Breast Augmentation (Breast Enlargement)

Breast augmentation, also known as breast enlargement, breast enhancement, or breast implants is a type of cosmetic surgery to increase breast size.

Women who desire to enhance their figure or who feel their breast size is too small may be good candidates for breast implants. Breast augmentation can also correct slightly sagging breasts or breasts that have lost volume due to pregnancy. Women that have uneven breasts or who have undergone a previous mastectomy may also be considered for breast augmentation.

Breast augmentation will not improve uneven nipples, move your breasts closer together, lift droopy breasts, or remove stretch marks. If your breasts are seriously sagging, you may want to consider a breast lift.

Before getting a breast enlargement, you will need to have a preoperative consultation with your surgeon. The surgeon will perform a thorough examination and evaluation of your breasts and discuss your surgical options. The types, shapes, and sizes of available breast implants will also be reviewed (see below for a description of the types of implants). The surgeon will give you preoperative instructions as to what you can or cannot eat or drink before surgery, which medications you should take or avoid, and a list of things you will need to have on hand for your recovery. During your consultation, the surgeon will answer any questions you might have, so come to your appointment prepared.

Types of Breast Implants

Saline implants are filled with sterile salt water. How much salt water an implant contains can affect the shape, firmness, and feel of the breast. If a saline implant leaks, it will collapse and the saline will be absorbed by the body.

Silicone implants implants are filled with an elastic gel. The gel feels and moves much like a natural breast. If a silicone implant leaks, the gel may remain inside the implant, or may leak into the implant pocket.

A leaking silicone implant may not collapse. If you choose this type of implant, you will likely need to visit your plastic surgeon regularly to make sure the implants are functioning properly.

Implant type and size will be determined not only by your desired size, but also on your breast anatomy, skin elasticity and body type.

In the past ten years, a number of independent studies have examined whether silicone gel-filled breast implants are associated with connective tissue disease or cancer. The studies, including a report by the Institute of Medicine, have concluded there is no convincing evidence that breast implants are associated with either of these diseases.

In November of 2006, the U.S. Food and Drug Administration (FDA) approved the use of silicone gel-filled breast implants for breast reconstruction in women of all ages and for breast augmentation in women ages 22 and older.

Breast augmentation is usually performed under general anesthesia, which means that you will be given drugs through an IV to put you to sleep.

The location of your incision is based on individual anatomy, your desired outcome, and the size and shape of your implants. You and your surgeon will work together to select an incision location that will be as inconspicuous as possible. There are three different types of incisions:

Inframmary incision(an incision made under the breast)
Transaxillary incision (an incision made in the underarm area)
Periareolar incision (an incision made around the areola [the darker skin surrounding the nipple])

The implants will be placed beneath the chest wall muscle or directly behind breast tissue; they will either be pre-filled or filled during surgery to create the desired volume.

Incisions are closed with sutures, skin adhesive, or surgical tape. Over time the incision lines will fade.

You should be able to go home the same day as your surgery, but you will need someone to drive you. During breast augmentation recovery, you may be sore for the first few days. Your surgeon can prescribe medications for pain. Bruising is usually minimal, but swelling may last for several weeks.

Breast augmentation scars are permanent, but once healed, are not usually noticeable except on very close observation. Scar location will depend on the incision site.

Most people are able to return to work within one week after surgery. You may be required to wear a surgical bra or other support garment (see below for post-surgical support garment options), and limit your activities for a few weeks following surgery.

Breast Augmentation Surgical Bras and Other Support (Compression) Garments
Immediately following a breast augmentation procedure your doctor may instruct you to purchase and continuously wear a compression garment. These are designed to help improve and increase blood circulation, rid your body of potentially harmful fluids, decrease your post surgery recovery time, and reduce swelling. They also help the new skin fit the body’s contours allowing you to recover faster. Breast augmentation garments are specifically designed to stabilize your implants, keep them in their correct position, and prevent the implant’s natural tendency to rise.

To purchase a breast augmentation surgical bra or other support garment, click on the links below. Among your garment options are augmentation bandeaus, compression vests, and a variety of compression and post-surgical bras. Ask your doctor which type(s) of garment is best for you.

These garments are typically worn immediately after your surgery. They are generally worn continuously for several weeks, so you may want to purchase more than one.

Although breast augmentation is a relatively safe procedure, all surgery comes with some risk. Potential breast augmentation risks may include:

• Bleeding
• Blood clots
• Poor wound healing
• Infection
• Reactions to anesthesia
• Scarring
• Changes in sensation
• Severe bruising
• Leaking
• Rupture

Many of these complications can be avoided if you closely follow your surgeon’s instructions.

Breast augmentation costs vary based on a number of factors including:

• Type of surgery
• Geographic location
• Facility fees
• Surgeon expertise and demand

Costs can range from around $4,000 to around $10,000.

American Society of Plastic Surgeons, www.plasticsurgery.org

University Hospitals Case Medical Center, www.uhhospitals.org

U.S. Food and Drug Administration