Breast Augmentation

Do you lack confidence because your breasts are too small? Are you self-conscious because one breast is smaller than the other? Has pregnancy, breastfeeding, or weight loss left you with smaller breasts? Are your breasts misshapen after surgery? If you relate to any of these problems, a cosmetic surgery procedure called breast augmentation might help you. According to the American Society of Plastic Surgeons, more than 250,000 such procedures are performed in the United States alone, many more worldwide.

What is a breast augmentation?

Breast augmentation, also known as augmentation mammoplasty, is a plastic surgery procedure to enlarge the size, increase the fullness, and improve the shape of the breasts. This is achieved by placing an implant under the pectoral muscle or breast tissue in the chest.

How does a breast augmentation work?

As noted, breast augmentation is done by placing breast implants behind the breast tissue or under the chest muscles. A breast implant is a sac that contains either sterile water or a material called silicone. The implant improves the breast profile, giving your breasts a larger, fuller, perkier appearance. Breast augmentation with implants does not involve fat transfer.

How is a breast augmentation done?

The plastic surgeon makes a cut in the natural skin fold under the breast. The implant is inserted through this opening. Sometimes, the surgeon may make a cut around the edge of the areola (the dark skin surrounding the nipple) or under the arm.

What is the difference between a breast augmentation and breast implants?

Breast augmentation is the name of the plastic surgery procedure that is performed to enlarge the breasts. Breast implants are the synthetic sacs that are inserted into the breast to achieve the enlargement in breast size.

What are breast implants?

A breast implant is a medical prosthesis or artificial part that is surgically placed inside the breast to enlarge it or change its shape. There are various types of breast implants, each with its pros and cons.

What types of breast implants are available?

Saline breast implants

These are breast implants that are filled with sterile salt water (saline) solution. The shell of the implant is constructed from a durable elastomer silicone material. The plastic surgeon can control the quantity of saline solution that is filled in the implant. This allows the surgeon to fine-tune the shape, firmness, look and feel of the breast after breast augmentation surgery. A key feature of saline breast implants is that in case of implant rupture or leakage, the implant collapses and the saline solution is naturally absorbed and expelled by the body. Saline breast implants are U.S. Food and Drug Administration approved for use in women over the age of 18. A slightly different type of saline implant is a structured saline breast implant which has an inner structure that makes the implant feel more natural.

Silicone breast implants

These are breast implants that consist of an outer silicone shell that contains a silicone gel material which has a very similar feel to natural breast tissue. If there is leakage from a silicone gel filled implant, the implant does not collapse. The gel either stays in the shell or escapes into the surrounding breast implant pocket. Women who get silicone implants need to return to their surgeon for more frequent checkups compared to women with saline implants. The plastic surgeon can order imaging with ultrasound or MRI to evaluate the silicone implants. Silicone gel implants are U.S. FDA approved for use in women over the age of 22.

Gummy Bear Breast Implants

This a type of breast implant surgery that uses form-stable implants that retain their shape even if the implant shell is torn. Gummy bear implants contain a thicker silicone gel material than traditional silicone implants. However, the disadvantage of gummy bear implants is that they are tapered in the upper part and have more projection in the lower part. The tear drop shape of the gummy bear implant means if the implant rotates, it can result in an unusual breast shape, which may require an additional procedure for correction. Also, the plastic surgeon has to make a slightly longer incision to place a gummy bear implant.

Round breast implants

These are implants that can make the breasts appear fuller and provide more projection to achieve a bolder breast profile. The advantage of these implants is that they are the same shape all around, so there is less concern about a misshapen breast in case of implant rotation.

Smooth breast implants

This is a type of breast implant that can move along with the pocket where it is placed, thereby providing a soft feel and natural movement. However, occasionally, rippling may be seen or felt under the skin with these types of implants.

Textured breast implants

These are breast implants with a textured shell that leads to the formation of scar tissue around the breast implant. This makes it less likely that the implant will move around or become displaced. This type of implant reduces the risk of developing a tight capsule with scarring.

What are the benefits of breast implants?

A breast augmentation surgery is performed to increase breast size. It can enhance your appearance and do wonders for your confidence and self-esteem. If you think your breasts are too small or that one breast is smaller than the other, the procedure can address these concerns. With a bigger breast size, you might be able to wear different types of clothes and feel more confident at work and socially. The key benefits of breast augmentation are:

• Added volume and curves to make the breasts look fuller, perkier, and more youthful
• Correction of asymmetrical breasts
• Restoration of breasts after pregnancy
• Restoration of lost volume due to age
• Reconstruction after mastectomy

Detailed Procedural Info

Preparing for your procedure

If you are considering breast implant surgery, one of the most important things you will do in preparation for the procedure is choose the type and size of implants with your surgeon. You will be allowed to put different sized implants into your bra to see how they look and feel.

During the procedure

Anesthesia

Breast augmentation surgery is usually done under general anesthesia. You will be asleep during the breast surgery and will not feel anything. Sometimes, however, a breast augmentation procedure may be done under local anesthetic, in which case you will be awake.

Incisions

The plastic surgeon will make an incision (cut) in either the inframammary fold (the natural crease under the breast), in the armpit, or around the nipple. The choice of incision will depend on your anatomy, the type of implant you are getting, how much enlargement you desire, and your and the plastic surgeon's preference.

Implant Placement

During the procedure, the implant can be inserted in one of two locations. It can either be placed under the pectoral muscle (chest muscles) or it can be placed behind the breast tissue and over the pectoral muscle.

To finish the breast augmentation surgery, your surgeon will close the incisions with layered stitches and place surgical tape on the skin to keep the incision closed.

Aftercare and recovery

After the breast augmentation procedure, it is normal to have some swelling, but this typically resolves in about two weeks. During the recovery period, you will receive pain medications to relieve discomfort. The incision line will be visible initially but will fade with time. The stitches are dissolvable and disappear on their own in about 6 weeks. If your surgeon has used non-absorbable stitches, a drain may be left in place near the breast. In this case, you will need to return to the surgeon to have the drain removed.

Because the surgery is performed under general anesthesia, you cannot drive home after breast augmentation. Therefore, you should arrange for someone to take you home after the procedure. You will be advised to avoid strenuous physical activity for 6 weeks after the procedure. However, your surgeon may advise some movements and exercises of the arms to relieve discomfort.

Your plastic surgeon will give you instructions on caring for your breasts after breast augmentation. You will be advised when to return for a followup visit. You will also be told to be vigilant for potentially serious signs and symptoms, in which case you should call the surgeon. This includes signs of infection such as fever, chills, redness, or warmth in the breast or symptoms like chest pain or shortness of breath.

How long will the results of breast augmentation last?

Breast implants do not expire. However, they are not guaranteed to last for your lifetime. On average, breast implants last about 7 to 12 years. Some saline and silicone breast implants may last as long as 20 years. Nonetheless, many patients have to get their saline or silicone gel implants removed sooner because of cosmetic concerns or complications. It is estimated that approximately 20% of patients have their implants removed within 10 years.

Limitations and Risks: Are there any side effects?

Like every surgical procedure, breast augmentation also carries some risk. The most common complications of breast augmentation are pain, infection, bleeding, temporary loss of sensation in the nipple and/or breast, leakage or rupture, and fluid accumulation.

Some patients need one or more additional operations after the initial procedure. Others have to undergo surgery to remove the implants due to various reasons, including:

Hardening

Hardening of the implants due to formation of capsular contracture, leading to symptoms like pain, tightness, and abnormal cosmetic appearance of the breast.

Rupture and Leakage

Implant rupture or leakage due to a tear in the shell. In the case of saline implants, this can lead to deflation of the breast over a few days, causing the breast to look abnormal and dramatically different from the opposite breast. Silicone gel implants can also rupture, but this may go unnoticed because the gel stays inside the shell or in the surrounding tissue. Symptoms of implant rupture can include decrease in breast size, formation of knots, swelling, numbness, tingling, and pain.

Rippling

Another complication that can necessitate replacement or removal of breast implants is the formation of ripples or wrinkles that you can feel or see through the skin.

Sagging

Breast augmentation does not prevent your breasts from sagging as you age. Correction of this problem requires another cosmetic surgery procedure called a breast lift. After breast augmentation, one breast may hang lower than the other side or the nipples may point in different directions.

BIA-ALCL

A rare complication of breast augmentation is breast implant associated anaplastic large cell lymphoma BIA-ALCL. This is a slow growing cancer of the immune system that can be treated by removing the breast implants and the surrounding scar tissue. It is not the same thing as breast cancer. It is worth noting that BIA-ALCL is a very rare occurrence and less than 10 women develop it every year out of the hundreds of thousands who undergo breast augmentation.

What to expect after a breast augmentation?

A common question women have is can I breastfeed after breast augmentation. There are some concerns about the ability to breastfeed successfully after breast augmentation. Women with implants are three times more likely to have inadequate milk supply to nurse their baby. However, there is no evidence to suggest that saline or silicone breast implants affect the safety of breast milk.

Breast Augmentation: What You Should Know

To get the best results from breast augmentation, you should carefully review the desired size, feel, and appearance of your breasts with your board certified plastic surgeon, cosmetic surgeon, or other ASPS member surgeons. You will be given the chance to ask any question that is on your mind. If you are deemed to be a good candidate for breast augmentation, you will be presented with a choice of implants, including smooth vs textured, round vs tear drop, and saline vs silicone breast implants. Before undergoing breast augmentation, you should be aware of the following:

• The breast implants will not last a lifetime. The average lifespan is 10 years. Factors like age, weight gain, weight loss, and pregnancy can change the appearance of your breasts.
• Breast implants do not prevent your breasts from sagging with age. As some point in your breast enhancement journey, you may need a breast lift operation to correct this problem.
• After breast augmentation, routine screening mammograms (breast imaging to detect cancer) can be complicated. Additional views may be needed in women with breast implants.
• Breast augmentation can hamper your ability to breastfeed. Some women can do it successfully while for others it is a challenge after a breast implant procedure.
• Breast augmentation is a cosmetic surgery procedure. It will likely not be covered by your health insurance, so you will have to pay out of pocket.
• If you decide at some point in your journey to get the breast implants removed, you may need additional corrective cosmetic surgery to restore the appearance of your breasts.
• If you are a breast augmentation patient, your doctor may recommend MRI scans every three years for routine monitoring.

How much do breast implants cost 2020?

The cost of breast augmentation depends on the type of implants used. It can range anywhere from $5,000 to $10,000. Breast implants are a cosmetic procedure and are usually not covered by health insurance.

How to find a board certified plastic surgeon or ASPS member surgeons?

The MeTime app makes it easy to find an expert cosmetic surgeon or board certified plastic surgeon for procedures like breast augmentation. You can click and upload pictures and have suggestions sent directly to you. Looking for breast augmentation providers in your area? Try the MeTime app now!