Procedure
Breast augmentation is a type of surgical procedure in which the size and shape of the breasts are enhanced through saline or silicone implants.
Depending on the size and type of implant chosen, as well as your desired outcome and body type, the procedure may be performed in one of three ways:
- Inframammary Approach – An incision is made in the fold beneath the breast, allowing the implant to be positioned beneath the pectoralis muscle.
- Periareolar Approach – The implant is inserted through a smaller incision around the base of the areola.
- Transaxillary Approach – An incision is made high in the armpit to avoid visible scarring on the breast, and the implant is inserted with the aid of a camera through a tunnel made from the armpit to the breast.
Generally we prefer the inframammary approach as the scar hides well within the natural breast crease, changes in nipple sensation are minimized, and revision rates are the lowest.
Anesthesia
Typically a breast augmentation procedure takes 1 to 1.5 hours and is performed under general anesthesia. This is an outpatient procedure.
Recovery
Normal daily tasks may be resumed immediately, with the ability to perform non-strenuous work (no lifting greater than 10 lbs) in 5 to 7 days. No strong pushing, pulling, or repetitive upper body movements for 3 weeks. Most patients are able to return to work in 3-5 days.
- Swelling/Bruising will be moderate-to-significant for 4 weeks, with mild swelling lasting 2 to 3 months (depending upon the extent of the procedure). The breasts will be sensitive to physical contact for 3 to 4 weeks.
- A support garment may be worn immediately following the procedure, and as needed for up to 6 weeks.
- Resume exercise only at 1/3 intensity after 2 weeks and 2/3 intensity at 4 weeks. Limit exercise to low impact activities at 1/3 of normal duration, repetitions, amount of weight, and pulse rate. Full intensity workouts, including high impact activities (running, yoga, horse back riding, high-impact aerobics) can be resumed at 6 to 8 weeks.
- Scar fading and improvement will occur gradually over time, with the first stage of scar tissue forming in the first 6 to 8 weeks. Scars will mature and fade further over a period of 6 to 12 months.
- Other possible side effects include temporary soreness, swelling, a change in nipple sensation, and bruising. The breasts will be sensitive to stimulation for a few weeks.
When Will I Start to Notice Results From My Procedure?
While results from breast augmentation are immediate, in the first few weeks following your procedure, your breasts will appear slightly full with a slight outward (convex) curvature to the upper portions. This fullness regresses as the lower portion of the breast skin envelope stretches from the weight and gravitational effect on the implant over time. Once the stretching in the lower portion of the breast is complete (up to 6 months), the upper pole profile of the breast becomes straight or slightly concave.
Duration of Results
Implants may require removal or replacement at some time in the future, though the time frame for these types of changes is usually years or decades. The type of implants chosen can also have an effect on whether or not you may need them replaced or adjusted in the future. We will discuss expectations for each type of implant and procedure during your initial consultation in order to help make the right choice for your needs.
Medication and Follow-Up Visits
Pain medicine may be prescribed and should be taken immediately following your procedure.
Two initial office visits will be scheduled at 5 to 7 days and 10 to 14 days. You should expect 4 to 5 follow up appointments in the first 3 months, and then yearly after that.
Risks
As with any surgical procedure, there is a very small chance of complications. While these risks are rare, they can include infection, asymmetrical results, implant rupture, and a change in the sensitivity of the nipples or breast skin. In a small percentage of cases, there is the chance for capsular contracture, a tightening and hardening of scar tissue around the implant. We will do everything we can to monitor your condition following the procedure in order to minimize these risks.
How Much Does Breast Augmentation Cost?
A breast augmentation typically costs between $6,200 to $7,800, which includes surgical fees, implants, anesthesia and operations room costs.
Silicone VS Saline Implants
There are many factors to consider when deciding on breast augmentation surgery. One of the most important decisions to make is whether to opt for silicone or saline implants. Each alternative offers a variety of advantages and disadvantages. Generally we prefer to use the new cohesive silicone gel implants. They have the advantage of being much softer and natural feeling, and had been proven to be as safe or safer than saline implants.
About Silicone Gel Implants
Silicone implants have a feel that is similar to breast tissue and are pre-filled with silicone gel. They collapse less when held upright compared to a saline implant, but do require a slightly larger incision. These types of implants are made up of a cohesive silicone gel, which provides a natural shape and does not leak. We will be happy to go over the different silicone implant options available to you, including the new Mentor and Allergan implants, during your consultation.
About Saline Implants
Saline implants are typically inserted through a slightly small incision and then filled to the correct size with sterile saline solution. If a saline implant happens to rupture, the body will be able to safely absorb the saline over the course of a few days.
The implant shell can then be replaced with either another saline implant or exchanged to a silicone gel implant. Saline implants tend to be more visible and palpable than silicone implants, and tend to feel less natural in the breast.
Procedure Timeline
Initial Consultation
During your first office visit, our doctors will:
- Review your medical history as well as your expectations about breast augmentation.
- Examine your breasts and provide you with more information tailored to your specific needs.
- Allow you to try on breast sizers to simulate results and guide in preoperative planning.
- Discuss surgical fees.
At your consultation, you should feel free to ask any questions or address any concerns regarding breast augmentation. Whether you decide to undergo the surgery is completely your decision, but our surgeons will advise you about your options and the expected results. As long as you are in good health, age is not a restriction for augmentation mammoplasty.
Before Your Augmentation Mammoplasty
For the best possible results, the doctors at Boulder Plastic Surgery believe nutrition plays a major role. That is why we employ a three-phase healing program so that your body recovers more quickly. Our program involves:
- Removing any supplements and medications that could interfere with the anesthesia or cause more bleeding about a week before the surgery.
- Giving patients nutrients that will detoxify the anesthesia or other medications as well as diminish pain and inflammation.
- Providing patients with healing nutrients to support a speedy recovery.
Before the surgery takes place, patients may also undergo routine laboratory tests such as blood counts/blood chemistries, an electrocardiogram for those 50 and over, and a pregnancy test if applicable. These important tests check for any abnormalities that could negatively affect the anesthesia or surgery.
The Day of Surgery
Before you move to the operating room, you will be asked to sit up briefly so that your surgeon is able to make small marks in the armpit and/or beneath the breasts to guide them during the procedure. You may be asked to bring in photographs of your desired results to aid in surgical planning. Augmentation mammoplasty is performed under a general anesthetic and typically takes anywhere from 45 to 90 minutes.
Incisions will be made depending on which approach is best for each individual patient. Those incisions are closed with dissolving sutures that do not require removal. After the procedure, you will be transported to a recovery area and observed for a few hours. Once that observation period is complete, you are able to leave with a person who will drive you home and remain with you the rest of the night following the surgery.
After Your Augmentation Mammoplasty
Our doctors want you to be as comfortable as possible after your surgery, which is why we recommend that you take any pain medication with a small amount of food. To decrease swelling and discomfort, it is also recommended that patients apply ice packs for the first 48 hours.
Any bandages that you received at the time of surgery may be taken off the next morning. You may shower after 48 hours. In the first few weeks after your surgery, the upper portions of your breasts may look full with a slight outward curvature. As the lower portion of the breast skin stretches, the fullness will regress.
Patients may also notice a small amount of bruising in the armpit or under the breast, which should subside within one to two weeks. If you notice any of the following symptoms following your surgery, notify your surgeon:
- A temperature of 101 degrees or above.
- Extreme swelling or tenderness in the breast.
- Redness along the incision lines or elevated breast temperature.
Most patients will return to normal activities within 48 hours and many return to work within 3-5 days.
Testimonials
“I am very pleased with the results!” – KG
“What can I say? You’re awesome! Thanks to you and your staff for taking good care of me and for always being so welcoming.” – CM