Breast Augmentation Guide

Breast augmentation is one of the most common plastic surgery procedures today. Breast implants are used during augmentation to increase the size and shape of the breast. When considering a breast augmentation to enhance you image, there are a variety of factors to evaluate, including:

Breast Mass and Form:

 

Breast size and shape can be improved through breast augmentation. Yet, a breast lift may also be necessary if the goal is to improve sagging of the breasts. Plastic surgeons evaluate the need for breast augmentation breast lift combination procedures as well as the need for stand alone procedures to achieve desired outcomes.  In the case of mastectomy, the need for breast reconstruction is evaluated which may involve a series of procedures and special considerations relating to the timeliness of the procedure.

Anesthesia, Location and Time:

 

Breast augmentation is performed under general anesthesia and the procedure may be performed in a hospital whereby the plastic surgeon has privileges to perform it there or an out patient surgical center. The procedure may require up to three hours or more when a breast lift is performed at the same time.

Breast Augmentation Incision Choices:

 

There are three types of incisions that may be used in breast augmentation procedures: under the crease of the breast, through the nipple or under the arm pit.

Breast Implant Placement:

 

Breast Implants may be placed above the pectoral muscle or below the muscle.

Breast Augmentation Recovery:

 

Plastic surgeons provide a complete list of pre and post operative instructions in order to reduce the risk of complications and allow for a smooth recovery. Breast augmentation patients can usually return to work and participate in most normal activities within two weeks of surgery. Most patients are pleased with the outcome of the procedure.

Breast Implant Risks:

 

As with all medical procedures, there are risks associated with breast augmentation.

Breast Augmentation Before and After Photos:

 

Imaging helps to describe outcomes of breast surgery procedures. Viewing before and after photos on websites and in the practices that you wish to visit can help set reasonable expectations for the outcome of your procedure.

Breast Augmentation Costs:

 

Breast augmentation costs vary among plastic surgeons. Factors relating to cost include: the geographic location of the surgeon, the type of facility used to perform the procedure, the type of anesthesia used, the type of implant, and the surgeon’s experience with the procedure.

Breast Implant Types

 

Breast augmentation types are saline implants and silicone breast implants. Breast implants require replacement over time. When comparing benefits, the following considerations apply:

Saline Breast Implants:

1. A variety of profiles to choose from, including round, tear drop shaped, textured and un-textured.
2. Safety has been identified by the FDA for a long standing time.
3. Easy diagnosis of leakage or rupture because the implant will deflate and becomes noticeable to the naked eye.
4. Mammography can produce accurate results for cancer detection.

Silicone Breast Implants:

1. Encased in a shell, very natural feel and look both clothed and unclothed.
2. MRI requirement every two to three years to uncover possible abnormalities surrounding the implant because defects are not necessarily apparent to the naked eye.
3. Safety was concern and silicone was not available for cosmetic use over the past several years. Since then, the FDA has approved silicone for cosmetic use.
4. Silicone breast implants cost more and the MRI is not covered by insurance.

Incision Choices:

 

Under the Crease of Breast:

The most common choice for incision is under the crease of the breast, the advantages as follows:
1. It is easy for the surgeon to place.
2. Decreased risk of bacteria
3. Simple reentry point for revision surgery, when necessary.

Under the Arm Pit:

1. Requires maneuvering the implant through the body.
2. Secondary incision may be necessary for revision surgery.

Nipple Location:

1. Alters sensation in the nipple.
2. May inhibit cancer detection.
3. Simple point of entry
4. Reduced risk of bacteria infiltration. .
5. Secondary incision may be necessary for revision surgery.

Breast Implant Placement:

 

Under the Muscle:

1. Less wrinkling of the skin surrounding the implant.
2. Decreased incidence of capsular contraction.
3. Less palpability

Above the Muscle:

1. Easier to place.
2. May produce less discomfort post surgery.
3. Mammography is not inhibited for cancer detection.

Breast Augmentation Risks:

 

It is important to note that breast augmentation risks are associated with the procedure but reduced when pre and post operative instructions are followed by the patient.

Bottoming Out:

Bottoming out occurs when the breast implant drops to a low location on the breast and lends the appearance that the nipples are located higher than normal. Bottoming out is more common among thin women with little breast tissue covering the breast implant.

Capsular Contraction:

Capsular contraction refers to a complication that results from the pocket formed to hold the implant tightens around the implant and has a protruding effect on the breast. Depending upon the degree of severity, further breast surgery may be required to improve capsular contraction.

Deep Vein Thrombosis:

Deep Vein Thrombosis is a condition the results in a blood clot which forms deeply in the body, commonly found in the legs or thighs.

Leak or Rupture:

Saline implants may deflate and the result is noticeable to the naked eye. Both saline and silicone may leak or rupture over time. In such cases, the implant will need to be replaced.

Hematoma:

Hematomas (blood clots) may result from breast surgery. Treatment for a hematoma is individual.

Interference with Cancer and Disease Detection:

Breast Implants may inhibit mammography performance for cancer and disease detection. There are special protocols that should be followed by technicians performing mammography in order to improve the accuracy of mammography that involve implants. Silicone breasts implant patients should undergo an MRI every two to three years.

Sensation Sensitivity or Loss:

Sensation of the nipples or surrounding breast area may be over enhanced or minimized through breast augmentation.

Seroma:

A seroma describes fluid accumulation that occurs around the implant. Seromas must be drained and sometimes appropriate treatment involves surgery.

Symnastia:

Symnastia results when the pectoral muscles move away from the sterum because of over dissection during surgery. Symnastia revision surgery techniques vary among plastic surgeons. The approach to Symnastia requires special consideration.