Despite clichés about appearances being only skin deep, the way you look is an important part of how you feel about yourself and how you present yourself to other people. For many women, a shapely body is especially important part of their appearance. Naturally small breasts, shrinkage after pregnancy or weight loss, and problems such as tubular breasts and asymmetry can all play havoc with a woman’s confidence. That’s why breast augmentation to correct those issues is one of the world’s most popular cosmetic surgeries.
Are you a breast augmentation candidate?
A breast augmentation uses implants to surgically increase or, in some cases, restore breast size. It is a safe procedure with a long history, and contrary to the stereotypes, the results can be extremely natural. The result is a rejuvenated and more feminine-looking body.
How Do I Choose the Correct Breast Implant?
Breast augmentations have a lot of options. There are three basic areas that you need to consider: Size, type of implant, and placement.
When selecting a size, balance is important. It should be large enough that you are satisfied and will not need to come back for a revision, but overly large implants will look unnatural on many frames and can have more complications. The diameter of the implants is also important. This is normally selected to match the width of your natural breasts. Finally, you must decide on a profile, or how much they project out from your chest. Implants are available in low, medium, and high profiles. A low profile will be more appropriate for a wider chest, while a high profile can allow a larger implant to be used on a narrower frame.
For the type of implants, your options are silicone or saline. Silicone implants come pre-filled with silicone gel and require a larger incision, but they feel more natural. Saline implants are inserted empty and then filled via syringe. They can use a smaller incision, but some patients dislike the feel of them. You’ll also need to decide between textured and smooth implants. Textured implants reduce the risk of capsular contracture and move around less in the pocket, but smooth implants rupture less often and have a reduced chance of wrinkling. Smooth implants also feel more flexible, while textured ones can be stiff.
In terms of placement, the implants can be placed over or under the muscle. Under the muscle provides an easier recovery, but over the muscle is preferred because it looks more natural. Once the location is selected, the implants can be placed by one of four approaches. The peri-areolar approach uses an incision under the areola, while the inframammary uses an incision in the crease under the breast. These are the most popular approaches since they allow maximum access for placement and for any future revisions. Underarm and transumbilical approaches are also used to reduce scarring, but these limit access and may require a different approach to be used for future revisions. The transumbilical approach, which goes through the navel, also uses such a small incision that it cannot be used with silicone implants.
The amount of options may seem overwhelming, but your first step is a consultation with Dr. Ortega, who will help you select the right choices for your frame and lifestyle. After you have gone over your problems and your goals for the surgery, Dr. Ortega will discuss the options and the procedure in detail. To help you select the correct size, he will measure your chest and breasts for diameter, projection, and nipple location. You will try on implants of various sizes in your bra and under a favorite top to see what looks best on your frame. Due to the level of detail in the consultation, you can expect to spend at least an hour at the office.
Breast augmentation is normally done under either general anesthesia or deep sedation with a nerve blockade. After you are anesthetized, Dr. Ortega will make the incisions and create a pocket in your chest under the breast tissue. The implant will be placed in the pocket and then, if it is a saline implant, filled to the correct level. After adjusting everything for the best shape, Dr. Ortega will close the incisions and apply surgical dressings. The entire procedure normally takes about two hours.
Breast augmentation is normally an outpatient procedure, so you will be sent home in surgical dressings. There will be significant swelling and bruising at first, but it will rapidly diminish. Your final results may not be immediately apparent due to the post-surgery swelling, but residual swelling should disappear in about a month. You will experience some discomfort and a tight feeling, and it may be difficult to raise your arms.
For the first few weeks, you’ll need to wear a special bra to support the healing tissues. Movement will be important to maintain good circulation, but avoid any strenuous exercise, and do not lift anything heavy since it will put stress on the healing areas. You should be able to return to work in a week if your job does not require physical labor.
Possible Risks and Complications
All surgeries have risks, including the normal risks of bleeding, infection, reactions to anesthesia, and hematoma. In addition, breast augmentation has several specific risks.
The most common complication is a change in sensation. Numbness, tingling, and occasional hypersensitivity are reported by many patients in the first weeks after surgery, but the numbness sometimes can persist for longer. In a few cases, it may remain for over a year.
Much less commonly, there is a risk of capsular contracture, which is an overreaction of the scar tissue around the implant. This can cause unnatural-looking and hard breasts, and it needs to be remedied surgically.
Ruptured implants are also a risk. While not dangerous, this can be painful and can leave your breasts deflated, hard, or lumpy. This also must be corrected surgically.
Breast Augmentation FAQs
Q. Is it safe to get pregnant after having a breast augmentation?
A. Absolutely. Breast implants cause no additional risks during pregnancy. Pregnancy can cause the breasts to expand, though, which can lead to stretched skin and sagging. For that reason, it may be a good idea to wait until after having a baby to get your augmentation if you plan on becoming pregnant in the near future.
Q. How can you tell if you need a breast lift or a breast augmentation?
A. In general, a breast lift will correct sagging without adding extra volume while an augmentation will add volume but only corrects very mild sagging. If you have only mild drooping with the nipple and areola still pointing straight ahead rather than downward, an augmentation may provide sufficient lift for you. Otherwise, a lift on its own or along with an augmentation may be necessary.
Q. One of my breasts is much larger than the other. Can an augmentation correct this?
A. Asymmetry is a common issue, and it is easily corrected surgically. Depending on the individual case, it may be necessary to reduce one while augmenting the other, to use implants of differing sizes, or another combination of procedures. Since the correction is so individual in nature, a consultation with Dr. Ortega will be necessary to determine exactly what needs to be done.
Q. I’d like to get a tummy tuck as well as a breast augmentation. Can these surgeries be done at the same time?
A. It’s very common to combine a tummy tuck with an augmentation, and for many women, the benefits of only having to go through surgery and anesthesia once outweighs the downside of a slightly longer recovery period. The viability of this will depend on the extent of the problems, however, so it’s important to see Dr. Ortega for a professional evaluation of your situation.
Q. Are there any age limits on getting a breast augmentation?
A. A breast augmentation can be performed on any healthy adult. Once breast development is complete after adolescence, there is no real difference between performing an augmentation on a healthy 25 year old versus performing one on a healthy 55 year old.