Breast Augmentation

By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.


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Those who are not eligible for breast augmentation include women that are pregnant or nursing or those who currently have breast cancer.


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In the initial consultation the surgeon will evaluate the patient's health and explain which surgical techniques are most appropiate, based on the condition of the breasts and the skin tone. If the breast are sagging, the doctor may also recommend a breast lift for optimal results.

Patients should always discuss their expectations with the surgeon. He or she can describe the alternatives and the risks and limitations of each procedure. The patient may want to ask the surgeon for a copy of the manufacturer's insert that comes with the implant that will be used, just to make sure the patient is fully informed. The patient should always tell the surgeon if she smokes, and if she's taking any medication, vitamins or other drugs.

The surgeon should explain the type of anesthesia to be used and the type of facility where the surgery will take place. Furthermore, the surgeon will give instructions how to prepare for surgery, including guidelines on eating, drinking, smoking and taking or avoiding vitamins and medications

Breast augmentation can be performed 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 this case the patient can plan on staying for a day or two. The patient should always arrange for someone to drive her home after the surgery and to help about for a few days.

Breast augmentation can be performed with a general anesthesia, so the patient will sleep through the entire operation. Some surgeons may rather use a local anesthesia, along with a sedative, so the patient will be relaxed, but awake, but also feel some discomfort.

The method of inserting and positioning the implant will depend on the patient's anatomy and the surgeon's recommendation. The incision can be made 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 scars will be as inconspicuous as possible.

The surgeon will lift the breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath the chest wall muscle (pectoral muscle). The implants are then centered beneath the nipples. Some surgeons believe that putting the implants behinh the chest muscle may reduce the potential for capsular contracture. Drainage tubes may be inserted for several days. This placement may also interfere less with examination by mammogram than if the implant is placed directly behind the breast tissue. On the other hand, placement behind the muscle may be more painful for a few days after surgery than placement directly under the breat tissue. Patients should discuss the pros and cons of these alternatives with their doctor before surgery.

The operation 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.

The patient will feel tired and sore for a few days following the surgery, but should be up and around in 24 to 48 hour. Most of the discomfort can be controlled by medication prescribed by the doctor. Within several days, the gauze dressings will be removed and you may be given a surgical bra. The patient may also experience a burning sensation in the nipples for about two weeks, but this will subside as bruising fades. The stitches will come out in a week to ten days, but swelling in your breasts may take three to five weeks to disappear.

The patient will be able to return to work within a few days, depending on the level of activity required for the patient's job. The patient should follow the surgeon's advice on when to begin exercises and normal activities. The breasts will probably be sensitive to direct stimulation for two to three weeks, so psychical contact should be avoided. After that, breast contact is fine once the breasts are no longer sore, usually three to four weeks after surgery.

The scars will be pink and firm for about six weeks. After that they may remain the same size for several months, or appear to widen. After several months the scars will be begin to fade, although they will never completely disappear.

After breast augmentation, routine mammograms should be continued for women who are in the appropriate age group. Remember that the mammographic technician should use a special technique to assure reliable reading.

The results of breast augmentation can be satisfying, even exhilarating. Regular examination by the surgeon and routine mammograms at prescribed intervals will help assure that any complications can be detected early.


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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 blood.

Some women may develop an infection around the implant. This may occur at any time, but happens mostly within a week after surgery. In some cases the implant may need to be removed until the infection clears. A new implant can then be inserted.

The nipples may become oversensitive, undersensitive or even numb. The patient may also notice small patches of numbness near the incisions. This usually disappears within time, but may be permanent in some cases. It's unlikely that breast implants affects fertility, pregnancy, or the ability to nurse. If the patient has nursed a baby within the year before the augmentation, some milk may be produced for a few days after surgery.

In rare cases breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of the breast and implant, causing the shell to leak. If a saline-filled implant breaks the implant will deflate in a few hours and the salt water will be absorbed by the body, which is harmless. However, if a gel-filled implant breaks, one of the following things may occur. If the shell breaks but the scar capsule around the implant does not, no change may be noticed. 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. A change in the shape or firmness of the breast may occur. Both types of braks 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 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 relation between silicone breast implants and the symptoms of what has been referred to as "connective-tissue disorders", but further study is requested.

Even though there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When a patient requests a mammogram, she must make sure the technicians are experienced in the special technique required to get a reliable x-ray of a breast with an implant. Ultrasound examination may be useful with some women with implants to detect lumps or to evaluate the implant.

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