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Breast Augmentation

What is breast enlargement surgery?

Breast augmentation, or augmentation mammaplasty, is a procedure to reshape the breast in order to make it larger. The procedure can also be performed to reconstruct the breast following breast surgery.

Concerns About Breast Implants

With breast augmentation, the surgeon inserts an implant underneath the breast. In the past, implants were made of silicone, however, because of controversy surrounding the silicone implants and their effect on the body, surgeons now use implants filled with a salt-water solution. New implants made of a substance that can be absorbed by the body in case of ruptures or leaks are currently awaiting FDA approval.

Possible complications associated with breast augmentation surgery:

Possible complications associated with breast augmentation surgery may include, but are not limited to, the following:

  • 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 is gone before a new implant is inserted.
  • capsular contracture
    A capsular contracture may occur if the scar or capsule around the implant begins to tighten. Treatment can involve either the removal or "scoring" of the scar tissue, or the removal or replacement of the implant.
  • oversensitive, undersensitive, or numb nipples
    Oversensitivity, undersensitivity, and/or small patches of numbness near the incisions may occur in some patients. The symptoms usually disappear with time, but may be permanent in some patients.
  • leaking or rupturing of implants
    A breast implant is a silicone shell filled with either silicone gel or saline.

    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. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will harmlessly be absorbed by the body.

    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 necessary.

There is no evidence that fertility, pregnancy, or the ability to nurse will be affected by breast implants. However, if you have nursed a baby within the year before breast augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your physician.

About the procedure:

Although each procedure varies, generally, breast augmentation surgeries follow this process:

  • Location options may include:
    • surgeon's office-based surgical facility
    • outpatient surgery center
    • hospital outpatient
    • hospital inpatient
  • Anesthetic options may include:
    • general anesthesia
    • local anesthesia, combined with a sedative (allows the patient to remain awake but relaxed)
  • Average length of procedure: about two hours
  • Location of incision: The method of inserting and positioning the implant depends on the patient's anatomy and the surgeon's recommendation. The incision can be made:
    • in the crease where 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, the patient may be given a surgical bra. Stitches will be removed in a week or so.

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