Breast Augmentation
Time, weight loss, pregnancy and nursing may decrease the volume, shape and symmetry of the breasts. Many women find that making the breasts larger – technically known as augmentation mammoplasty – can help create a more comfortable, more flattering, more balanced look. This is a commonly performed procedure that enhances the size and shape of a woman’s breasts by inserting an implant behind each breast mound and chest (pectoralis) muscle.
Breast Augmentation Overview
If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:
- Increase fullness and projection of your breasts
- Improve the balance of your figure
- Enhance your self-image and self-confidence
Implants also may be used to reconstruct a breast after mastectomy or injury.
Candidates include women who have small, underdeveloped breasts, suffer from a reduction in breast volume after pregnancy and breastfeeding, or have breasts of different sizes. The procedure involves an incision in the crease under the breasts, or sometimes around the areola. Dr. Sholar then creates a “pocket" behind the pectoral muscles for the implant to sit. When the breasts are very droopy, a breast-lift might be combined with the augmentation to create a more pleasing appearance to the breasts. Silicone or Saline implants can be used for breast augmentation. This is performed under IV or general anesthesia in an outpatient setting and normally takes 1-2 hours.
What it won’t do
Breast augmentation does not correct normal anatomical asymmetries such as differences in nipple position, uneven inframammary creases, and unequal ribcage widths. The two sides of your chest and breasts will never be mirror images.
Also, implant placement alone will never correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Dr. Sholar will assist you in making this decision.
Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast augmentation may be a good option for you if:
- You are physically healthy
- You have realistic expectations
- Your breasts are fully developed
- You are bothered by the feeling that your breasts are too small
- You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
- Your breasts vary in size or shape
- One or both breasts failed to develop normally
Your Consultation
The success and safety of your breast augmentation procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
- Family history of breast cancer and results of any mammograms or previous biopsies
Your plastic surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of breast augmentation and any risks or potential complications
- Discuss the use of anesthesia during your breast augmentation
Preparing for surgery
Prior to surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the day of surgery
- Where your procedure will be performed
- Post-operative care and follow-up
- Breast implant registry documents (when necessary)
Breast augmentation surgery may be performed in an accredited office-based surgical center, outpatient ambulatory surgical center or a hospital.
If your breast augmentation is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Options for Breast Implants
Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.
Saline implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed by the body.
Silicone implants are filled with a cohesive gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel will remain within the implant shell. A ruptured implant filled with silicone gel will not collapse. If you choose these implants, an ultrasound or MRI screening can assess the condition of breast implants.
- Currently Saline implants are FDA-approved for augmentation in women 18 years of age and older.
- Currently Silicone implants are FDA-approved for augmentation in women 22 years of age and older.
- Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.
See www.breastimplantsafety.org for current information.
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