Breast augmentation, or breast enlargement, uses implants to increase the size of the breasts at the same time that the surgeon reshapes the breast. This procedure is usually adopted by women with small breasts, women who have an asymmetry between the breasts or women who have lost volume after pregnancy and/or nursing.
Breast augmentation surgery generally lasts between 1 and 3 hours and can be conducted on either an inpatient or outpatient basis using either a general or local anesthetic coupled with sedation. There are three different types of incisions used to cut into the breast – each with its own set of advantages and disadvantages:
- Trans-axillary approach, where an incision is made through the armpit.
- Infra-mammary approach, where an incision is made in the natural crease under the breast.
- Peri-areolar approach, where the incision is made at the juncture between the areola (dark skin around the nipple) and the natural skin.
Regardless of the approach, once the incision is made, the surgeon gently pulls the skin away from the muscle and soft tissue and creates a pocket either in or below the pectoralis major or between the muscle and the breast gland tissue. An implant made of a silicone outer shell is inserted into the pocket and centered beneath the nipple. The implant is slowly filled with a saline solution until the desired size is reached. The incision is closed with sutures and the area may be draped with bandages. Drainage tubes may be inserted to help remove excess liquid over the next 1 to 2 days. The surgery generally lasts between 1 and 3 hours.
There is the possibility of infection following any surgery. Your surgeon will likely prescribe antibiotics to avoid infection in addition to any pain medication. Bruising and swelling are common following breast augmentation surgery, particularly around the nipple area, and will subside slowly over 3 to 5 weeks. Patients may be required to wear a surgical bra for a while to support the breasts during recovery. Patients are encouraged to get up within the first 24 to 48 hours. Stitches are removed in 7 to 10 days and normal activity is resumed in roughly 2 weeks. However, strenuous activity and direct stimulation of the breasts are discouraged for up to 4 weeks.
Scars from breast augmentation surgery are permanent, but are usually placed as inconspicuously as possible. They do fade over a period of 6 to 9 months. Patients may experience a change in nipple sensation. Breast implants may also make performing and reading mammograms more difficult. Pregnancy can affect the long-term stability of breast implants. Be sure to discuss all the alternative surgical options with your surgeon to make the best choice for you.