Breast augmentation has provided many women a state of great satisfaction and well-being. The decision to have a breast augmentation is a very personal one. Every woman’s decision is different and should be made by her, based on her needs, desires and expectations. There are many options available today for the woman who decides that breast augmentation is right for her. The more you know about the procedure and the options involved, the better equipped you will be to make the decision that is best for you.
Breasts vary greatly in both size and shape. The size and shape of your breasts are determined and affected by factors such as age, past pregnancies, genetics and skin elasticity. Even breasts on the same body may vary, making one slightly different from the other. Such variations in size and shape are normal, and they occur in most women.
Before you undergo breast augmentation you need to be well-informed of the procedure, the different choices involved, the results you can expect, and the potential risks and complications that could occur.
The surgery is performed in adulthood at any age. The earliest time for the surgery would be after a young woman’s breasts are fully developed, usually no sooner than age seventeen or eighteen. Rarely, the surgery may be performed at an earlier age if the patient is suffering emotionally from a vast asymmetry of her developing breasts. Breast augmentation can achieve many different goals. Some of the most common goals realized by women who have had breast augmentation are:
enlargement of small breasts
balancing breasts differing in size and/or shape
reshaping of breasts that are misshapen
reshaping and enlarging breasts that have lost their shape or fullness due to pregnancy or age
Psychological and emotional benefits have included an enhanced self-esteem, a more satisfying body image and personal gratification.
PRIOR TO SURGERY
At your initial consultation, Dr. Glassman will ask you to express your concerns about your appearance. Your goal for the eventual size and shape of your breasts will be discussed. Your medical history will be reviewed, and a physical examination will be conducted to determine if a breast augmentation is best for you. If you are a good candidate for surgery, Dr. Glassman will explain what can be done to assist you. He will discuss the options which he thinks are best for you such as:
implant type, size and shape
where the incisions should best be made
whether the implant should be inserted under or on top of the muscles of your chest
He will further discuss variables that may affect the procedure such as your age, the size and shape of your breasts, and the condition of your skin.
Dr. Glassman may request that you visit your private medical doctor for a check-up and for any necessary lab work and x-rays. If you have not had a recent mammogram, one will be requested.
Precise preoperative instructions are provided, and all necessary prescriptions are given to you in advance of the surgery. All aspirin, aspirin-containing products, and anti-inflammatory products must be stopped at least ten days before and for ten days after surgery. You will be provided with a complete list of which medications to avoid. Tylenol may be taken during this time. Also, you will be given a list of vitamins and homeopathic preparations to take prior to and after the surgery. This is done to promote healing and limit bruising.
TYPES OF BREAST IMPLANTS
Breast implants come in many shapes and sizes, with differing inner and outer materials. Together, you and Dr. Glassman will select the options that are best suited for you and most likely to achieve the results you desire.
All breast implants have an outer pliable envelope (or shell). The contents of the envelope are used to achieve fullness and create the most natural breast-like feeling possible. The implants are filled with either saline (salt water) or silicone gel. Both saline and silicone implants come in many sizes and shapes.
General anesthesia is given for all breast augmentation cases. You will be asleep through the entire operation.
A breast augmentation is generally performed as an outpatient in a private facility. It may be combined with other procedures, such as facial surgery and/or body contouring.
Before anesthesia is given, careful measurements are taken of your breasts and chest wall. A special surgical marking pen is used to apply a “map” of the surgery to the skin of your breasts.
After anesthesia is given, small one and a half inch incisions are made through which the implants are inserted. No one incision is right for every woman. Therefore, by knowing your options and discussing them with Dr. Glassman, together you can decide upon the best choice for you. There are traditionally three choices of incisions:
the inframammary incision is made in the skin fold below the breast
the transaxillary incision is made in the fold of the armpit
the periareolar incision is made along the edge of the colored area around the nipple
All of these incisions allow the implant to be placed either submuscular (below the chest muscle) or subglandular (between the chest muscle and your breast tissue). The advantages of the level of placement will be discussed as part of the planning between you and Dr. Glassman.
During the surgery, temporary implants called “sizers” are inserted to choose the appropriate size and shape for your body. While you remain sleeping, you may be placed in a sitting position so that the shape and size of your breasts can be seen while you are upright. Once the appropriate size and contour is determined from inspecting the sizers, they are removed and replaced with the permanent implants.
Fine stitches are used to close the incisions. You will be wrapped in a supportive bandage before you are awakened. The operation takes one and a half to two hours.
THE POSTOPERATIVE PERIOD
The first one to two hours after surgery are spent in the recovery room. When you are fully alert, you will be able to return home in the care of a friend or family member. A private nurse can be provided at your request. Some patients chose to spend the first night after surgery in an aftercare facility, where care is provided around the clock by licensed nurses.
The following morning, all bandages are removed in our office. The surgical sites are inspected and cleansed, and a surgical bra or a lighter bandage is placed. Instructions are given on how to care for the incisions until the stitches are removed in one week.
The pain following a breast augmentation is described by most patients as mild to moderate. Pain medication is prescribed, although this is usually unnecessary after the first day or two.
There may be mild bruising and swelling which lasts for approximately one week. Most patients may drive a car and return to work or social activities after one week. Strenuous physical exercise is avoided for three weeks following a breast augmentation. You must avoid lifting or pushing anything heavy during this three week period.
It is advisable to avoid sex for the first week after surgery, since sexual arousal can cause increased swelling and bruising. Only gentle contact with your breasts is recommended for about six weeks.
RISKS AND COMPLICATIONS
As with any operation, a breast augmentation has minimal risks and potential complications. However, with highly trained doctors and nurses making up the surgical team, complications are less frequent.
DEFLATION OF SALINE-FILLED IMPLANT
Infrequently, a saline implant deflates in the first few months after being implanted or occasionally after several years. Most remain intact ten or more years after the surgery. The implant can break due to injury to the breast or through normal wear over time, releasing the saline (salt water) filling. Whenever a saline-filled implant does deflate, it usually happens quickly and requires surgery to remove and replace the ruptured implant. Since salt water is naturally present in the body, the leaking saline from the implant will be absorbed by the body instead of being treated as foreign matter.
BREAKAGE OF SILICONE-FILLED IMPLANT
The lifespan of a silicone implant is estimated at fifteen years. Follow up examinations at annual intervals as well as MRIs at 3-5 year intervals are employed to determine the structural integrity of the implant. In the event that a leak develops, the implant is replaced in a timely manner.
MAKING BREAST CANCER HARDER TO FIND
The implant could make mammography more difficult to interpret. The radiologist can use special techniques to minimize the possibility and to get the best possible views of the breast tissue.
The internal scar tissue or capsule that normally forms around the implant may tighten and squeeze the implant. This is called capsular contracture. Over several months to years, some women have changes in breast shape, hardness or pain as a result of this contraction. If these conditions are severe, more surgery may be needed to correct or remove the implants.
Infection can occur with any surgery. All breast implant patients are treated during and after the surgery with antibiotics.
A hematoma is a collection of blood inside the body (in this case, around the implant or around the incision). If a hematoma occurs, it will usually be soon after surgery. Small hematomas are absorbed by the body, but large ones may have to be drained surgically for proper healing.
CHANGES IN FEELING IN THE NIPPLE AND BREAST
Very rarely, feeling in the nipple and breast can increase or decrease after implant surgery. hanges in feeling can be temporary or permanent and may affect sexual response or the ability to nurse a baby.
There is no scientific evidence that women with breast implants are more susceptible to cancer than other women.
Dr. Glassman will make every effort to customize the surgery for your anatomy and your needs. It is his intention that your breasts appear and feel as normal and natural after the surgery. He and his staff will use all of their efforts to make this surgery as successful and easy as possible for you.
ADVANTAGES OF BREAST AUGMENTATION SURGERY
Breast augmentation may be a way of achieving the look you would like. Enhanced self esteem and confidence are the primary advantages of this type of surgery.