Breast augmentation (augmentation mammaplasty) is a cosmetic surgery procedure that has been routinely performed in the United States since the 1980s. Now, more and more women are choosing to change the shape and size of their breasts with saline or silicone implants. According to statistics collected by the American Society of Plastic Surgeons, the popularity of the procedure increased by almost 40 percent between 2000 and 2010. These days, about 300,000 women get breast implants in the United States each year.
Why Do Women Seek Breast Augmentation?
Women look to breast implants to improve their appearance in ways that help boost their self esteem or make them feel less self-conscious. Here are some typical cosmetic issues female patients are often seeking to correct:
- Breasts that have failed to develop to the desired cup size after puberty
- A bottom heavy figure that could be balanced out and made more hourglass shaped with a larger bust
- Breasts that are pointy, flat or otherwise shaped in a way the patient doesn’t prefer
- Lost tissue volume after weight loss or pregnancy/breastfeeding
- Lack of firmness due to body changes such as aging
- Breasts that are not symmetrical in size or shape
Additional cosmetic concerns such as drooping are often addressed at the same time as augmentation. Some women choose to have a tummy tuck or liposuction along with their implant procedure for complete body reshaping.
Who Is a Good Candidate for Breast Augmentation?
The ideal candidate for breast implants is in good health and at a stable body weight. Smokers and individuals with certain medical conditions that could increase the risk of complications during or after surgery may not be appropriate candidates.
Patients who want mammaplasty for cosmetic purposes should generally be at least 18 years old (21 for silicone implants). Regardless of your age, you should have realistic expectations about the level of improvement you can expect in your personal appearance and how this will affect your body image. This surgery isn’t intended to correct deep-seated feelings of unhappiness or low self worth. Your plastic surgeon should discuss all aspects of your procedure — including any expected emotional and physical aftereffects — to help you make an informed decision.
You should also recognize that many patients require follow up procedures to replace ruptured or deflated implants. Although today’s breast implant devices are more durable and less prone to these problems than older models, they are not expected to last a lifetime.
Breast Augmentation Procedure and Implant Choices
There are lots of choices you will need to make if you decide to get breast implants. Here are some of the decisions you will discuss with your cosmetic surgeon:
Silicone vs. Saline — Both types of implant have a silicone shell, it’s just the filler material that is different. Many patients feel that silicone delivers a more natural look and texture. However, saline implants can typically be inserted through a smaller incision.
Volume — The actual volume of implants is measured in CCs, but you can state your preference as a cup size in your consultation. A C cup is a very popular size, but you should make your decision based on your specific body structure. You may wish to wear a padded bra for several weeks to help you determine what cup size makes you feel comfortable and confident about your appearance.
Shape — The shape of the breast implant can make a huge difference in your appearance. Round implants provide a “grapefruit” look that is very perky and may give you an appearance of having lots of cleavage. Teardrop-shaped implants are designed to appear more natural and may be your preferred choice if you want a more subtle enhancement.
Placement — Breast augmentation surgery can involve placing an implant under the fatty and ductal tissue in your breast (this is called sub-glandular placement). The other option is placing the implant under the pectoral muscle (sub-pectoral placement). Many surgeons prefer the sub-pectoral approach since it hides the outline of the implant and provides more support for the device.
Insertion Technique — Depending on the type of implant you choose (saline or silicone), you may have a variety of options for insertion. One of the most common techniques is making an incision in the crease where the breast meets the ribcage. An implant may also be inserted through an incision around the lower edge of the areola or through the armpit. A less common and more complex method is inserting a saline implant through the belly button where the scar won’t show.
Breast Augmentation Procedure Overview
This procedure is performed using general anesthesia or IV sedation based on your medical history and preferences. The time required for the operation ranges from one to three hours. The surgeon makes an incision at the desired location, creates a pocket to receive the implant and inserts the device. Some implants are designed for last minute adjustment of filler volume at this stage to ensure the correct size and symmetry is achieved. After the implants are in place, the surgeon closes the incisions and places small tubes to help drain out fluid accumulation in the surgical sites. These tubes will be removed after a couple of days. The stitches typically come out in about a week.
What to Expect During Breast Augmentation Recovery
Post-operative pain is usually managed with medication for the first few days after surgery. Swelling will be very noticeable during the first week. Your breasts may continue to feel sensitive with a sensation of the overlying skin being tight or itchy. The skin will often look bruised or discolored during healing. The incision scars will continue to mature and fade over a period of a year or more.
Most of the physical recovery occurs within the first month after the procedure. During the initial phases, movement is limited to walking, sitting and standing with no pushing, pulling or lifting. Return to work will depend on healing and whether you have a sedentary job. Activities such as exercise may be restricted for more than a month depending on how quickly you recover.
Potential Complications of Breast Augmentation
This procedure is associated with many of the same risks as other types of major plastic surgery. It also has some unique risks including:
- Uneven or rippling skin texture over the implant
- Implant rupture and deflation
- Development of hard and fibrous scar tissue around the implant (capsular contracture)
- Numbness or other changes in nipple/breast sensation
- Loss of the ability to breastfeed future children
To reduce your risk of complications and help ensure a satisfactory aesthetic outcome, you should select a surgeon who is board certified in plastic surgery and who comes highly recommended by previous patients.