Before you actually have surgery, you can expect to feel some anxiety, some excitement, and some stress. But the most important thing to do is be confident in your decision, follow all of your cosmetic surgeon’s instructions, and get ready to toss away those padded bras! Women who undergo breast augmentation by credentialed, skilled, experienced cosmetic surgeons report very high satisfaction, not only in appearance, but also in the way their breasts feel. Much of the key to your success in breast augmentation, as with any cosmetic surgery procedure, is to consult with a qualified, boardcertified cosmetic surgeon. He or she should have experience in breast augmentation and other breast procedures. In addition, the surgeon you choose should listen carefully to your goals for surgery, that is, the physical change you want to achieve and your personal expectations for enhancing breast size.
Women of any age who are in good physical and emotional health are good candidates for breast augmentation. It should not, however, be performed in patients younger than 18 years unless severe asymmetry exists. If the breasts are severely ptotic (sagging), augmentation should not be performed without some form of mastopexy (breast lift); otherwise, your outcome may actually worsen the appearance of your breasts, rather than achieving naturally full and rounded breasts. If you are age 30 years or older, a baseline mammogram prior to augmentation is a good idea and may be required by your cosmetic surgeon. Smokers should refrain from smoking for several weeks or months before surgery and during recovery.
Breast augmentation is most commonly an outpatient procedure performed either under general anesthesia or local anesthesia with sedation, in an office-based, freestanding, ambulatory, or hospital-based surgical facility. An overnight hospital stay may be recommended in some cases. Your surgeon will make an incision based on your discussions and consent, and will create a pocket in which to place the implant. The implant will be placed, filled if it was not pre-filled, and the incisions will be closed.
When you awaken from surgery, you will be stiff and sore. Tissues will be stretching to accommodate the breast implant and the swelling that occurs from the surgery itself. Most discomfort may be controlled with oral medications. Placement of a pain pump, which is a device that delivers medication directly to the surgical site, is very helpful to control discomfort during the first three days after surgery. In some cases, small, thin tubes may be placed at the incision sites to drain any excess fluid that might accumulate. You will be wearing a support bra, elastic bandage, or chest band for the first week or more following surgery, as recommended by your surgeon. If you have had sub-mammary placement, you will be back to your daily routine in just a few days; add a few more days if the implant was placed sub-muscularly. You’ll want to refrain from heavy exercise, twisting, pushing, pulling, or lifting until your cosmetic surgeon advises that you may ease into these activities. Proper wound care and subsequent breast massage as instructed by your cosmetic surgeon can help to avoid capsular contracture and unsightly scars.Wearing your support bra as directed is imperative to proper healing. Even when your surgeon allows you to discontinue wearing a support bra, you may find that wearing light support, like a shelf bra or camisole, to be comfortable for sleeping.
The risks and complications of breast augmentation include hematoma or blood pooling beneath the skin, breast tenderness, and heightened or lack of nipple sensation. There is a slight chance you may have unexpected milk production following insertion of breast implants. This may stop on its own or require medication. There is also the possibility of poorly healed or wide scars. Capsular contracture may develop. Breast implants can be displaced, leak, or rupture. If they become infected, they very likely will need to be removed. There are also the risks associated with anesthesia. Once healing is completed, an annual examination with your cosmetic surgeon to assess the condition of your breast implants and your breasts is also important. You should also have an annual exam with your primary physician or gynecologist to check for breast changes and masses.
The results of breast augmentation are visible immediately, although you will be somewhat swollen and your breast implants will appear higher than you might wish your final outcome to be. It may take six to eight weeks or more before breast implants settle to a final position. By this time, you will be shopping for new sweaters, swimsuits, and bras. Breast augmentation generally should not interfere with a woman’s ability to breast-feed, nor should it significantly alter the sensations in a woman’s nipples. However, any surgery of the breast may result in these conditions. Breast augmentation with implants has the advantage of slowing the natural aging or sagging process of the breasts in some women. However, where implant size is excessive, sagging and aging of the breasts may actually be exaggerated. Some women find they need not wear a bra, and find new freedom and satisfaction in the way clothing fits and in new clothing options to enhance their figures.
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