The most frequently performed cosmetic surgery procedure in the U.S., breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.
Implants are silicone shells filled with saline (salt water) and are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia, although local anesthesia combined with a sedative is also possible. After surgery the patient’s bustline may be increased by one or more cup sizes.
Incisions are made in inconspicuous places on the breast to minimize scar visibility (in the armpit, in the crease on the underside of the breast, or around the areola, the dark skin around the nipple). The breast is then lifted, creating a pocket into which the implant is inserted.
Placement behind the chest wall muscle offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery.
After the implants are placed and centered beneath the nipples, incisions are stitched, taped and bandaged. In a few days these bandages may be replaced with a surgical bra. Most patients feel tired and sore after surgery, but this usually passes in a day or two and many patients return to work within the week. Stitches are removed in a week to 10 days and any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars will begin to fade in a few months and will continue to fade for months or years.
Complications following surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant as a result of injury or the normal compression and movement of your breast (if this happens the implant will simply deflate in a few hours and your body will absorb the salt water).