Breast enlargement basics and procedure

Today, women are choosing breast augmentation to enhance their profile and improve the appearance of breasts. Breast augmentation is one of the most common procedures in cosmetic plastic surgery.

There were 364,610 breast augmentation procedures in 2005, a 9 percent increase from 2004, according to the American Society for Aesthetic Plastic Surgery.

Basics of Breast Augmentation

Breast augmentation is performed by inserting a breast implant behind breast tissue or above the breast muscle. Implants come in a variety of shapes and sizes, with varying designs, in a range of materials. They can be placed in different positions through a variety of incision locations.

Breast surgery is a medical procedure that requires advanced surgical skill. The goal is to leave your breasts looking as natural as possible, while enlarging them to your desired size. Because of the surgery’s complexity, you are better off using a board-certified plastic surgeon who has experience in all aspects of breast enhancement.

Breast Lift with Breast Augmentation

The plastic surgeon may recommend that a breast lift and breast augmentation be performed at the same time. This is most commonly recommended to treat the sagging appearance that results from aging or pregnancy. During this combined procedure, some breast tissue is removed, the breast skin is tightened and lifted and an implant is inserted.

Another, newer technique to provide a breast lift and breast augmentation is laser bra breast surgery. In this technique, a laser is used to provide more support for the breast.

Initial Consultation

During the initial consultation, the surgeon will discuss your goals and expectations, the size and shape you are looking for and your feelings about the procedure.

You and your surgeon should make decisions together about the type of implant, the incision location and the implant placement. Your anatomy plays a major role in these decisions. The surgeon will talk with you about the options for surgery — depending on your current measurements, your body frame and your expectations.

How Is Breast Augmentation Performed?

Breast augmentation is often performed in an office surgical suite or an outpatient surgical center, using local anesthesia (you remain awake). Breast surgery can also be performed in a hospital under general anesthesia (you are asleep). Time in surgery is typically one to three hours.

To begin the procedure, an incision is made in one of four primary locations:

Under the breast (inframammary incision)
Around the nipple (periareolar incision)
In the arm pit (transaxillary incision), or
In the navel area (transumbilical or TUBA incision).
After the incision, a special surgical tool will be used to form a pocket so that the implant can be inserted. There are three primary positions where the implants can be placed:

Subglandular or above the pectoral muscles
Partial submuscular or partially behind the muscles
Complete submuscular or completely behind the muscles
The choice of incision and implant placement depend on the size and shape of the implant, your body frame, amount of breast tissue and the planned scar location.

Patients can choose the type of breast implants. Implant factors include the implant size, shape, and material, in addition to whether or not the implant volume can be adjusted after surgery, all of which should be discussed beforehand with your surgeon.

After Surgery

Because breast tissue is stretched and separated, and because implants are inserted through incisions, the breasts will be bruised, sore, and swollen after surgery. You can expect to wear a surgical bra for several days. There may be some moderate pain, but that can be treated by a prescription from your plastic surgeon. Your doctor may suggest that you wear an athletic or support bra until the swelling has subsided.

Heavy lifting or straining should be avoided after surgery because this can cause the breasts to swell and increase pressure. You can typically return to work within a week and to full activity within a few weeks. Sensation in your nipples may be reduced temporarily, but should return to normal as your breasts heal. Breast feeding usually is not hindered; however, it is important to ask the doctor about breast feeding during your initial consultation.

After healing, some permanent scarring will remain. Scars are typically small and inconspicuous. Your surgeon’s goal will be to make them as unnoticeable as possible. Inframammary and periareolar incision scars are on the breast. Transaxillary or TUBA incisions can be placed in a natural fold in the skin under the armpit, virtually unnoticeable after surgery.

As with any surgery, there is risk of complications related to infection or reaction to anesthesia. Excessive bleeding may also occur. With proper precautions by the surgical team, complications are typically minimized or prevented. This is another reason to choose a board-certified plastic surgeon. Risk can be further reduced by fully informing your doctor about your medical history prior to surgery and by carefully following pre- and postoperative instructions.

Consult a qualified surgeon with your questions about new cosmetic-surgery techniques; discuss expectations, risks, cost, and the benefits of each plastic surgery option.