Also known as augmentation mammoplasty, breast augmentation is performed to enhance the shape and size of a woman's breast using a breast implant. The breast augmentation procedure can have a very strong impact on patient self-esteem. A breast augmentation can be performed through many different approaches. The three most common are around the areola, underneath the breast, or inframammary, and in the armpit, or transaxillary. Based on your initial consultation and on your particular preference, we will determine the best approach in your particular case. You will also have a choice of either saline-filled or silicone gel implants. Both of these implants come in a number of sizes and profiles. Your doctor will discuss with you the pros and cons of saline and silicone breast implants at the time of your consultation.
Click to see more breast enlargement before and after photos
The implants themselves can be placed either underneath the breast tissue itself or underneath the pectoralis muscle, between the muscle and the ribs. The advantage of placing the implant above the muscle is that it is less painful, and in women bodybuilders, contraction of the pectoralis muscle may be less noticeable. In our practice, the majority of implants are placed underneath the muscle. This offers several advantages, such as:
- The appearance of the augmented breast is much more natural, with a smooth transition from the chest wall to the breast mound.
- The rates of scarring around the implants, also known as "capsular contracture," are significantly lower.
- The risk of having visible folds in the implant is decreased because of the greater amount of the patient's own tissue over the implant.
- The ability to obtain an adequate mammogram is enhanced when the implant is under the muscle because the technician is better able to separate the breast from the implant when the muscle is interposed.
At the time of the initial consultation, a pertinent medical and family history will be obtained with particular emphasis on breast issues. A complete breast examination will be performed with careful attention to issues of breast size, symmetry, and degree of sagging of the breasts. All these factors will affect not only the size of implant required, but also the type of breast augmentation procedure that will achieve the best results. Often, for example, in addition to the augmentation, it is necessary to perform a breast lift, or mastopexy, in order to achieve the desired result. During this initial visit, it is important for you to clearly have in mind the final breast size you would like to have. One good way to have an idea of the appropriate size implant for you is to bring a photograph of a woman's breasts that you find desirable. This will give a good impression of what your wishes are for breast augmentation. The breast augmentation procedure itself takes about 1 to 2 hours to perform. You will then be in the recovery area for another 2 hours. Once you have recovered from the effects of anesthesia, you will be allowed to go home, but it is imperative that a responsible adult accompany you. You will feel discomfort after the surgery, and we recommend that you take the pain medication as prescribed. You will also be given antibiotics to take for 5 days. Your bandages should remain on until you are seen again in the office, usually 2 to 3 days following surgery. At that time you will be asked to wear a support bra or sports bra for a period of 4 weeks. You should not wear a push-up bra or bras with underwires, as these may displace the implants. When you are able to tolerate it, you should begin daily breast massages; this will help over time to keep the implants soft and to settle in their final position. In the first few weeks after breast augmentation surgery, the implants will appear unusually high. This is normal, and with time the swelling will subside and the implants will settle into proper position.
Click to see more breast lift with enlargement before and after photos
Early complications of breast augmentation
Bleeding or hematoma: This is unusual but can occur if heavy physical activity or strenuous exercise is done immediately following surgery. We strongly recommend avoiding any strenuous activity for the first two weeks.
Infection: Implants can become infected; however, by using meticulous techniques and with the use of preventive antibiotics, the risk of an infection is less than 1%. Loss of nipple sensation- Most patients have some change in nipple sensation following breast augmentation. This change is usually temporary, and sensation returns. Permanent loss of sensation is very unusual.
Implant malposition: Every effort is made to achieve perfect symmetry. This requires fine adjustments in implant placement. On rare occasions, especially in patients that are very asymmetrical to begin with, a second procedure is required to achieve satisfactory symmetry.
Late complications of breast augmentation
Capsular contracture: This is caused by hardening of the scar that surrounds the implant. The scar around the implant is a normal reaction of the body. For unknown reasons, some individuals form thicker scars than others. A very thick scar can distort the shape of the breast and cause discomfort. If this is severe, it will require surgery to correct. By placing the implant underneath the muscle, the incidence of capsular contracture is less than 4%.
Interference with mammography: Implants interfere with the ability to image the breast by mammography. Implants placed underneath the muscle can be imaged by the special Eklund mammography technique. This allows the breast to be separated from the underlying implant. Implants placed under the breast can cause interference with mammography.
Deflation: The incidence of implant leakage is about 1% per year. Today's implants are better than 10 years ago, so the true rate of deflation is even lower. If an implant should deflate, the body would absorb the sterile saline solution, and the implant could be exchanged with a relatively brief and simple surgical procedure. At the time of your consultation, we will discuss these and any other possible risks and complications with you.
If you are interested in breast augmentation plastic surgery or have any questions for Dr. Adams, call 505.327.1754 for a consultation.