Breast Augmentation

Technically called an augmentation mammaplasty, this surgical procedure enhances the size and shape of a woman's breast by inserting an implant behind the breast and increasing the bust line by one or more bra cup sizes. Most women who want this procedure, want to be one or two cup-sizes larger. The goal is to give a fuller breast, with a bit more "lift". It will correct the reduction in breast volume after pregnancy or age, and will give balance to breasts differing in size or shape.

This surgery is usually performed on an outpatient basis, and does not require an overnight hospital stay. General anesthesia is commonly used. The surgery usually lasts one to two hours. The incision is small, about 2 inches long. Drainage tubes may be used for several days following the surgery. No stitches need to be removed.

A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline. Saline-filled implants continue to be available for breast enlargement procedures. If the implant should leak and the saline is released, it can be safely absorbed by your body.

Silicone gel-filled implants are available only to select patients participating in approved studies.

There are three possible incision sites:

1. In the crease under the breast (Inframamary incision).
2. In the lower half of the areola (the colored skin around the nipple), (Periareolar incision).
3. Axila (armpit), (Transaxillary incision).

The most commonly placed incision is in the Inframamary fold. It is hidden by all clothes and is not visible when one stands without clothes. The breast tissue is minimally disturbed, and the remaining incision scar is concealed within the fold of skin under the breast. All of these incisions allow the implant to be placed either submuscular (below the chest muscle) or subglandular (between the chest muscle and the breast tissue). If the implant is placed submuscularly, one may feel more discomfort for several days longer than if it is placed in the subglandular position. A person may also have difficulty raising arms above the head until healing is complete.

As with any other surgery, there are inherent risks and complications with breast augmentation. The surgery may make part or all of the breast numb for weeks, or even as long as six months, and may decrease nipple response to sexual stimulation for several months (some women report that their nipples become oversensitive, undersensitive or even numb). Possible complications from breast enlargement include bleeding, infection, or complications related to the implant.

Occasionally, breast implants may break or leak, due to injury to the breast or through normal wear over time, releasing the saline filling. It usually happens quickly and requires surgery to remove and, if desired, replace the rupture implant. If a break occurs in a silicone gel-filled implant, it may not be possible to remove all of the silicone gel in the breast tissue. The gel may collect in the breast and cause a new scar to form around it. There is no evidence that breast implants will affect fertility, pregnancy, or the ability to nurse.

Some implants deflate (or rupture) in the first few months after being implanted and some deflate after several years, yet some seem to be intact 10 or more years after the surgery. A ruptured implant has to be replaced. Whenever a saline-filled implant does deflate, the leaked saline will be absorbed by the body instead of being treated as a foreign matter.

While there is no evidence that breast implants cause breast cancer, the implant could interfere with finding breast cancer during mammography.

Infection can occur with any surgery. The frequency of infection with implant surgery is very rare. According to scientific studies, women with breast implants, in general, are not at an increased risk for autoinmune or connective tissue diseases.

During the first twenty-four to forty-eight hours after surgery, the patient will experience the most discomfort. One will probably feel tired and sore for several days, and breasts may remain swollen and sensitive (very tender) to physical contact for as long as a month. One may also experience a feeling of tightness in the breast area as the skin adjusts to the new breast size. A few patients will develop an intense burning in the nipple. This sensation is cause by the bruising of the nerves connected to the nipple, and it may last for about two weeks, but will subside as bruising fades. Pain medication may be required for a day or so.

The swelling in breasts may take three to five weeks to disappear. No need to remove stitches in this operation. Every women's recovery time is different and resumption of many of regular activities is probable after about one week.

The full results of breast augmentation may not be visible until breast tissue adjusts.

Post-operative care is usually quite simple, involving use of a post-operative bra or jogging bra for extra support and positioning while healing takes place. One should wear a front-fastening bra (with under-wire), day and night for four weeks, except when changing into a clean bra or bathing.

The post operative scar will be pink and firm for the first six weeks. Around six months, scars begin to fade. A person will most likely be able to return to work within a few days, although any strenuous activities should be avoided. Sex at two weeks should be done cautiously without touching breasts, if they are sore.

A decision to have breast augmentation is highly personal. Psychological and emotional benefits have included an enhanced self-esteem, a more satisfying body image and personal gratification.

Before	After

Before	After

Before	After

Before	After

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