Definition
Breast augmentation is a procedure to enlarge or change the shape of the breasts.
Alternative names
Breast enlargement; Breast implants? Breast implants? Mammoplasty – augmentation
Description
Breast augmentation is done by placing implants behind the breast tissue or under the pectoral muscle.
An implant is a sac filled with either sterile salt water (saline) or a material called silicone.
The operation is performed in an outpatient clinic or in a hospital.
- Most women receive general anesthesia for this surgery. You will be asleep and pain free.
- If you get a local anaesthetic, you will be awake and given medicine to numb your breast area to stop the pain.
There are several ways to place breast implants:
- In the most common technique, the surgeon makes an incision (incision) on the underside of your breast, in the natural fold of the skin. The surgeon places the implant through this opening. Your scar may be a little more visible if you’re younger, thinner, and haven’t had children yet.
- The implant can be placed through an incision under your arm. The surgeon can perform this surgery using an endoscope. This is a tool with a camera and surgical tools at the end. The endoscope is inserted through the incision. There will be no scar around your breast. However, you may have a visible scar on your lower arm.
- The surgeon may make an incision around the tip of your nipple. This is the dark area around your nipple. The implant is placed through this opening. You may have more trouble breastfeeding and loss of sensation around the nipple with this method.
- A saline implant can be placed through an incision near your belly button. An endoscope is used to move the implant into the breast area. Once in place, the implant is filled with saline.
The type of implant, the size of the implant, and the implant surgery can affect:
- How much pain do you have after the procedure?
- The appearance of your breasts
- The risk of the implant breaking or leaking in the future
- Your future mammograms — additional views will be required to allow visualization
Your surgeon can help you decide which procedure is best for you.
Why is the process running?
Breast augmentation is done to increase the size of your breast. It may also be done to change the shape of your breasts or to correct a birth defect (congenital deformity).
Talk to a plastic surgeon if you are considering breast augmentation. Discuss how you expect to look and feel better. Keep in mind that the desired result is improvement, not perfection.
Risks
The risks of anesthesia and surgery in general are:
The risks of breast surgery are:
- Difficulty breastfeeding
- Loss of sensation in the nipple area
- Small scars, often in an area that is not very visible
- Thick, raised scars
- Abnormal nipple position
- Different sizes or shapes of the two breasts
- Implant rupture or leakage
- Visible rippling of the implant
- Need for more breast surgeries
It is normal for your body to create a ‘capsule’ made up of scar tissue around your new breast implant. This helps keep the implant in place. Sometimes, this capsule becomes thick and larger. This can cause a change in the shape of your breast, hardening of the breast tissue or some pain.
Emotional risks for this surgery may include feeling that your breasts don’t look perfect. Or, you may be disappointed with people’s reactions to your “new” breasts.
There are some risks that can occur months or even years after an implant is placed.
A rare type of lymphoma (cancer of the immune system) has been reported with certain types of implants. It’s called breast implant-associated lymphoma. Symptoms include a mass or swelling around the implant and chest pain. It can be treated by removing the implant and the area around the implant.
Some patients experienced systemic symptoms after receiving implants. This has been called “breast implant disease” although there is not yet enough evidence for it to be a recognized disease. Reported symptoms include:
- Fatigue
- Memory and concentration problems (“brain fog”)
- Joint and muscle pain
- Worry
- Hair loss
- Depression
- Skin rash
- Autoimmune disease
- Inflammation
- Weigh profit or loss
Women report that symptoms improve after the implant is removed. Despite these rare risks, breast implants are considered safe.
Before the Process
Tell your healthcare provider:
- If you are or could be pregnant
- What medicines you take, including over-the-counter medicines, supplements or herbs
In the days before surgery:
- You may need a mammogram or breast x-ray before surgery. The plastic surgeon will do a routine breast exam.
- Several days before surgery, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other medications that make it harder for your blood to clot.
- Ask your provider what medications you should still be taking on the day of surgery.
- You may need to fill prescriptions for pain medication before surgery.
- Arrange for someone to drive you home after surgery and help you around the house for 1 or 2 days.
- If you smoke, it is important to stop. Smoking can cause problems with healing. Your surgeon may postpone surgery if you continue to smoke. Ask your provider for help to stop.
On the day of surgery:
- You will usually be asked not to drink or eat anything after midnight the night before the operation.
- Take the medications your provider has told you with a small sip of water.
- Wear or bring loose clothing that buttons or zips up the front. And bring a soft, loose fitting bra without an underwire.
- Get to the outpatient clinic or hospital on time.
After the Process
You will likely go home when the anesthesia wears off and you can walk, drink water, and reach the toilet safely.
After breast augmentation surgery, a bulky gauze bandage will be wrapped around your breasts and breasts. Or, you can wear a surgical bra. Drainage tubes may be attached to your chest. These will be removed within 3 days. Your surgeon will give you instructions on when you can bathe or shower.
The surgeon may also recommend breast massage starting 5 days after surgery. Massage helps reduce the hardening of the capsule surrounding the implant. Ask your provider first before massaging your implants.
Outlook
You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself. Also, any pain or skin symptoms due to the surgery will likely disappear. You may need to wear a special supportive bra for a few months to reshape your breasts.
Scars are permanent and are often more visible in the year following surgery. They may fade after that. Your surgeon will try to place the incisions so that your scars are as hidden as possible.
bibliographical references
Calobrace MB. Breast enlargement. In: Peter RJ, Neligan PC, eds. Plastic Surgery, Volume 5: Breast. 4th ed.Philadelphia, PA: Elsevier; 2018: chapter 4.
Lee M, Ponraja G, McLeod K, Chong S. Breast implant illness: Abiofilm hypothesis. Plast Reconstr Surg Glob Open. 2020? 8(4):e2755. PMID: 32440423 www.ncbi.nlm.nih.gov/pmc/articles/PMC7209857/.
Padilla PL, Khoo KH, Ho T, Cole EL, Sirvent RZ, Philips LG. Plastic surgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed St Louis, MO: Elsevier; 2022: chapter 69.
US Food and Drug Administration website. The medical device reports on systemic symptoms in women with breast implants. www.fda.gov/medical-devices/breast-implants/medical-device-reports-systemic-symptoms-women-breast-implants. Current as of August 20, 2020. Accessed May 5, 2021.
US Food and Drug Administration website. Risks and complications of breast implants. www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants. Current as of September 28, 2020. Accessed May 5, 2021.
