What are the goals of breast augmentation?
Contrary to popular belief, the goal of surgery is not to only make the breast bigger. The goal is to create a breast that is as natural in appearance and feel as possible. Also at the same time, if there are any other issues with the breast such as congenital problems or simple changes of motherhood, they should be addressed at the same time.
How long does the procedure take?
Breast augmentation usually takes under an hour to perform. Depending on each individual patients anatomy and goals, it may take a little less or more than an hour.
What type of anesthesia will I get?
There are two options, local with sedation or general. The great majority of plastic surgeons use general anesthesia.
How much discomfort will I have?
Everybody has different thresholds for discomfort. Typically, patients will take pain medication for the first 24-48 hours. After that, ibuprofen and/or acetaminophen are all that is needed. You can expect to feel as if you went to the gym and did a very heavy chest workout. The feeling over the next few days is not pleasant, but certainly not intolerable.
When can I go back to work?
Most sedentary, non-physical jobs can be resumed by 5-7 days.
When can I shower?
You may shower 72 hours after your procedure.
How long until I can drive again?
To be able to drive you must be off the pain medication for 24 hours, and feel confident that you can safely operate your vehicle. This usually takes a few days.
How about exercise?
You will have all restrictions lifted after the fourth week.
Where will the implant be placed?
There are three choices; above the muscle or sub-glandular; behind the muscle which is the most common; and subfascial. The advantages of the subfascial position are yet to be determined. Behind the muscle is the most common. What is important to know is that no one technique is appropriate for everybody. That is why your surgeon should be trained and familiar with all of the techniques.
What are some of the potential complications of this procedure?
Although the list below is not exhaustive, it does represent some of the possible yet still uncommon potential complications of the procedure:
- Bleeding (hematoma): if this occurs you may need another operation to drain the hematoma and try to find the source.
- Infection: if your implants are infected they must be removed. There will be a 6 month period that you will be without the implant. If you want the implant replaced, you will require a third operation. So as you can see if you get an infection you will need three procedures to correct it.
- Poor Scarring: many people believe that a bad scar means that they had a bad operation. The truth of the matter is that we as surgeons have very little control over how an individual will scar. Fortunately most individuals do make good scars. There are four potential scar locations: the crease; the underside of the areola; the axilla or armpit; and, the least common, the belly button. I offer only two: the crease and the lower part of the areola.
- Asymmetry: our bodies are not mirror images. There is always some asymmetry of breasts. If the asymmetry is major it should be improved. If it is minor it will persist, there is never perfect symmetry.
- Hardening (encapsulation): this is when the capsule that forms around the breast continues to thicken and the breast becomes firm, and the implant tends to migrate upward. This is the most common reason for re-operation and occurs in about 3%-5% of patients with implants. We are not certain of a cause and the only treatment is surgical release of the capsule.
- Numbness: anytime you have a procedure of the breast there can be residual numbness. It has nothing to do with the incision location. I tell all of my patients that if their breast is an erogenous zone they should think very carefully about having the procedure.
- Implant migration: this is a rare complication. After some time the implant comes to rest in a position that is not ideal. The only way to correct it is surgically.
- Implant failure: if your implant fails, whether it is saline or silicone, it will need to be replaced.
- Rippling: in some patients that are very thin, the edges of the implant can ripple or scallop, this may become visible. All implants ripple, saline more so that silicone. It only becomes a problem if it is visible, and this directly related to the amount of subcutaneous fat and breast tissue there is above the implant.
What will happen if I have a baby and nurse?
The only thing that you can say for sure is that your breast will change. How much and in what way is impossible to predict. There is no way to know if after having a baby you will need further surgery.
Does having implants increase my risk for breast cancer
No. As long as you are diligent with self-examination and screening, women with implants do not have more, or more severe, breast cancer.
Will I get saline or silicone
Both implants are safe and effective. This is a personal choice. If a patient is better suited for one over the other, this will be discussed during the consultation.