Health & Fitness

Doc Talk: Answers to questions about breast augmentation

Breast augmentation is the most frequently performed plastic surgery nationwide. But for many, details about the procedure are a mystery. Here are answers to some common questions people have when they are considering having the aesthetic surgery.

Q: How common is breast augmentation surgery?

A: There were 307,180 breast implant surgeries performed in the United States in 2011, according to the Plastic Surgery Statistics Report. This is a 4 percent increase in procedures from 2010. Surgeries were a combination of saline and silicone implant augmentations.

Q: How do saline implants differ from silicone implants?

A: Both types of implants consist of a silicone shell. Saline implants are inserted into the breast empty and are filled by the surgeon with saline (sterile salt water). Because they are filled at the time of surgery, slight adjustments in size can be made during surgery, whereas silicone implants come prefilled with silicone gel and cannot be adjusted during surgery. Both types of implants are available in a variety of shapes and sizes. The surgeon will determine what implant style best meets your needs and expectations.

Q: How are breast implants inserted into the breast?

A: During breast augmentation surgery, patients undergo general anesthetic. Incisions can be placed on the lower side of the areola, under the fold of the breast or in the axilla, or armpit. Your surgeon will make an incision, typically two inches in length, to allow access to the inside of the breast. Your surgeon will make a space under the breast tissue but above (subglandular) or below (submuscular) the pectoralis muscle to place the implant. Once the space has been made, the implant is inserted and the skin is closed with dissolvable sutures.

Q: How long is recovery from breast augmentation surgery?

A: Most patients feel tired and have mild to moderate pain after surgery. They are provided with prescription pain medication, which they may need for only a few days or a couple of weeks. Patients’ breasts will be swollen and sensitive for several weeks after surgery. They should plan to wear a soft, supportive bra day and night for three weeks to encourage breast implants to settle into the desired location and prevent them from shifting. They will have a restriction in cardiovascular exercise for two weeks and a lifting restriction of 10 to 15 pounds for four weeks postoperatively.

Q: What are the potential risks of breast augmentation surgery?

A: No surgical procedure is without risks, but surgeons take extensive precautions to prevent them. There is a risk of possible infection or bleeding after surgery. Antibiotics are given during surgery, and antibiotic irrigation is used to cleanse the inside of the breast prior to placing the implant. Limiting activity after surgery helps prevent postoperative bleeding.

Occasionally, complications can occur with the implants themselves. In about 5 percent of patients, capsular contracture occurs. This is when the lining that forms around the implant tightens, causing the breast to become overly firm, which can lead to pain. Implant rupture is another possible complication. The lifespan of an implant (saline or silicone) is between 10 to 15 years. All implants will rupture at some time as a result of normal wear from daily activities. Surgical interventions may be necessary in the event of capsular contracture or implant rupture. Patients should contact their surgeon if they notice any changes in the shape, size or feel of their breasts.

Q: I am ready. What is the next step toward breast augmentation surgery?

A: Find a board-certified plastic surgeon to perform the surgery. This certification ensures that your surgeon is specifically trained and qualified to perform the surgery. The next step is to schedule a consult appointment.

Q: What can you expect from a breast augmentation consult with a plastic surgeon?

A: On the day of the consult, patients will be asked to fill out a complete health history to help their surgeon review their health and determine if there are any risks for general anesthetic or surgery. The surgeon will discuss the procedure in detail as well as what the patient’s expectations are, including desired breast size, implant type and desired location for implant placement. The surgeon will examine a patient’s breasts and take measurements to ensure that the correct size of implants for each person’s body shape is used. Preoperative pictures will be taken. Some plastic surgeons have the ability to take 2-D digital photos as well as 3-D images. Three-D imaging provides an excellent tool for working with the surgeon to determine the best implant size for each body type.