Women who seek breast augmentation are unhappy with the appearance of their breasts or the way clothes fit because their breasts are too small in proportion to the rest of their body or they have lost their shape and tone thanks to age, genetics or childbirth. Breast augmentation remains the most requested cosmetic surgical procedure among women in the United States.
Breast augmentation can include implants, reconstruction, lift and/or fat grafting. Implants come in a variety of materials (silicone, saline or a combination of both), shapes (round and teardrop) and sizes (B through DD).
Silicone gel implants are the oldest type of breast implant, which were banned in the 1990s when women claimed they caused health complications. Since then, the FDA has reduced the ban after studies refuted the claims and manufacturers improved their products. Saline implants have been the most popular type of breast implant since they were introduced in 2000. Saline implants are made with a silicone outer shell and filled with a sterile saline, which, if ruptured, does not harm the body.
Breast Implant Incisions
Incisions for breast implants fall into four categories: inframammary, pariareolar, tranaxillary and TUBA.
Inframammary incisions are placed in the crease under the breast. They are less visible and allow the implants to be placed under the muscles and glands, which benefit women who want to breastfeed.
Periareolar incisions are made around the edge of the nipple. Scarring is disguised by the nipple. This method can be used in conjunction with a breast lift, and the nipple can be repositioned. A common side effect of periareolar incisions in breast augmentation surgery is a loss of sensation that might not return fully. Women who have had periareolar incisions might also find breastfeeding difficult.
Transaxillary incisions are made in the armpit, which is ideal if breast scarring is a concern.
TUBA incisions-or transumbilical-are made through the navel. This is a less common technique and might be used on a woman who is having multiple procedures, including abdominoplasty or a mommy makeover.
The type of incision that a cosmetic surgeon will recommend depends on the type of implant used, the childbearing status of the woman, whether other procedures will be performed in the same setting, the patient's concern about scarring and the size of the implant.
Breast Implant Complications & Considerations
All invasive surgical procedures come with a standard set of possible complications: infection, scarring and pain. In addition, breast augmentation comes with risks of implant rupture, capsular contracture (hardening of the tissue), changes in nipple and breast sensation and deformity. In addition, some women find the results are not what they expected. Although these complications are rare, they are best avoided by choosing a qualified cosmetic surgeon.
Keep in mind that breast implants are not intended to be permanent. They have an expected life of 10-15 years, and some surgeons will advise replacing them when and if they rupture or deflate. As your cosmetic surgeon about replacement expectations at your initial consultation.
Breast Augmentation Via Fat Grafting
This is an interesting method of breast augmentation that uses the patient's own fat, removed from an unwanted area such as the thighs or abdomen, and injected into the breasts. The greatest advantage of fat grafting over implants is a foreign material is not inserted into the patient's body. The procedure requires small incisions and less recovery time than implant surgery. An added bonus is that the patient can have fat removed from one are of the body via liposuction. The risks of breast augmentation via fat grafting are lumps, ripples, fat being absorbed into the body, calcification, infection, fat embolism and the need for repeat procedure if the first one did not produce the desired results.
After Breast Augmentation Surgery
Patients typically leave the surgical center an hour or two after surgery, which is performed on an outpatient basis. The breast area will be tightly wrapped in bandages, which will stay in place until they are removed at the first post-operative visit in one to two days. Activity is restricted to sedentary activities with no lifting of anything heavier than a pencil for the first two weeks. The cosmetic breast surgeon might suggest wearing a sports bra for several weeks after surgery. The patient gradually returns to normal activity and exercise.