Breast augmentation procedures are often performed under general anesthesia and will take approximately one and a half hours to perform. In the holding area prior to surgery, the patient's "before" pictures are taken and then the breasts marked. After speaking with the anesthetist/anesthesiologist, the patient is brought to the operating room. After asleep, local nerve blocks combined with a medication that shrinks blood vessels and capillaries to reduce any bleeding are instilled.

Next, the incisions are made and the "pockets" created - generally under the pectoralis muscle - and the implants are placed. Saline implants are inserted into the "pocket" while empty and then filled after in position. An antibiotic solution is generally added to the saline which some studies suggest reduces the incidence of capsular contracture (firmness and hardening of the healing tissue around the implant). Cohesive silicone gel implants are prefilled and require a slightly larger incision to be placed.

The operating room table back is elevated to place the patient in a sitting position to check implant position and symmetry. Minor adjustments are made to the implant "pocket" as necessary to obtain the best possible results and symmetry. After the table back is lowered, a long acting anesthetic is placed into the "pockets" which greatly reduces postoperative discomfort. The incisions are closed with sutures predominantly below the surface of the skin to avoid cross-hatching suture marks and optimize the chances for the finest scars. Steri-strips are applied as well as being placed in a post surgical bra.

Breast Augmentation Recovery

Following the surgery, patients generally report mild to moderate discomfort which is easily controlled with medication. Varying degrees of swelling, bruising and firmness subside over several weeks to months. Sutures (stitches) are removed after seven days. Patient's can generally return to work after several days to one week. Light exercise may begin after to four to six weeks. A support bra is generally worn for two to three months following surgery and is encouraged as much as possible thereafter to maintain the contour. Recovery and healing will vary from patient to patient and depend on the extent of the surgery.

Over the weeks and months, the breasts will soften and relax, looking and feeling more natural as swelling subsides and the effects of gravity and tissue relaxation act on the newly implanted breasts. It must be remembered that complete healing takes time and patience, taking up to one year before realizing the final result of the surgery.

Breast Augmentation Complications

As with most surgical procedures complications are unlikely when performed by a skilled and competent surgeon. Complications include, but are not limited to anesthesia risks, bleeding, infection, capsular contracture (firmness or hardening of the healing tissues around the implant), deflation, poor healing with prominent or obvious scars, numbness, altered nipple sensation, loss of nipple sensation, asymmetry in breasts and/or areolas, enlarged areolas and need for revisional surgery or implant removal. Also rare, but possible are blood clots or emboli (blood clots which dislodge and travel in the blood stream to distant sites).

Venodyne calf compression devices are often used for breast augmentation surgery (as well as other surgeries). Venodynes are pressure cuffs that fit over each lower log from the ankle to the knee circulating every one to two minutes to reduce the pooling of blood in the lower extremities and further reduce the possibility of blood clots or emboli. Smoking seriously decreases blood circulation in the skin which increases the risks of complications and poor healing.

Frequently Asked Questions

Breast Augmentation Frequently Asked Questions

Are connective tissue diseases caused by silicone gel-filled breast implants?

The Institute of Medicine recently concluded that "Evidence suggests diseases or conditions such as connective tissue diseases, cancer, neurological diseases or other systemic complaints or conditions are no more common in women with breast implants than in women without implants."

Do silicone gel-filled breast implants cause cancer?

Published studies indicate that breast cancer is no more common in women with breast implants than in women without breast implants. In its authoritative 1999 report, the Institute of Medicine (IOM) concluded that, "There is no increase in primary or recurrent breast cancer in implanted women.:

What are the effects of silicone gel-filled breast implants on pregnancy and breastfeeding?

Women with breast implants do not risk exposing their breastfed children to excessive amount of silicone. The Institute of Medicine concluded, "No evidence of elevated silicone in breast milk or any other substance that would be deleterious to infants was found in women with silicone gel-filled breast implants."

Although many patients have been able to breast-feed after breast augmentation, breastfeeding difficulties have been reported following breast surgery including breast augmentation.

How will silicone gel-filled breast implants effect having mammograms?

Current recommendations for getting screening mammograms are no different for women with breast implants that for those without implants. Radiologists experienced in the evaluation of women with breast implants should interpret mammography exams. It is essential that you tell you mammography technologist before the procedure that you have a breast implant. You should request a diagnostic mammogram rather than a screening mammogram because more pictures are taken with diagnostic mammography. The technologist can use special techniques to reduce the possibility of rupture and to get the best possible views of the breast tissue.

Are breast implants permanent?

Breast implants are not considered lifetime devices. You will likely undergo implant removal with or without replacement over the course of your life. Whether undergoing augmentation or reconstruction, be aware that breast implantation is often not a one-time surgery often requiring additional surgery and doctor visits over the course of one's life.

Is it possible to develop a silicone allergy?

It is possible for anyone to develop an allergy to almost any substance on earth. However, silicone allergies are very rare. We are all exposed to silicone in our environment everyday. It is found in many household items such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings and chewing gum.