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Breast Augmentation
Augmentation Mammoplasty


It may be argued that fashion is fickle but many women have coveted bigger breasts for centuries. The first surgical breast augmentation was performed in 1890 using paraffin injections. In 1920 this technique was abandoned in favor of fat transplants. Fatty tissue was surgically removed from the abdomen and buttocks and transferred into the breasts. In the 1950's polyvinyl "sacs" were frequently used to achieve fuller, more projected breasts. Although invented in the early 1960's, it wasn't until the 1980's that the silicone implant, as we know it, really began to take off. Today, the most commonly used implants have a silicone shell but are filled with a salt-water solution known as saline.

"The first surgical breast

augmentation was performed in 1890 using paraffin injections."

Motivations vary but the main reasons a woman has breast augmentation are that she feels her breasts are too small, she has uneven breasts or she wants to regain the size and shape of her breasts after experiencing significant weight loss or pregnancy.

Breast Augmentation, clinically referred to as Augmentation Mammoplasty, is currently the most popular cosmetic surgery procedure performed in the United States. According to the American Society of Plastic Surgeons, over 307,000 breast augmentation procedures were performed in 2011 within the United States. The number of breast augmentation procedures conducted in the U.S. has increased by more than 45% over the past ten years.

Breast AugmentationWith the increasing popularity of various cosmetic surgery procedures, including breast augmentation, it is imperative that the prospective patient research and understand various issues such as what the procedure can and cannot treat, inherent risks, costs, etc. Keep in mind, cosmetic surgery is just that - a surgical procedure of which the results cannot simply be erased. While the information contained in this website will provide you with a good introduction to breast augmentation, when considering this cosmetic surgery procedure, or any other cosmetic surgery procedure for that matter, we recommend that you consult a qualified provider with significant experience in breast augmentation surgery. This being said, some important elements you should understand regarding breast augmentation include the following:

Benefits of Breast Augmentation Surgery:

"The most appropriate candidates

for breast augmentation surgery are those who are looking for improvement and not perfection."

The cosmetic surgery procedure of breast augmentation can enhance one's breast size and shape, resulting in a more proportional figure. While the reasons may vary as to why one would seek breast augmentation surgery, some of the more common reasons include:
  • To increase the breast size, for a number of reasons including the perception that one's breast are too small;
  • To enhance the overall body contour, balance and proportions;
  • To achieve an enhanced appearance, size, projection, etc., following pregnancy and/or weight loss;
  • To restore appearance through reconstruction following breast surgery (i.e., mastectomy).
As with other cosmetic surgery procedures, the most appropriate candidates for breast augmentation surgery are those who are looking for improvement and not perfection. Additional factors such as being over eighteen years of age, possessing good physical and mental health, and being realistic in their expectations are additional considerations one should keep in mind while determining whether or not breast augmentation surgery is right for them.
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How is Breast Augmentation Surgery Performed?

In its most simple form, breast augmentation surgery involves making an incision, lifting the breast tissue, creating a pocket in the chest/breast area, and placing an envelope, referred to as an "implant," containing a soft implant material underneath (i.e., saline, gel, silicone, etc). For most breast augmentation surgeries, saline filled implants are most frequently used. However, under certain conditions, such as reconstructive breast surgery, silicone breast implants may be used. As a result of the ongoing debate regarding the safety level of silicone gel breast implants and an alleged link to various autoimmune diseases, these implants are only available on a limited basis and under approved studies. Recently introduced to the breast implant market are saline filled
"adjustable" implants. Similar to standard saline filled implants, "adjustable" implants include a small connector tube through which the doctor may adjust the size of the implants by injecting more/less saline. Adjustable implants do require an additional incision, and therefore a scar, to expose the injection port of the implants.

Multiple factors such as the patient's anatomy and the surgeon's preference determine how the breast implant is inserted and positioned. Typically, breast augmentation surgery incisions are located in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. More recent implantation techniques utilize a small incision placed in the bellybutton region. Most cosmetic surgeons are very careful to take every effort possible to minimize scarring and to make resulting scars as inconspicuous as possible.

Once the incision has been created, the surgeon lifts the breast tissue and skin to create a pocket. It is within this "pocket" that the breast implant will be placed and centered beneath the nipple and areola. Depending on the patient's anatomy, the size of the implant, the surgeon's technique, etc., the implants will be placed either directly behind the breast tissue or underneath the muscles of the chest wall (sub-muscular).

Breast augmentation surgery usually requires one to two hours to complete. Following the insertion and placement of the breast implants, sutures are used to close the surgical incisions. Many cosmetic surgeons will wrap the chest region with a gauze bandage to provide support and to assist with healing. Occasionally, tubes may be used for a brief time following the breast augmentation surgery to drain the surgical site.

Breast augmentation surgery stretches the breast tissue and, therefore, can be painful especially in those breast augmentation cases where the implants have been placed under the chest muscle. Typically, the greatest amount of pain is experienced within the first forty-eight hours following breast augmentation surgery. The level of pain typically reduces day-by-day and may be effectively treated by various pain medications.

"Breast augmentation surgery

usually requires one to two hours to complete."

Prior to breast augmentation surgery, you will meet with your surgeon who will provide you with specific instructions that you should follow as you prepare for surgery. During this consultation visit, the surgeon will provide you with guidelines on eating, drinking, smoking, and taking or avoiding particular vitamins and medications. Additionally, your cosmetic surgeon and you will discuss where your breast augmentation procedure will be performed. While many breast augmentation surgeries are performed in the cosmetic surgeon's office suite, others may be performed in a freestanding surgical center or in an outpatient hospital facility. If the breast augmentation surgery involves significant time and work, your cosmetic surgeon may recommend performing your breast augmentation surgery in an inpatient hospital. This environment will provide you with the post-surgical support needed to ensure an effective healing process provided by trained medical staff.

Additional issues discussed during the consultation visit should include an overview of all the costs associated with breast augmentation surgery (i.e., surgeon's fee, facility fee, anesthesia fee, etc.) as well as the type of anesthesia to be used.

Depending on the type of surgical technique to be used, as well as the preference of the patient and the cosmetic surgeon anesthesia options may vary. For example, while breast augmentation surgery is most frequently performed with a general anesthesia, allowing the patient to sleep through the entire operation, some surgeons will use a local anesthesia, combined with a sedative, which will relax the patient but they will remain awake during the procedure.

Following your breast augmentation surgery, it is important to take any medication(s) prescribed by your cosmetic surgeon such as anti-inflammatories and antibiotics. Keep in mind, it will important to arrange for someone to drive you home following breast augmentation surgery. Furthermore, you may need some assistance at home for the first few days following breast augmentation surgery.
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What Are the Risks Associated With Breast Augmentation Surgery?

Despite popular belief, breast implants are not lifetime devises and cannot be expected to last forever. Occasionally, breast implants do rupture. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours. Breast augmentation patients may recognize leakage because a change in the size of the breast is clearly noticed. While an implant may rupture as a result of blunt trauma to the chest region, more frequently it occurs spontaneously with no apparent cause. Either way, surgery will be required to replace the implant if the patient desires to do so. A new FDA-approved implant, popularly referred to as the
"gummy bear" implant is a more highly cohesive silicone gel that will not leak if it is punctured.

"Despite popular opinion,

breast implants are not lifetime devises and cannot be expected to last forever."

One of the most frequently encountered issues associated with breast augmentation surgery is a condition known as capsular contracture. With capsular contracture the scar or capsule surrounding the breast implant begins to tighten and harden. As a result of this "contracture" the breast may feel hard and tight. Fortunately, there are several ways to prevent and treat capsular contracture. Frequent massaging of the breast during healing, as well as following your cosmetic surgeon's instructions will help prevent capsular contracture from forming. In cases where this condition develops, it may be required that the scar tissue is surgically removed and perhaps the implant as well. Furthermore, it is common for most women to experience some degree of numbness and sensitivity following breast augmentation surgery. These symptoms typically disappear with time. The Furry Brazilian breast implant is said to lower the risk of capsular contracture because of its textured surface.

Another frequent side effect associated with breast augmentation surgery is "rippling." This condition develops when the implant(s) move and is characterized by the presence of indentations, or "ripples" on the surface of the implant. In severe cases of "rippling," the implants may need to be replaced.

Occasionally, some women will develop an infection around the implants. Typically, this infection occurs within the first week following surgery, but may develop at any time. While most infections may be treated with antibiotics, in some cases the implants must be removed until the infection clears.

Recently, a great deal of discussion and research has taken place regarding the use of breast implants and the development of various immune system diseases such as scleroderma and other arthritis like conditions, as well as cancer. To date, current research has found no clear relationship between breast implants and these immune system conditions. However, the U.S. Food and Drug Administration has requested that additional studies be conducted. Recent developments regarding this ongoing research may be found on the FDA's website.

While most women do not experience complications with their breast augmentation surgery, each patient should still discuss the possibility of developing some of these conditions. Remember, breast augmentation is a form of medical surgery. As such, you need to understand the risks and consequences of breast augmentation surgery.
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What Are The Typical Costs Associated With Breast Augmentation Surgery?

"The national average

for surgeon fees, relative to breast augmentation surgery, is $3,351."

According to cost data supplied by the American Society for Aesthetic Plastic Surgery in 2011, the national average for surgeon fees, relative to breast augmentation surgery, is $3,351. Surgeon fees within various regions may vary depending on whether the practice is in an urban, suburban or rural area. The national average fee covers the surgeon's fee only and does not include fees for the surgical facility, anesthesia, medical tests, prescriptions, or other miscellaneous costs related to breast augmentation surgery. A comprehensive cost figure may be obtained while consulting with the surgeon. Make sure the total figure includes any and all costs associated with the breast augmentation surgery. Due to the various costs associated with breast augmentation surgery, most surgeons offer multiple financing options.


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How Much Pain is Associated with Breast Augmentation?

You will be in discomfort following breast implant surgery. Your doctor can prescribe medications to help you deal with the pain. During the first couple of weeks, you will notice some bruising and swelling to the area, but this usually subsides fairly quickly. Your doctor may tell you to put cool packs on your breasts to help with the swelling and pain. This will not completely rid you of pain, but will help significantly. If capsular contracture (when the tissue around the implant hardens) occurs, this can be very painful and feels as though the implant is being squeezed. Antibiotics can soften the tissue and relieve some of the pressure. The doctor can also remove the hardened tissue with subsequent surgery.

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Ten Questions Every Breast Augmentation Surgery Patient Should Ask Their Surgeon:

breast augmentationPrior to all breast augmentation procedures, a consultation will occur between the prospective patient and the providing surgeon. During this consultation the cosmetic surgeon and patient will discuss issues such as the desired outcome, various options that are available to address said outcome, the procedure itself as well as various risks and limitations. The surgeon will also provide information regarding anesthesia options, the location and description of where the breast augmentation procedure will be performed (i.e., hospital vs. office surgical suite) and associated costs. A discussion regarding the patient's medical history, as well as a physical examination of the area to be treated will also take place during the consultation visit.

In an effort to educate the patient regarding breast augmentation procedures, as well to assist in formulating realistic breast augmentation expectations, it is recommended that the patient view numerous
before and after photographs, speak with previous breast augmentation patients, as well as obtain responses to the following questions:
  1. Are the desired results I described realistic?
  2. Where is the breast augmentation surgery performed and how long will it take?
  3. In my case, will the breast implants be implanted below the skin, or below the chest muscle and where will the incision scars be visible?
  4. What kind of anesthesia will the surgeon use during the breast augmentation surgery and what are the side effects associated with this anesthesia?
  5. How much does breast augmentation surgery cost and what elements factor into that cost (i.e., hospital fee, anesthesia, etc)?
  6. What is the surgeon's level of experience in performing breast augmentation surgery?
  7. What percentage of breast augmentation patients experience complications with breast augmentation surgery?
  8. What is the surgeon's policy in regards to correcting or repeating the procedure if the breast augmentation surgery does not meet agreed upon goals?
  9. What should I expect, post-operatively, in terms of soreness, scaring, activity level, etc?
  10. Have you ever had your malpractice insurance coverage denied, revoked or suspended?

"It is recommended that

interested persons request and view several before and after photographs of recent patients who have received breast augmentation."

It is also recommended that interested persons request and view several before and after photographs of recent patients who have received breast augmentation surgery from the surgeon. These photos may be supplemented with additional valuable information by requesting the names and contact information for several of the surgeon's breast augmentation surgery patients.

In addition to the previously mentioned questions, it is imperative that breast augmentation surgery patients relay to their surgeon information regarding any allergies and serious medical conditions they may have. Furthermore, breast augmentation patients should inform the surgeon of any medications they are taking.

This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. But medical information is not the same as medical advice--the application of medical treatment to an individual's specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.

For more information on breast augmentation safety, please visit Breastimplantsafety.org.


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Related Links

Can I Breast-feed after Breast Augmentation Surgery?
"Gummy Bear" Sientra Breast Implants Receive FDA Approval
PIP Implants and Regulations in Plastic Surgery

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