By inserting an implant behind each breast, we 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 us if there is anything you don't understand about
the procedure.
The Ideal Candidates
Breast augmentation can enhance your appearance and your selfconfidence,
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 us.
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.
Changes After 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. The bra has to be worn day and night for one month. The bra helps the
implant to rest within the pocket and to enhance the new inframammary
fold. It has to be a sport bra with straps to regulate chest width and
shoulder height. 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.
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. I recommend not to do exercise in 10 days. You can resume your work in 3-
4 days. 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, as discussed earlier.
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.
Complications
Breast augmentation is relatively straightforward. But as with any operation,
there are risks associated with surgery and specific complications associated
with this procedure.
The most common problem, capsular contracture, occurs if the scar or
capsule around the implant begins to tighten. This squeezing of the soft
implant can cause the breast to feel hard. Capsular contracture can be
treated in several ways, and sometimes requires either removal or "scoring"
of the scar tissue, or perhaps removal or replacement of the implant.
In some cases, the implant may need to be removed for several months
until the infection clears. A new implant can then be inserted.
Some women report that their nipples become oversensitive, undersensitive,
or even numb. You may also notice small patches of numbness near your
incisions. These symptoms usually disappear within time, but may be
permanent in some patients.
There is no evidence that breast implants will affect fertility, pregnancy, or
your ability to nurse. If, however, you have nursed a baby within the year
before augmentation, you may produce milk for a few days after surgery.
This may cause some discomfort, but can be treated with medication
prescribed by your doctor.
Occasionally, breast implants may break or leak. Rupture can occur as a
result of injury or even from the normal compression and movement of your
breast and implant, causing the man-made shell to leak. If a saline-filled
implant breaks, the implant will deflate in a few hours and the salt water
will be harmlessly absorbed by the body.
If a break occurs in a gel-filled implant, however, one of two things may
occur. If the shell breaks but the scar capsule around the implant does not,
you may not detect any change.Both types of breaks may require a second
operation and replacement of the leaking implant. In some cases, it may not
be possible to remove all of the silicone gel in the breast tissue if a rupture
should occur.
A few women with breast implants have reported symptoms similar to
diseases of the immune system, such as scleroderma and other arthritis-like
conditions. These symptoms may include joint pain or swelling, fever,
fatigue, or breast pain. Research has found no clear link between silicone
breast implants and the symptoms of what doctors refer to as "connectivetissue
disorders,".
While there is no evidence that breast implants cause breast cancer, they
may change the way mammography is done to detect cancer. When you
request a routine mammogram, be sure to go to a radiology center where
technicians are experienced in the special techniques required to get a
reliable x-ray of a breast with an implant.
Breast Augmentation Techniques
PLANNING YOUR SURGERY
In your initial consultation, we 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, maybe a breast lift
is indicated.
PREPARING FOR YOUR SURGERY
We 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.
ABOUT THE OPERATION
The method of inserting and positioning your implant will depend on your
anatomy and our 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. Most of my patients choose the axillary approach, because the
scar is completely hidden and the breast tissue and areola are not disturbed.
I never do the crease incision. Howver some women prefer to have the
incision in the areola rather than in the armpit. Working through the incision, the breast tissue is lifted 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. Putting the implants behind your chest muscle may reduce the potential for
capsular contracture. Drainage tubes may be used for several days following
the surgery. 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.
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 is applied overnight and substituted for the bra before you leave
the clinic.
