The Procedure

Breast enlargement (or augmentation) is generally performed on women with underdeveloped breasts or on women who have experienced a decrease in breast size or shape due to pregnancy or weight loss and desire a fuller breast appearance. Breast augmentation is quite successful at making the breasts larger and makes them appear fuller. Although the results are never perfect, they are often quite good and the breasts usually look natural. Implanted breasts tend to be a bit more round and less saggy than natural breasts of the same size, and are therefore not usually completely "natural" looking, but most find these differences to be an improvement over the "natural" look.

How is Breast Enlargement Done?

The surgery consists of making an incision, lifting the breast tissue, creating a pocket in the chest/breast area, and placing an envelope containing a soft, natural feeling implant material underneath. Although several implants are available at the present time, the implant which is used nearly universally for augmentation purposes, is made of a silicone rubber sack, which is filled with a saline solution. Under certain conditions, silicone gel implants can be used, but these are mostly used for revision surgery. There are a variety of implant designs, all of which have advantages and disadvantages. Your surgeon will discuss the choice of implant, reasons for the selection, and will review with you the size changes that are possible with the operation.

What are the options for anesthesia ?

It is usually recommended that the patient receive a general anesthetic. Verify that this anesthetic is being given by a board-certified Anesthesiologist. The Anesthesiologist's only responsibility is to provide you with a safe experience during the surgery. He is a critical part of the operative team and is responsible for your welfare during the procedure. If you are opposed to general anesthesia, your anesthesiologist may offer alternatives for a safe and pleasant experience.

How long does the procedure take?

The surgical time for a breast augmentation is dependent upon many factors including the surgical approach used, location of the breast implants, the patient's anatomy, and type of anesthetic used. Generally, the procedure requires a range of 1-3 hours.

Do I have to stay in the hospital?

Most breast augmentation surgery is performed as a "same day surgery" where the patient returns home the same day without staying in the hospital.

Is it safe?

Breast augmentation is fairly safe, but no procedure is completely risk free. There are several concerns regarding breast augmentation: the surgery itself, the implants, breast cancer, and the risk of anesthesia. The risks involved with breast augmentation have received a lot of attention, but it is very unlikely that you would get breast cancer or arthritis solely caused by the breast implants.

There is no known association of breast implants with breast cancer in human beings, and in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. (Breast implant type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.) There are risks associated with any surgery and anesthesia. Modern-day anesthetic techniques, with use of IV sedation, have reduced these risks quite a bit, but do not eliminate them completely. Discuss with your doctor the type of anesthesia that you prefer.Together you can decide on the type of anesthesia based on your request and based on your medical history.

What are some of the possible complications?

Some of the more common possible complications include postoperative infection, hematoma (a blood clot in the breast tissue requiring evacuation of the blood clot during a subsequent surgical procedure); implant rupture, deflation or leakage; capsular contracture, calcium deposits, changes in nipple or breast sensation, interference with mammogram readings, shifting of the implant. A detailed description of the complications along with further readings can be found at "www.fda.gov/oca/breastimplants/bitac.html".

AFTER EFFECTS

What is required of me after surgery?

You may be required to wear a support bra. The added support during your healing process will allow your augmented breasts to form and maintain a pleasing dimension to your overall proportion and symmetry.

Does it hurt?

Breast augmentation involves surgical separation of the tissues in the anterior chest, and placement of a breast implant. If the implant is placed behind the breast tissue but in front of the chest muscle, then pain is often quite minimal. If you elect to place the implant under the muscle, on the other hand, then the pectoral muscle must be stretched out considerably in order to fit the implant. This gives an aching pain that most people are familiar with after vigorous exercise, only it is more severe. It is usually quite strong at first, but improves with each day and is somewhat relieved by pain medications.

Is there much scarring?

It is necessary to make a small incision to insert the implant, and this will leave a scar. Cosmetic surgeons are remarkably clever at hiding this incision, however. Common places to hide it include: placing the incision in the axilla (armpit) ; placing the incision where the skin changes color at the border of the dark-colored areola around the nipple and the regular skin; hiding the incision under the breast in the crease.

How long until I can go back to work?

Usually it is possible to resume quiet activities in two or three days. You will still be sore, of course, and should avoid heavy use of the arms. If your work is quite sedentary, it would be possible to return to work at this time. If your work is more vigorous, however, then you will have to take more time off in order to allow for proper healing.

How long before I can resume normal activities?

You will probably be able to return to all normal activities by about two months. Recovery varies from patient to patient and depends upon the technique, type of implant, and site of placement that the doctor uses as well as the level of activities in the daily routine . Consult with your doctor for more specific information regarding your case.

What benefit could I expect from the surgery?

Breast augmentation reliably increases the size of the breasts as well as possibly "balancing" one's figure; top to bottom. In America, this often results in increased attention from the male half of the population, leading to preferential treatment. In addition, you will hopefully have an increase in your self-esteem because your new appearance is pleasing to your eyes.

Special Instructions

Wash carefully before surgery.
Avoid aspirin and aspirin containing medicines for 2 weeks prior to surgery.
If possible, try to schedule surgery at a time other than your menstrual period.
For at least 3-5 days, try to keep arm extension to a minimal. Elbows should not be raised higher than ones axilla/armpit. This allows the tissue to heal without added stretching and separating muscle/tissue surrounding the breast implants.

For most patients, Dr McCurdy recommends the newer style tear drop shaped, textured surface implants that have been shown to reduce the occurence of breast firmness. The implants are placed using a minimal scar technique. Dr. McCurdy was one of the pioneers in use of textured surface implants and has published scientific articles and lectured widely on breast implant surgery.

 This information is only intended as an introduction to this procedure. It should not be used to determine whether you will have the procedure performed nor to guarantee the result. The best method of determining your options would be to consult surgeons who are accessible to you to answer all your questions.