| Dr. Phillip Dahan 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?
A. Breast augmentation is a surgical procedure where silicone or saline implants are placed under the pectoralis major muscle or breast tissue through an incision in the areola, axilla, lower breast skin or umbilicus to symmetrically enhance the size of the breasts.
Q. Who is a good candidate for breast augmentation?
A. Any female (18 years or older for saline or 22 years or older for silicone) in good physical and mental health who perceives her breasts to be smaller than desired, uneven or misshapen, is a good candidate for breast augmentation surgery. It is appropriate for women before or after pregnancy and nursing, and can be revised, as needed using larger, smaller or different shapes or types of implants. Many women with sagging breasts (ptosis) will benefit from having a breast lift (mastopexy) at the same time as the augmentation or at a later date as needed. Breast implants do not lift the breasts; they just enlarge them and improve the shape.
Q. How should one prepare for breast augmentation surgery?
A. On average, most women who have thought about breast augmentation have done some research for about 5 years prior to consulting a plastic surgeon. Most women undergoing breast augmentation surgery wish to enhance their breasts from an A or B cup to a C or D cup. Currently, silicone implants are more popular than saline implants and sub muscular placement through periareolar or inframammary incisions are the most common techniques. The best way to prepare for breast augmentation surgery is to obtain a consultation with a board certified plastic surgeon who has a great reputation and significant experience with the procedure. It is always very helpful to review before and after photographs of breasts that are appealing to the patient and to have a thorough breast examination by the plastic surgeon to determine the physical characteristics of the breasts. Women 40 years or older may need a preoperative mammogram. Finally, the patient must consider whether she plans to lose or gain weight, become pregnant and nurse, and how she wishes to look after surgery.
Patients should stop smoking 4-6 weeks preop and avoid aspirin, anti-inflammatory and fish oil 7-10 days preop. They should eat a balanced diet and may benefit from using arnica and drinking pineapple juice to reduce bruising and swelling.
Q. How is a breast augmentation surgery performed?
A. Breast augmentation should always be performed in an accredited surgery center by a board certified plastic surgeon. I perform this operation under general anesthesia using a board certified anesthesiologist as a same day (outpatient) procedure. The patient is marked preoperatively and implant size and type have already been decided at the preop visit. A small incision is made (about one inch for saline implants and slightly larger for silicone implants) in the lower aspect of the areola and gentle dissection is performed to create a pocket under the pectoralis major muscle where the implant is placed. This is done symmetrically on both sides to achieve a naturally appearing enhancement of the breasts. I prefer to sit the patient up during the operation to ensure the best results possible. The incisions are closed with buried sutures to obtain the best scar possible (almost invisible). The breasts are dressed with gauze pads and a snug ace wrap to reduce discomfort, bruising and swelling. Bleeding is minimal and drains are not needed. I see my patient the next day to change the dressing and teach them gentle breast massage.They may shower 2 days postop and begin wearing a comfortable bra. I also see my patient 1 week postop to slide out the areolar suture and start Mederma scar reduction ointment.
Q. What is the recovery time for breast augmentation?
A. Most patients return to school, light work and other activities 3-6 days postop. I allow gentle exercise within the first week avoiding the chest muscles for 2-3 weeks. There is usually minimal pain, swelling or bruising. Normal work and physical activities may be started 1-2 weeks postop. Patients may wear any type of bra they prefer by 3 weeks postop.
Q. What are the risks associated with breast augmentation?
A. Although very rare in my practice, the main risk is patient dissatisfaction with the size, shape, position and asymmetry of the breasts. Early complications may include infection, hematoma, nipple sensory changes and discomfort. Late complications may include capsular contracture, implant deflation or leakage, sagging, stretch marks and changes with weight fluctuations, aging, pregnancy and nursing. Again, these are very rare in my practice. There is no known association between breast implants and breast cancer. Both saline and silicone breast implants have lifetime replacement warranties and even compensate patients a certain amount if they deflate within ten years. Patients over 40 years old or with a strong family history should have a preoperative mammagram. The overwhelming majority of breast augmentation patients are thrilled with their results and have no regrets or complications.
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