Women who choose to have breast augmentation surgery do so to improve their self-image. Some feel dissatisfied because their breasts never developed to a size that meets their expectations. Others want to bring balance to a breast that is somewhat smaller than the other. Often, women want the procedure to restore their natural breast volume, which may have decreased as a result of pregnancy, weight loss, or aging.
What Makes a Good Candidate for Breast Augmentation Surgery?
- You are bothered by the feeling that your breasts are too small
- Weight loss has changed the size and shape of your breasts
- After having children, your breasts have become smaller and lost their firmness
- Dresses that fit well around your hips are often too large at the bustline
- One of your breasts is noticeably smaller than the other
- You feel self-conscious wearing a swimsuit or form-fitting top
In addition, there are several musts for anyone considering breast augmentation:
- If you are a young woman, your breast development must be complete.
- You must be emotionally mature and fully understand your own motivations for wanting the procedure (the best reason is to feel better about yourself).
- You must have realistic expectations, knowing that the procedure can bring improvement, but not perfection.
A personal consultation with our plastic surgeon is the first step for every patient considering breast augmentation. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery. Providing photos of the look you want to achieve is helpful
You should arrive at the consultation ready to provide complete information about:
- Previous surgical procedures
- Past and present medical conditions
- Medications you are taking, including herbal remedies or nutritional supplements
- The results of previous mammograms
- Any history of breast cancer in your family
We will help you understand the factors that may affect your results. For example, gaining or losing a significant amount of weight may change your breast size. Pregnancy can also alter breast size in an unpredictable way. If you are over 35, a mammogram should be considered prior to surgery.
During this exam, we will consider the size and shape of your breasts, the quality of your skin, and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). We may suggest additional cosmetic procedures to improve your results. For example, if your breasts are sagging, a breast lift procedure may need to be performed in conjunction with your breast augmentation surgery.
There are currently two basic types of breast implants approved for use: saline and silicone gel. Silicone gel implants now have two subtypes available. The silicone gel implant approved in 2006 is a cohesive gel implant that is proven safe for all patients. In 2013, a more highly cohesive “form stable” silicone gel implant became available that the press has labeled the “gummy bear implant.”
The saline filled implants can be placed through the smallest incision, about 3 cm (1 ¼ inch) since the implant is filled after it is inserted. The saline filled implant is slightly firmer and does have a greater chance of rippling. Any leakage will be absorbed by your body. You will notice a deflation on the affected side which will need to be replaced.
The cohesive silicone gel implant is a little softer and has a smaller chance of visible rippling but does require a bigger incision, usually about 4 to 5 cm (1.5 to 2 inches). If the silicone gel implant leaked, you would not be aware of it because the gel is cohesive. Any leakage will remain within the scar capsule and continue to give a nice result. The manufacturer recommends patients to have an MRI to check for rupture three years after the surgery and every two years thereafter. A warranty is also provided with the silicone implants.
The highly cohesive silicone gel implant approved in 2013 will usually take a 5 to 6cm incision (2 to 2.5 inches). The gel in this implant is even more cohesive, which enables the implant to shape the breast more but can be slightly firmer. This implant seems to have an even lower risk of rippling.
We will discuss the differences between these options at length during your consultation.
The surgery is performed under a general anesthetic and usually takes approximately 1 hour. Incision options include an incision at the edge of the areola and in the fold below the breast. The incision at the edge of the areola is usually not an option with silicone gel implants due to the length of the incision needed. We place most implants beneath the pectoralis muscle, however just beneath the breast tissue is a good option for some patients. Beneath the muscle gives more coverage and support in most women.
Preparing for Surgery
When the date for your surgery has been set, we will provide you with specific instructions for the days immediately before and after your surgery, including:
- Avoiding certain medications that may complicate surgery or recovery (aspirin, ibuprofen, vitamins and herbs)
- Stopping smoking for one week before and after surgery is recommended
- Nothing to eat or drink after midnight before your scheduled surgery
- Arranging for help or special care following surgery.
Day of Surgery
After your surgery, you will spend 1 hour in the recovery room. You will need a friend or family member to drive you home. Bring a pillow to protect your chest area from the seat belt and a shirt that buttons or zips up the front for easier dressing. Keep your head and chest elevated to limit swelling while sleeping. A surgical bra with a bandeau strap will be provided. The bandeau strap is placed over the upper portion of breast to aid in swelling and provide downward pressure to implants. Ice packs may be used during the first 24 hours if you wish. You will need someone to pamper you this first day, as you will be very sore.
Day 1 (After Surgery)
You may notice a small amount of drainage on bra. Take pain medication as directed and stool softener as needed
Days 2 to 7 (After Surgery)
You may remove your bra and gauze to shower in 48 hours. Leave Steri strips on. No dressing is needed, other than bra. You may wear a sports bra that zips up the front while laundering the surgical bra. Wear your surgical bra 24/7. It is very important to keep the incision clean and dry. The breast will be swollen and usually fuller in the upper portion of the breast. It is not uncommon for one side to be more swollen and painful than the other. You will be asked to come to the office 1week after your surgery. Do not drive if taking pain medication. You may resume work 3-5 days post procedure. Housework is restricted which includes vacuuming and laundry. Lift nothing over 10 pounds, which is approximately a gallon of milk.
After 1st Week
Pain and swelling continue to improve. Steri strips may be removed the 2nd week. Gentle massage on the breasts in a downward direction may be started. Light cardio exercise may resume after 2 weeks but no upper body involvement. You will be asked to come back to the office about six weeks after your last follow-up visit.
After 1st Month
After this visit, you will have no restrictions after 6 weeks. Continue daily massage to keep capsule soft.