Breast Augmentation
What is a Breast Augmentation?
Breast augmentation is a procedure designed to enhance the size of the breast and improve its shape. While breast augmentation is typically performed using breast implants, liposuction with transfer of fat to the breasts is becoming increasingly common for the right candidates.
How is a Breast Augmentation Done?
Breast augmentation typically involves placing a breast implant underneath the breast tissue, either above or below the pectoralis major muscle. The implants used have a silicone shell, and may be filled with either saline or silicone. The breast implants come in many shapes (round vs. tear-drop/anatomic), sizes, and profiles in order to give you a customized procedure to achieve your ideal results. Dr. Krochmal uses implants from all the major implant manufacturers with approval in the U.S. (Allergan, Mentor, Sientra, and IDEAL) to make the procedure fully individualized. The small incision is placed either underneath the breast, around the areola, or through the armpit. Typically the procedure is done under general anesthesia for patient comfort, but may also be performed under sedation in some circumstances.
If fat grafting is used, liposuction is first performed in your “problem areas” to improve your shape. The fat is then processed and purified before placing into the breasts, increasing the volume and improving its shape. Because you are using your body’s own tissue, there are no foreign objects that you need to worry about, and since you breast is made of fat anyway, fat grafted breasts feel the most natural. The potential downsides to fat grafting are that sometimes you need multiple surgeries to get to your desired result, or you may not have enough fat elsewhere on your body to be a candidate for the procedure.
Who is a Good Candidate?
A good candidate for a breast augmentation procedure is somebody who is overall in good health and desires larger breasts. Candidates include women, and people transitioning from male to female. Ideally, you would want to wait until you are done having children before breast augmentation, as the breasts can change significantly with pregnancy. However, many women choose to get breast implants before pregnancy and know that a revision may be necessary at some point.
If your breasts have size differences, then different sized implants may be placed. If your breasts aren’t “saggy”, then typically a breast augmentation is all a patient will need. If your breasts do sag, then you may need a breast lift also to get the areola in the proper position over the implant. Also, to keep the implants in a good position longer, your doctor may talk to you about the using mesh (such as GalaFlex) to create an “internal bra” of sorts.
What is the Recovery For a Breast Augmentation?
Breast augmentation recovery is pretty straightforward. You’ll be a bit sore for a few days (like you did a lot of pushups), but you’re otherwise functioning and feeling fine. You’ll get pain medication to help with the discomfort. Most patients are out to dinner the following day, and driving after several days. You can shower the next day, but no soaking in water, heavy lifting, or strenuous activity for 1 month while the implants are settling in. For postoperative garments, you’ll be given a special surgical bra to wear afterwards to keep the implants in the proper position.
Following breast augmentation surgery, it will be necessary to periodically check the implants to make sure they aren’t causing any issues. Talk to your surgeon about the latest recommendations for implant surveillance.
What About ALCL and BII?
Your doctor will also talk to you about rare issues some people have with implants, including BIA-ALCL and BII. These are both being actively researched to understand how and why they occur, and the best treatments for them. For the vast majority of people, breast implant surgery is a fantastic procedure with very high satisfaction rates, and the only complaint is that people didn’t get it done sooner!