Breast Augmentation

Breast augmentation, also known as a "boob job" or augmentation mammoplasty is designed to increase the fullness, shape and size of the breast. Within the past few decades, there have been major advancements in breast enhancement materials and techniques as new anatomically shaped implants have come on the market. Patients can choose between saline, silicone and gummy bear implants as well as increase their breast volume via fat grafting. Patients consider breast augmentation for a number of reasons like being unhappy with the appearance of their breasts or feeling that their breasts are too small.

Am I a Good Candidate for Breast Augmentation?

In general, GOOD CANDIDATES for breast augmentation are:

• At least 18 years of age
• Have fully developed breasts but feel they are too small
• Have breasts that lost volume or shape after pregnancy, aging or weight loss
•  Have asymmetrical breasts
•  Have elongated or misshaped breasts

Patients who are NOT GOOD CANDIDATES include:

• Women who are under 18 years of age
• Patients who get augmentation to make someone else happy rather than satisfy their own physical or emotional needs

How is Breast Augmentation Performed?

In order to prepare for breast augmentation, patients will be asked to stop smoking at least a month before surgery. They will also be asked to stop taking aspirin and anti-inflammatory drugs as both of these can increase the risk of bleeding. Patients can take a normal shower before arriving for surgery.

Implants

One of the biggest decisions with breast augmentation is the type of implant used by the surgeon if the patient decides to have implants. The implant process involves the surgeon creating an incision in the crease of a number of locations including:

•  Under the breast (inframammary)
•  The armpit (transaxillary)
• The belly button (transumbilical)
• The areola or pigmented area around the nipple

Once the decision is made regarding where to place the implant, it is then inserted into the patient. The implant can be placed above the muscle (subglandular) or under the muscle

(submuscular). No matter where the implant is placed, the incision is closed with sutures once the implant is inserted into the patient.

The following implants are FDA-approved and can be used depending on the anatomy of the patient as well as her aesthetic goals for the surgery:

• Saline breast implants - They contain sterile salt water and are usually filled at the time of surgery to deliver a uniform shape and feel.
• Silicone breast implants - These implants are filled with an elastic, silicone gel and are approved for patients 22 years of age or older. They are pre-filled and require a longer incision but many patients think they provide a more natural feel compared to saline.
•  Gummy Bear Implants - These cohesive gel silicone implants are filled with a thick, form-stable gel that retains its shape. Gummy bear breast implants have a teardrop shape which gives them more projection at the bottom of the breast.

Fat Grafting

Some patients choose to increase their breast volume via fat grafting or autologous fat transfer. Fat grafting involves fat being liposuctioned from the abdomen, thighs or other areas of the body. The fat is then recessed and re-injected into the breasts. This method is a good option for patients with excess fatty tissue in their midsection or flanks and who are not interested in implants. These patients do not want implants but have fat elsewhere that can be used.  It is a nice option in weight loss patients who have lost breast volume.

Scars after Breast Augmentation

Patients typically have a scar after breast augmentation. The size of the scar depends on the length of the incision as well as the type of implant. Saline implants usually require smaller incisions while silicone implants require longer incisions. Breast augmentation scars may initially be red and a bit raised but they normally fade or flatten after 3-6 months. Patients prone to visible scarring might have more visible scars than other patients.

Combined with Other Procedures

A breast augmentation can be performed in combination with other procedures such as a tummy tuck, a breast lift and a Brazilian butt lift to further contour the body. Patients should discuss these options with their surgeon to see if they are an ideal candidate to combine procedures.

What is the Cost of Breast Augmentation?

The cost of breast augmentation surgery varies depending on factors such as the geographic location of the procedure, any fees charged by the surgeon or facility, the type of surgery/ performed, the type of implants used and the complexity of the operation.

The cost for breast augmentation with implants is typically $6000-$10,000 while breast augmentation via fat grafting is $10,000-$15,000. Breast surgery to treat conditions such as traumatic injuries, Poland Syndrome and an absence of breast after mastectomy for breast cancer may have some costs covered by medical insurance. Patients should check with their surgeon to see if any of the costs will be covered by insurance.

Recovery and Downtime

Patients should have a family member or friend on hand to drive them home from surgery and to help out once they arrive home. The amount of time off work for RECOVERY depends on the amount of physical activity required for the job. Patients should avoid lifting anything heavier than 5-10 pounds. Pain medication can be prescribed by the doctor to help ease any pain after surgery. Patients should expect some swelling and bruising following the surgery but they should subside after 2-3 weeks. Patients should also expect some DOWNTIME for 6-8 weeks when it comes to exercise and intense physical activity after the surgery.

Any surgery scars will be visible for 3-6 months but they will start to soften and fade. It takes about 12 months for scars to mature and some doctors recommend scar cream to help reduce their appearance.

Results

Determining the correct breast augmentation size is specific to the individual patient. The final decision depends on:

• The amount and elasticity of existing breast tissue
• The height, weight, rib cage width and body type of the patient

3D imaging helps patients visualize the results before having the actual surgery. High definition cameras recreate the body of the patient in 3D which gives women the opportunity to try out different breast sizes through computer simulation. A 3D imaging system is valuable in helping patients see what size implants will best achieve their goals.

When it comes to the final results, patients should improve their appearance in a manner that will make them happy rather than trying to have "perfect breasts". Some of the most common results from breast augmentation include an increase in breast size, asymmetry correction and restoring fullness in breasts that have lost volume due to age or pregnancy. The final results also depend on the type of augmentation procedure undergone by the patient. In general, fat grafting results should last a lifetime while implants can last anywhere from 10-25 years.

Limitations of Breast Augmentation

Some of the common limitations of breast augmentation include:

• The breast size patients can achieve and still have natural looking results
• A limit to how long breast implants last
• The amount of fat that can safely be transferred

Risks of Breast Augmentation

Some common breast augmentation risks include:

Capsular contracture

• Rippling
• Infections
• Hematoma – An abnormal collection of blood within the breast
• Numbness of the nipples
• Implant rupture/Leaky implants/Deflated implants
•  Implant malposition

Don't Do It for Others

Before undergoing breast augmentation, patients should make sure their doctor of choice is experienced in performing breast augmentation. When discussing the desired results with a patient, the doctor should make sure the person wanting the surgery is making a change they want and not doing it to make someone else happy. Breast augmentation is a very personal decision with long lasting results.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Beth Preminger, MD in New York, NY