In our society today, it is extremely important for us to feel good about the way we look. For this reason many women are considering cosmetic surgery to feel better about themselves and improve the way they look in their clothes. Because an individual’s body build is determined greatly by genetic influences, women may not be able to achieve the look they want through diet and exercise alone. Today, through modern technology, many women are able to alter the shapes of their bodies. Some with small, underdeveloped or asymmetrical breasts choose to undergo breast augmentation. Breast augmentation is a safe, effective surgical procedure designed to improve the contour of a woman’s body by implanting specially designed materials beneath the breast or chest wall muscles.
Before Breast Implant Surgery
Prior to surgery, a complete medical history is taken in order to evaluate your general health. A thorough examination of the breasts is also made to determine the most effective surgical approach, implant size and implant style. At the consultation Dr. Hendrick will discuss with you the type of anesthesia to be used, the procedure, what results might realistically be expected, and the possible risks and complications. Photographs of your breasts will be taken for the record and you will have an opportunity to try sizers on. Feel free to bring pictures of breasts you think are attractive in size and shape.
Mammograms will usually be requested or ordered. Preoperative instructions include the elimination of certain drugs which contain aspirin or ibuprofen in order to minimize the possibility of excess bleeding.
The Breast Augmentation Procedure
A breast augmentation is done in our office surgical suite as an outpatient surgical procedure. You will be given local anesthetic with sedation or general anesthetic. You will have no pain whatsoever during the procedure. Dr. Hendrick may choose from a variety of surgical approaches, depending upon what changes are desired. There are four ways to place an implant:
* An inframammary incision is an opening made in or just above the hidden fold beneath the breast.
* An areolar incision is made under the nipple.
* A transaxillary incision is made in the underarm.
* An umbilical incision is made in the navel (belly button).
Regardless of which incision is used, breast tissue is raised to create a pocket either under the breast tissue or beneath the chest wall muscle. An implant, usually containing a saline (saltwater) solution, is inserted into the pocket. Different sizes of implants may be used to correct breast asymmetry.
After the implant is securely in place and inflated, small sutures are used to close the incision. A breast augmentation can take 1 to 2 hours, depending upon the procedure and extent of the surgery.
Following Your Surgery
Following surgery, you will be sent home to recover under supervision and with postoperative instructions. You will have a dressing, surgical bra and strap.
Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics will be prescribed to prevent infection. Instructions for the day of surgery include bedrest and limited activities. Dr. Hendrick determines when normal activities can be resumed; however, strenuous exercise and overhead lifting must be avoided for several weeks.
Sutures are removed in about 7 days, at which time Dr. Hendrick may recommend massage to keep the breast supple. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from the incisions, although permanent, are “hidden” and fade significantly with time.
What kinds of breast implants are available?
The most common types are gel filled and saline filled. Each has a silicone rubber envelope. Saline implants are primarily used. The FDA requires saline implants to be used for primary augmentation. If you have had previous breast augmentation surgery or meet other criteria you may qualify for silicone gel implants under a “Silicone Gel Study”. Implants are available with a smooth or textured surface and can be round or tear-drop in shape. Smooth round implants are used in most cases.
Is this breast operation dangerous?
There is some risk with any operation. This operation is about as dangerous as a tonsillectomy but not as dangerous as an appendectomy. This operation is performed under local or general anesthesia and usually as an outpatient. The patient arrives for surgery in the morning, has the operation and goes home that day without staying in a hospital.
Can breast implants cause breast cancer?
In the millions of cases where breast implants have been used, there have been no reported cases where cancer was caused by the implant. An augmentation will not prevent cancer from developing.
Does breast implant surgery leave unsightly scars?
Whenever the skin is cut, a scar line remains after healing. The surgeon tries to make the scar as invisible as possible. Usually the small scar that remains is not easily seen. It may be under the fold of the breast, under the nipple, under the arm or hidden in the navel (belly button).
How may I find out from the FDA the present status of breast implants?
The FDA toll-free consumer information line number is 888-463-6332. Ask for the book “Breast Implants - An Information Update”. A lot of up-to-date information can be obtained from the FDA.
How long will the breast implant last?
The exact lifespan of an implant is unknown and varies from woman to woman. Implants last many years in some women and have to be replaced more frequently in others. Saline implants are expected to deflate eventually and may have a lifespan of only 5 to 10 years though they may last longer. The person choosing saline implants should expect to require further surgery at additional cost to themselves to repair or replace implants in the future. Some manufacturer warranties may apply.
How is the size of the breast implant determined?
By discussion with your surgeon. Your surgeon wants your new breasts to have a pleasing, balanced appearance in proportion to your shoulders, chest and hips. Filling a plastic sandwich bag with water and placing it in the bra can help determine the size desired.
Can one breast-feed if she has implants?
Even women without breast implants are sometimes unable to breast-feed. For this reason, breast-feeding with implants can’t be assured. The implant is placed between the breast gland and the pectoral muscle or under the muscle and does not usually interfere with the normal functioning of the milk ducts. Many women have been able to breast-feed successfully after breast implant surgery. Dr. Hendrick can locate incisions so as to maximize this possibility, but the patient has to accept the chance breast-feeding won’t be successful. Furthermore, the repeated engorgement and relaxation of nursing breasts can produce a lasting sagging and drooping of the breast, which could compromise your long-term result. If you feel you want to breast-feed, you may do so with the above facts in mind.
Will I still have feeling in my breast and nipples?
Yes, usually. There may be reduced feeling right after surgery. With few exceptions sensation improves in a few days to a few months. There can be some permanent numbness.
Can I expect any problems or complications with my breasts after implant surgery?
Yes, possibly. Although thousands of women have implant surgery each year, each person’s reaction to surgery is different. Breasts with saline implants may not look or feel normal. The most common problems are hardness, loss of sensation, hematoma, infection, rejection, deflation, asymmetry, wrinkling or rippling, distortion, rupture and interference with mammography and breast-feeding. Cancer and autoimmune disease may occur with or without implants but at this time there is no proven association between breast implants and development of these diseases.
What may I do after the breast implant surgery? How long will it be before I can start normal activities?
Some of this depends on where your incisions and implants are located. For the first few days you must rest and relax. You will be wearing a jog bra without underwiring. You may sit or lie on your back or either side. You may be up to the bathroom and for meals. There should be no housework at all for the first two to three days. After three days, all “normal activities” may be resumed, except for strenuous exercise and heavy lifting. Most strenuous activities can be resumed after four to six weeks. Following surgery, Dr. Hendrick will give you specific instructions regarding your participation in everyday activities and athletics.
How will I feel?
You will feel drowsy as the anesthetic wears off. You may feel some soreness, swelling or discomfort, but this is quite natural. You may feel tired and exhausted. These feelings are normal and usually last only a short while.
How much will the entire procedure cost?
Fees will vary depending on your unique anatomy and needs. Please call for pricing.
Is breast implant surgery covered by medical insurance?
Usually not, but this too can vary. It is a good idea to check with your insurance company ahead of time if you have questions.
Can breast cancer be detected if one has implants?
Breast implants are not known to cause, but may delay, detection of breast cancer. Self-examination should be performed once a month about a week after your period, when the breasts are usually not tender or swollen. This is recommended by the American Cancer Society (ACS) whether or not there are breast implants. Mammograms are more difficult to interpret after augmentation but can be supplemented with ultrasound when necessary. It is still important to get mammograms regularly after age 40. This recommendation is the same whether or not there are breast implants. Any lump that develops needs to be diagnosed. Most breast lumps are benign.
Can the breast implants be broken?
The material is very elastic and easily stretched, thus it is difficult to break the implant. Patients have been victims of blunt trauma to the chest sufficient enough to fracture their ribs, yet did not rupture the implants. This does not imply that they absolutely cannot be broken, but it would take a considerable force to break an implant. If in the unlikely event it did break, it would have to be replaced.
Does flying affect breast implants?
Flying does not affect the implants. Many stewardesses have implants and fly almost every day.
Are patients put to sleep for this surgery?
The surgery is successfully performed with IV sedation and local anesthetics, which speeds recovery and minimizes postoperative nausea. The surgery can also be done using general anesthesia.
Why do some breast implants develop firmness?
An unusually thick capsule of scar tissue that forms around the implant causes the firmness. Some scarring is expected and necessary to maintain the position of the implant. Some people form thicker scars than others do. The newer implants seem to cause less scar formation. Implants placed beneath the chest muscles may have less tendency to form thick capsules.
Can a person go bra-less after breast implants are placed?
Certainly, if inclined to do so. However, a bra should be worn during jogging, running, tennis, horseback riding, and any other time the breast might get jostled.
What about more information?
Besides the information and product literature we provide to you, you can also get more information from the following resources:
The American Society of
Cosmetic Breast Surgery
Food & Drug Administration
1-888-info-FDA www.fda.org.gov/cdrh/breast implant
If you are interested in learning more about breast augmentation at Heartland Cosmetic and Reconstructive Surgery, please contact our office at 1-866-760-0900 or 785-309-0900.
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