Best Candidates for Breast Augmentation
The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.
The choice of implant filler, implant size, shape and other features will be determined based on your breast anatomy, body type and your desired increase in size. Your lifestyle, goals and personal preferences, as well your plastic surgeon’s recommendations and sound surgical judgment are also determining factors. Implant manufacturers occasionally introduce new styles and types of implants, and therefore there may be additional options available to you.
Risks Associated with Breast Implant Surgery
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard and distort the breast shape. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant. This is a particularly bothersome problem for both the surgeon and patient. Once a contracture develops, it is difficult to treat and sometimes cannot not be alleviated as it can recur. The cause of capsular contracture can happen from postoperative bleeding, ruptured silicone and, most commonly, we think it comes from a sub-clinical (difficult to detect) infection. It can occur at any time, but usually happens months after the original procedure and happens despite use of antibiotics at the time of the operation.
Breast implants do not generally interfere with a woman’s ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman’s body may alter the results of any breast surgery, including surgery to place breast implants. Therefore, it is important to discuss the options of breast implant surgery with your plastic surgeon if you are interested in becoming pregnant and breast feeding in the future.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and repeated movement of your breast and implant, causing the man-made shell to weaken, and leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be absorbed and naturally expelled by the body. If a silicone-gel filled implant leak or break, the elastic silicone gel may remain within the implant shell, or may escape into the breast implant pocket (a capsule of tissue that surrounds the implant). A leaking implant filled with silicone gel may not deflate and may not be noticeable except through imaging techniques such as an MRI. For this reason, a woman with silicone breast implants is advised to visit her plastic surgeon annually to assess that her implants are functioning well. An MRI screening can help assess the condition of breast implants; after 3 years it is recommended that all silicone implants be properly screened.
While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
In 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 may also recommend a breast lift.
A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison.
What to Expect During Surgery
The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, most commonly on top of the chest wall (submuscular placement) but may also be placed directly behind the breast tissue (submammary or subglandular placement). Submuscular placement is most commonly used as it has the advantage of decreased capsular contracture, and a more natural appearance of the implant as there is more soft tissue coverage over the upper portion of the implant. The disadvantage of submuscular placement is that there will be movement of the implant with pectoralis flexion. However, most women do not find this overly bothersome.
Breast Surgery Recovery
You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor. You should be able to return to work within 7-10 days, depending on the level of activity required for your job.
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammography technician should use a special technique to assure that you get a reliable reading.
For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance.
Even if you believe your implants are functioning well, it is important that you follow-up as directed with your plastic surgeon to assess the condition of your breast implants. In addition, whether you choose to have breast implants or not, it is essential to your health that you practice a monthly breast self-exam and schedule regular diagnostic breast screenings.
Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.
Please note that the information provided in this discussion is an expression of Dr. Maier’s philosophy and practice.