Breast Augmentation is a procedure in which the breasts are enlarged by placing breast implants underneath the mammary gland or underneath the mammary gland and the pectoralis major muscle. Women with small, uneven, or slightly sagging breasts can benefit from breast augmentation.
PRE-OPERATIVE – SURGICAL PREPARATION
Preoperatively the patient may be requested to have blood testing such as CBC and serum electrolytes or electrocardiogram to obtain clearance, depending on existing medical conditions. If the patient is over the age of 33, they will also be required to have a preoperative mammogram. The patient will be advised to abstain from certain foods and medication, such as Aspirin, Ibuprofen, Vitamin E, garlic and broccoli, as well as to abstain from smoking or alcohol use, for several days prior to surgery. These precautions decrease the risk of bleeding and circulation complications. Photos of the existing area will be taken in order to assess the improvement obtained by the procedure.
TYPES OF IMPLANTS
There are different type of implants that can be used in a breast augmentation. Implants may be filled with saline solution or silicone gel. They come in different shapes and forms – some are round and some are anatomical, like a teardrop. The surface of the implant can be smooth or textured. There is a cost difference between the saline and the silicone implants, with the silicone implant being much more expensive than the saline implants. In our practice, round, smooth implants are the most common type used in our patients’ breast augmentations. All options will be discussed at the time of your consultation and an implant type will be recommended based on your anatomy and desired results. Due to the difference in bra manufacturer sizing, we cannot guarantee a specific cup size result.
The procedure takes approximately 1 to 1 ½ hours. It is performed under twilight or general anesthesia in an accredited surgical facility in an office, or in the hospital operating room. There are three possible incision techniques, and the chosen technique will depend on the individual’s anatomy, the desired results, and the complexity of the procedure. In many cases, an incision is made around the areola, the implant is inserted into the breast cavity, and the areola is sutured back in place. This technique results in the most scarring that is virtually undetectable and it does not compromise the structure of the external breast tissue. Another common technique is to make an incision underneath in the breast crease, which is typically the case when the implant is inserted under the muscle. In very few cases, an incision may be made in the axilla (armpit area). Sometimes, a breast lift may be performed in conjunction with augmentation. When the surgery is complete, the area will be bandaged tightly.
POST-OPERATIVE – RECOVERY
Postoperatively the patient will be seen in the office the following day for follow-up examination and evaluation, and will be asked to perform certain exercises to keep the pocket of the implant enlarged. Patients can expect minimal discomfort for the first 24-48 hours. Swelling and ecchymoses (black and blue) can be expected and will subside in time. If necessary, pain medication will be prescribed. Antibiotics may be prescribed prior to or after surgery to prevent infection. The patient may return to work within a few days, as long as there is no heavy lifting. While full recovery takes about 2-3 weeks, most daily activities can be resumed within a few days. The patient will be advised to abstain from salty food which can increase the swelling in the operative site.
Some possible risks and complications can occur with this procedure, including those that could occur with any type of surgery, such as bleeding, infection and, most uncommonly, anesthesia complications. Other possible risks and complications include lack of circulation to the skin or the nipple areola complex, which will delay the healing, or lack of nipple sensation. Breast asymmetry is also possible, although the surgeon will try to create symmetry between the two breasts to the best of his ability. Most women have a slight asymmetry of the breast prior to surgery, which will persist with typical breast augmentation using implants of the same size. Should an infection occur, the implant may have to be removed. A certain timeframe must pass before the implant can be replaced. Scars may develop on the wound of entrance, and on occasion may become hypertrophic and more noticeable. Capsule formation is another possible complication and may require additional surgeries.
It is important that the patient discusses future pregnancy and lactation plans with the surgeon prior to having this procedure. The patient should expect the breasts to engorge if she becomes pregnant, and if she gains a lot of weight after surgery the breasts might grow or change shape to an extent. The patient may be unable to lactate after future pregnancies. These and any other less common risks and complications will be discussed at the time of surgical consent. It is necessary for the patient to comply with our pre- and post-operative instructions in order to decrease the likelihood of complications.
The fee for this procedure varies depending on the geographic location of your surgeon, the reputation of the surgeon, and the complexity of the individual surgical procedure. Our fees for the procedure range from $7,500-$12,500, depending on the implant selection and complexity of the procedure. You may incur other fees such as anesthesia or operating room fees.