How to prepare:
It is important that you are not taking any medications that thin the blood prior to your surgery. You will be provided with a list of medications and the time period in which they need to be stopped before having your surgery. If you are a smoker, you must not smoke for 4 weeks prior to surgery and for 8 weeks after. You should plan to wear a loose fitting top on your day of surgery. Arrange for a friend or family member to escort you home from surgery and to remain with you for 24 hours following your surgery.
What will happen during a breast augmentation:
Once in the operating room you will receive anesthesia to keep you asleep during your surgery. Prior to your surgery, your surgeon will discuss with you where your incisions will be made. The two most common incisions for a breast augmentation are either around the areola or along the crease of the breast where an underwire lies. After the incision is made, the surgeon will create a pocket for your breast implant to be placed. The implant will be inserted after this pocket under the breast skin is made. Typically breast implants are placed partially under the chest muscles, but occasionally will be placed over the muscle in certain circumstances. Which approach is best for you will be discussed with you during your pre-operative visit. After the placement of the implants the surgeon may adjust the operative bed to a sitting position to confirm the correct placement of the implants and that the breasts appear symmetric. Your incisions will be closed with sutures that sit underneath the skin which do not require removal in the future. A surgical bra will be put on you at the completion of your operation.
What are the risks:
- Breast augmentation carries the risk of bleeding and infection. If infection does occur and does not improve with antibiotics, it is sometimes necessary to remove the implants to allow for resolution of the infection.
- Breast implants have about a 1% risk per year of rupture or leaking. If you have saline implants, this will be obvious as the implant will deflate and the breast with appear smaller. With silicone implants a ruptured implant is not as obvious as the substance inside the implant will not leak out due to its extreme thickness. Some women will experience breast pain after a silicone implant rupture.
- Capsular contracture is a complication of breast augmentation that occurs in up to 15% of women. This problem occurs when the special tissue that normally forms around a breast implant begins to tighten. This produces an increasingly firm breast, a breast that will begin to sit higher on the chest then the unaffected breast, and sometimes pain. Surgery to remove the tightened tissue and place a new implant is required to fix this problem.
- It is possible to have some asymmetry of the breasts after surgery.
- A minority of women will have chronic breast pain after breast augmentation or changes in breast and nipple sensation.
What to expect after surgery:
You will need to take antibiotics to prevent infection and will also be given pain medication to take if needed. It is expected that you will feel some pain in the breasts and with moving the arms, as this uses the chest muscles. You may apply ice (wrapped in a towel, not directly on the skin) to your breasts to improve pain and swelling. You need to sleep on your back with several pillows to keep your chest elevated. It is important to only wear the surgical bra given to you, or another non-wire bra which closes in the front for the first 2-3 weeks. If your implants were placed under the muscle, you should avoid arm movements which extend over the height of the breasts for 2-3 weeks. Also avoid heavy lifting or strenuous activity for 2 weeks and do not perform chest muscle exercises for 6 weeks. Your first post-operative visit will be about 1 week after your surgery and at this time, the dressing over your incision will be removed. You are able to shower 2 days after surgery but you must avoid scrubbing along your incision. It is expected that your breasts remain swollen for 3-5 weeks after surgery.
Contact your surgeon if:
- Your breasts begin to appear red or be hot to the touch, or if one breast becomes must more swollen than the other over a short period of time.
- You have a fever over 101 deg F
- You have significant bleeding through your incision
Seek care immediately or call 911 if:
- You experience sudden chest pain or difficulty breathing