Breast Augmentation
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Top Breast Implants Doctor 2010Breast Augmentation Overview

Breast augmentation is a plastic surgery procedure designed to enhance the size and fullness of the breasts. Breast augmentation is performed in women with naturally small breasts or in patients with asymmetry of their breasts. Many patients will experience an increase in their self-image and level of self-confidence. Breast augmentation is sometimes combined with a breast lift to treat severely drooping breasts. Dr. Gallego will discuss the procedure including your specific options, likely recovery, and potential complications during your complimentary consultation.

The Breast Augmentation Procedure

After arriving in the operating room, an anesthesiologist will administer general anesthesia for the procedure. The surgeon will then make an incision to place the breast implant. The three most commonly used incisions are areolar (along the darker skin around the nipple), transaxillary (armpit), and inframammary (under the breast). These incisions are designed to minimize visible scarring, and the type of incision used is based on the implant type, patient anatomy, and personal preference.

Commonly used breast augmentation incisions

During the breast augmentation procedure, breast implants are used to increase the size of the breasts and improve their shape. The implants used are either filled with saline or silicone gel. Saline implants use saline (salt water) to create the size of implant desired. Silicone implants use silicone gel to create the size and shape of the implant. The advantages of silicone gel implants are that they generally feel more like natural breast tissue and they have less wrinkling or rippling. The disadvantages include larger incisions, higher price, more detailed follow up, and silent rupture. In general, the type of implant used is based on factors including desired incision site, body type, and breast anatomy. You may discuss the advantages and disadvantages to each implant type during your consultation with Dr. Gallego. (For more information, please see the FDA Website for Consumer Information on Breast Implants).

Images of a saline filled, silicone gel filled, and a textured surfaced implants

In general, implants are placed partially under the chest muscle to hide the superior portion better and to make mammography easier. Patients are sat up on the operating room table to verify symmetry. Suction drains are almost never used unless the procedure is being combined with the removal of excessive scar tissue (capsulectomy). The incision site is then closed by the surgeon using dissolving sutures.

The subglandular (left) and subpectoral (right) implant pockets

Risks of Breast Augmentation:

  • Infection
  • Delay in wound healing
  • Bleeding/hematoma
  • Unsightly scars
  • Altered sensation in the nipple
  • Rippling or wrinkling of the implant
  • Asymmetry
  • Capsular contracture
  • Implant deflation or rupture
  • Dissatisfaction with size
  • Need for surgery revision

Recovery from Breast Augmentation Surgery

After breast augmentation surgery, patients are likely to experience moderate pain for the first 2 to 3 days.  Most patients elect to take oral pain medications which greatly reduce their discomfort.  Some patients are opting to use a pain pump (“virtually pain free surgery”) in order to decrease the amount of oral pain medications they have to take.  Dressings will be removed during the first postoperative visit.  Bruising and swelling are common and will slowly resolve in a period of a few weeks.  There are typically no sutures to be removed.  A sports bra is generally worn for the first 8-12 weeks following surgery.  After one week, patients are instructed how to perform implant massage (displacement exercises).  Some plastic surgeons believe these exercises help to prevent excessive scar tissue and can improve implant position.

Patients are discouraged from any strenuous activity or heavy lifting during the first two weeks following surgery.  Patients are allowed to slowly increase their activity level after two weeks.  Most women feel back to normal around 4-6 weeks following their breast augmentation.  The implants will sometimes seem high early on, but tend to settle after 3-6 months.  Scars are always pink and more visible in the beginning, but tend to fade dramatically during the first year.

Examples of areolar, inframammary, and axillary scars three months after surgery

Additional Links

Areolar Breast Augmentation Photos

Inframammary Breast Augmentation Photos

Axillary Breast Augmentation Photos