Breast augmentation is one of the most popular cosmetic procedures, and rightly so: It can make a huge difference in a woman’s appearance and self-esteem. While a large percentage of patients opt to get breast implants to correct problems like tubular breasts, asymmetry, and mastectomy, many more have it done for aesthetic reasons. It makes sense to do so. Your appearance has a great impact on your confidence, so bringing your exterior more in line with your self-image can absolutely transform your outlook on life. Not only that, but appearance also has a great deal to do with how others treat and perceive you. For all of these reasons, it’s natural that many women seek an augmentation to improve the size and shape of their breasts.
Before the Surgery
Before any cosmetic surgery, the first step is a consultation with Dr. Masri. During this consultation, he will listen to your goals for the outcome of the procedure and help you to figure out what is realistic and achievable for your body.
One of the most important decisions you’ll need to make before your augmentation is the size of the implants. While most people think of comically huge breasts when they think of implants, the modern reality is that they can be practically any size and, if chosen well, will look quite natural. The simplest way to decide what size would suit your frame is to place the varying sizes of implants into your bra under your shirt and then look in the mirror. Some women find that taking pictures of each size on their frame helps a great deal with this process since it adds a bit of distance that aids in objectivity.
The other major decision you’ll need to make with Dr. Masri before the procedure is which type of implants to use. While silicone implants have a bad rap due to safety concerns with older models, they’ve been back on the market for some time and are now completely safe. Silicone implants come already filled with silicone gel, and they generally feel more natural than saline implants, making them a good choice for women who are very slender or who have very little natural breast tissue. Saline implants, on the other hand, arrive empty, so they require a smaller incision and can be adjusted as needed during surgery. When placed under the muscle on a woman who has some natural breast tissue, they also feel quite natural.
During your breast augmentation, you will be made comfortable with a sedative and local anesthetic, or if you prefer, a general anesthetic. After the necessary disinfecting and preparation has been done, the procedure will begin with the incision, which can be done in a variety of locations.
The most common location for the incision is inframammary, or under the breast, which allows for a well-hidden scar without much risk of damaging nerves or milk ducts. Peri-areolar placement is another common option goes under the nipple between the areola and the breast skin. While the scar is smaller, this approach requires cutting through more breast tissue, so it may impact breastfeeding and can also harm nipple sensitivity. An underarm approach is gaining in popularity as well. It leaves a barely noticeable scar in the underarms and has very little risk of damaging breast tissue, but the small size of the incision makes it only practical for saline implants. A final option is the belly button incision, but this is seldom used since it can damage the implants.
One the incision has been made, the implants will be placed either under or over the muscle. While placing it over the muscle gives an easier recovery, the edges of the implant sometimes remain unnaturally apparent, so under the muscle is preferred for most women. The incisions are then closed, making the entire procedure complete in just one to two hours.
Breast augmentation is normally an outpatient procedure, so you should be able to go home within several hours. Immediately post-surgery there will be bruising and swelling, which will likely take 3-5 weeks to fade. The bandages and surgical dressings will be removed within a few days, but you will likely need to wear surgical bra to support everything until it heals. Most women can return to work in just a few days.
While desk jobs are fine, strenuous exercise and heavy lifting should be avoided for 4-6 weeks to avoid making the swelling worse and to minimize risks of tearing unhealed tissue. While the incision should be completely healed within about two weeks, you can expect the scar to take up to a year to fade to its final shade.
Risks and Complications
Like all surgeries, breast augmentation runs a risk of infection and bleeding, which we minimize through good surgical practices. More specific risks include rippling, changes in nipple sensitivity, capsular contracture, and rupture.
Rippling means that the implant develops a ridge or wrinkled texture that is apparent either visually, to the touch, or both. If it occurs, you’ll need a revision surgery to correct it, but it can generally be corrected by sizing the implant correctly, filling it to the right level, and placing it under the muscle.
Changes in nipple sensitivity are quite common and can mean either numbness or hypersensitivity. In most cases, these changes are temporary and will go away in a few months as the nerves heal, but at times they are permanent. While there are some medications that will help to restore sensitivity, this is something you should discuss with Dr. Masri at your consultation if you are concerned.
Capsular contracture is less common. It’s an immune reaction in which the scar tissue overreacts to the implant, leading to a hard, abnormally-shaped, or painful breast. It can be treated with a revision surgery.
Finally, rupture is always a possibility with implants. It can be detected easily by feel with a saline implant but can require an MRI with a silicone one. Chances of a rupture are smaller with a properly-sized implant, but since implants do not always last forever, there is always a small risk. If this happens, it is necessary to remove and replace the ruptured implant.
Q. What happens if I get pregnant after getting breast implants?
A. Pregnancy after an augmentation is perfectly safe. Your breasts will still grow and fill with milk during pregnancy, and most women are still able to breastfeed. The only real risk is that the implants will make your pregnancy-enlarged breasts even heavier, which can contribute to sagging, making another procedure likely.
Q. Can implants correct my asymmetry?
A. Yes. There are several ways to correct asymmetrical breasts during an augmentation. In most cases, implants of differing sizes will be used to make up for the natural imbalance, but it is also possible to use an implant on one side and just perform a lift on the other, or in extreme cases, use an implant on one side and perform a reduction on the other.
Q. Will implants correct my sagging, or do I need to have a lift?
A. An implant will have some lifting effect, but it depends on how heavy your natural breasts are. Larger breasts may require more of a lift than implants alone can provide. At your initial consultation, measurements will be taken to help you and Dr. Masri decide on the correct treatment for your concerns.
Q. What do the various types of profile mean?
A. The profile types refer to how far the implants will project forward. What is now considered a moderate profile used to be the only shape available, and it’s still the most commonly chosen. Other profiles can be good for women of differing body shapes, though. A woman with a wider ribcage, for instance, might be better suited by a low-profile implant that will take the same volume of implant but spread it a bit wider across the chest.
Q. Will I be able to get exactly the results I want?
A. Everybody is shaped a bit differently, which means that identical implants placed in the exact same way will look quite different on different women. This can be disappointing if your ideal body is a type very different from your own natural shape. For those patients who have realistic expectations, though, results are typically very much in line with what is discussed at their consultations.