With Breast Surgery, The Operative Word Is ‘Precaution’

Breast augmentation is the second-most-popular plastic surgery procedure in the United States, next to the rhinoplasty, or nose job. The best candidates for breast surgery are women who are looking for improvement – not perfection – in the way they look. Augmentation will enhance the bust line, creating a fuller, rounder, and more feminine silhouette.

Breast implants are often used to correct a reduction in breast volume after pregnancy, and the procedure also may be called on to balance a difference in breast size. Many women involved in the pageant, modeling, and entertainment industries choose to have augmentation in order to enhance their already fit figures. Most women report a renewed sense of confidence after the surgery, and successful augmentations result in improved satisfaction with how one looks in swimwear and other clothing.

First and foremost, creams and pills claiming to enhance breast tissue simply do not work; surgery is the only option for larger breasts. Breast augmentation is an outpatient procedure, and most surgeons can complete the operation in approximately one hour. The patient will spend an hour or so in the recovery room before going home.

The method of inserting and positioning an implant will depend on the woman’s anatomy and her surgeon’s recommendation. An incision can be made either in the crease where the breast meets the chest, around the areola, in the armpit, or in the navel. Every effort is made to assure that the incision is placed so resulting scars will be as inconspicuous as possible. If she has a skilled surgeon, the woman may barely notice a scar one year after the operation.

Working through the incision, the surgeon will lift the breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath the chest wall muscle, then each implant will be centered beneath the nipple. It is preferable for the surgeon to use sizers during this portion, and sit the patient up during surgery to make sure her implants do not look artificial. The implants chosen by the surgeon should fit as perfectly as possible. If it is obvious to others that breast implants are in place, the surgeon did not do a good job.

There are many different types of implants, with saline implants being mandatory for first-time implant insertion and silicone implants, available for women participating in approved silicone implant studies. Implant styles vary as well, and can include smooth rounds, textured rounds, and anatomically shaped implants, among others. They vary in size as well, depending on the manufacturer.

With the implants in place, the surgeon then determines how many cubic centimeters (cc) of fluid to place in the implant for the desired result. Some women will need as few as 120 cc, but there are implants available that may accommodate as much as 850 cc. A skilled surgeon will know whether the left and right breast are not of equal size, and will introduce different amounts of saline at this time to ensure an even appearance.

The patient is likely to feel tired after surgery. Some report a great deal of pain, while others take a Tylenol and go to dinner the following evening. Working women may return to work within two to three days, depending on their occupation. The stitches will be removed approximately on the 10^th day following the procedure, and it can take several weeks or months for the swelling to disappear.

Breast augmentation is relatively straightforward, but as with any operation, there are risks associated with surgery and specific complications may result from this procedure. The most common problem is capsular contracture, which occurs when the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant.

As with any procedure, excessive bleeding following the operation may occur, requiring another operation to control the bleeding and remove the accumulated blood. Other rare complications include infection, uneven size, and scarring. Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness around your incisions. This is permanent in some patients. Occasionally, breast implants may break or leak. As with any surgery, there are other severe and unusual complications that can result in permanent injury or death. The surgeon should go over all of the possible complications with his patient prior to doing the procedure.

Choosing a Practitioner

There are many surgeons out there, and some will use snappy advertising and promotional gimmicks to lure patients. The best way to find a surgeon is by word-of-mouth; ask someone who has had the surgery what she thought of her surgeon. Ask for pre operative and post operative pictures; beware of a surgeon who won’t show his or her work. Ask a plastic surgeon to provide contact information for his last five to 10 patients who would be willing to speak about their experience with a potential client. Choose a board certified plastic surgeon who specializes in breast augmentation.

Once those qualifications are met, beware of discount breast implant and liposuction centers. The average cost of an entire augmentation – including surgeon fees, hospital fees, and anesthesia fees – runs between $4,000 and $10,000 nationally.

A woman’s decision to have her breasts surgically enhanced is a very personal decision, one that not everyone will understand. The important thing is how the woman feels about it. Breast surgery is most often a decision women are thrilled with.

Dr. Ronald Bergman

Pageantry Magazine