Breast Augmentation

What is breast augmentation (enlargement) surgery?

Breast augmentation, or augmentation mammaplasty, is a procedure to reshape the breast in order to make it larger. The procedure can also be performed to reconstruct the breast following breast surgery.

A breast implant is a silicone shell filled with either silicone gel or saline:

• Saline-filled implants
  If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will harmlessly be absorbed by the body.

• Gel-filled implants
  The leak or rupture of a gel-filled implant can cause one of two things: if the shell breaks but the scar capsule around the implant does not, changes may not be detected; if the scar also breaks or tears, especially following extreme pressure, the silicone gel implant 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. The shape or firmness of the breast may change. A second operation and replacement of the leaking implant may be necessary. 

There is no evidence that fertility, pregnancy or the ability to nurse will be affected by breast implants. However, if you have nursed a baby within the year before breast augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your physician.

Each breast augmentation procedure varies; however, the following are general guidelines for the surgery:

Location options

• Surgeon’s office-based surgical facility
• Outpatient surgery center
• Hospital outpatient
• Hospital inpatient

Anesthetic options

• General anesthesia
• Local anesthesia, combined with a sedative (allows the patient to remain awake but relaxed)

Average length of procedure

Approximately two hours.

Location of incision

The method of inserting and positioning the implant will depend on your anatomy and the surgeon’s recommendation. The incision can be made:

• In the crease where the breast meets the chest
• Around the areola (the dark skin surrounding the nipple)
• In the armpit

Working through the incision, the surgeon lifts the breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath the pectoral muscle in the chest wall. The implants are then centered beneath the nipples.

Recovery

When the dressings are removed, the patient may be given a surgical bra. Stitches will be removed within a week or two following the procedure.

Complications

Possible complications associated with breast augmentation surgery may include, but are not limited to, the following:

Infection

Infection is most common within a week after surgery. The infection can be treated with antibiotics or, in severe cases, the implant is removed for several months until the infection is gone before a new implant is inserted.

Capsular Contracture

This may occur if the scar or capsule around the implant begins to tighten. Treatment can involve either the removal or "scoring" of the scar tissue, or the removal or replacement of the implant.

Oversensitive, undersensitive or numb nipples

Oversensitivity, undersensitivity and/or small patches of numbness near the incisions may occur in some patients. The symptoms usually disappear with time, but may be permanent in some patients.

Leaking or rupturing of silicone & gel implants

Leaking or rupturing of the implant may occur as a result of an injury, or even from the normal compression and movement of the breast and implant.