What is Breast Augmentation?
Breast augmentation is a very popular and common procedure that can increase your breast size by one or more cup sizes. By surgically inserting breast implants beneath the breast tissue or the chest muscle, women can achieve larger, shapelier breasts. This type of breast enhancement is sometimes performed in conjunction with a breast lift. Breast implants are commonly filled with silicone gel or saline. Both have been shown to be equally safe by the FDA. For some women, breast augmentation is an excellent way to enhance self-image and self-confidence.
Quick Facts
- LENGTH: 1.5 to 2 hours
- ANESTHESIA: General – Outpatient Surgery
- SIDE EFFECTS: Temporary soreness, swelling, change in nipple sensation, bruising. Breast sensitive to stimulation for a few weeks.
- RISK: Infection. Asymmetry. Tightening & hardening of scar tissue around the implant (“capsular contracture”), or rupture of implant; either may require surgery to release the scar tissue, to remove or replace the implant. Increase or decrease in sensitivity of nipples or breast skin, occasionally permanent.
- RECOVERY: Tasks of daily living may be resumed immediately. Back to non-strenuous work (no lifting greater than 10 lbs) in 3 to 5 days. No strong pushing, pulling or repetitive upper body movements for 3 weeks.
- EXERCISE: Resume low impact activities at 2 – 3 weeks (1/3 duration of exercise, repetitions, amount of weight and pulse rate). Moderate impact activity @ 4 – 6 weeks. Full intensity including high impact (running, horse back riding, high impact aerobics) @ 8 weeks.
- PHYSICAL CONTACT with Breast: 3 to 4 weeks.
- FADING & SCAR IMPROVEMENT: 6 to 12 months
- SWELLING: Moderate/Significant 4 weeks, Subtle/Mild 2 to 3 months, all of which are dependent upon extent of procedure(s).
- DURATION OF RESULTS: Variable. Implants may require removal or replacement at some time in the future. Time frame usually years or decades!
- OFFICE VISITs: 1st post op visit at 5 to 7 days / 2nd Visit 10 to 14 days / Anticipated # of visits: 4 to 5 the first 3 months then yearly.
- GARMENT WORN: Support as needed 6 weeks
- PAIN MEDS: Ibuprofen or Narcotics as needed
Considerations
The breast is composed of two basic units, the skin envelope and the breast tissue within that envelope. There is normally a wide variation in breast sizes, and the size of the breast often changes significantly during a woman’s lifetime. As the breasts enlarge during puberty, both the breast tissue within the envelope as well as the skin envelope itself increases in size. This increase may vary significantly from woman to woman, but the larger the breast becomes, the greater the gravitational effect on the tissue within the skin envelope and hence the greater the stretching of the skin envelope. Following pregnancy, the glandular tissue within the envelope involutes or shrinks, often to a smaller size than the breast was originally. The amount of breast enlargement during puberty or pregnancy depends on many factors including genetics and breastfeeding.
Breast augmentation is a useful procedure to increase the volume within the skin envelope. There is a definite limit to the size to which a breast can be enlarged if we are to maintain normal breast appearance and shape. In a native breast, no matter how large, the upper pole of the breast seen in profile should appear slightly concavely curved. When you are standing, breast tissue normally settles to the bottom of the breast, and without a bra there is very little rounding of the upper pole contour of the breast. If, during augmentation, an excessive amount of volume is placed within the skin envelope in the form of an implant, this can exceed the capability of the envelope to accommodate that size and maintain a normal upper pole contour. The result is an unnatural appearing bulge in the upper part of the breast. Besides being unnatural, this appearance is a telltale sign of augmentation and does not aesthetically mimic the normal breast.
Cleavage is not a function of the normal breast form. Rather it results from a bra pressing the breast tissue toward the middle of the chest. No degree of augmentation will provide cleavage without a bra. We feel very strongly that a well done augmentation enlarges the breast, but preserves all of its natural features so that it does not appear operated on or unnatural. Often, immediately after your surgery, there will be fullness in the upper pole of your breasts. Over the next six weeks to six months, the lower half of the skin envelope will stretch slightly due to gravitational effect and “settling” of the implant into its pocket. As the lower portion stretches, the slight bulging in the upper pole will be relieved, leaving a natural profile. During your consultation, we can further discuss your individual desires regarding breast size, as there is a range of implant sizes that your tissues can accommodate.
In women with very small breasts (A cup), there is a relative paucity of breast tissue within a tight skin envelope. Implants are best placed beneath the pectoralis muscle to provide additional soft tissue coverage over the prosthesis. Due to the tight skin envelope, the newly augmented breast will seem excessively full, especially in the upper pole, but as the lower pole skin stretches out to accommodate the implant, the breast will take on a natural shape and contour. This process may take up to six months. In larger breasts (B and C cup) or breasts that have been stretched by pregnancy, the implants usually settle into their pockets more quickly. Occasionally, a mastopexy (breast lift) may need to be added to the procedure to lift excessively sagging breasts.
There are several types and shapes of implants that are used in breast augmentation. Currently, silicone gel and saline filled implants are approved by the FDA for cosmetic breast enhancement. Clinical studies have been underway since 1992 on silicone gel implants, and as of January 2007 silicone filled implants have been approved for unrestricted use in breast enhancement. We utilize round implants in women who have a nice natural shape to their native breast and simply desire volumetric enhancement. Anatomic implants are most often used for breast reconstruction patients, and aesthetic patients who need to change both the form and the volume of their native breasts.
Breast augmentation can dramatically improve the appearance of a woman’s breasts. During your breast augmentation consultation, you’ll learn more about your options for creating your ideal breast appearance, including:
- Implant size, style, and shape.
- Implant material (silicone gel or saline).
- Implant position (above or below the pectoralis muscle).
- Implant incision site.
The goal is to create a natural and alluring look. Which implant size that will work best for you must be individually determined with your input. The size, shape, style, and type of implant will be decided after a comprehensive examination.
Advantages of Saline Implants
Saline implants offer several advantages over other forms of breast implantation. The saline solution itself is a liquid that is administered into a shell to create a larger breast contour. Unlike other approaches, the saline implant only requires a smaller incision since the shell is inserted into the breast before it is filled with saline. Additionally, this form of implant offers greater firmness and offers greater volume flexibility which can be altered during your procedure.
Advantages of Silicone Gel Implants
Silicone gel implants are unique in that they closely resemble the feel of genuine breast tissue. While squishy in texture, it also has firm qualities to resemble a semisolid feel. One of the biggest advantages of sillicone gel implants is that they are significantly less likely to create a rippling appearance in the skin, creating a more even breast complexion.
Advantages of Fat Transfer Implants
Fat transfer implantation allows for a natural means of augmenting the breasts. During this procedure, no foreign materials are used, only fatty tissue from other parts of the body. Perhaps the biggest advantage of a fat transfer implantation is the more natural-looking results along with slimmer contours in parts where fat is harvested for the procedure.
