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Breast Augmentation General Information

Breast augmentation is performed to increase breast fullness and volume for women with small breasts or those who have experienced a decrease in breast size due to pregnancy or weight loss. There is a wide variety of implant designs, shapes, sizes, and textures, all of which have certain advantages and disadvantages. A breast implant is basically a soft, silicone envelope with various fillers that is surgically implanted under the tissues of your chest to simulate natural breast tissue.

The breast implant used for primary breast augmentation is made of a silicone shell filled with a saline solution. Saline filled adjustable implants that are similar to the standard saline filled implants with the addition of a small connector tube through which the surgeon can adjust the size via injection. This implant requires a second incision to remove the injection port in an additional breast augmentation procedure. Under certain conditions, including breast reconstruction, breast lift and other secondary breast procedures, silicone gel implants are now approved by the FDA.

Breast augmentation may be performed under local anesthesia with intravenous sedation, or general anesthesia. General anesthesia may be recommended for women desiring implant placement below the muscle. The breast augmentation surgery consists of making an incision, lifting the breast tissue, creating a pocket in the chest/breast area, and placing an envelope containing a soft, implant material underneath. An incision may be made either in the crease below the breast, around the Areola, or under the armpit. The implants can be placed either under the chest muscle or directly under the breasts. Placement considerations include the anatomy of your breasts, breast feeding, and your personal preference.

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.

A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.

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.

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.

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.

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.

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