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If you're
considering breast augmentation . . .
Breast augmentation, technically known as
augmentation mammoplasty, is a surgical procedure
to enhance the size and shape of a woman's
breast for a number of reasons:
- To enhance
the body contour of a woman who, for personal
reasons, feels her breast size is too
small.
- To correct
a reduction in breast volume after pregnancy.
- To balance
a difference in breast size.
- As a reconstructive
technique following breast surgery.
By inserting an
implant behind each breast, surgeons are able
to increase a woman's bustline by one or more
bra cup sizes. If you're considering breast
augmentation, this will give you a basic understanding
of the procedure--when it can help, how it's
performed, and what results you can expect.
It can't answer all of your questions, since
a lot depends on your individual circumstances.
Please ask your surgeon if there is anything
you don't understand about the procedure.
The best
candidates for breast augmentation
Breast augmentation can enhance your appearance
and your self-confidence, but it won't necessarily
change your looks to match your ideal, or
cause other people to treat you differently.
Before you decide to have surgery, think carefully
about your expectations and discuss them with
your surgeon.
The best candidates
for breast augmentation are women who are
looking for improvement, not perfection, in
the way they look. If you're physically healthy
and realistic in your expectations, you may
be a good candidate.
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Breast
augmentation is usually done to balance
a difference in breast size, to improve
body contour, or as a reconstructive
technique following surgery. |
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Types
of implants
A breast implant is a silicone shell filled
with either silicone gel or a salt-water solution
known as saline.
Because of concerns
that there is insufficient information demonstrating
the safety of silicone gel-filled breast implants,
the Food & Drug Administration (FDA) has
determined that new gel-filled implants, at
the present time, should be available only
to women participating in approved studies.
Some women requiring replacement of the implants
may also be eligible to participate in the
study (we are part of such study and have
the silicone implant available for eligible
patients).
Saline-filled
implants continue to be available to breast
augmentation patients on an unrestricted basis,
pending further FDA review. You should ask
your doctor more about the specifics of the
FDA decisions. (Above guidelines are current
as of July 1992.)
All surgery
carries some uncertainty and risk
Breast augmentation is relatively straightforward.
But as with any operation, there are risks
associated with surgery and specific complications
associated with this procedure. These risks
will be discussed by your surgeon and staff
during your initial consultation.
While the majority
of women do not experience these complications,
you should discuss each of them with your
physician to make sure you understand the
risks and consequences of breast augmentation.
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Planning
your surgery
In your initial consultation, your surgeon
will evaluate your health and explain which
surgical techniques are most appropriate for
you, based on the condition of your breasts
and skin tone. If your breasts are sagging,
your doctor may also recommend a breast lift.
Be sure to discuss
your expectations frankly with your surgeon.
He or she should be equally frank with you,
describing your alternatives and the risks
and limitations of each. You may want to ask
your surgeon for a copy of the manufacturer's
insert that comes with the implant he or she
will use -- just so you are fully informed
about it. And, be sure to tell your surgeon
if you smoke, and if you're taking any medications,
vitamins, or other drugs.
Your surgeon
should also explain the type of anesthesia
to be used, the type of facility where the
surgery will be performed, and the costs involved.
Because most insurance companies do not consider
breast augmentation to be medically necessary,
carriers generally do not cover the cost of
this procedure.
Preparing
for your surgery
Your surgeon will give you instructions to
prepare for surgery, including guidelines
on eating and drinking, smoking, and taking
or avoiding certain vitamins and medications.
While making
preparations, be sure to arrange for someone
to drive you home after your surgery and to
help you out for a few days, if needed.
Where
your surgery will be performed
Your surgery will be performed in our
accredited operating room.
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Types of
anesthesia
Breast augmentation can be performed with
a general anesthesia, so you'll sleep through
the entire operation. Some surgeons may use
a local anesthesia, combined with a sedative
to make you drowsy, so you'll be relaxed but
awake.
The
surgery
The method of inserting and positioning your
implant will depend on your anatomy and your
surgeon's recommendation. The incision can
be made either in the crease where the breast
meets the chest, around the areola (the dark
skin surrounding the nipple), or in the armpit.
Every effort will be made to assure that the
incision is placed so resulting scars will
be as inconspicuous as possible.
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Incisions
are made to keep scars as inconspicuous
as possible, in the breast crease,
around the nipple, or in the armpit.
Breast tissue and skin is lifted to
create a pocket for each implant. |
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Working through
the incision, the surgeon will lift your breast
tissue and skin to create a pocket, either
directly behind the breast tissue or underneath
your chest wall muscle (the pectoral muscle).
The implants are then centered beneath your
nipples.
Some surgeons
believe that putting the implants behind your
chest muscle may reduce the potential for
capsular contracture. This placement may also
interfere less with breast examination by
mammogram than if the implant is placed directly
behind the breast tissue. Placement behind
the muscle however, may be more painful for
a few days after surgery than placement directly
under the breast tissue.
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The
breast implant may be inserted directly
under the breast tissue or beneath
the chest wall muscle. |
You'll want to
discuss the pros and cons of these alternatives
with your doctor before surgery to make sure
you fully understand the implications of the
procedure he or she recommends for you.
The surgery usually
takes one to two hours to complete. Stitches
are used to close the incisions, which may
also be taped for greater support. A gauze
bandage may be applied over your breasts to
help with healing.
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After
surgery, breasts appear fuller and
more natural in tone and contour.
Scars will fade with time.
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After
your surgery
You're likely to feel tired and sore for a
few days following your surgery, but you'll
be up and around in 24 to 48 hours. Most of
your discomfort can be controlled by medication
prescribed by your doctor.
Within several
days, the gauze dressings, if you have them,
will be removed, and you will continue to
wear the surgical bra for four weeks
after your surgery. You may also experience
a burning sensation in your nipples for about
two weeks, but this will subside as bruising
fades.
Your stitches
will come out in a week to 10 days, but the
swelling in your breasts may take three to
five weeks to disappear.
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Getting
back to normal
You should be able to return to work within
a few days, depending on the level of activity
required for your job.
Follow your
surgeon's advice on when to begin exercises
and normal activities. Your breasts will probably
be sensitive to direct stimulation for two
to three weeks, so you should avoid much physical
contact. After that, breast contact is fine
once your breasts are no longer sore, usually
three to four weeks after surgery.
Your scars
will be firm and pink for at least six weeks.
Then they may remain the same size for several
months, or even appear to widen. After several
months, your scars will begin to fade, although
they will never disappear completely.
Routine mammograms
should be continued after breast augmentation
for women who are in the appropriate age group,
although the mammographic technician should
use a special technique to assure that you
get a reliable reading. (see All surgery
carries some uncertainty and risk.)
Your
new look
For many women, the result of breast augmentation
can be satisfying, even exhilarating, as they
learn to appreciate their fuller appearance.
Regular examination
by your plastic surgeon and routine mammograms
for those in the appropriate age groups at
prescribed intervals will help assure that
any complications, if they occur, can be detected
early and treated.
Your decision
to have breast augmentation is a highly personal
one that not everyone will understand. The
important thing is how you feel about it.
If you've met your goals, then your surgery
is a success.
Before
and After Images
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