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Breast Augmentation

What is breast augmentation surgery?

Breast augmentation surgery is a surgical procedure that enhances the size and appearance of the female breast. The fem

breast augmentation NYC

ale breast remains the ultimate symbol of feminine form, which makes its beautification through breast augmentation surgery one of the most popular plastic surgery procedures in America.

Enhancement of breast size and shape is usually performed with the insertion of breast implants. However, fat transfer breast augmentation surgery is becoming a popular alternative to the use of breast implants. In either option, the overall goal is to improve the cosmetic appearance of the female breast.

Breast augmentation what to expect?

The breast augmentation process begins with a decision to enhance the appearance of your breasts. Reasons for making this decision vary, but usually involve either an underdevelopment/small breasts or loss of breast volume that can occur with weight loss or childbirth.

Once this very personal decision has been made, consultation with an American Board of Plastic Surgery board certified plastic surgeon usually ensues. From there, the process varies somewhat depending on your goals, expectations, options and the surgeon’s particular practice operations. The final expectation is that the breasts will have a new, enhanced, more aesthetic appearance that matches your pre-surgical goals.

Breast augmentation procedure steps

The steps toward breast augmentation surgery begin with the decision to enhance your breasts. Once this decision has been made, the initial consultation includes a discussion defining your goals and expectations, a physical examination and a further discussion delineating your options in accordance with the goals and physical findings.

In my practice, with occasional exceptions, after choosing a surgical date patients to return for a second evaluation to finalize goals, implant options, surgical technique options and to obtain preoperative instructions, measurements, and photographs. The preoperative instruction packet includes vital information such as, what medications to take or avoid, what to eat when to stop eating, what to do on the day before surgery and general information about your planned breast augmentation.

Most of the time, surgery is scheduled for the morning hours so that you can recover during the day and return home at a reasonable hour. The first postoperative office visit is scheduled for within one week of the surgery. Visits beyond this point are dependent on the healing process and your overall recovery.

Breast augmentation candidates

Virtually everyone that is dissatisfied with the appearance of their breasts is a potential candidate for breast augmentation surgery. Even gender barriers have been broken in this category with advances in gender reassignment. Of course, the choice of procedure and options are dependent on many factors and can only be fully appreciated after a full and formal examination.

Breast augmentation recovery

Recovery from a breast augmentation operation is generally very easy since it involves the only skin, breast tissue and sometimes muscle and is usually performed on relatively healthy individuals. The finer points of recovery are, of course, dependent on many factors, including, individual pain tolerance, how much muscle is involved, implant size and several others.

Typically, you will be performing your normal activities of daily living on the day following the surgery. Returning to work is also usually very rapid, one or two days, again depending on several factors, such as type of work performed.

Breast augmentation results

The results of breast augmentation surgery are usually phenomenal. The satisfaction rate for patients makes it consistently the number one or number two most commonly performed cosmetic surgical procedure performed in this country annually for the last two decades.

Breast augmentation risks and safety

Safety is always our prime objective in any surgical procedure. It is even more critical in a procedure that is completely elective and cosmetic in nature. The overwhelming safety, along with consistently excellent results, of breast augmentation surgery, is what maintains its position as the number one or two most commonly performed cosmetic surgical procedures in America annually.

Preparing for breast augmentation surgery

Preparation for breast augmentation surgery is relatively simple. Each plastic surgeon may have preparation instructions specific to their practices, such as showering the night before, dietary restrictions and others. The greatest preparation that you can make is mental and emotional.

Most patients have already made that emotional commitment by walking through the consultation door. Smoking cessation is the most universal preparation recommended by all.

Breast augmentation post-op

The postoperative recovery from breast augmentation is relatively smooth and straightforward. Activities of daily living, i.e. showering, walking, dressing, eating, can be resumed immediately after surgery.

Returning to work is purely dependent on the type of work. Desk, administrative and nonphysical jobs can be resumed one or two days after surgery. More strenuous vocations will depend on the level of activity required. Some plastic surgeons require the use of a post breast augmentation bra and some use no bra at all.

Return visits to the plastic surgeon also vary with each surgeon. In my practice, patients return for their first visit within the first week of surgery. The second visit typically occurs two weeks following the first and the third visit occurs six weeks after that. These visits can vary depending on the need for more, or fewer visits.

Types of breast implants

Since the introduction of breast implants in 1963, they have undergone numerous improvements and technological changes over the years, providing us with a now vast assortment of choices that can be tailored to almost any breast and any patient. If fact, to discuss ALL of the implant options would extend beyond the scope of this document.

In general terms, the types available today include saline (salt water) and silicone gel filled implants, in round and anatomical (teardrop) shapes, with smooth and textured surfaces. The type, shape, and size of breast implant specific to your personal, individual goals and expectations will be determined in consultation with your American Board of Plastic Surgery board certified plastic surgeon.

Fat transfer breast augmentation

The “newest” and perhaps most glamorous method of breast augmentation is that of fat transfer. This technique of augmenting the breast has become very fashionable since its near condemnation by the American Society of Plastic Surgeons as recently as 2007. After study in tens of thousands of women confirming its safety, fat transfer breast augmentation has now taken center stage in the options for breast enhancement.

The surgery involves taking fat by liposuction from other parts of the body, processing it, and reinjecting it into the breasts. Fat transfer does have some limitations, such as typically only providing a one cup bra size increase, but has now become a viable alternative in the discussion of options for breast augmentation.

Your breast augmentation consultation: “what to discuss”

During your consultation with an American Board of Plastic Surgery board certified plastic surgeon for breast augmentation, your main goal should be to communicate with your surgeon. You have undoubtedly sat in front of a mirror and possibly viewed numerous photos of breasts that you desire. Try to verbalize the goals that you have to yourself before going for your consultation.

If you can verbalize to yourself, it will be easier to express the goals to your surgeon. Your surgeon should then be adept at guiding the conversation and discussion toward the goals that you have preconceived.

Choose a breast augmentation surgeon you can trust

Although the process of breast augmentation surgery has become so refined, satisfying and safe as to be very commonplace in America today, do not take it lightly. Breast augmentation is still surgery. Plastic surgeons certified by the American Board of Plastic Surgery have undergone rigorous training and an arduous examination process to become experts in the field of breast augmentation.

Additionally, maintenance of that certification is required of all certified plastic surgeons. This ongoing certification includes submission and review of surgical cases, educational activities, and cognitive testing in the form of examinations. It is THE reason that the procedure has become so safe and satisfying. Your only choice of a surgeon is considering breast augmentation should be a surgeon certified by this board.

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Frequency asked questions

Breast augmentation surgery, also known as augmentation mammoplasty, is a cosmetic surgical procedure that involves the placement of breast implants to increase the size, shape, and fullness of the breasts.

The goal of the surgery is to improve the appearance of the breasts and enhance the patient's overall figure. The procedure involves making an incision, either in the crease under the breast, around the areola, or in the armpit, to create a pocket for the implant.

The implant is then placed either under the chest muscle or directly behind the breast tissue, and the incision is closed. The procedure is typically performed under general anesthesia and takes about two to three hours.

There are many reasons why women choose to get breast augmentation surgery, including:

  • To increase the size of small or underdeveloped breasts
  • To restore breast volume after weight loss or pregnancy
  • To achieve more balanced and symmetrical breasts
  • To improve the overall appearance of the breasts
  • To boost self-confidence and self-esteem

There are two main types of breast implants: silicone and saline. Silicone implants are filled with a silicone gel that feels and behaves like human fat, while saline implants are filled with a saltwater solution.

 

Both types of implants come in a variety of shapes and sizes, and the choice of implant depends on the patient's individual needs and goals.

Like any surgical procedure, breast augmentation surgery has both risks and benefits. Some of the potential benefits include:

  • Improved breast size, shape, and fullness
  • Improved self-esteem and confidence
  • Improved overall figure and appearance
  • Achieving a more balanced and symmetrical appearance

However, there are also potential risks and side effects, including:

  • Scarring
  • Changes in sensation in the breasts and nipples
  • Implant rupture or leakage
  • Asymmetrical results
  • Rippling or wrinkling of the implants
  • Infection
  • Anesthesia risks

There are several surgical techniques used in breast augmentation surgery, including:

  • Inframammary incision: Made in the crease under the breast
  • Periareolar incision: Made around the areola
  • Transaxillary incision: Made in the armpit

The choice of incision depends on the patient's individual needs and goals, as well as the surgeon's recommendation.

Breast augmentation surgery typically takes two to three hours to complete. The recovery period varies from patient to patient, but most patients can expect to return to work within one to two weeks and resume normal physical activity within four to six weeks.

 

During the recovery period, patients should avoid heavy lifting and high-impact exercise, and they may need to wear a special surgical bra to support the breasts.

The cost of breast augmentation surgery varies depending on several factors, including the surgeon's fee, the cost of the implants, and the cost of the anesthesia and facility fees.

Some common side effects of breast augmentation surgery include:

  • Pain and discomfort
  • Swelling and bruising
  • Changes in sensation in the breasts and nipples
  • Scarring
  • Temporary changes in nipple placement

Less common side effects include:

  • Implant rupture or leakage
  • Asymmetrical results
  • Rippling or wrinkling of the implants
  • Infection
  • Anesthesia risks

Breast augmentation surgery is generally considered safe, but like any surgical procedure, there are risks and side effects. Patients should carefully weigh the risks and benefits of the procedure before deciding to undergo surgery.

 

It's also important to choose a qualified and experienced plastic surgeon who can provide personalized care and minimize the risks of complications.

The placement of the implant during breast augmentation surgery can vary. Some common options include:

  • Subglandular placement: The implant is placed behind the breast tissue and over the chest muscle
  • Submuscular placement: The implant is placed underneath the chest muscle
  • Dual plane placement: A combination of subglandular and submuscular placement

The choice of implant placement depends on the patient's individual needs and goals, as well as the surgeon's recommendation.

Breast implants are not lifetime devices, and they will eventually need to be replaced. On average, silicone implants last between 10 and 20 years, while saline implants last about 10 years.

 

However, the lifespan of the implants can vary depending on factors such as implant quality, patient age, and implant placement. Patients should be prepared for the possibility of future surgery to replace or remove the implants.

Breastfeeding after breast augmentation surgery can be possible, but it depends on several factors, including the type of implants, the incision site, and the technique used during surgery. Some patients may experience difficulties with breastfeeding after surgery, while others are able to breastfeed without any problems.

Patients who are considering breast augmentation surgery and who hope to breastfeed in the future should discuss their goals and concerns with their surgeon before undergoing the procedure.

Exercise after breast augmentation surgery is generally discouraged for the first four to six weeks, as the body needs time to heal and recover. During this time, patients should avoid heavy lifting and high-impact exercise.

 

After the initial recovery period, patients can gradually return to their normal physical activity and exercise routine, although they may need to modify their activities to accommodate for the implants.

Smoking before or after breast augmentation surgery is discouraged, as it can affect the healing process and increase the risk of complications. Smoking can constrict blood vessels and reduce the amount of oxygen in the bloodstream, which can slow down the healing process and increase the risk of infections and other complications. Patients who smoke should quit smoking at least four weeks before surgery and should avoid smoking during the recovery period.

Yes, patients can get mammograms after breast augmentation surgery. However, mammograms may be more difficult to perform on women with breast implants, and they may require additional views or special techniques to ensure that the implants are not obstructing the view of the breast tissue. Patients should inform their mammogram technologist of their breast implants, and they may need to have mammograms more frequently to monitor for any changes or complications.

The signs of implant rupture or leakage can vary, but some common symptoms include:

  • Pain or tenderness in the breast
  • Changes in the shape or size of the breast
  • A sudden increase or decrease in the volume of the breast
  • Changes in the appearance of the breast, such as rippling or wrinkling of the implant
  • Asymmetrical results, with one breast appearing different from the other

In some cases, implant rupture or leakage may not cause any noticeable symptoms. Patients with breast implants should undergo regular follow-up appointments with their surgeon, and they should be aware of the signs and symptoms of implant rupture or leakage, so they can seek prompt treatment if necessary.

The recovery time for breast augmentation surgery can vary, but most patients can expect to return to work and other normal activities within a few days to a week after the procedure. However, the full recovery process can take several weeks or months, and patients should be prepared to follow their surgeon's instructions for a safe and effective recovery. During the recovery period, patients may experience some discomfort, swelling, and bruising, which should gradually subside as the body heals.

Silicone and saline breast implants are the two main types of implants used for breast augmentation surgery. Silicone implants are made from a silicone gel, while saline implants are filled with a sterile saline solution. Some differences between the two types of implants include:

  • Feel: Silicone implants are known for having a more natural feel, while saline implants may feel firmer
  • Risks: Silicone implants have a slightly higher risk of rupture or leakage, while saline implants have a lower risk of complications
  • Appearance: Silicone implants are more likely to maintain their shape and appearance over time, while saline implants may sag or ripple

The choice of silicone or saline implants will depend on the patient's individual needs and goals, as well as the surgeon's recommendation.

The process for removing breast implants will depend on the patient's individual needs and goals, as well as the technique used during the initial breast augmentation surgery. In some cases, breast implants can be removed without replacement, while in other cases, patients may choose to replace the implants with new implants or to undergo a breast lift procedure. The removal process can be performed under local or general anesthesia, and the recovery time can vary, depending on the patient's individual circumstances. Patients should discuss their options and concerns with their surgeon before deciding to remove their breast implants.

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Kenneth R. Francis, MD

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