Breast augmentation continues to be one of the most popular aesthetic surgeries, growing in popularity every year. If you are considering having a breast augmentation, the following information should help you come to a well-informed, safe decision that suits your needs. We developed this page to answer the most common questions we encounter from patients and to provide you with the latest, up to date information on breast augmentation. We have addressed the following questions:
-Are you a candidate for a breast augmentation?
-Do I need a “breast-lift” as well?
-Do I need to be put to sleep for the operation?
-What happens in the days following a breast augmentation (How long is the recovery time)?
-Will my breasts look natural after the augmentation?
-What are the differences between saline and silicone breast implants?
-How long do breast implants last?
-Do breast implants affect breast-feeding?
-What are the potential risks and complications?
Are you a good candidate for breast augmentation?
Patients who seek breast implants typically range from their late teens to well into their sixties. Breast growth and development must be complete before considering breast augmentation. If you have no significant medical problems, have no breast health issues, and would like to increase the size and perkiness of your breasts, then you may be a good candidate for breast augmentation.
The most important thing is to make sure that you have an in depth discussion with one of our plastic surgeon at the Schwarz Plastic Surgery Center regarding all aspects of the surgery, including how your breasts will appear after this plastic surgery and what you can expect to gain from getting breast implants.
How is a breast augmentation performed, and what decisions must I make before having one?
There are FOUR CHOICES you must make prior to having a breast augmentation:
- Choose what type of incision the surgeon will use to insert the implants
- Choose whether to have the implants placed “over” or “under” your chest muscles
- Choose the type of implant you would like (silicone or saline, round or “shaped” implants)
- Choose the size of the implants
An incision can be made either underneath the breast, just above the crease, around the lower edge of the areola or within the armpit.
Breast augmentation can be performed using one of three types of incisions: Transaxillary, periareolar, or inframmamary incisions.
Transaxillary incision:
A two to three centimeter incision in the hair-bearing area under your arms.
Periareolar incision:
A two to three centimeter incision at the lower edge of your areola.
Inframmamary incision:
A two to three centimeter incision in the fold under your breast.
All three choices are safe and reliable, and your surgeon should help guide you in choosing which best suits you.
Implants can be placed under the chest muscles or over them. The benefits of placing them under the muscle include a lower chance of seeing “rippling” in the upper portion of the implant, a lower chance of having a “capsular contracture” (see below for explanation), and in some patients, a more natural appearance.
Implants should be placed over the muscle in patients who are bodybuilders, gymnasts, or serious weightlifters, where powerful use of the chest muscles can shift the implant position during contraction.
Silicone and saline implants both have very similar safety profiles. During the early 1990’s, silicone implants got a lot of negative publicity for three reasons. First, the implants lacked the quality of what is available today, and they were prone to breaking and “leaking.” Second, the implant manufacturers had not performed enough long-term scientific studies to prove the safety of their implants. Third, there were no guidelines as to how closely patients with breast implants should be followed by their surgeons. Over the last two decades, the implant manufacturers have not only dramatically improved the quality of their implants, but have also studied and shown the long-term safety of their products, dispelling many of the fears that patients had in the past. As for surgeon follow-up of breast augmentation patients, our policy is to see all on a yearly basis.
The major advantage of silicone over saline implants is that they provide a more natural look and feel of the breast, because they are filled with a soft, silicone gel. The advantages of saline implants include a slightly shorter incision and, if they break, they deflate almost immediately, with the body absorbing the salt water. When a silicone implant breaks, it can be trickier to detect, but can be easily confirmed by an ultrasound or an MRI. You should ask the surgeons of the Schwarz Plastic surgery Center about you the pros and cons of silicone vs. saline implants so that you make an informed, comfortable decision.
The final choice to be made is the size/volume and shape of the implant you would like. Implants come in round or “tear-drop” shaped forms. Which one is most appropriate for you depend on the shape and dimensions of your breasts. It is particularly important that your surgeon guide you through this process, and can provide you with “sizing implants” during the consultation to choose the appropriate size and shape. Our surgeon’s most important role at this point is to make sure that the implant you choose fits with the dimensions of your chest/breasts, ensuring a good-looking, long lasting result.
The Procedure:
A breast augmentation takes about 1-1 ½ hours to complete. We perform the entire operation via a 2-3 centimeter incision, through which we create a pocket (under or over the muscle) for the implant. Once the pocket is made, we often use “sizers” (temporary implants) to determine which final implant size looks best for the patient. The sizers are removed immediately and the final implants are placed in the pockets. After confirming a nice, symmetric result, we close the incisions with absorbable stitches that are placed deep to the skin, leaving only a fine line at the incision site. At the end of the operation, we place a simple gauze dressing over our patients’ breasts. After awakening from anaesthesia, our patients are brought to the recovery room and are cared for by a dedicated recovery room nurse. When patients are comfortable, they are escorted home by a friend or family member. We provide everyone with antibiotics and pain medication for a few days.
Do I need a “breast-lift” as well?
The technical name for a “breast-lift” is “mastopexy.” Patients who have excess breast skin and whose breasts “sag” significantly often benefit from a “breast-lift” at the same time as the breast augmentation. While the implant does fill some of the extra skin, any excess must be addressed by doing a “breast-lift” at the same time. The benefit is a much-improved shape and better nipple position, resulting in perkier breasts. At the time of consultation, our surgeon can determine whether or not you would benefit from such a procedure.
Do I need to be put to sleep for the operation?
We perform all breast augmentations under general anaesthesia, meaning patients are completely asleep during the operation. This provides the safest and most comfortable alternative for our patients.
What happens in the days following a breast augmentation (How long is the recovery time)?
For the first 48 hours, patients are expected to keep the gauze dressing over their breasts dry, but can sponge bathe liberally. The first post-operative appointment is typically 48-72 hours after this plastic surgery, when we remove the gauze dressing. Patients are allowed to shower once the dressing is removed. We also show patients how to “massage” their implants, ensuring that they remain soft and supple. Patients can choose to wear a bra or not, whichever they are most comfortable with. As for restrictions, patients can begin their daily lives as soon as they are comfortable, provided they avoid exercise, strenuous activity, or heavy lifting. Most patients will schedule a week away from work for recovery. All restrictions are lifted three weeks after the date of surgery, at which point patients no longer have limitations. Follow-up appointments are then scheduled at one week, three week, three month, and then yearly intervals. The current recommendation from implant manufacturers is that all breast augmentation patients get an MRI of their breasts every three years.
Will my breasts look natural after the operation?
Patients are often concerned that their breasts will look “fake” after a breast augmentation. We reassure everyone that a natural-looking breast augmentation can be achieved. It all depends on technique and the choice of implant. Whether our patients want full, perky breasts or a subtle increase in size of their breast will determine how we perform the operation and what implant to use. These important details are discussed at length with all of our patients during the consultation.
How long do breast implants last?
Silicone and saline breast implants both last about the same amount of time before they “break.” Contrary to popular belief, there is no such thing as a breast implant that lasts forever. In fact, we tell all of our younger patients that their implants will likely have to be changed some time in the distant future. The chance that a breast implant breaks is about ½ percent a year. This means that, ten years after the surgery, there is a 95 percent chance that the implant is intact.
If an implant does break, it should be removed and can usually be easily replaced through the same incision.
Do breast implants affect breast-feeding?
It is a misconception that breast implants affect breast-feeding. Patients who undergo breast augmentation can expect to breast-feed normally, with no effect whatsoever on the breast milk or the baby.
What are the potential risks and complications?
Breast augmentation is a safe, predictable procedure. As with any surgery, there are associated risks and complications. These include infection, bleeding, asymmetry, decreased nipple sensation, implant malposition, “rippling,” and implant rupture. There is also a risk of capsular contracture, which is when the body produces a tight shell of scar tissue around the implant, causing it to “harden” and possibly shift position. While complications are relatively rare, they should all be discussed with your surgeon during the consultation process.