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Breast Augmentation (Breast Implants and Enlargement)

Breast Augmentation is done on an outpatient basis, usually under general anesthesia. A breast implant (prosthesis) is placed through an incision, under the breast tissue or under the muscle. The incision can be made around the nipple, in the belly button, or under the arm. A breast implant is composed of an outer silicone shell filled with saline or silicone. The outer surface may be smooth or textured, and implants come in various shapes to meet the individual woman's needs.

When the implant is placed sub muscularly under the breast, there is a lower chance of contracture (contraction of the tissue capsule surrounding the implant), and mammography is more reliable. There is also less risk of visible or palpable implant edges. However, in some cases the implant has a more natural appearance when placed above the muscle, under the breast tissue.

Determining Implant Size
The shape of your augmented breasts depends on the implant. Many choices are available in our Los Angeles office, and implants may be round or teardrop-shaped (anatomical). The choice depends on the look you want to achieve: Anatomical implants produce a gentle slope, resulting in a fuller upper area, whereas round implants create a round curve in the upper part of the breast. Another factor to consider prior to surgery is breast width, which determines the amount of cleavage between your breasts and the outer curves, which you may want to balance with your hips.

Realistic expectations of this procedure are important. Women often think of breast size in terms of bra cup size. If you are currently a size A and wish to be a size C, there must be adequate existing breast tissue coverage; otherwise you will be warned of visible or palpable implant edges and other possible risks.

Post Operative Care
You must have someone drive you home and stay with you for 24 hours after breast augmentation surgery. You will experience some pain the first day or two that is easily controlled with pain pills. Some tightness in the breast area is also normal as your body adjusts to the implants.

You can move about freely after surgery. Wear a bra at all times (except when showering) during the first 2 weeks following surgery. Avoid heavy lifting for 2-3 weeks. Moderate exercise such as walking or stationary biking is allowed after the first week. Vigorous exercise such as jogging or aerobics may be resumed at 3-4 weeks. You will most likely be able to return to work within a few days, but you will need to avoid any strenuous activity for at least a couple of weeks.

During recovery, the breasts will be somewhat swollen. Within a few weeks, the actual shape and size will be evident. You may notice some asymmetry; however most breasts are naturally somewhat asymmetrical.

Possible Complications
Delayed wound healing may occur in persons with diabetes, history of radiation, autoimmune disease or smokers. Other complications include capsular contracture, bleeding, infection, or irregularity of the skin. It is important to have a thorough medical evaluation beforehand to address these potential risks. You also need to know that even a small hole in an implant can cause the saline to leak out, resulting in a 'flat' implant and necessitating surgical replacement. This is completely avoidable, however, by taking proper precautions.

Conclusion
Augmentation mammaplasty is a safe procedure that has produced pleasing and satisfying results for many women. Those who are psychologically stable and have realistic expectations benefit the most. A preliminary consultation can help you determine whether breast augmentation is right for you.

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