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Many
women choose to have their breasts enlarged in order to satisfy
their own desire for a fuller bust line. Your breasts may not have
developed to a size that meets your expectations, or one breast
may be significantly smaller than the other. You may have been happy
with your breasts in the past but feel that they look different
now. Often, after weight loss, childbirth or as a result of aging,
the breasts lose volume and their shape changes. Breast augmentation
can enhance your breast size and shape, and give you the more proportional
figure that you always wanted.
Is Breast Augmentation For Me?
One or more of the following feelings or conditions may indicate
that you are a good candidate for breast augmentation:
~
You
are bothered by the feeling that your breasts are too small
~ Clothes that fit well around your hips are often too large at the
bust line
~ You feel self-conscious wearing a swimsuit or form-fitting top
~ Your breasts have become smaller and lost their firmness after having
children
~ Weight loss has changed the size and shape of your breasts
~ One of your breasts is noticeably smaller than the other
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How Will My Plastic Surgeon Evaluate Me For Breast Augmentation Surgery?
Your
plastic surgeon will examine your breasts and perhaps take photographs
for your medical record. He or she will consider such factors as
the size and shape of your breasts, the quality of your skin and
the placement of your nipples and areolas (the pigmented skin surrounding
the nipples). If your breasts are sagging, a breast lift may be
recommended in conjunction with augmentation.
You
should come to the consultation prepared to discuss your
medical history. This will include information about any medical
conditions, drug allergies, medical treatments you have received,
previous surgeries including breast biopsies, and medications that
you currently take. You will be asked whether you have a family
history of breast cancer and about results of any mammograms. It
is important for you to provide complete information.
There is no scientific evidence that breast augmentation increases
the risk of breast cancer. The presence of breast implants, however,
makes it more technically difficult to take and read mammograms.
This may be a special consideration for women who perhaps are at
higher risk for breast cancer because of their family history or
other reasons. Placement of the implant underneath the pectoral
muscle may interfere less with mammographic examination, but other
factors may also need to be considered with
regard to implant placement. Your plastic surgeon will discuss this
with you.
If you are planning to lose a significant amount of weight, be sure
to tell your plastic surgeon. He or she may recommend that you stabilize
your weight prior to undergoing surgery.
If you think that you may want to become pregnant in the future,
you should mention this to your surgeon. Pregnancy can alter breast
size
in an unpredictable way and could affect the long-term results of
your breast augmentation. There is no evidence that breast implants
will affect pregnancy or your ability to breast-feed, but if you
have questions
about these matters, you should ask your plastic surgeon.
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Understanding The Surgery
The
goal of your plastic surgeon and the entire staff is to make your
surgical experience as easy and comfortable for you as possible.
In some instances, your plastic surgeon may recommend a baseline
mammogram before surgery and another mammographic examination some
months after surgery. This will help to detect any future
changes in your breast tissue. Following breast augmentation, you
will still be able to perform breast self-examination. If you are
a smoker, you will be asked to stop smoking well in advance of surgery.
Aspirin and certain anti-inflammatory drugs can cause increased
bleeding, so you should avoid taking these medications for a period
of time before surgery. Your surgeon will
provide you with additional preoperative instructions.
Breast
augmentation is usually performed on an outpatient basis. If
this isthe case, be sure to arrange for someone to drive you home
after surgery and to stay with you at least the first night following
surgery.
Medications are administered for your comfort during the surgical
procedure.
Frequently, local anesthesia and intravenous sedation are used for
patients undergoing breast augmentation, although general
anesthesia may be desirable in some instances.
Individual factors and personal preferences will help you and your
plastic surgeon to determine your appropriate breast size, the location
of incisions, and whether the implants will be placed on top of
or underneath the chest muscle. The surgery itself consists of an
incision made either underneath the breast, just above the crease,
around the lower edge of the areola or within the armpit. The implant
is placed in a pocket either directly behind the breast tissue or
underneath the pectoral muscle which is located between the breast
tissue and chest wall.
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What About Implants?
In
1992, because further studies were needed to establish the safety
of breast implants, the Food and Drug Administration decided that
silicone gel-filled
implants would not be generally available for cosmetic breast enlargement.
Currently, all women undergoing breast augmentation receive saline-filled
implants which consist of a silicone shell filled with sterile saltwater.
New
scientific data on the safety of breast implants is rapidly being
collected. In the future, it is possible that additional types of
filler materials may become available. Your plastic surgeon will
be able to provide you with the latest information.
One
of the advantages of a saline-filled implant is that, because it
is filled with saltwater after being inserted, only a small incision
is
needed. Often, an incision of less than one inch is made underneath
the breast, just above the crease, where it is usually quite inconspicuous.
Another possible location for the incision is around
the lower edge of the areola. A third alternative is to make a small
incision within the armpit.
Once the incision is made, the surgeon creates a pocket into which
the implant will be inserted. This pocket is made either directly
behind the breast tissue or underneath the pectoral muscle which
is located between the breast tissue and chest wall.
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What To Expect After Surgery?
When surgery is completed, you will be taken into a recovery area
where you will continue to be closely monitored. Your breasts will
be wrapped in gauze dressings or a surgical bra. You may be permitted
to go home after a few hours, unless you and your plastic surgeon
have determined that you will stay in the hospital or surgical facility
overnight.
A
day or two after surgery, you should be up and about. Any dressings
will be removed within several days, and you may be instructed to
wear a support bra. Your plastic surgeon will probably permit you
to shower between three and seven days following
surgery. Stitches will be removed in about a week. Some discoloration
and swelling will occur initially, but this will disappear quickly.
Most residual swelling will resolve within a month.
After
breast augmentation surgery, it is often possible to return to
work within just a few days or a week, depending on your job. Vigorous
activities, especially arm movement, may be restricted for
two to three weeks. Sexual activity should be avoided for at least
the first week following surgery. After that, care must be taken
to be extremely gentle with your breasts for at least the next month.
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Understanding Risks
Every
year, many thousands of women undergo successful breast augmentation
surgery; however, anyone considering surgery should be aware of
both the benefits and risks. The subject of risks and potential
complications of surgery is best discussed on a personal basis between
you and your plastic surgeon, or with a staff member in your surgeon's
office.
Some
of the potential complications that may be discussed with you include
reactions to anesthesia, blood accumulation that may need to be
drained
surgically and infection. Although rare, an infection that does
not subside
with appropriate treatment may require temporary removal of the
implant.
Changes in nipple or breast sensation may result from breast augmentation
surgery, although they usually are temporary.
When a breast implant is inserted, a scar capsule forms around it
as part of the natural healing process. The capsule may sometimes
tighten and compress the implant, causing the breast to feel firmer
than normal. Capsular contracture can occur to varying degrees.
If it is severe, it can cause discomfort or changes in the breast's
appearance. In such cases, more surgery may be needed to modify
or remove the scar tissue, or perhaps remove or replace the implant.
Breast
implants are not lifetime devices and cannot be expected to last
forever. If a saline-filled implant breaks, its contents are harmlessly
absorbed by the body within hours. A definite change in the size
of
the breast is clearly noticed. Rupture can occur as a result of
trauma
to the chest, but more commonly it occurs spontaneously with no
apparent cause. Surgery will be required to replace the implant,
if desired.
If you are at an age when mammographic examinations should be conducted
on a periodic basis, it will be important for you to select a radiology
technician who is experienced in taking x-rays of augmented breasts.
Additional views of your breasts will be required. Your plastic
surgeon, in some instances, may recommend other types of examinations
such as ultrasound or magnetic resonance imaging. It is possible
that the presence of breast implants could delay or hinder the early
detection of breast cancer.
Some
women with breast implants have reported problems including certain
connective tissue and immune-related diseases. Women without implants
also have these disorders, so the key question is whether breast
implants increase the risk of developing the conditions. Several
large studies have been completed that provide reassurance that
women with breast implants do not have a significantly increased
risk for these diseases.
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What Should I Know About The Results?
Breast augmentation will make your breasts fuller and enhance their
shape. You will find it easier to wear certain styles of clothing.
Like many women who have had breast augmentation, you may have a
boost in self-confidence.
Except in the event of implant deflation requiring surgical replacement
with a new implant, the results of your breast augmentation surgery
will be long-lasting. However, gravity and the effects of aging
will eventually alter the size and shape of virtually every woman's
breasts. If, after a period of years, you become dissatisfied with
the appearance of your breasts, you may choose to undergo a breast
"lifting" to restore their more youthful contour.
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