surgical procedures

Breast augmentation is a surgical procedure in which implants are placed in pockets created behind the breast tissue or the pectoral muscles beneath the breasts to enlarge the breasts. It is one of the most frequently requested procedures performed by plastic surgeons today.

Silicone gel implants were re-approved by the FDA in 2006, and there is no significant evidence that they increase the risk of connective tissue disorders, autoimmune disease, or breast cancer. Silicone or saline implants may be used to enhance the size and shape of breasts for various medical or aesthetic reasons.

Some women lose volume in their breasts following pregnancy, significant weight loss, or the aging process coupled with the effects of gravity. The breasts become saggy and lose their toned, youthful appearance. Often, patients choose augmentation combined with a breast lift procedure to tighten overly-saggy breasts.

Other women seek breast augmentation because of injury, surgery affecting the breasts, or small breasts that are disproportionate to their bodies.

Breast augmentation with implants can correct these problems and give a boost to the self-confidence of the person receiving them. Your doctor will thoroughly discuss the options for this procedure as well as the pros and cons of each type of implant during your consultation.

There are a variety of sizes and types of implants, and you will have an opportunity to fully explore what would be the best option for your body. It is very important to your doctor that you have all the knowledge you need to make informed decisions about the procedures available to you.

The best candidates for breast augmentation:

• have breasts that have lost fullness and are sagging slightly.
• have small breasts that are out of proportion to their bodies.
• have breasts that are asymmetrical or uneven in size.
• wish to enhance their bodies by augmenting their breasts for aesthetic reasons.
• have completed their growth and development.
• are generally healthy and have realistic expectations.

The procedure takes one to two hours and is usually performed with general anesthesia. There are several choices that can be made for the incision:

Axillary (in the armpit)
The incision is made within the natural folds of the armpit. A path to the breast is created, and an endoscope (small tube with light and camera embedded in the end) is inserted to provide visibility for placing the implant. After placement and positioning of the implant, the incision is closed with stitches or taped. The procedure is  minimally invasive with only minor bleeding and scarring and has the added advantage of having the scar hidden in the armpit, not on the breast. (If a breast lift is performed at the same time, the axillary location would not be used for the incision.)

Inframammary (under the breast) 
The incision is made along the crease beneath the breasts (where the bottom of the breast meets the chest wall). Through this opening, the surgeon will create a pocket behind the breast (or the pectoral muscle beneath the breast) to hold the implant. After positioning the implant, the incision will be closed. The advantage of this procedure is that the surgeon has direct access to the breast tissue itself as he forms the pocket and places the implant rather than working through a channel. The scar will not be hidden as completely as in the axillary procedure, but will still be minimally visible.

Periareolar (skin surrounding the nipple)
The incision is made on the perimeter of the darker skin around the nipple. With this procedure, the surgeon has a great degree of control in forming the pocket for the implant and positioning it. Although the scar will be directly on the breast, it is concealed to some degree by being located in the transition area between the darker skin around the nipple and the surrounding breast skin.

You may experience some swelling, soreness, and bruising following the procedure. Incision-site stitches are internal and will dissolve on their own. Some patients have reduced sensation in their nipples but this should resolve itself as the healing process is completed. You will need to avoid heavy lifting or straining but can resume most activities by the third week.

You will be given instructions for your post-operative care relevant to the particular surgical procedure used. As the swelling subsides, the final size and shape of your newly enhanced breasts will become apparent.

Complications following breast implants are rare, but the most common are capsular contracture in which scar tissue surrounding the implant hardens and may cause pain, wrinkling of breast skin, hardening of breast tissue and changes in the shape of the implant, leakage or rupture of the implant, and loss of nipple sensitivity due to nerve damage.

Risks that are present with any surgical procedure are infection, reaction to anesthesia, collection of blood under the skin (hematoma), poor healing of incisions, and unfavorable scarring.

The skill of your surgeon and your adherence to post-operative instructions will eliminate or greatly reduce the risk of any complications.