Breast augmentation is performed to increase breast size and/or fix breast asymmetry. Candidates include women who want larger breasts, and those who want to restore the breast volume often lost as a result of pregnancy or significant weight loss. Breasts can be enlarged with implants or by fat transplantation. Breast augmentation is not a substitute for a breast lift (mastopexy), which is a procedure to “lift” breasts that sag significantly.
Breast Augmentation with Implants
Silicone and saline are the two implant types most commonly used in breast augmentation. Silicone implants feel more like natural breasts than saline ones. However, if a saline implant ruptures, the saline is naturally absorbed by the body, whereas if a silicone implant has an extracapsular rupture (a rupture to the outer capsule), silicone filler leaks into the body, possibly resulting in inflammatory nodules or enlarged lymph glands.
Implants are placed behind each breast, underneath either breast tissue or the chest-wall muscle. The procedure lasts 1 to 2 hours, and is typically performed with general anesthesia, although local anesthesia combined with a sedative may be used. Incisions are made in inconspicuous places (in the armpit, in the crease on the underside of the breast, or around the areola) to minimize scar visibility. The breast is then lifted, creating a pocket into which the implant is inserted.
Advantages of implant placement behind the chest-wall muscle include a possible reduced risk of capsular contracture (hardening of scar tissue around implant), and less interference during mammograms. Disadvantages include the possible need for drainage tubes, and a longer recovery period. Advantages of implant placement beneath breast tissue include that the breasts move more naturally as the patient uses her chest muscles, and that slight breast sagging is corrected.
Recovery from Breast Augmentation
After a breast augmentation with implants, drainage tubes may be inserted; incisions are stitched, taped and bandaged. A surgical bra is typically put over the bandages to minimize swelling and support the breasts. For a few days postsurgery, most patients feel tired and sore, but many return to work within a week. Stitches are removed in 1 week to 10 days; postoperative pain, swelling and sensitivity diminish during the first few weeks. Scars begin to fade in a few months.
Risks of Breast Augmentation
In addition to the risks associated with surgery and anesthesia, those related to a breast augmentation using implants include the following:
- Capsular contracture
- Implant leaks and ruptures
- Implant deflation or shifting
- Temporary or permanent change in nipple/breast sensation
- Irregularities in breast contour/shape
- Partial or total loss of nipple/areola
Breast Augmentation FAQs
Who is a candidate for breast augmentation?
A woman who wants to increase the size of her breasts, to fix asymmetrical breasts, or to restore lost volume to her breasts is a candidate for breast augmentation. She must have fully developed breasts, be physically healthy, and have realistic expectations about the outcome of the surgery.
During a breast augmentation using implants, incisions are made in inconspicuous places (in the armpit, in the crease on the underside of the breast, or around the areola), which minimizes scar visibility. During breast augmentation using fat transplantation, there are no incisions because fat is injected, so scarring is rarely an issue.
What are the risks and complications of breast augmentation?
In addition to the risks associated with surgery and anesthesia, those related to breast augmentation using implants include capsular contracture; implant leaks and ruptures; and implant deflation or shifting.
How much recovery time does breast augmentation require?
After breast augmentation with implants, most patients feel tired and sore, but many return to work within a week. After breast augmentation with fat transplantation, recovery time is quite short, with normal activities being resumed as soon as the patient feels comfortable.