| Dr. Jeff Angobaldo 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 breast augmentation?
Also known as augmentation mammaplasty, breast augmentation surgery involves using breast implants to fulfill your desire for fuller breasts or to restore breast volume loss after weight reduction or pregnancy.
There are many reasons why women choose to have a breast augmentation. The most well known answer is to enhance the size of their breasts. For other women it may be that their breasts are not symmetrical or the patient was born with an abnormality such as tubular breasts. Some woman may have had satisfactory breasts at one time and after a pregnancy or weight loss found that the firmness and shape of their breast may have changed.
There are several options available to you as a patient. The first choice to make is whether you want a gel implant or saline filled implant. The gel implant is generally more costly than the saline. The feel of both implants is also different. When you consult with your surgeon ask to feel each implant and that may help you make a decision as to which one you prefer. The other option is usually dictated by your chest width and your body frame. There are implants that are designed to lay more widely across the chest while other styles are more prominent.
Q. How is a breast augmentation surgery performed?
Multiple factors such as the patient’s anatomy and the surgeon’s preference determine how the breast implant is inserted and positioned. Typically, breast augmentation surgery incisions are located in the crease where the breast meets the chest, around the areola or in the armpit. There are surgeons that may also choose to enter a saline implant through the belly button. I don’t recommend this method as it may void the warranty on the implants.
Once the incision has been created, the surgeon lifts the breast tissue and skin to create a pocket. It is within this "pocket" that the breast implant will be placed and centered beneath the nipple and areola. Depending on the patient’s anatomy, the size of the implant, the implants will be placed either directly behind the breast tissue or underneath the muscles of the chest wall.
Breast augmentation surgery usually requires one to two hours to complete. Following the insertion and placement of the breast implants, sutures are used to close the surgical incisions. Many plastic surgeons will wrap the chest region with a gauze bandage or provide the patient with a special bra to support and to assist with healing. Tubes may be used following the breast augmentation surgery to drain the surgical site. The patient should expect to be in recovery at least an hour or two.
Q. What are the possible immediate post-operative effects in breast augmentation surgery?
During the first 24 to 48 hours after breast augmentation surgery, recovery is uncomfortable for most patients. Fatigue and breast pain are common during this time. In most cases, pain can be managed with medication, but you may still feel sore, uncomfortable, and very tired. Some patients also report a feeling of heaviness on their chest which is the body trying to adjust to the implants. There are patients that may also have muscle spasms and so a muscle relaxer may be prescribed to aid with this. If stitches need to be removed, they will be taken out in 7 to 10 days. Getting as much rest as possible is key within the first few days. The first night is always the hardest and each day after that gets better. On the first night of your surgery you should get up once every few hours to keep your blood flowing throughout your body. You should be aided by a friend or family member to prevent a fall or injury.
Q. What are the possible longer-term, local effects in breast augmentation surgery?
Breast implants are not lifetime devises as breast implants can rupture. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours. Breast augmentation patients may recognize leakage because a change in the size of the breast is clearly noticed. An implant may rupture as a result of blunt trauma to the chest region, such as a car accident. More frequently it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant if the patient desires to do so. Many implant companies provide partial financial support if the implant is found to have a manufacturing defect.
One of the most frequently encountered issues associated with breast augmentation surgery is a condition known as capsular contracture. With capsular contracture the scar or capsule surrounding the breast implant begins to tighten and harden. As a result of this contracture the breast may feel hard and tight. Fortunately, there are several ways to prevent and treat capsular contracture. Frequent massaging of the breast during healing, as well as following your cosmetic surgeon’s instructions will help prevent capsular contracture from forming. In cases where this condition develops, it may be required that the scar tissue be surgically removed and possibly the implant. Furthermore, it is common for most women to experience some degree of numbness and sensitivity following breast augmentation surgery. These symptoms typically resolve with time.
Another frequent side effect associated with breast augmentation surgery is "rippling." This condition develops when the implant(s) move and is characterized by the presence of indentations, or "ripples" on the surface of the implant. In severe cases of "rippling," the implants may need to be removed or replaced.
Infection around the implants is also a possibility. Typically, this infection occurs within the first week following surgery, but may develop at any time. While most infections may be treated with antibiotics, in some cases the implants must be removed until the infection clears.
Recently, a great deal of discussion and research has taken place regarding the use of breast implants and the development of various immune system diseases such as scleroderma and other arthritis like conditions, as well as cancer. To date, current research has found no clear relationship between breast implants and these immune system conditions.
While most women do not experience complications with their breast augmentation surgery, each patient should still discuss the possibility of developing some of these conditions. Remember, breast augmentation is a form of medical surgery. As such, you need to understand the risks and consequences of breast augmentation surgery.
Q. Who is a good candidate for breast augmentation?
The best candidates for breast augmentation are women who are emotionally well-adjusted and who have an understanding of the procedure. These patients should also be in good health, participate in some sort of physical activity, and eat a healthy diet. Breast surgery is a good choice to enhance your figure, but not to completely change it and it is essential that patients have realistic expectations before they have surgery.
Q. What is the recovery time for breast augmentation?
Patients can usually return to work after one week, provided that their jobs do not require heavy lifting or other strenuous activities. Breast augmentation recovery includes limiting movement and getting plenty of rest. Any activity that involves lifting, bending, or straining should be avoided, as it can increase pain and soreness and delay healing.
Your surgeon will provide you with specific guidelines to follow so that your breast augmentation recovery time will be as minimal as possible. Following these instructions will also help you to achieve optimal breast implant results. You should maintain communication with your surgeon after the initial follow-ups directly following surgery. There should also be a 3-6 month follow-up and varied follow-up visits after that depending on the practice.
It is important to allow yourself ample recovery time after a breast augmentation. By avoiding certain activities and following your surgeon’s instructions closely, you will experience a shorter and more comfortable breast augmentation recovery period.
Q. How much does breast augmentation cost?
As an elective surgery, the cost of breast augmentation is a consideration for many patients. This procedure is generally not covered by medical insurance. The cost for breast augmentation may vary based on the type and cost of breast implants used, as well as geographic location.
Cost for a breast augmentation may include the following:
1. Surgeon’s fee
2. Hospital or surgical facility costs
3. Anesthesia fees
4. Breast implant cost
5. Prescriptions for medication
6. Post-surgery garments
7. Medical tests
There may be medical financing available, so patients should inquire whether or not your doctor participates in these programs.
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