1. How are the breast implants put in?

There are 4 incision options for a patient undergoing breast augmentation including around the lower part of the areola, in the crease under the breast, in the axilla (armpit), and the belly button. There are advantages to each option, but the vast majority of patients will chose an incision around the areola or in the crease under the breast. Once the incision is created, a pocket is made in the breast (either on top of or underneath the muscle of the chest) for the implant to be placed. The incision is then closed with dissolvable stitches underneath the skin surface.


2. What is a "drain" and when is one used?

With some operations, the body has a tendency to collect fluid under the skin, similar to the type of fluid in a blister. When there is a high risk of fluid accumulating, a surgeon may place a small tube through the skin into the area of the surgery to allow that fluid a way of escaping. The tube with the container the fluid collects in is called a drain. For most patients undergoing their first breast augmentation surgery, a drain is not necessary. Patients who have had previous breast surgery may be at a higher risk of fluid accumulation and a drain may be placed during their operation and removed in the office within a few days.


3. What about doing other operations at the same time?

Breast augmentation surgery can be combined with other operations, but the safety of combining operations needs to be assessed on a case by case basis. Generally I think about several issues when making these decisions including: - How long will the surgery take? I believe it s safest to limit the time spent in surgery to under 6 hours - Is it possible that germs from another part of the body could get on the implant? It is extremely important to reduce the risk of infection after breast augmentation surgery, so I prefer not to operate on a "dirty" part of the body (the mouth, for example) at the same time as I place a breast implant. - How will having multiple procedures affect the patient s recovery? While it is possible to combine a breast augmentation with a tummy tuck, for example, the patient needs to understand that taking care of herself after surgery is more difficult when her chest and abdomen both hurt. - Will combining the operations increase the risks of the surgery? For example, when a breast lift is combined with an augmentation, the risk of the surgery is higher than if these two procedures were performed separately. The combined surgery can still be done, but it is important that the patient understand these risks ahead of time.


4. Why must I have an adult stay with me the first night?

After any surgical procedure involving anesthesia, it is safest to have someone with you for 24 hours afterwards to make sure you are able to take care of yourself and to help you contact your doctor if any issues arise.


5. What measures can be taken to prevent capsular contracture?

Capsular contracture is an overgrowth of scar tissue that can develop around a breast implant. There are several theories about why this may develop, but there is no concrete proof of why this happens in certain patients. We do know that implants under the muscle of the chest have a lower risk of developing a contracture. If the implants are placed above the muscle of the chest, using a textured implant will also lower the risk of contracture. There are some surgeons that believe that certain medications placed into the implant pocket during surgery or even some medications taken after surgery will decrease the risk of contracture, although this belief is controversial.


6. What is the "Band" or "Strap" that everyone talks about wearingafter operation?

Some surgeons will have patients wear an elastic band over the top of their breast implants after surgery to keep the implants settled in the lower part of the breast during the initial healing process.


7. What is meant by the Rapid Recovery method?

The Rapid Recovery method is an approach to breast augmentation that involves pre-operative patient education, choosing an implant that is appropriately sized for the patient s body, careful surgical technique, and a post operative regimen that encourages stretching exercises and minimizes the use of narcotic pain medication. With this approach, many women are able to resume most of their normal activities within a few days of surgery.


8. How much swelling is there after operation?

There is not typically a lot of swelling after breast augmentation surgery, although the implants will often feel tight and there can be more visible fullness at the top of the breasts right after surgery. The implants will settle into place over approximately 3 months.