Breast Enlargement (Breast Augmentation)

Procedure

The surgery takes from one to two hours and is usually performed in a surgical facility under a light, general anesthetic administered by an anesthesia specialist. A long acting, local anesthetic is also added to help eliminate discomfort following surgery. While the procedure is carried out, you will be on a specially designed table that can be placed in a sitting position. This allows the doctor to adjust volume and adjust the implants position for the best aesthetic results.

The breasts are enlarged by placing soft implants through an incision, using one of four different approaches: axillary, around the nipple, through the nipple, or under the breast. The doctor will discuss with you your preferences and his recommendations. The implants are made of saline or silastic (an inert plastic-type material), and come in different types, each having its specific indication. Silastic has a good safety record, having been used in heart valves, artificial hips and other joints, and replacement blood vessels for more than twenty years.

Different approaches can be used:

1. Axillary or Armpit— This approach is utilized when a patient's breasts are small, in good position, and relatively symmetrical. The implant is introduced through a 1 to 1 1/2" incision in the center of the axilla, and is generally placed under the muscle mass. In patients who are extremely muscular, this placement may show movement of the implant. In such cases, the implant is placed over the muscle tissue. Absorbable stitches are placed in the armpit area, and a small tubular drain may be used to collect fluid for a day or two in order to decrease swelling.
    
2. Nipple— This commonly used approach involves a 1 to 1 1/2" incision on the lower border of the pigmented areola and allows not only enlargement but some correction of shape and position discrepancies. The incision generally heals well with minimal scarring. Although blockage of nipple ducts is a theoretical problem, it rarely occurs.
    
3. Inframammary Incision— In a small number of cases where the areola is very small, an incision is made in the crease below the breast. Absorbable stitches are used internally, while the incision is closed externally with stitches which are removed in our office seven to ten days later.

A surgical support bra is placed after surgery and worn for 24-48 hours. Due to early swelling, some implants may sit high. We recommend continued support of the breasts with a well-fitted, comfortable bra after augmentation. If your breasts are a little "high" after surgery, the doctor may recommend going without a bra for two to three weeks or until the implants settle.

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