Introduction

Breast augmentation, technically known as augmentation mammaplasty, is a surgical procedure to enhance the size and shape of a woman's breast in the following situations: to improve the silhouette of a woman who thinks her breasts are too small, to correct breast reduction that occurs after some pregnancies, to correct a difference in size between both breasts as a reconstructive procedure following breast surgery. It is possible to augment your breasts one or several sizes through the introduction of a prosthesis under the breast.

Planning the surgery

In your initial consultation, your surgeon will evaluate the size and shape of your breasts, your skin tone and your health. The surgeon will also perform a clinical breast exam and, in some cases a mammography would be required. The surgeon will explain the different surgical techniques that will be used, you will decide upon the size and shape your breasts will have and the combination of procedures that suit you best. Be sure to discuss your expectations frankly with your surgeon so that he would be equally frank with you, describing your alternatives and the risks and limitations of each. Your surgeon should also explain the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.

The catalog of Social Security benefits does not include cosmetic breast augmentation; nevertheless, severe breast asymmetry and breast reconstruction after mastectomy are.

Don`t forget to tell your surgeon if you smoke, if you're taking any medications, vitamins, or other drugs, the number of previous pregnancies and if you are planning to get pregnant or breastfeed. Feel free to ask any questions that arise, especially those regarding your expectations about the results.

Preparing for your surgery

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, medication and iron supplement. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

Surgery and anesthesia

The breast surgery is performed in an operating room within a clinic or hospital. It often requires hospitalization, the patient being discharged the following day. Breast augmentation is usually performed under general anesthesia, therefore the patient will sleep through the entire operation. In very specific cases, the surgery may be performed under local anesthesia, combined with a sedative.

Breast augmentation is performed through a small incision located, depending on the patient`s anatomy and on the surgeon`s preferences, around the areola, in the groove under the breast or in the armpit. The incision is designed so that the resulting scars would be almost invisible. Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle. Drainage tubes are then placed and used for several days following the surgery. The procedure takes between 1 to 2 hours.

After your surgery

You're likely to feel tired for a few days following your surgery, but you´re life will be back to normal in 24 to 48 hours. Most of your discomfort can be controlled with medication prescribed by your surgeon, though your breasts my hurt for a couple of weeks. Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will come out in a 7 to 10 days; the swelling in your breasts may take up to 3 to 6 weeks to completely disappear.

After breast augmentation you should be able to return to work within a few days, depending on the level of activity required for your job. Follow your surgeon's advice on when to begin exercises and normal activities; avoid lifting objects above your head for 2 to 3 weeks. Your breasts will probably be sensitive for 2 to 3 weeks, so you should avoid much physical contact until 3 or 4 weeks have passed. At first, your scars will be pink but their aspect will improve continuously beginning with the 6^th week. Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the doctor should be warned about the existence of the prosthesis. Surgery will not limit your ability to breastfeed if case you remain pregnant.

Are there risks? Are there any guarantees?

Breast augmentation surgery is a safe, provided it is done by a qualified plastic surgeon. However, as with any operation, complications and risks may occur. In breast augmentation, the most common complication is capsular contracture, which occurs when the internal scar that forms around the implant shrinks excessively, causing the breast to become tougher. It can be treated in various ways, sometimes requiring the removal of internal scar, and even replacing the prosthesis.

Another complication, typical of any surgery, is a hematoma which only in some cases requires further surgery to remove the accumulated blood. A small percentage of women develop an infection around the implant, usually within the first weeks after surgery. Some women report that their nipples become oversensitive, undersensitive, or even insensitive. These changes are usually temporary, although in a few cases will be permanent. There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse.

It is extremely rare that the prostheses can break, causing the contents to come out of its capsule. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body. If a break occurs in a gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant.

There is no proven scientific evidence that the breast implants cause breast cancer or connective tissue diseases. The breast implant does not intervene with the mammograms.

The results

For many women, the result of breast augmentation can be very gratifying. Regular examination by your plastic surgeon and routine mammograms (for those in the appropriate age groups) will help assure that any complications, if they occur, can be detected early and treated. The decision to have breast augmentation is a highly personal one that not everyone will understand; if you are satisfied, then your surgery is a success.

Breast augmentation surgery: summary

The only definitive method to obtain an increase of the mammary volume is by means of a mamoplasty augmentation. In this intervention, the surgeon places implants or mammary prosthesis behind the existing gland. There are other methods using tissues from your own body but they are mainly used in Reconstructive Surgery.

The positioning of these implants can be made behind the same gland and in front of the pectoral muscle or behind the pectoral muscle, depending on each individual case. In order to place the prosthesis, the surgeon must make an incision in the armpit ( in some cases this incision is traced around the mammary areola), this surgery being performed under general anesthesia.

The prosthesis used in almost every case is the silicone shell filled with silicone gel, which managed to decrease drastically the capsular retraction (chest felt hard, spherical and sometimes bothersome) to percentages below 2%. Other possible local complications such as hematoma, infection, intolerance to sutures, etc., will require proper treatment, but have an extremely low incidence.

The information contained on this page cannot, and does not replace the information provided individually by your plastic surgeon. In case of doubt, your plastic surgeon will provide appropriate clarifications. If you are planning to undergo an intervention or Aesthetic Plastic Surgery, see a specialist in Plastic, Reconstructive and Aesthetic Surgery.