Pros and Cons of Breast Augmentation/Enlargement

Pros:

• Immediate Results: The effects of breast augmentation are visible immediately after surgery.

• Customizable: The procedure can be tailored to each patient's specific goals and body type.

• Boost in Self-Image: Patients experience improved self-confidence and body image.

• Variety of Options: Patients can choose from different types of implants and surgical techniques.

• Safe: When performed by a board-certified plastic surgeon, breast augmentation is generally considered safe.

Cons:

• Surgical Risks: As with any surgery, there are risks of complications such as infection or adverse reactions to anesthesia. Check with your doctor to see if the surgery is right for you.

• Recovery Time: Patients need to allow time for healing and may need to take time off work.

• Potential Need for Revision: Some patients may require additional surgeries in the future for implant replacement or to address complications.

• Cost: Breast augmentation can be expensive and is typically not covered by insurance when done for cosmetic reasons.

• Implant Maintenance: Regular check-ups and possible future surgeries may be necessary to maintain results.

• Interference with Mammograms: Implants can make it more challenging to read on mammograms. However, in about 90% of breast cancer cases, women find a breast lump via self-examination. It’s critical to check your breasts regularly and understand how your new breasts with implants look and feel.

Cost of Breast Augmentation

The cost of breast augmentation can vary widely depending on several factors:

• Surgeon's experience and geographic location

• Type of implant used

• Facility fees

• Anesthesia fees

• Post-operative care

• Health insurance

On average, breast augmentation in the United States can cost between $5,000 and $10,000. However, prices can be higher in major metropolitan areas or when using more expensive implant types. Most health insurance plans do not cover cosmetic breast augmentation or related complications. However, some surgeons offer financing plans to help make the procedure more affordable.

How Breast Augmentation Works

Breast augmentation is typically performed as an outpatient procedure under general anesthesia. The entire procedure typically takes 1 to 2 hours. The basic steps include:

1. Anesthesia: The patient is put under general anesthesia or intravenous sedation.

2. Incision: The surgeon makes an incision in an inconspicuous area to minimize visible scarring. Common incision locations include:

   - In the crease under the breast (inframammary fold)

   - Around the nipple (periareolar)

   - In the armpit (transaxillary)

3. Implant Placement: The breast implant is inserted into a pocket either:

   - Under the pectoral muscle (submuscular placement)

   - Directly behind the breast tissue, over the pectoral muscle (submammary/subglandular placement)

4. Closing the Incisions: The incisions are closed with layered sutures in the breast tissue and with skin adhesive or surgical tape.

Types of Breast Augmentation

There are three main approaches to breast augmentation: implants, fat transfer, and combination procedures. Each method has its unique benefits and considerations, making it essential for patients to understand their options to make an informed decision.

• Breast Implants offer substantial and predictable increase in size, an ideal option for those seeking a significant enhancement. The surgeon makes an incision and places the implant either under the pectoral muscle (submuscular) or directly behind the breast tissue (subglandular). The incision is then closed with sutures and the area is bandaged. This option offers a wide range of sizes and shapes to customize the look.

• Fat Transfer provides a more natural option with the added benefit of body contouring, suitable for those looking for a modest increase. Liposuction is used to harvest fat from other areas of the body with excess fat, such as the abdomen, thighs, or flanks. The harvested fat is purified and then injected into the breasts to enhance the volume and shape. By using the patient’s own fat, it reduces the risk of allergic reactions or rejection.

• Combination procedures offer the best of both worlds, delivering enhanced volume with a natural appearance. The procedure combines the use of implants with fat transfer to achieve the desired breast size. Implants provide the primary increase in volume, while fat transfer is used to refine the shape and contour, and to cover any visible edges or rippling of the implants.

Consult with a board-certified plastic surgeon to determine the best option for you and your personal needs.

Recovery from Breast Augmentation

Recovery from breast augmentation is a gradual process that varies from person to person. On average, most patients can expect to resume their normal routines within six to eight weeks, with full recovery up to six months. By following post-operative care instructions and taking the necessary precautions, patients can ensure a smooth and successful recovery.

1. Immediate Post-Op (First 24-48 Hours): Expect to feel tired and sore for a few days. Your surgeon will prescribe pain medication to manage discomfort.

2. First Week: You'll wear a surgical bra and should avoid strenuous activities. Most patients can return to work within a week, depending on the physical demands of their job.

3. Weeks 2-4: Swelling and bruising continue to subside. You can gradually resume normal activities but should still avoid heavy lifting.

4. Months 1-3: Your breasts will start to settle into their new position, and you'll begin to see your final results.

5. Long-Term: Continue to follow your surgeon's instructions for massage and implant displacement exercises if recommended.

Risks and Side Effects of Breast Augmentation

Breast Augmentation, like any surgical procedure, comes with certain risks and potential side effects. However, understanding these risks and knowing how to mitigate them can help ensure a safe and successful outcome. Choosing an experienced, board-certified plastic surgeon is crucial in minimizing these risks and achieving the best possible results.

• Capsular Contracture: Formation of tight scar tissue around the implant, which can cause the breast to feel hard. Massaging the breasts as recommended by your surgeon and choosing the right type of implant and placement can help reduce the likelihood of capsular contracture. Regular follow-up appointments are essential for early detection and management.

• Changes in Nipple or Breast Sensation: Some patients experience temporary or permanent changes in sensitivity. This side effect is often temporary and improves over time. Discussing incision placement with your surgeon can help minimize nerve damage.

• Implant Rupture or Leakage: Implants can rupture or leak, requiring removal or replacement. Regular monitoring through MRI or ultrasound, as recommended by the FDA, can detect silent ruptures early. Choosing high-quality implants and a skilled surgeon can also reduce the risk.

• Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): A rare type of non-Hodgkin's lymphoma associated with textured implants. Discussing implant types with your surgeon and opting for smooth implants can reduce this risk.

• Infection: Although uncommon, infections can occur and may require implant removal. Following post-operative care instructions, such as keeping the surgical area clean and taking prescribed antibiotics, can significantly reduce the risk of infection.

• Implant Malposition: The implant may shift from its original position. Choosing an experienced surgeon and following post-operative care guidelines, including wearing supportive garments, can help ensure proper implant positioning.

• Breast Pain: Some women experience ongoing breast pain. This side effect is often temporary and improves over time. Discussing incision placement with your surgeon can help minimize this issue.

Results of Breast Augmentation

The results of breast augmentation are typically long-lasting but not permanent:

• Immediate Results: You'll notice an immediate increase in breast size, although final results may take a few months as swelling subsides and implants settle.

• Scarring: Incision lines will fade over time but may be permanently visible.

• Long-Term Satisfaction: Many patients report high levels of satisfaction with their results for many years after surgery.

• Potential Changes: Pregnancy, weight fluctuations, and aging can all affect the appearance of augmented breasts over time.

• Implant Longevity: While breast implants are not considered lifetime devices, many last 10-20 years without complications.

Fat Transfer Breast Augmentation

Fat transfer breast augmentation, also known as autologous fat transfer, is a natural alternative to traditional breast implants. The procedure involves fat that is harvested from other areas of the body via liposuction. The purified fat is then carefully injected into the breasts to enhance their size and shape. This method offers a dual benefit: not only does it increase breast volume, but it also provides body contouring benefits at the fat harvest sites, improving overall body proportions.

One of the most appealing aspects of fat transfer breast augmentation is the natural feel of the results, as it uses the patient’s own tissue. This can lead to a more natural look and feel compared to synthetic implants. However, it’s important to note that some of the transferred fat may be reabsorbed by the body over time, which could affect the longevity of the results. Despite this, many patients find fat transfer to be a highly satisfying option for achieving a modest increase in breast size while simultaneously refinding other areas of their body.

Breast Implants

There are three main types of breast implants:

• Silicone Implants:

  - Filled with silicone gel

  - Tend to feel more like natural breast tissue

  - Require regular MRI or ultrasound screenings to check for silent ruptures

• Saline Implants:

  - Filled with sterile salt water

  - Provide a uniform shape and firmness

  - Ruptures are immediately noticeable as the implant deflates

• Gummy Bear Implants:

  - Contain a cohesive gel that helps maintain shape even if the implant shell is broken

  - Known for their durability

  - Lower risk of complications

How To Choose A Breast Augmentation Surgeon

Selecting the right surgeon for your breast augmentation is a critical decision that can significantly impact the outcome of your procedure and your overall satisfaction. Here are some essential factors to consider when choosing a surgeon:

• Board Certification: One of the most crucial aspects to look for in a surgeon is board certification. Surgeons certified have undergone rigorous training. They must pass comprehensive written and oral exams in plastic surgery. Certification also ensures that the surgeon has met high standards of education, training, and ethical practice.

• Experience and Specialization: Experience matters when it comes to breast augmentation. Look for a surgeon who specializes in breast procedures and performs them regularly. Ask about their specific experience with the type of augmentation you're considering, whether it's implant-based or fat transfer. A surgeon who frequently performs breast augmentations is likely to have refined their technique, leading to better outcomes.

• Bedside Manner and Communication: Your surgeon should make you feel comfortable, confident, and heard. They should listen to your goals and concerns and provide clear, honest answers to your questions. A good surgeon will not pressure you into additional procedures and will suggest options that are best for your health and aesthetic goals. The relationship you build with your surgeon is important, as they will guide you through the entire process, from consultation to recovery.

• Before and After Photo: Reviewing before and after photos of previous patients can give you a sense of the surgeon's work and the results you can expect. These photos should be available during your consultation, even if they are not posted online due to privacy concerns. Look for results that align with your aesthetic goals and ensure that the "before" photos resemble your current body shape.

• Facility Accreditation: Ensure that the surgery will be performed in an accredited facility. Accredited surgical centers meet strict safety and quality standards, providing a safe environment for your procedure. Look for accreditation from organizations such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) or the Accreditation Association for Ambulatory Health Care (AAAHC).

Before & After

The journey of breast implants leads to a significant transformation in both physical appearance and self-confidence. These before and after images provide a visual representation of the results of the procedure, showing the enhancements in breast size, shape, and overall symmetry.