Breast Augmentation

Breast augmentation is not only a medical decision, it is a personal one. The perception we have of ourselves defines who we are and how we introduce ourselves to the world. Not every woman may feel the need for breast augmentation, but for many women it has afforded a state of great personal satisfaction and well being. There are many options available today for the woman who decides that augmentation is right for her. The more you know about the procedure and the options involved, the better equipped you will be to make the decision that is best for you.
Remember, medical personnel can give you their recommendations and family members may tell you what they think you should do, but only you can make the breast augmentation decision that is right for you. This website is designed to help you make an educated, informed decision and is not intended to replace any discussion with your doctor.

Breast implant manufacturers have developed many styles, unique features, shapes and sizes of breast implants.

Am I a good candidate for breast augmentation?
One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:

  • you are bothered by the feeling that your breasts are too small
  • clothes that fit well around your hips are often too large at the bust-line
  • you feel self conscious wearing a swimsuit or form-fitting top
  • your breasts have become smaller and lost their firmness after having children
  • weight loss has changed the size and shape of your breasts
  • one of your breasts is noticeably smaller than the other

Breast augmentation can be performed at any age after the breasts are fully developed. A good candidate for breast enlargement is emotionally mature, understands her personal motivations and has realistic goals for the procedure.

How will my plastic surgeon evaluate me for breast augmentation surgery?
Your plastic surgeon will examine your breasts and perhaps take photographs for your medical record. He or she will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples).

If your breasts are sagging, a breast lift may be recommended in conjunction with augmentation.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information.

There is no scientific evidence that breast augmentation increases the risk of breast cancer. The presence of breast implants, however, makes it more technically difficult to take and read mammograms. This may be a special consideration for women who perhaps are at higher risk for breast cancer because of their family history or other reasons. Placement of the implant underneath the pectoral muscle may interfere less with mammographic examination, but other factors may also need to be considered with regard to implant placement. Your plastic surgeon will discuss this with you.

If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. He or she may recommend that you stabilize your weight prior to undergoing surgery.

If you think that you may want to become pregnant in the future, you should mention this to your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask your plastic surgeon.

HOW BREAST AUGMENTATION IS PERFORMED
Individual factors and personal preferences will help you and your plastic surgeon to determine your appropriate breast size, the location of incisions, and whether the implants will be placed on top of or underneath the chest muscle.

What type of implants will be used?
In 1992, because further studies were needed to establish the safety of breast implants, the Food and Drug Administration decided that silicone gel-filled implants would not be generally available for cosmetic breast enlargement. Since then plenty of evidence has been established about the safety of silicon implants.

You can decide with your surgeon the choice available for you.

The implant is placed in a pocket either directly behind the breast tissue (right) or underneath the pectoral muscle which is located between the breast tissue and chest wall.

Where are the incisions placed?
One of the advantages of a saline-filled implant is that, because it is filled with saltwater after being inserted, only a small incision is needed. Often, an incision of less than one inch is made underneath the breast, just above the crease, where it is usually quite inconspicuous.

Another possible location for the incision is around the lower edge of the areola.

A third alternative is to make a small incision within the armpit and place the implant with the assistance of an endoscope.

Once the incision is made, the surgeon creates a pocket into which the implant will be inserted. This pocket is made either directly behind the breast tissue or underneath the pectoral muscle which is located between the breast tissue and chest wall.

An incision is made either underneath the breast just above the crease, around the lower edge of the areola (the pigmented skin surrounding the nipple) or within the armpit.

THE SURGICAL INCISION AND PLACEMENT CHOICES
Usually breast implants are surgically inserted utilizing one of three traditional incisions: the inframammary incision, the periareolar incision, or the transaxillary incision. All of these incisions allow the implant to be placed either submuscular (below the chest muscle) or subglandular (between the chest muscle and your breast tissue).

No one incision and placement is right for every woman. Therefore, by knowing your options and discussing them with your doctor, together you can decide upon the best combination for you.

The inframammary incision is made in the skin fold below the breast, and the breast implant is inserted through this incision. The breast tissue is minimally disturbed, and the remaining incision scar is concealed within the fold of skin under the breast.

The periareolar incision is made along the edge of the colored area around the nipple, and the breast implant is inserted through this incision. The incision scar is well camouflaged in this area.

The transaxillary incision is made in the armpit and the implant is inserted through this incision.

An additional option that patients with ptotic or sagging breasts may elect to have during the breast implant surgery is a mastopexy (breast lift).

UNDERSTANDING THE RISKS
Every year, many thousands of women undergo successful breast augmentation surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.

I understand that every surgical procedure bas risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and our plastic surgeon, or with a staff member in our surgeon’s office.

Some of the potential complications that may be discussed with you include reactions to anesthesia, blood accumulation that may need to be drained surgically and infection. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant. Changes in nipple or breast sensation may result from breast augmentation surgery, although they usually are temporary.

When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast’s appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.

Breast implants are not lifetime devices and cannot be expected to last forever. If a salinefilled implant breaks, its contents are harmlessly absorbed by the body within hours.

A definite change in the size of the breast is clearly noticed. Rupture can occur as a result of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant, if desired.

If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. Your plastic surgeon, in some instances, may recommend other types of examinations such as ultrasound or magnetic resonance imaging.

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