Augmentation Mammoplasty

Breast Augmentation Mammoplasty

What are the steps of a breast augmentation procedure?

A breast augmentation procedure includes the following steps:

Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision
Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include: along the areolar edge (peri-areolar incision), the fold under the breast (inframammary fold) and in the armpit (axillary incision). A belly-button approach is associated with a higher complication rate. Incisions vary based on the type of breast implant, degree of enlargement desired, your particular anatomy and patient-surgeon preference.

Step 3 – Inserting and placing the breast implant
After the incision is made, a breast implant is inserted into a pocket either:
A. Under the pectoral muscle (a submuscular placement)
B. Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)
The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon's recommendations.

Step 4 – Closing the incisions Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade. The quality of scar depends on many things, including your genetics, exposure of your body to nicotine and infection.
What should I expect during my breast augmentation recovery?

During your breast augmentation recovery, your breasts will be wrapped in gauze dressings and an elastic bandage or support bra will minimize swelling and support the breasts as they heal. Immediately after surgery, you will be taken into a recovery area for close monitoring. You may be permitted to go home when you are stable for discharge, typically after an hour or so. Before leaving, you will be given specific postoperative instructions for your breast implant recovery and a follow-up appointment with your plastic surgeon. You may also receive medications or a prescription, but many plastic surgeons prescribe postoperative medications in advance. Your prescribed medications may include pain pills and an antibiotic to prevent infection. Wear your support garment (a bra or elastic band, called a bandeau) around the clock as instructed by your plastic surgeon. Some surgeons may ask patients cleanse the incision sites and apply ointment, while others will ask their patients to keep tape or a bandage on. Instructions vary, so it's important to follow all your plastic surgeon's directions carefully. Because it is possible to bleed into the pockets around the breast implants for the first several days, take it easy until you have permission to increase your activity level. Acute pain typically subsides after one to five days, but you may experience soreness and swelling for a few weeks. Resume exercise and normal activity according to your plastic surgeon's directions.
What results should I expect after breast augmentation surgery?

While a breast augmentation yields larger breasts right away, the final results may take a few weeks as the swelling subsides and the skin stretches. Some patients may need to wear a bandeau to help shape their breasts, especially if they have underlying asymmetry or very small breasts to start with. Incision lines may take several months, even a couple of years, to fade.
Breast implant replacement

Breast implants are not considered to be lifetime devices, and they may need to be replaced. You can see your plastic surgeon for an annual examination to evaluate your breast health and implant integrity. Over time, your breasts will change due to aging, weight fluctuations, hormonal factors and gravity. As the appearance of their breasts changes with time, some patients have a breast lift or an implant exchange to restore a more youthful contour.
What words should I know about breast augmentation?

Areola
Pigmented skin surrounding the nipple.

Augmentation mammaplasty Breast enlargement or breast enhancement by surgery.

Breast augmentation
Also known as augmentation mammaplasty; breast enlargement or breast enhancement by surgery.

Breast implants
Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants fall into two categories: saline breast implants and silicone breast implants.

Capsular contracture
A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.

General anesthesia
Drugs and/or gasses used during an operation to relieve pain and alter consciousness.

Hematoma
Blood pooling deep to the skin.

Inframammary incision
An incision made in the fold under the breast.

Intravenous sedation
Sedatives administered by injection into a vein to help you relax.

Local anesthesia
A drug injected directly to the site of an incision during an operation to relieve pain. Mammogram
An x-ray image of the breast.

Mastectomy
The removal of breast tissue, typically to rid the body of cancer.

MRI
Magnetic Resonance Imaging; a painless test to view tissue similar to an x-ray.

Periareolar incision
An incision made at the edge of the areola.

Saline implants
Breast implants filled with sterile salt water.

Silicone implants
Breast implants filled with an elastic gel.

Submammary or subglandular or subfascial placement
Breast implants placed directly behind the breast tissue, over the pectoral muscle.

Submuscular or subpectoral placement
Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall.

Sutures
Stitches used to hold skin and tissue together.

Transaxillary incision
An incision made in the underarm area.

Ultrasound
A diagnostic procedure that projects high-frequency sound waves into the body and records the echoes as pictures