Breast Augmentation Procedure
PROCEDURE OVERVIEW
*Content provided by the American Society of Plastic Surgery (ASPS)
What is a Breast Augmentation:
Breast augmentation surgery involves using implants to increase the size of your breasts or restore breast volume that has been lost after weight reduction or pregnancy. Breast augmentation can:
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Increase fullness and projection of your breasts
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Improve the balance of your figure
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Enhance your self-image and self-confidence
Breast augmentation is a very personal procedure and you should do it for yourself, not for someone else. Breast augmentation is a good option if:
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You are physically healthy
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You have realistic expectations
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Your breasts are fully developed
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You are bothered by the feeling that your breasts are too small
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You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
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You are unhappy with the upper part of your breast appearing “empty”
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Your breasts are asymmetrical
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One or both breasts failed to develop normally or have an elongated shape
What it won’t do
Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation.
Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.
Augmentation Options:
Implant Choices:
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Saline implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body. They provide a uniform shape, firmness and feel. Saline implants are FDA-approved for augmentation in women age 18 or older.
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Silicone implants are filled with silicone gel. The gel feels a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel will not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants. Silicone implants are FDA-approved for augmentation in women age 22 or older.
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Form-stable implants are sometimes referred to as gummy bear implants because they maintain their shape even when the implant shell is broken. The consistency of the silicone gel inside the implant is thicker than traditional silicone gel implants. These implants are also firmer than traditional implants, but are thought to be less likely to break.
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Form-stable implants are shaped rather than round. They have more projection at the bottom and are tapered toward the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast. Placement of form-stable implant requires a longer incision in the skin.
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Round implants have a tendency to make breasts appear fuller than form-stable implants. Higher profile options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place.
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Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available. Whether you choose saline or silicone implants, it is important for you to monitor your breast implants and follow up with your plastic surgeon for appropriate checkups.
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Surface Texture
Smooth breast implants are the softest feeling. These implants can move with the breast implant pocket, which may give more natural movement. These implants may have some palpable or visible rippling.
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Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and get repositioned. Texturing offers some advantage in diminishing the risk of a tight scar capsule.
Other options:
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Fat grafting A fat transfer breast augmentation essentially uses liposuction to take fat from other parts of your body and inject it into your breasts. This is an option for women who are looking for a relatively small increase in breast size and would prefer natural results. Risks include cysts, infection, microcalcification, necrosis (death) of fat cells and the possibility that some of the transferred fat cells will leave the breast area. Your plastic surgeon may also have you use a tissue expansion system during the weeks before your surgery to improve your results. You may need touch-up injections to retain your improved shape if you choose this surgery.
The Procedure:
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The Incision
Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include:
Periareolar Incision
Inflammatory Incision
Transaxillary Incision
*Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.
Step 3 - Inserting and Placing the Implant
After the incision is made, a breast implant is inserted into a pocket either:
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A. Under the pectoral muscle (a submuscular placement), or
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B. Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement).
*The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and your surgeon’s recommendations.
Step 4 - Closing the Incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.
Step 5 - See Results
The results of breast augmentation are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.