Breast augmentation (breast enlargement) surgery is one of the most commonly performed cosmetic surgical procedures in the United States. Breast augmentation was first introduced in the early 1960s and over the ensuing decades, more than 2,000,000 women in the United States have undergone this type of surgery.
In addition, millions of women throughout the world have also had successful breast enlargement surgery. The satisfaction rate among patients who have had breast enlargement is extremely high.
Candidates for breast augmentation are women who always had small breasts or women who have noticed loss of breast volume as a result of pregnancy, breastfeeding, fluctuations in weight, or simply aging and the effects of gravity. Breast augmentation is currently performed with breast implants made of a silicone rubber "bag" which is filled either with saline solution (saltwater) or with silicone gel. Recently, the United States Food and Drug Administration lifted all restrictions on the use of silicone gel-filled implants after these devices were proven to be safe and effective. Most experienced plastic surgeons and the majority of patients currently prefer silicone gel-filled implants. However, good results can be obtained both with saline-filled implants and with silicone gel-filled implants. Each device has advantages and disadvantages.
If you live in or around the Los Angeles area and would like to make an appointment for consultation regarding Cosmetic Breast Augmentation with Dr Handel of Beverly Hills click here for additional contact info.
Breast Enlargement Surgery
The operation is typically performed on an outpatient basis in a surgery center. This procedure is performed under general anesthesia (patient completely asleep) and a board certified physician anesthesiologist administers the anesthetic. Once the patient is comfortably asleep in the operating room, a small incision is made in one of several locations to create a “pocket” or space for the implant. The pocket is created beneath the breast tissue and sometimes under the pectoral muscle as well (submuscular position). The short surgical incision can be made in the armpit area (axilla), in the fold beneath the breast (inframammary), or along the lower border of the areola (periareolar). A small incision can also be made in the umbilicus for insertion of breast implants, but with the umbilical approach, only saline-filled implants can be used whereas through the other incisions, either silicone gel-filled or saline-filled implants can be used.
Breast Augmentation Recovery
The operation usually takes about one and a half to two hours. Patients have mild to moderate discomfort afterwards, which can be managed with pain pills. Patients go directly home after surgery (there is no overnight stay) but need to have a responsible adult in attendance for the first 24 hours after general anesthesia. Most patients can resume many normal daily activities within just a day or two after surgery, but more vigorous physical activities such as aerobic exercise, golf, tennis, Pilates, etc., should not be resumed until four to six weeks after surgery.
While most patients experience good results and do not have complications, all surgical procedures carry some risk of complications. Some of the complications that can occur after breast augmentation include infections, hematomas (postoperative bleeding), changes in sensation (feeling) in the nipple or breast skin, implant malposition or asymmetry and capsular contracture. Capsular contracture refers to a situation in which the lining of scar tissue that normally forms around the breast implant begins to contract or shrink, causing the breast to feel firm. In some cases, this can also give a breast an abnormal spherical configuration. Capsular contracture occurs in approximately 5 to 10 percent of patients who have breast augmentation and can be treated with medications, but sometimes additional surgery is required to achieve the best result.
Breast Implants
Breast implants come in a variety of sizes and in different shapes. We now have access to implants that have different degrees of projection (Moderate Profile, Moderate Plus Profile, and High Profile devices). With careful preoperative planning and measurements of the breasts, the proper implant can be selected to help a patient achieve the desired cosmetic result.
At one time there were concerns about the potential health risks of silicone gel. Some patients and some doctors felt that there might be a risk of immune disorders such as lupus or scleroderma in women who had silicone gel-filled implants. For this reason the United States FDA placed some restrictions on the use of silicone implants. Considerable data have now been collected which show that women with silicone gel-filled implants are not at increased risk for any type of medical condition compared to women with saline implants or women who have no implant at all. There is not an increased risk of breast cancer, other types of tumors or any kind of immune disease with breast implants. The FDA has now "lifted all restrictions" on the use of silicone gel-filled implants. Women are free to choose with their plastic surgeon what type of implant they would like.
How Long Do Breast Implants Last?
Breast implants, like virtually all "manmade" devices, are subject to a certain "failure rate" over time. Many patients who have breast implants undergo the surgery when they are relatively young (in their 20s and 30s) and it is not expected that these devices will last "for a lifetime." If a crack or tear occurs in a saline-filled implant, the saltwater leaks out and the implant deflates. The breast would become smaller, the patient would soon be aware of the problems and implant replacement surgery could be undertaken. With modern silicone gel-filled implants, the device is filled with "Memory Gel" which is a more highly cohesive gel. It is a "semi-solid" and does not have a “watery” consistency. For that reason, if a tear or perforation occurs in the implant, typically the gel will not leak out. It will remain contained within the breast. In most cases the "rupture" of the implant would be "silent." In other words, it would not be easily detectable by the patient or possibly even by her surgeon. The most reliable way to detect rupture of a silicone gel-filled implant usually is with an MRI or ultrasound study of the breast. If a leak or rupture of the shell is detected, it is recommended the implant be removed and replaced with a new device. However, it is important to keep in mind that there is no health risk associated with a tear in the shell of a modern gel-filled implant, and it is not an "emergency" to have it replaced.
Saline-filled implants and silicone gel-filled implants both come with "warranties" and the manufacturers will provide new implants and cover a portion of the cost of replacement in the event of failure of the device.
Breast Augmentation / Breast Implant Risks
Women with silicone gel-filled or saline-filled breast implants should still be able to breast feed after surgery. There is no increased risk of breast cancer in women with implants. Some studies show that there may be a shadow cast by saline-filled and silicone gel-filled implants which could impair mammography, but the most recent data (published by Dr. Handel and his colleagues) shows that women with breast implants who develop breast cancer are not diagnosed at a more advanced stage of disease and do not have a worse prognosis than women without breast implants.
Before deciding to undergo breast augmentation surgery, patients should have a thorough consultation with a qualified plastic surgeon who can fully inform them of the advantages, disadvantages, risks, postoperative recovery, and anticipated outcome. In spite of the fact that there are always some risk associated with surgery, the overwhelming majority of patients who have had breast implants for cosmetic breast enhancement are "happy" and would "do it again."
Breast Augmentation Consultation
If you live in or around the Los Angeles area and would like to make an appointment for consultation regarding Cosmetic Breast Augmentation with Dr Handel of Beverly Hills click here for contact details.
Additional Resources
- Click here for Breast Augmentation Surgery Before and After Photos
- Click here to for more information about Dr Neal Handel of Beverly Hills
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