| Dr. Stephan J. Finical, MD.,is a plastic surgeon certified by the American Board of Plastic Surgery. Here the Doctor has answered some of the common questions bizymoms visitors have about Breast Augmentation.
Q. What is a breast augmentation?
A. Breast augmentation is a procedure where an implant is placed behind the breast to give the breast added volume. This can be done with either a saline-filled or a silicone-gel filled prosthesis.
Q. How is breast augmentation surgery performed?
A. I perform breast augmentation surgery with the patient asleep. An incision is made either just below the nipple or in the crease below the breast and, through that incision, a pocket is made underneath the breast and most times underneath the muscle that is under the breast, and then an implant is placed into that pocket. The patient typically is asleep for one and one-half to two hours, recovers for 45 minutes to an hour and is able to go home that day.
Q. What are the possible immediate postoperative effects of breast augmentation surgery?
A. Postoperatively, the patients would wake up in a recovery area, and once fully awake, we would make sure they were able to eat, drink, and sustain themselves before they would be allowed to go home. We encourage them to ambulate because it is good for their circulation and it opens their lungs after having an anesthestic. Because we use a very high quality outpatient anesthetic, there is very little hangover-type feelimg after the surgery. I ask most people not to lift anything heavier than a full half-gallon of milk which is about 5 pounds with either hand for about 10 days following surgery. I would normally visit the patient back the next day and make sure that pain medicines are working. They will take a short course of antibiotics. Then, 10 days after surgery, I will take out stitches from the skin. I use dissolving stitches deeper inside but on the surface, I use a suture that I take out because that will leave a better scar.
Q. Who is a good candidate for breast augmentation?
A. Essentially two groups of women typically are interested in breast augmentation. The first is that group of women who never developed a volume of breast tissue that they desired and would simply like to be larger. The second group is those women who have finished having babies and have oftentimes lost some of the volume that they had prior to motherhood. Both of these are very good candidates for breast augmentation surgery.
Q. What are the risks associated with breast augmentation?
A. Risk associated with breast augmentation luckily are rare, but any patient who goes under an anesthetic is at risk of blood clots, so we use sequential devices on people’s feet to push the blood through their legs while they are under an anesthetic to try to diminish any risk of blood clots forming in the legs. We also do this as an ambulatory surgery which is good for their circulation but it also opens the lungs in the early postoperative period so the risk of any breathing problems after an anesthetic are minimized. Any time I make an incision on anyone for any reason, I worry about bleeding, infection, and scar, although bleeding would be very unusual and we certainly would not require a patient to donate their blood or expect to give any blood. Statistically, the most common early postoperative risk with augmentation is a hematoma or a blood collection that forms around the implant. If that were to manifest as a large bruise or swelling of the breast, typically the night of surgery, then it might require a second anesthetic to wash out that blood and replace the implant back into position. This would certainly shorten the healing process if necessary. Nationally, the rate of hematoma is about 4%. Here in our practice, it is less than half that but it will never become zero because occasionally a patient will develop some blood around the implant and it would need to be washed off in order to shorten the recovery period. As far as other risks that need to be addressed, there is potentially a slight risk of ability to breast-feed. There can be alteration in nipple sensation but this is usually temporary. Although there is concern of ability to do proper breast cancer screening in the future, a compression view of Ecklund views of the breast are required on mammogram and we certainly encourage self-examinations.
Q. What is the recovery time for breast augmentation?
A. Recovery time varies with individuals. I have had patients who have gone out to dinner the night of surgery but the typical recovery is a long weekend. After the first 24-48 hours, the patient usually quits taking any narcotic pain medicine and will go to just Tylenol. The discomfort at that time is usually just muscle stretching, more soreness, like the first day of tennis season rather than incisional pain which is really diminished at that time. Other than limiting some lifting restrictions, most people are back to activities of daily living at 3-5 days, and once they are off narcotics, it would be safe as long as they had full range of motion of their arms to drive. Most people resume strenuous physical activity, that which would raise your blood pressure, approximately 2 weeks after the surgery.
Q. How much does breast augmentation cost?
A. Breast augmentation typically cost between $4,000 and $5,000 and some of the variables have to do with whether the surgery is performed in a hospital or a surgery center, what type of implant the patient chooses.
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