Breast Augmentation
Breast augmentation is an operation to increase the size and change the shape of a woman's breast. Most patients undergo breast augmentation in an effort to enhance their body contour, balance different sized breasts or to correct a loss in breast volume after pregnancy. Placement of an implant behind the breast or pectoralis muscle will increase a woman's bust line to her desired size. Many of our patients note an increased sense of self confidence with the improvement of their appearance after surgery. We always stress, however, that this surgery should be done for the patient only and not for husbands, partners or boyfriends. The decision for surgery should be yours only. You will be a good candidate for this operation if your expectations are healthy.
There has been much controversy regarding breast implants. Thus, we aim to educate our patients with regards the pros and cons of breast augmentation so they fully understand the benefits, options and risks of the procedure.
Types of Implant
A breast implant is a silicone rubber shell filled with either medical grade silicone gel or a salt-water solution known as saline. Many people feel that silicone-filled implants give a slightly more natural look and feel to the breast over saline implants. The differences between the two implants can be subtle and you should discuss the best option for you with your surgeon. Due to the controversy over silicone, the Food and Drug Administration (FDA) determined that new silicone (gel filled) implants should be available only to women participating in approved studies, women who need exchange of their implants or for cancer reconstruction purposes. However, today we primarily use saline filled implants with a silicone outer shell for primary augmentation. Saline is essentially a salt water solution similar to your body's own composition. Saline filled implants continue to be available on an unrestricted basis.
Surgical Details
Breast augmentation is performed under local anesthesia with sedation or preferably under general anesthesia by a board certified anesthesiologist in our fully certified operative suite. The incisions are made either directly below the nipple/areolar complex, in the crease below the breast, or in the axillary region, depending on the patient's anatomy and preference. The implants are usually placed underneath the pectorals (chest) muscle, as saline implants in this location give the breast a much more natural feel and appearance. Nearly all breast tissue may be visualized in mammograms with the implants under the muscle; less so when it is placed over the muscle.
Following surgery, the patient can expect to be sore for two to four days but this is well controlled by pain medication that we prescribe for you. The dressing is usually removed 2 to 3 days after surgery. Most people return to work as early as 4 days after the operation. Normal activities are usually resumed 2 to 3 weeks after surgery.
Possible Complications
Breast augmentation is relatively straightforward, but complications may occur, such as scarring around the implant, known as capsular contracture. This can be treated in several ways if it does occur. As with other operations, excessive bleeding or pooling of blood may occur and this would require removal of the accumulated blood. Sometimes an infection can develop around the implant and this may require removal of the implant for a short amount of time. It will be replaced at a later date. Some women report either an increase or decrease of sensation in the nipples but this is a rare complication and usually temporary. Infrequently, breast implants may leak or rupture and this would require removal of the implant and placement of a new implant. The advantage of saline implants is that the salt water present in the implant is harmless and will be absorbed by the body if a leak does occur. If a gel filled implant break occurs, surgical removal of the implant material (gel) is required prior to replacement of another implant.
There is no evidence that breast implants cause breast cancer, or other common breast pathology. However, having breast implants may change the mammography technique necessary to detect cancer. When you undergo a mammogram be certain to inform the technician that you have breast implants so that the newer mammography techniques may be used. Sometimes additional views are required. We recommend mammography as per guidelines by the American Cancer Society (ACS) and you should mention to your mammographer the presence of your breast implants. We like to examine our patients on a yearly basis after surgery to be certain that the implants are in appropriate position.
It should be noted that contrary to the accusations of breast implants causing diseases of the immune system and arthritis-like conditions, recent clinical research at major medical institutions including Harvard, Johns Hopkins, Mayo Clinic and others, have found no clear link between silicone breast implants and the symptoms of what doctors refer to as “connective tissue disorders”. However, the FDA has still not approved the gel implants for primary augmentation, although it is speculated that the gel implant will be approved in the US in the near future. Roughly 90% of primary implants placed in the European countries over the last decade have been silicone gel implants. Breast enlargement is commonly a satisfying, positive experience. Please call our office to schedule a complimentary consultation so that your personal questions and issues may be answered in confidence. We look forward to seeing you in our Greenbrae office in the near future.
Consult one of our board certified plastic surgeons at the Plastic Surgery Specialists for a complete consultation regarding eyes/browlift and how it may improve your self confidence and restore a more youthful appearance to your skin.