The female breast remains, to this day, the ultimate symbol of feminity and sexuality in our society. Many women feel that their breasts are out of proportion to their bodies as a result of genetics, or volume loss due to breast feeding or aging effects. Consequently, many women seek cosmetic enhancement or augmentation of their breasts. Breast augmentation surgery is performed to surgically enhance the physical appearance of the breast and is one of the most commonly performed plastic surgery procedures in the U.S. The surgery is performed on an outpatient basis in either a hospital operating room, surgery center, or surgical suite in a plastic surgeon’s office. The procedure generally takes between one and two hours and is performed under either sedation or general anesthesia. After surgery the breasts will appear fuller and have better contour. Scars will fade to an almost invisible quality in most cases.
In consultation with Dr. Francis you will be intimately involved in the decision making process to determine what breast size is most appropriate for your situation, which incision will be used and where the implants will be placed (above or below the muscle). The three most commonly used incision sites are the axillary (under the arm), the periareolar (around the areola) and the inframammary fold (under the breast). The axillary incision is away from the breast and therefore does not prompt the idea that breast surgery was done. It is also the least likely to affect nipple sensation and breast feeding ability. However, because the incision is away from the breast some precision in implant positioning is compromised. The periareolar incision is a well concealed access incision, but is associated with a higher likelihood of affecting nipple sensation and ability to breast feed. The inframammary incision is technically the easiest access for the surgeon assuring precise implant positioning, but may be visible. It is also associated with a lower likelihood of affecting nipple sensation and breast feeding ability. A fourth incision choice, the umbilical (transumbilical) is offered by very few plastic surgeons.
Implant placement above or below the chest muscle will be determined primarily by your body characteristics, the type of implant chosen and your desire to avoid capsular contracture (hardening) of the implant. Below the muscle (submuscular) is the most commonly chosen implant position. This position is the least likely to lead to implant hardening, provides the best implant coverage and allows easier mammographic imaging of the breast tissue. Positioning above the muscle or below the breast (subglandular) will make the surgery and recovery time shorter and is less painful. However, subglandular positioning may result in more visible implants, higher likelihood of capsular contracture and more difficult mammographic imaging.
Recovery from breast augmentation surgery generally takes between three days and one week depending on the implant position chosen. You may be asked to wear a special bra after surgery and you may be taught special implant massaging techniques to maintain the breast softness. Return to full exercise activity may take two weeks.
Any surgical procedure carries associated risks. In addition to the general risks of infection, bleeding, and wound healing problems, breast augmentation may carry risks of loss of sensation, difficulty breast feeding, implant exposure or infection, implant hardening (capsular contracture), scarring and implant rupture/leakage. Dr. Francis will discuss these risks during your consultation. A full consultation with Dr. Francis will determine the appropriate method of breast augmentation for your needs.