WAIT!! If you're considering breast
augmentation... look here
Breast augmentation, technically known as augmentation
mammoplasty, is a surgical procedure to enhance the size and shape
of a woman's breast for a number of reasons:
- One - To enhance the body contour of a woman who, for personal
reasons, feels her breast size is too small.
- Two - To correct a reduction in breast volume after pregnancy.
- Three - To balance a difference in breast size.
- Four - As a reconstructive technique following breast surgery.
By inserting an implant behind each breast, surgeons are able to
increase a woman's bustline by one or more bra cup sizes. If you're
considering breast augmentation, this will give you a basic
understanding of the procedure--when it can help, how it's
performed, and what results you can expect. It can't answer all of
your questions, since a lot depends on your individual
circumstances. Please ask your surgeon if there is anything you
don't understand about the procedure.
THE BEST CANDIDATES FOR BREAST
AUGMENTATION
Breast augmentation can enhance your appearance and your
self-confidence, but it won't necessarily change your looks to match
your ideal, or cause other people to treat you differently. Before
you decide to have surgery, think carefully about your expectations
and discuss them with your surgeon.
The best candidates for breast augmentation are women who are
looking for improvement, not perfection, in the way they look. If
you're physically healthy and realistic in your expectations, you
may be a good candidate.
TYPES OF IMPLANTS
A breast implant is a silicone shell filled with either silicone
gel or a salt-water solution known as saline.
Because of concerns that there is insufficient information
demonstrating the safety of silicone gel-filled breast implants, the
Food & Drug Administration (FDA) has determined that new
gel-filled implants, at the present time, should be available only
to women participating in approved studies. Some women requiring
replacement of the implants may also be eligible to participate in
the study.
Saline-filled implants continue to be available to breast
augmentation patients on an unrestricted basis, pending further FDA
review. You should ask your doctor more about the specifics of the
FDA decisions.
ALL SURGERY CARRIES SOME
UNCERTAINTY AND RISK
Breast augmentation is relatively straightforward. But as with
any operation, there are risks associated with surgery and specific
complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar
or capsule around the implant begins to tighten. This squeezing of
the soft implant can cause the breast to feel hard. Capsular
contracture can be treated in several ways, and sometimes requires
either removal or "scoring" of the scar tissue, or perhaps removal
or replacement of the implant.
As with any surgical procedure, excessive bleeding following the
operation may cause some swelling and pain. If excessive bleeding
continues, another operation may be needed to control the bleeding
and remove the accumulated blood.
A small percentage of women develop an infection around an
implant. This may occur at any time, but is most often seen within a
week after surgery. In some cases, the implant may need to be
removed for several months until the infection clears. A new implant
can then be inserted.
Some women report that their nipples become oversensitive,
undersensitive, or even numb. You may also notice small patches of
numbness near your incisions. These symptoms usually disappear
within time, but may be permanent in some patients.
There is no evidence that breast implants will affect fertility,
pregnancy, or your ability to nurse. If, however, you have nursed a
baby within the year before augmentation, you may produce milk for a
few days after surgery. This may cause some discomfort, but can be
treated with medication prescribed by your doctor.
Occasionally, breast implants may break or leak. Rupture can
occur as a result of injury or even from the normal compression and
movement of your breast and implant, causing the man-made shell to
leak. If a saline-filled implant breaks, the implant will deflate in
a few hours and the salt water will be harmlessly absorbed by the
body.
If a break occurs in a gel-filled implant, however, one of two
things may occur. If the shell breaks but the scar capsule around
the implant does not, you may not detect any change. If the scar
also breaks or tears, especially following extreme pressure,
silicone gel may move into surrounding tissue. The gel may collect
in the breast and cause a new scar to form around it, or it may
migrate to another area of the body. There may be a change in the
shape or firmness of the breast. Both types of breaks may require a
second operation and replacement of the leaking implant. In some
cases, it may not be possible to remove all of the silicone gel in
the breast tissue if a rupture should occur.
A few women with breast implants have reported symptoms similar
to diseases of the immune system, such as scleroderma and other
arthritis-like conditions. These symptoms may include joint pain or
swelling, fever, fatigue, or breast pain. Research has found no
clear link between silicone breast implants and the symptoms of what
doctors refer to as "connective-tissue disorders," but the FDA has
requested further study.
While there is no evidence that breast implants cause breast
cancer, they may change the way mammography is done to detect
cancer. When you request a routine mammogram, be sure to go to a
radiology center where technicians are experienced in the special
techniques required to get a reliable x-ray of a breast with an
implant. Additional views will be required. Ultrasound examinations
may be of benefit in some women with implants to detect breast lumps
or to evaluate the implant.
While the majority of women do not experience these
complications, you should discuss each of them with your physician
to make sure you understand the risks and consequences of breast
augmentation.
PLANNING YOUR
SURGERY
In your initial consultation, your surgeon will evaluate your
health and explain which surgical techniques are most appropriate
for you, based on the condition of your breasts and skin tone. If
your breasts are sagging, your doctor may also recommend a breast
lift.
Be sure to discuss your expectations frankly with your surgeon.
He or she should be equally frank with you, describing your
alternatives and the risks and limitations of each. You may want to
ask your surgeon for a copy of the manufacturer's insert that comes
with the implant he or she will use -- just so you are fully
informed about it. And, be sure to tell your surgeon if you smoke,
and if you're taking any medications, vitamins, or other drugs.
Your surgeon should also explain the type of anesthesia to be
used, the type of facility where the surgery will be performed, and
the costs involved. Because most insurance companies do not consider
breast augmentation to be medically necessary, carriers generally do
not cover the cost of this procedure.
PREPARING FOR YOUR
SURGERY
Your surgeon will give you instructions to prepare for surgery,
including guidelines on eating and drinking, smoking, and taking or
avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to
drive you home after your surgery and to help you out for a few
days, if needed.
WHERE YOUR SURGERY WILL BE
PERFORMED
Your surgeon may prefer to perform the operation in an office
facility, a freestanding surgery center, or a hospital outpatient
facility. Occasionally, the surgery may be done as an inpatient in a
hospital, in which case you can plan on staying for a day or
two.
TYPES OF ANESTHESIA
Breast augmentation can be performed with a general anesthesia,
so you'll sleep through the entire operation. Some surgeons may use
a local anesthesia, combined with a sedative to make you drowsy, so
you'll be relaxed but awake, and may feel some discomfort.
THE SURGERY
The method of inserting and positioning your implant will depend
on your anatomy and your surgeon's recommendation. The incision can
be made either in the crease where the breast meets the chest,
around the areola (the dark skin surrounding the nipple), or in the
armpit. Every effort will be made to assure that the incision is
placed so resulting scars will be as inconspicuous as possible.
Working through the incision, the surgeon will lift your breast
tissue and skin to create a pocket, either directly behind the
breast tissue or underneath your chest wall muscle (the pectoral
muscle). The implants are then centered beneath your nipples.
Some surgeons believe that putting the implants behind your chest
muscle may reduce the potential for capsular contracture. Drainage
tubes may be used for several days following the surgery. This
placement may also interfere less with breast examination by
mammogram than if the implant is placed directly behind the breast
tissue. Placement behind the muscle however, may be more painful for
a few days after surgery than placement directly under the breast
tissue.
You'll want to discuss the pros and cons of these alternatives
with your doctor before surgery to make sure you fully understand
the implications of the procedure he or she recommends for you.
The surgery usually takes one to two hours to complete. Stitches
are used to close the incisions, which may also be taped for greater
support. A gauze bandage may be applied over your breasts to help
with healing.
AFTER YOUR SURGERY
You're likely to feel tired and sore for a few days following
your surgery, but you'll be up and around in 24 to 48 hours. Most of
your discomfort can be controlled by medication prescribed by your
doctor.
Within several days, the gauze dressings, if you have them, will
be removed, and you may be given a surgical bra. You should wear it
as directed by your surgeon. You may also experience a burning
sensation in your nipples for about two weeks, but this will subside
as bruising fades.
Your stitches will come out in a week to 10 days, but the
swelling in your breasts may take three to five weeks to
disappear.
GETTING BACK TO
NORMAL
You should be able to return to work within a few days, depending
on the level of activity required for your job.
Follow your surgeon's advice on when to begin exercises and
normal activities. Your breasts will probably be sensitive to direct
stimulation for two to three weeks, so you should avoid much
physical contact. After that, breast contact is fine once your
breasts are no longer sore, usually three to four weeks after
surgery.
Your scars will be firm and pink for at least six weeks. Then
they may remain the same size for several months, or even appear to
widen. After several months, your scars will begin to fade, although
they will never disappear completely.
Routine mammograms should be continued after breast augmentation
for women who are in the appropriate age group, although the
mammographic technician should use a special technique to assure
that you get a reliable reading, as discussed earlier. (see All
surgery carries some uncertainty and risk.)
YOUR NEW LOOK
For many women, the result of breast augmentation can be
satisfying, even exhilarating, as they learn to appreciate their
fuller appearance.
Regular examination by your plastic surgeon and routine
mammograms for those in the appropriate age groups at prescribed
intervals will help assure that any complications, if they occur,
can be detected early and treated.
Your decision to have breast augmentation is a highly personal
one that not everyone will understand. The important thing is how
you feel about it. If you've met your goals, then your surgery is a
success.
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