks and to have realistic expectations
about the outcome of your surgery. Only through an in-depth discussion
with surgeon will you be able to understand the risks, benefits, and
expected outcomes. Nipple necrosis leading to loss of the areola and/or
nipple is a rare but serious side effect when the incision is made
near the areola. Nipple necrosis is caused by impaired blood flow
to the nipple and areola after surgery. The risk of this complication
is higher in smokers. Asymmetry of the size and shape of the breast
is a common complication. It is impossible to create perfect symmetry
and small differences should be expected. Inability to breast feed
after can occur but many of the procedures used today usually do not
affect breast feeding. The risk varies with the type of surgery. Breast
augmentation can lead to changes in the skin sensitivity because removal
of the skin involves cutting through nerves that are in the skin.
Loss of sensation is usually minimal and returns over the course of
a few months. Fluid accumulation in the breast, called a seroma, can
occur after breast augmentation. Seromas can be drained and usually
resolve within a few weeks. Accumulation of blood in the skin after
surgery is called a hematoma and usually must be removed surgically.
Hematomas can increase the risk of infection and may increase the
scarring. It is important that you stop all over the counter, herbal,
and prescription medications and vitamins that affect bleeding to
decrease your risk of hematoma formation. Scarring occurs with any
surgery and final scar appearance cannot be predicted. A scar from
vary from a nearly invisible line to a large, raised, discolored scar.
Unattractive scars can be treated through medical or surgical intervention.
Infection is always a risk of surgery. You may be given antibiotics
after the surgery and post operative wound care is important as well.
After the surgery, your breasts may stretch and change in ways that
are unattractive. Furthermore, after the implant is inserted, a scar
forms around the implant which can cause the breast to feel firmer
than normal. In extreme cases, the scar formation distorts the whole
breast and the implant and/or scar may need to be removed. Breast
implants are not expected to last forever. For example, the implant
can break, leading to deflation of the breast. The fluid from the
implant is absorbed by the body and the implant will need to be replaced.
The presence of implants may affect breast cancer screening. Sometimes,
tests other than mammography are ordered (i.e. MRI or ultrasound)
to better visualize breast tissue after augmentation. Some women who
have silicone breast implants have developed autoimmune diseases.
However, large studies have shown that the risk in women with breast
implants appears to be the same as the risk in women without implants.
More Breast Augmentation Facts...
How much do breast augmentations cost?
According to the American Society of Plastic Surgeons, the average
breast augmentation costs in 2003 was $3,360. Breast augmentation
costs vary from doctor to doctor depending on other fees such as anesthesia
and operating fees. More Breast Augmentation Facts...
Breast Augmentation Related Articles
Disclaimer:
This information is intended only as an introduction to this procedure.
This information should not be used to determine whether you will
have the procedure performed nor does it guarantee results of your
elective surgery. Further details regarding surgical standards and
procedures should be discussed with your physician.
By OnlineSurgery Staff
Updated: May 29, 2007
Cosmetic/Plastic Surgery
