Breast enlargement, or augmentation mammaplasty, is a surgical procedure to enlarge the breasts with implants.
How is the surgery performed?
The method of inserting and positioning your implant will depend on your anatomy and your 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), or in the armpit.
Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples.
Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle, however, may be more painful for a few days after surgery than placement directly under the breast tissue.
You'll want to discuss the pros and cons of these alternatives with your doctor before surgery to make sure you fully understand the implications of the procedure he or she recommends for you.
The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing. Drainage tubes may be used for several days following the surgery.
Will the surgery result in permanent scarring?
Scars are permanent and will be firm and pink for at least six weeks, then they may remain the same size for several months, or even appear to widen. After several months your scars will begin to fade, although they will never disappear completely. Every effort will be made to assure that the incisions are placed so resulting scars will be as inconspicuous as possible.
How long does the procedure take?
A typical breast augmentation procedure will take one to two hours.
How long is the recovery time?
You should be able to return to work within a few days, depending on the level of activity required for your job.
Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery.
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading, as discussed earlier.
Will I need anesthesia?
Breast augmentation can be performed with a general anesthesia, so you'll sleep through the entire operation. Some surgeons may use a local anesthesia, combined with a sedative to make you drowsy. You'll be relaxed but awake, and may feel some discomfort.
What materials are the implants made of?
A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.
Do implants interfere with mammograms?
Current implants do partially block X-rays that are used in mammograms, but most radiologists feel that, with extra views, they can see most of the breast tissue adequately. There are no studies to date documenting a case in which a breast implant caused cancer to be hidden. Nevertheless, there is at least a possible risk of a delay in diagnosis. It is recommended that a mammogram be done in women older than the age of 35 who desire breast implants to establish a baseline. There continues to be research for implants that do not obscure X-rays.
Am I a good candidate for breast enlargement?
The best candidates for breast augmentation are women who are looking for improvement in their appearance and who are physically healthy, emotionally stable and realistic in their expectations.
During your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor also may recommend a breast lift.
You may want to ask your surgeon for a copy of the manufacturer's insert that comes with the implant he or she will use - just so you are fully informed about it. Be sure to tell your surgeon if you smoke and if you're taking any medications, vitamins, or other drugs.
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Rest as much as possible when you return home. It is normal to feel drowsy or sluggish the entire day. You may feel especially dizzy or uncomfortable upon standing or walking, so be sure that support from a person or object is nearby.
Stay in bed at all times except for during meals and when you need to use the bathroom.
Keep your head and chest elevated on at least two to three pillows at all times.
Sleep on your back rather than your side. (Sleeping on your side will cause you to become more swollen on that side.)
Take pain medication as needed and as directed. *DO NOT take pain medication on an empty stomach. Avoid alcohol beverages.
Wear the Ace wrap as instructed and keep it on until your next follow-up appointment.
Monitor any drainage you may have.
Activity may be increased gradually after a few days. Most women can resume normal activities within the first week after surgery.
No high-impact exercising for one month.
Heavy physical exertion, such as tennis, swimming or golfing, should be delayed for approximately two to three weeks after surgery.
You can drive within four to five days, and most women return to normal work activities by the seventh to tenth post-operative day.
If you are a smoker, DO NOT smoke for one to two weeks after surgery.
You will return on the day following surgery for a check by your physician and probably removal of drainage tubes, if present. A few days after surgery, the dressing is removed and you will usually be placed into a brassiere.
sutures are removed within a few days.
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