Breast Augmentation San Diego

Considering Breast Augmentation

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast, and is performed for a number of reasons. Some women feel that their breast size is too small for their body contours, while others may be seeking to turn the clock back on the effects of age and gravity. A lack of symmetry and living with the discomfort of ill-fitting clothing that comes as a result; lost volume due to weight loss or pregnancy; coping with missing or misshapen breasts as a result of trauma, disease (such as cancer), or congenital abnormalities.

By inserting an implant behind each breast, surgeons are able to increase a woman’s bust line by one or more bra cup sizes. If you’re considering breast augmentation, it’s good to know before-hand about the procedures, risks, and alternatives involved, and what can be expected with each. This page will give you a basic understanding of the procedure–when it can help, how it’s performed, but your doctor will be your best resource.

The Best Candidates for Breast Augmentation

Breast augmentation can enhance your appearance and your self-confidence. It might change your looks to match your ideal, or cause other people to treat you differently, but not necessarily. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.

Types of Implants

The choice of implants depends on more than just aesthetics. Implant manufacturers occasionally introduce new styles and types of implants, and therefore there may be additional options available to you. There are numerous factors to take into consideration. For the implant itself, consider:

  • Filler: Breast implants are medical devices with a solid silicone rubber shell. The implant shell may be filled with either saline solution (sterile salt water) or elastic silicone gel. Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an implant has been rigorously researched and tested, and reviewed by an independent panel of physicians for safety.
  • Size: The size of a breast implant is measured in cubic centimeters (ccs) based on the volume of the saline or silicone filler. The implant may have a low, medium or high profile (the depth of the implant from the base, which is the side positioned over the chest wall, to the highest point of the implant curve), and the diameter is measured across its base.
  • Shape: The implant may have a round profile or one that is anatomic (teardrop or tapered shape)
  • Texture: The implant shell may be smooth or textured.
  • Diameter: The width of the implant measured across its base.
  • Lifespan: You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Regular examinations for breast health and to evaluate the condition of your implants are important whether you have chosen saline or silicone breast implants.

Other factors include the patient, herself:

  • Her breast anatomy
  • Her body type
  • Her lifestyle
  • Her desired increase and other goals

Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a woman’s breasts are fully developed prior to placement of breast implants. Saline implants are FDA approved for augmentation in women 18 years of age and older. Silicone implants are FDA approved for augmentation in women age 22 and older. Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

Perhaps the most valuable factors are your plastic surgeon’s experience, recommendations and sound surgical judgment.

Surgery Carries Some Risk

All surgical procedures come with some measure of risk, and the most common risk in breast augmentation is that of capsular contracture, which occurs when the capsule or scar around the implant begins to tighten. This can cause the breast to feel hard, and can exacerbate difficulties with mammography. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

Breast implants do not generally interfere with a woman’s ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman’s body may alter the results of any breast surgery, including surgery to place breast implants. Therefore, it is important to discuss the options of breast implant surgery with your plastic surgeon if you are interested in becoming pregnant and breast feeding in the future.

Injury and even normal compression and movement of the breast can cause rupture and leakage. Saline-filled implants simply drain into the body, where the salt-water is absorbed and expelled naturally. Silicone-filled implants may not deflate, and a rupture may not even be noticeable without ultrasound or MRI. For this reason, a woman with silicone breast implants is advised to visit her plastic surgeon annually to assess that her implants are functioning well. An ultrasound exam or MRI screening can assess the condition of breast implants. After 3 years it is recommended that all silicone implants be properly screened.

Following breast augmentation surgery, regular mammography screenings should continue, though a special technique is needed to ensure a reliable reading because implants can obscure some of the image. The screening must incorporate additional views of the tissue to ensure coverage. Because of the compression required for mammography, it is important to be frank and open so that an accurate reading can be obtained with minimal risk of rupture. A facility which sees more women with implants can also help.

These complications do not affect the majority of women who receive breast augmentation surgery. Still it is important to know all the facts before going under the knife, and wise to practice basic preventive maintenance after, all of which is facilitated by candid discussion with your physician.

Planning Your Surgery

In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts, your skin tone, and any other applicable factors. If your breasts are sagging, your doctor may also recommend a breast lift.

Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. You may want to ask your surgeon for a copy of the manufacturer’s insert that comes with the implant he or she will use — just so you are fully informed about it. And, be sure to tell your surgeon if you smoke, or if you’re taking any medications, vitamins, or other drugs. Your surgeon will give you instructions to prepare for surgery, including eating and drinking guidelines, avoiding smoking, and taking or avoiding certain vitamins and medications. A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison.

Your surgeon should also explain:

  • Your surgical procedure, and its pros and cons
  • Alternatives, and their pros and cons
  • The type of anesthesia to be used
  • The type of facility where the surgery will be performed
  • Where incisions will be
  • Where the implants will be placed
  • The recovery process
  • Your obligations as a patient
  • The costs involved.

Because most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications of your surgery. There may be a waiting period of several days to weeks from the time of your consent to the day of surgery.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

The Surgery

You’ll want to make sure you fully understand the implications of the procedure your doctor recommends for you before surgery. Your surgeon may prefer to perform the operation in an office facility, a freestanding surgery center, or a hospital outpatient facility. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

General anesthesia may be used, in which case you’ll sleep through the entire operation. Some surgeons will use a local anesthesia, combined with a sedative to make you drowsy, so you’ll be relaxed but awake, and may feel some discomfort.

The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation. Incisions are generally made in the crease where the breast meets the chest, around the areola, or in the armpit. A saline implant may be placed through an incision at the navel. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

The surgeon will lift your breast tissue and skin through the incision to create a pocket, either directly behind the breast tissue or beneath the pectoral muscle, on top of the chest wall (submammary and submuscular placement, respectively). Once the implant is positioned, the incisions are closed with sutures, skin adhesive and/or surgical tape. A gauze bandage may be applied to help with healing. The surgery usually takes one to two hours to complete.

You will probably be feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, any gauze dressings will be removed, and you may be given a surgical bra, which you should wear as directed. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to subside. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. Scars will begin to fade after several months, although they will never disappear completely.

You should be able to return to work within a few days, depending on the level of activity required for your job. Follow your surgeon’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. Once your breasts are no longer sore, breast contact is fine; usually three to four weeks after surgery.

Again, routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammography technician should use a special technique to assure that you get a reliable reading, as discussed earlier.

Your New Look

For many women, the result of breast augmentation is satisfying, even exhilarating, as they the people around them learn to appreciate their fuller appearance.

Even if you believe your implants are functioning well, however, it is important that you follow up as directed with your plastic surgeon to more fully assess the condition of your breast implants. Whether you choose to have breast implants or not, it is essential to your health that you practice a monthly breast self-exam and schedule regular diagnostic breast screenings.

Your decision to have breast augmentation is a highly personal one that not everyone will understand it. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.

Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.

Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.

The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.

After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.