What is breast augmentation?

Breast augmentation is a surgical technique in which an implant is used to enhance the shape and volume of the breast. As in any aesthetic surgical intervention, patient selection is the key. Your consultation with a board certified plastic surgeon should review your general and breast health. A thorough breast exam and evaluation of appropriate breast imaging (mammogram / ultrasound) should be performed. Your specific aesthetic concerns should be discussed to be sure that an individualized and realistic surgical plan is formulated. The risks of breast augmentation include bleeding, infection, changes in the nipple-areolar sensation and function, and post operative aesthetic contour abnormalities. Bleeding and infection are rare events. I have never personally had a post operative augmentation implant infection; however, even excellent surgeons can have a patient with an infection. This is one reason to choose a surgeon with experience. Your surgeon should be familiar with the management of all complications which might arise from surgery - even rare ones. Changes in the sensation and function of the nipple areolar complex has to do with the nerve supply to the nipple.A good rule of thumb is - the bigger the change in breast size, the more likely that you will compromise the sensation of your nipple. Your surgeon should be a good resource as to appropriate implant sizes for your body size. Contour abnormality is a position or implant placement problem. This comes from the actual implant placement at the time of surgery. This can lead to asymmetry between the breasts. Too large or too small an implant can also be considered a contour problem. We now have at our disposal two types of implants - saline and silicone. In my practice silicone implants are now the principle augmentation implant. They have a more natural feel and appearance than saline implants. But, keep in mind, that saline implants have been used for years and have a 95% efficacy rate among patients. That means that 95% of women who have them are happy with them. All implants have inherent risks. With saline implants comes deflation, contracture, and rippling. Silicone implants can rupture and contract. The FDA has also suggested a schedule of MRI follow up of silicone implants. Saline implants are less expensive but may not last as long. Again, find a experienced surgeon that you can trust and use them as a resource in your implant selection. My usual incision is in the crease beneath the breast. I use this incision for a variety of reasons. I think it limits the risks of infection and contracture.I also believe that this incision allows me to control the shape of the breast and position of the breast crease most reliably. I almost always place the implant beneath the pectoralis muscle. I think it provides for the most natural appearance. There is some information that indicates that a submuscular implant may have a lower incidence of contracture (though this risk is very low in my practice). I think that the greatest advantage of the submuscular implant is in future breast imaging. An implant above the muscle has the potential to hide breast tissue from future mammograms. Breast augmentation surgery is typically performed under a sedation anesthesia. It takes about an hour. Post operative pain is managed with anti-inflammatory drugs and a short period of narcotic pain medication. My patients are all seen by me on the day after surgery. After that visit, the patient may shower and wear a soft bra. I restrict patient activity to light lifting and minimal exercise for a month. After four weeks my patients return to routine pre-operative gym activity.