Breast Augmentation

What is breast enlargement surgery?

Breast augmentation, or augmentation mammoplasty, is a procedure to reshape the breast with an implant to make it larger. The procedure can also be done to reconstruct the breast after breast surgery.

Possible complications of breast augmentation surgery

Possible complications of breast augmentation surgery include:

• 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 has resolved, and a new implant is inserted.

• Capsular contracture. A capsular contracture may occur if the scar or capsule around the implant starts to tighten. This may change the appearance of your breast. Or, in some cases, cause discomfort. Treatment can involve either the removal of the scar tissue, making multiple incisions through the capsule scar tissue, or the removal or replacement of the implant. The condition can recur.

• Oversensitive, undersensitive, or numb nipples. Oversensitivity, undersensitivity, or small patches of numbness near the incisions may occur in some people. The symptoms usually disappear with time but may be permanent in some people.

• Leaking or rupturing of silicone gel or saline 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.

• Rippling of the implant. In thin people, the implant edges can be seen under the skin. It's normal to feel the implant edge at the side and bottom of the breast.

• Lymphoma. There is a very small risk of developing a type of cancer, a lymphoma, in the capsule next to an implant. This may be related to the type of shell of the implant. Discuss this with your surgeon.

• Systemic symptoms. Symptoms may include memory loss, rash, joint pain, and fatigue. These symptoms are sometimes referred to as breast implant illness. The cause of these symptoms is still not fully understood. In some cases, symptoms go away when the implant is removed.

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 or days and the saline (salt water) will harmlessly be absorbed by the body. A second operation and replacement of the leaking implant may be needed.

• 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 needed. There is no evidence that a ruptured implant will affect your health.

Each type of implant has advantages and disadvantages. Your healthcare provider will discuss the types of implants with you and help determine which type is best for you.

There is no evidence that pregnancy or the ability to nurse will be affected by breast implants. But pregnancy and nursing may affect the appearance of your breasts. If you have nursed a baby within the year before breast augmentation, you may make milk for a few days after surgery. This may cause some discomfort but can be treated with medicine prescribed by your healthcare provider.

There is no evidence that having an implant in place will make the detection of breast cancer more difficult. You will still need to have mammograms as advised by your healthcare provider. Special views will be obtained. Be sure to inform the mammographer that you have implants in place.

About the procedure

Although each procedure varies, breast augmentation surgeries generally cover the following considerations:

Where the procedure may be done

• Surgeon's office-based surgical facility

• Outpatient surgery center

• Hospital outpatient

Anesthesia choices

• General anesthesia

• Local anesthesia combined with an IV sedative. This lets you remain awake but relaxed.

How long will it take?

• About 1 to 2 hours

Location of incision

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

• In the crease where the bottom of 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 centered beneath the nipples.

Recovery period

When the dressings are removed, you may be given a surgical bra. Stitches will be removed in a week or so. Your surgeon will direct you about the need to wear a bra and activity restrictions.