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By inserting
an implant behind each breast, surgeons
are able to increase a woman's bustline
by one or more bra cup sizes. If you're
considering breast augmentation, this
will give you a basic understanding of
the procedure--when it can help, how it's
performed, and what results you can expect.
It can't answer all of your questions,
since a lot depends on your individual
circumstances. Please ask your surgeon
if there is anything you don't understand
about the procedure.
The best
candidates for
breast augmentation
Breast augmentation can enhance your appearance
and your self-confidence, but it won't
necessarily change your looks to match
your ideal, or cause other people to treat
you differently. Before you decide to
have surgery, think carefully about your
expectations and discuss them with your
surgeon.
The best
candidates for breast augmentation are
women who are looking for improvement,
not perfection, in the way they look.
If you're physically healthy and realistic
in your expectations, you may be a good
candidate.
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Breast
augmentation is usually done to
balance a difference in breast
size, to improve body contour,
or as a reconstructive technique
following surgery. |
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Types
of implants
A breast implant is a silicone shell filled
with either silicone gel or a salt-water
solution known as saline.
Because of
concerns that there is insufficient information
demonstrating the safety of silicone gel-filled
breast implants, the Food & Drug Administration
(FDA) has determined that new gel-filled
implants, at the present time, should
be available only to women participating
in approved studies. Some women requiring
replacement of the implants may also be
eligible to participate in the study (we
are part of such study and have the silicone
implant available for eligible patients).
Saline-filled
implants continue to be available to breast
augmentation patients on an unrestricted
basis, pending further FDA review. You
should ask your doctor more about the
specifics of the FDA decisions. (Above
guidelines are current as of July 1992.)
All surgery
carries some uncertainty and risk
Breast augmentation is relatively straightforward.
But as with any operation, there are risks
associated with surgery and specific complications
associated with this procedure. These
risks will be discussed by your surgeon
and staff during your initial consultation.
While the
majority of women do not experience these
complications, you should discuss each
of them with your physician to make sure
you understand the risks and consequences
of breast augmentation.
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Planning
your surgery
In your initial consultation, your surgeon
will evaluate your health and explain
which surgical techniques are most appropriate
for you, based on the condition of your
breasts and skin tone. If your breasts
are sagging, your doctor may also recommend
a breast lift.
Be sure to
discuss your expectations frankly with
your surgeon. He or she should be equally
frank with you, describing your alternatives
and the risks and limitations of each.
You may want to ask your surgeon for a
copy of the manufacturer's insert that
comes with the implant he or she will
use -- just so you are fully informed
about it. And, be sure to tell your surgeon
if you smoke, and if you're taking any
medications, vitamins, or other drugs.
Your surgeon
should also explain the type of anesthesia
to be used, the type of facility where
the surgery will be performed, and the
costs involved. Because most insurance
companies do not consider breast augmentation
to be medically necessary, carriers generally
do not cover the cost of this procedure.
Preparing
for your surgery
Your surgeon will give you instructions
to prepare for surgery, including guidelines
on eating and drinking, smoking, and taking
or avoiding certain vitamins and medications.
While making
preparations, be sure to arrange for someone
to drive you home after your surgery and
to help you out for a few days, if needed.
Where
your surgery will be performed
Your surgery will be performed in
our accredited operating room.
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Types
of anesthesia
Breast augmentation can be performed with
a general anesthesia, so you'll sleep
through the entire operation. Some surgeons
may use a local anesthesia, combined with
a sedative to make you drowsy, so you'll
be relaxed but awake.
The
surgery
The method of inserting and positioning
your implant will depend on your anatomy
and your surgeon's recommendation. The
incision can be made either in the crease
where the breast meets the chest, around
the areola (the dark skin surrounding
the nipple), or in the armpit. Every effort
will be made to assure that the incision
is placed so resulting scars will be as
inconspicuous as possible.
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Incisions
are made to keep scars as inconspicuous
as possible, in the breast crease,
around the nipple, or in the armpit.
Breast tissue and skin is lifted
to create a pocket for each implant. |
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Working through
the incision, the surgeon will lift your
breast tissue and skin to create a pocket,
either directly behind the breast tissue
or underneath your chest wall muscle (the
pectoral muscle). The implants are then
centered beneath your nipples.
Some surgeons
believe that putting the implants behind
your chest muscle may reduce the potential
for capsular contracture. This placement
may also interfere less with breast examination
by mammogram than if the implant is placed
directly behind the breast tissue. Placement
behind the muscle however, may be more
painful for a few days after surgery than
placement directly under the breast tissue.
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The
breast implant may be inserted
directly under the breast tissue
or beneath the chest wall muscle. |
You'll want
to discuss the pros and cons of these
alternatives with your doctor before surgery
to make sure you fully understand the
implications of the procedure he or she
recommends for you.
The surgery
usually takes one to two hours to complete.
Stitches are used to close the incisions,
which may also be taped for greater support.
A gauze bandage may be applied over your
breasts to help with healing.
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After
surgery, breasts appear fuller
and more natural in tone and contour.
Scars will fade with time.
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After
your surgery
You're likely to feel tired and sore for
a few days following your surgery, but
you'll be up and around in 24 to 48 hours.
Most of your discomfort can be controlled
by medication prescribed by your doctor.
Within
several days, the gauze dressings, if
you have them, will be removed, and you
will continue to wear the surgical
bra for four weeks after your surgery.
You may also experience a burning sensation
in your nipples for about two weeks, but
this will subside as bruising fades.
Your stitches
will come out in a week to 10 days, but
the swelling in your breasts may take
three to five weeks to disappear.
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Getting
back to normal
You should be able to return to work within
a few days, depending on the level of
activity required for your job.
Follow
your surgeon's advice on when to begin
exercises and normal activities. Your
breasts will probably be sensitive to
direct stimulation for two to three weeks,
so you should avoid much physical contact.
After that, breast contact is fine once
your breasts are no longer sore, usually
three to four weeks after surgery.
Your scars
will be firm and pink for at least six
weeks. Then they may remain the same size
for several months, or even appear to
widen. After several months, your scars
will begin to fade, although they will
never disappear completely.
Routine
mammograms should be continued after breast
augmentation for women who are in the
appropriate age group, although the mammographic
technician should use a special technique
to assure that you get a reliable reading.
(see All surgery carries some uncertainty
and risk.)
Your
new look
For many women, the result of breast augmentation
can be satisfying, even exhilarating,
as they learn to appreciate their fuller
appearance.
Regular
examination by your plastic surgeon and
routine mammograms for those in the appropriate
age groups at prescribed intervals will
help assure that any complications, if
they occur, can be detected early and
treated.
Your decision
to have breast augmentation is a highly
personal one that not everyone will understand.
The important thing is how you feel about
it. If you've met your goals, then your
surgery is a success.
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