One of the most frequently performed cosmetic surgery procedures in the U.S., breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.
Breast implants are silicone shells filled with saline (salt water) and are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia, although local anesthesia combined with a sedative is also possible. After breast augmentation surgery the patient's bustline may be increased by one or more cup sizes.
Incisions are made in inconspicuous places on the breast to minimize scar visibility (in the armpit, in the crease on the underside of the breast, or around the areola, the dark skin around the nipple). The breast is then lifted, creating a pocket into which the implant is inserted.
Placement behind the chest wall muscle offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery.
After the implants are placed and centered beneath the nipples, incisions are stitched, taped and bandaged. In a few days these bandages may be replaced with a surgical bra. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two and many patients return to work within the week. Stitches are removed in a week to 10 days and any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars will begin to fade in a few months and will continue to fade for months or years.
Complications following breast augmentation surgery are uncommon. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant as a result of injury or the normal compression and movement of your breast (if this happens the implant will simply deflate in a few hours and your body will absorb the salt water).
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Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
During the breast reduction procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after breast reduction, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks. Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
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