BREAST AUGMENTATION - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. The web info will give you a basic understanding of the procedure - when it can help, how it is performed and what results you can expect. It can not answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a certified Plastic Surgeon about anything you do not understand.
Q: WHAT IS BREAST AUGMENTATION?
A: Breast augmentation, or augmentation mammaplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:
An implant may be able to increase a woman's bustline by one or more bra cup sizes. Most women are happy with a modest improvement.
Q: WHO ARE THE BEST CANDIDATES FOR BREAST AUGMENTATION?
A: Augmentation mammaplasty, like other cosmetic procedures, can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations - they must be realistic.
The best candidates are women whose goal is improvement and not perfection, in the way they look. You should be physically healthy, psychologically stable, and realistic in your expectations.
Q: WHAT ARE THE TYPES OF IMPLANTS?
A: Currently there is only one type of implant available in Canada. This is the saline or salt water filled silicone shell (bag) implant. Recently, the silicone gel filled implant created a lot of anxiety when the American FDA withdrew it from the market. There was concern that it might be harmful but all research to-date shows that there is either no higher or only slightly higher risk of any disease for women with this type of implant compared with the normal female population.
Q: WHAT ARE THE RISKS?
A: All surgery carries some uncertainty and risk. Augmentation mammaplasty is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon.
Nevertheless, complications and/or side effects can occur. See the Special Consent to Breast Augmentation.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and the implant, causing the man-made shell to leak. When a saline implant breaks, the implant will deflate and the salt water will be harmlessly absorbed by the body. A second operation for removal and replacement should be done as quickly as possible.
Q: WHAT HAPPENS BEFORE SURGERY?
A: Most patients are seen at least twice before surgery. At the initial consultation, we evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts, skin tone and past scar formation history. If your breasts are sagging, you may require a breast lift or mastopexy.
Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved.
During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
At the next consultation, or informed consent visit, the patient who is a suitable candidate has a chance to discuss the risks again or other details prior to the actual day of surgery.
Q: WHAT HAPPENS ON THE DAY OF SURGERY?
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Most breast augmentation procedures are performed under deep sedation and local anesthesia in our out-patient private facility. Occasionally admission to a public hospital and surgery there, under general anesthesia, is required.
The surgery takes a couple of hours. The technique (method of inserting and positioning your implants) is tailored to each individual. The incision can be made either in the crease where the breast meets the chest, around the areola or in the armpit. Every effort is made to assure that the incision is placed so resulting scars are as inconspicuous as possible.
The implant is placed in a pocket that is created either directly behind the breast tissue or underneath the chest wall muscle (pectoral muscle). The implants are then centered beneath your nipples. Drains are inserted, the incisions closed and a compression bra placed around your chest for comfort and support.
The patient is then monitored in the recovery area for a few hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
Q: WHAT HAPPENS AFTER SURGERY?
A: Follow-up visits vary according to the patient and the procedure. Most patients are seen again the next day. Early post-op instructions usually include taking prescribed medications, wearing the elastic compression garment and performing breast massage exercises to reduce the incidence of capsular contracture.
Do not expect to look or feel great right after surgery. The breasts will be swollen and bruised. Discomfort can be controlled with pain medications. You often feel stiff and sore for a few days (especially if the implants are sub-muscular). Your stitches will be removed in a couple of weeks, but the swelling in your breasts may take a few months to disappear.
Most patients are quite active a few days after surgery and many are back to work or school within a week. Further follow-up is usually scheduled for six weeks and then six months after surgery. If you have any unusual symptoms between visits or any questions about what you can or can not do, do not hesitate to call us. Strenuous activities are best avoided for at least 4-6 weeks. Some patients prefer to wear the surgical support bra when engaging in vigorous exercise in the first few months post-op.
Q: WHAT ARE THE RESULTS?
A: Breasts are the symbol of femininity. For many women, having larger breasts can be a satisfying, even exhilarating experience. The decision to have cosmetic surgery is a highly personal one that not everyone will understand. The important thing is how you feel about it. See the Surgical Art Gallery for examples of patients who felt their surgery was a success.
