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Breast Augmentation | Return to Previous | |||
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Overview Breast augmentation (or augmentation mammoplasty) is a surgical procedure to increase the size and shape of the breasts. Women may consider having their breasts enlarged for several different reasons:
Breast augmentation involves the placement of a saline (salt-water) implant either behind the breast tissue or under the chest wall (pectoral) muscle. The insertion of an implant will push the breast tissue forward, making the breast appear larger and more full. According to the American Society of Plastic Surgeons, more than 206,000 women underwent breast augmentation in 2002. Most procedures are performed in an outpatient setting. The majority of women who undergo breast augmentation are between 19 and 34 years old. Main Menu:
In most cases, women who are considering breast augmentation will set up an initial consultation with a plastic surgeon. All plastic surgeons should be certified by the American Society of Plastic Surgeons (ASPS). The surgeon will evaluate the woman’s health and determine which surgical techniques are best for the woman, based on her situation. While breast augmentation may increase a woman’s self-confidence, she must be realistic about the results. Though breast augmentation will increase the size of a woman’s breasts, it will not perfect them. Most plastic surgeons will discuss alternatives to plastic surgery as well as the risks and limitations of the procedure. Physically healthy women who are realistic about breast augmentation are usually the best candidates for the procedure. Issues discussed in the initial consultation may include:
Women considering breast augmentation should tell their plastic surgeons about any medications, vitamins, or other drugs they may be taking. It is very important that women who smoke tell their plastic surgeons because smoking could possibly delay the healing process and cause additional complications. Most plastic surgeons will recommend the woman have a baseline mammogram before undergoing surgery. In 1992, the U.S. Food and Drug Administration (FDA) imposed a ban on the general use of silicone gel-filled breast implants until additional medical trials determine their safety. Currently, only saline (salt water) filled implants are used in breast augmentation surgeries with the exception of a few closely monitored experimental studies. Breast augmentation is almost always performed under general anesthesia. The procedure may be performed at an office facility, a surgical center, or a hospital outpatient facility. Occasionally, women must check into a hospital for the procedure. The plastic surgeon will determine the best method of inserting the saline implant based on a woman’s breast condition and personal situation. Surgical incisions may be placed either in the upper portion of the underarm (transaxillary), in the armpit (axillary), around the nipple (periareolar), or through the fold under the breast (inframammary). A small scar will remain after surgery, although most plastic surgeons will try to make the incision in an area that will minimize visibility of the scar (such as through the fold under the breast). The transaxillary incision, for example, is made in the armpit area, which places the scar away from the breast area. Through the incision, the surgeon will lift the breast tissue and skin to create a pocket either directly behind the breast tissue or underneath the chest wall (pectoral) muscle. The saline implant will then be inserted. Many plastic surgeons prefer to place the implant under the chest wall muscle to separate the breast tissue from the newly inserted implant. This position may give the breast a more natural appearance, reduce the chances of capsular contracture (tightening of the scar around the implant), and help make mammograms easier to read (special mammography views are required for breasts with implants). Drainage tubes are usually inserted in the breast or under the arm to help remove blood or other fluids which may accumulate during the healing process. The tubes are typically removed several days after surgery. Breast augmentation surgery usually takes between one and two hours. Stitches will be placed to close incisions, and gauze bandages may be placed over the breasts to facilitate healing. Most women will experience breast pain, discomfort, and fatigue during the first 24 to 48 hours after surgery. The breasts are usually swollen, bruised, and sensitive after augmentation surgery. Pain medications may be prescribed to help alleviate discomfort. Most women are able to resume normal daily activities within a week and strenuous activities within a month or two. A burning sensation may occur in the nipples during the first two weeks after surgery; swelling and increased sensitivity may last for up to a month. Stitches will usually be removed seven to 10 days after surgery. Surgical scars will be firm and pink for up to two months after surgery. Scars will generally remain the same size for several months and may even appear to widen. Scars will fade after several months but will remain indefinitely. Women over 40 years of age should continue having annual mammograms to screen for breast cancer after breast augmentation surgery. Because of the implant, several special mammography views must be taken to allow visualization of both the breast tissue and the implant. Diagnostic mammography is usually performed on women with breast implants rather than screening mammography. Imaginis.com is unaware of any documented cases where mammography has been the direct cause of implant rupture. The x-rays used for mammographic imaging of the breasts cannot penetrate silicone or saline implants well enough to image the overlying or underlying breast tissue. Therefore, some breast tissue (approximately 25%) will not be seen on the mammogram, as it will be covered up by the implant. The most common side effect of breast implant surgery is capsular contracture: the scar or capsule around the implant begins to tighten and squeezes down on the soft implant, causing the breast to feel hard. Capsular contracture may be treated with additional surgery to remove the scar tissue. Occasionally, patients with capsular contracture may have to have the breast implant removed and replaced with a new one. However, a recent study shows that the likelihood of capsular contracture may be reduced if implants are treated with antibacterial agents during surgery. Other possible side effects of breast implants include:
Other less common factors that could affect breast appearance include:
Breast implants may deflate or rupture from injury to the breast or through normal wear over time. Saline implants deflate quickly and surgery is usually done immediately to remove or replace the implant. Saline (salt water) is absorbed naturally by the body and does not pose any health risks. Approximately 50% of saline implants need some type of modification or replacement after five or 10 years. Nursing After Breast Augmentation Breast-feeding is possible in most instances after breast augmentation surgery unless implants were placed to rebuild the contour of the breast following breast removal with mastectomy (as part of treatment for breast cancer). Women who have breast reconstruction often have the nipple and areola (dark pigmented region around the nipple) re-grafted on the breast, but because the glands and milk ducts were removed during surgery, they are unable to produce milk. On the other hand, women who have breast-fed within a year before augmentation may produce some milk for a few days following surgery. Though this may be uncomfortable, it can be treated with medications prescribed by a physician. Additional Resources and References
Updated: October 24, 2007 |
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