Breast Augmentation Surgery
Breast Augmentation (Augmentation Mammaplasty)
Augmentation mammaplasty (breast enlargement) is performed to increase breast size and/or fix breast asymmetry. Candidates include women who want larger breasts, and those who want to restore the breast volume often lost as a result of pregnancy or significant weight loss. Breasts can be enlarged with implants or by fat transplantation. Augmentation mammaplasty is not a substitute for mastopexy, which is a procedure to "lift" breasts that sag significantly.
Breast Augmentation with Implants
Silicone and saline are the two implant types most commonly used in augmentation mammaplasty. Silicone implants feel more like natural breasts than saline ones. However, if a saline implant ruptures, the saline is naturally absorbed by the body, whereas if a silicone implant has an extracapsular rupture (a rupture to the outer capsule), silicone filler leaks into the body, possibly resulting in inflammatory nodules or enlarged lymph glands.
Implants are placed behind each breast, underneath either breast tissue or the chest-wall muscle. The procedure lasts 1 to 2 hours, and is typically performed with general anesthesia, although local anesthesia combined with a sedative may be used. Incisions are made in inconspicuous places (in the armpit, in the crease on the underside of the breast, or around the areola) to minimize scar visibility. The breast is then lifted, creating a pocket into which the implant is inserted.
Advantages of implant placement behind the chest-wall muscle include a possible reduced risk of capsular contracture (hardening of scar tissue around implant), and less interference during mammograms. Disadvantages include the possible need for drainage tubes, and a longer recovery period. Advantages of implant placement beneath breast tissue include that the breasts move more naturally as the patient uses her chest muscles, and that slight breast sagging is corrected.
Other types of implants include "gummy bear," round, smooth and textured.
Breast Augmentation with Fat Transplantation
Augmentation mammaplasty with fat transplantation (fat transfer) uses liposuction to harvest excess fat from other parts of the body; the fat is then injected into the breasts. Augmentation mammaplasty is appropriate for women who are not looking for a dramatic increase in breast size, and want breasts that look and feel as natural as possible.
For a number of weeks prior to augmentation mammaplasty, tissue expanders may be placed below the muscles of the chest wall to expand the breasts, and increase the amount of fat they can hold. When the tissue has expanded enough, augmentation using fat transfer can begin. First, fat is removed using liposuction, in which a cannula (a thin, hollow tube) is inserted through small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or a cannula-attached syringe. The harvested fat cells are then purified. In the second procedure, which takes place on the same day, the fat is injected into the breast through small incisions. The procedure takes approximately 4 to 5 hours.
Frequently Asked Questions
What is Breast Augmentation Surgery?
Sometimes referred to as a "boob job", breast augmentation surgery involves the use of breast implants and or fat transfer to increase the size of the breasts. It is also referred to as augmentation mammoplasty.
What are the Risks of Breast augmentation?
- Anesthesia risks
- Changes in nipple or breast sensation
- Poor scarring
- Wrong or faulty position of the implant
- Implant leakage or rupture
- The formation of tight scar tissue around the implant (capsular contracture)
- Fluid accumulation (seroma)
- Wrinkling of the skin over the implant
- Persistent pain
- Possibility of revision surgery
Am I a candidate for breast augmentation?
Breast augmentation is a very personal decision, therefore it is important that you're seeking this operation for your benefit.
Candidates include those patients who have realistic expectations, fully developed breasts, seek more volume in the breasts, have breast asymmetry, failed development of one or both breasts, dissatisfied with the shape and or loss of volume of your breasts. Candidates must be healthy and not pregnant or breast feeding.
How is breast augmentation performed?
Breast augmentation can be performed through several different incisions. Common incisions include the axillary (armpit), periaerolar, and inframammary fold incisions (fold of the breast). The decisions on which incision to use is decided upon based upon the shape of your breasts, type of implant to be used, scarring characteristics, and surgeon preference.
The procedure is performed by placing the breast implant directly above the muscle or directly beneath the muscle. This decision is made based upon your own personal anatomy, desired final result, implant to be used, and surgeon recommendation.
Skin incisions are closed with dissolvable sutures and skin glue or strips are placed to seal the incision. No drains are necessary for this operation.
What is the recovery process from Breast Augmentation?
During your breast augmentation recovery, your breasts will be wrapped in gauze dressings and an elastic bandage or support bra to minimize swelling and support the breasts as they heal.
Immediately after surgery, you will be taken into a recovery area for close monitoring. You may be permitted to go home when you are stable for discharge; typically after an hour or so.
Before leaving, you will be given specific postoperative instructions for your breast implant recovery and a follow-up appointment with your plastic surgeon. You may also receive medications or a prescription, but it is our general practice to provide you these medications prior to surgery. Your prescribed medications may include pain pills and an antibiotic to prevent infection.
Wear your support garment (a bra or elastic band, called a bandeau) around the clock as instructed.
You will be allowed to shower 48 hours after surgery, but no baths. You will not be applying any type of scar management to the incision until cleared to do so at your post-operative visits.
Because it is possible to bleed into the pockets around the breast implants for the first several days, take it easy until you have permission to increase your activity level. Acute pain typically subsides after one to five days, but you may experience soreness and swelling for a few weeks. Resume exercise and normal activity according to follow up instruction at your post-operative visits.
Full recovery is generally 6 weeks, but most patients are able to return to work and normal activities within 1-2 weeks.