What is a Breast Augmentation or Enlargement Surgery?
Breast augmentation surgery also known as breast enlargement surgery or by the common name boob job all refer to breast surgery that is done to increase or restore the size of the breasts. Although breast augmentation surgery is mainly meant to increase the volume and fullness of the breast, in many cases it also improves the shape and tone of the breasts. Breast augmentation surgery is accomplished by adding volume to the breast in the form of implants such as silicone or saline, or in some cases by transferring ones own fat to the breasts. Surgery for enlarging the breasts is one of the most common plastic surgeries done today and has a high degree of satisfaction among patients. At Artistic Lipo in Tampa FL, Dr. Meegan Gruber, a board certified plastic surgeon is the expert in transforming your breasts into the shape and fullness you desire.
When to Consider Breast Augmentation or Breast Implants
- If you want a better proportioned or more voluptuous figure.
- If you wish your clothes fit better.
- When pregnancy, weight loss or aging has affected the size and shape of your breasts.
- To restore symmetry if one of your breasts is smaller than the other.
The Pros and Cons of Breast Augmentation/Enlargement
- Augmentation is a long-term solution for achieving your desired figure.
- Swimwear may fit better if you are more evenly proportioned.
- You may feel more confident in your clothes and appearance in general.
- Breast implants require monitoring.
- Implants will eventually need to be replaced.
- Fat transfer is unpredictable in regard to final volume.
- Normal surgical risks are involved.
How is a Breast Implant Procedure Performed?
In breast augmentation using implants, Dr. Gruber makes an incision, lifts the breast tissue, creates a pocket in the chest/breast area and places an implant in the pocket.
An additional option for breast augmentation is autologous fat transfer, a process in which Dr. Gruber removes your own fat, using liposuction, from a fat-yielding body part (such as your abdomen, thighs, or flanks), processes it, and then injects it into your breasts. This procedure is currently considered experimental, due to a limited history of data, but the process has shown promise.
Where will my Breast Implants be Placed?
Multiple factors, including your anatomy and Dr. Gruber’s recommendations, will determine how your breast implant is inserted and positioned. The implant is placed in a pocket either:
- Underneath the pectoral muscle, which is located between the breast tissue and chest wall.
- Underneath the breast tissue and on top of the pectoral muscle.
What Options or Types of Breast Implants are Available?
There have never been more choices for breast augmentation. The following options are available, depending on your medical history, body shape and aesthetic goals.
Saline-filled breast implants are filled with sterile salt water. They may be prefilled at a predetermined size or filled at the time of surgery to allow for minor modifications in implant size.
Silicone gel-filled breast implants are filled with soft, elastic gel and are available in a variety of shapes. All silicone gel breast implants are pre-filled and may require a longer incision for implant placement.
Autologous fat transfer removes fat through liposuction from an area of your body in which there are abundant fat cells, such as your thighs, abdomen and hips. After a process of preparation and refinement, the fat cells are injected into your breast. This is a less common method than breast implant augmentation and is still undergoing clinical studies and research for safety and effectiveness.
Dr. Gruber might combine any of these breast augmentation options with a breast lift if there is any sagging or drooping of your breasts.
Your anatomy and health profile as well as your personal preferences will help you and your surgeon determine:
- The best type of surgery for you.
- Your optimal breast size.
- The type of implant and incision location that will best fill your needs.
- Factors that influence the size and type of breast augmentation recommended for you include:
- Your medical history.
- Your goals for breast enhancement.
- Your existing body frame and mass.
- Your existing breast tissue.
- Your preferences related to size and incision placement.
- The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy, safe and comfortable as possible.
What will my Breast Augmentation Incisions and Scars be like?
Dr. Gruber prefers to insert the implant from an incision in one of two places:
Inframammary: Underneath the breast, just above the crease
Periareolar: Around the lower edge of the areola (the dark area surrounding the nipple)
Is Breast Augmentation Safe?
It is important for women with breast implants to keep in mind that breast implants are intended to last 10 to 15 years, so replacement in the future will be necessary. After breast implant surgery, you should have periodic examination Dr. Gruber or another board-certified plastic surgeon to monitor your implants.
Silicone gel−filled breast implants have been under scrutiny for years, but after gathering detailed and meticulous research and data, the FDA has approved them for use in cosmetic breast enhancement surgery, finding no link between silicone gel breast implants and connective tissue disease, breast cancer or reproductive problems.
Dr. Gruber will examine, measure and photograph your breasts for your medical record. Dr. Gruber will consider:
- The current size and shape of your breasts.
- The breast size and shape that you desire.
- The quality and quantity of your breast tissue.
- The quality of your skin.
- The placement of your nipples and areolas.
- Previous surgeries.
- Past and present medical conditions.
- Allergies and current medications.
- Medical treatments you have received.
- Medications you currently take.
- Family history of breast cancer.
- Current mammogram results.
If your breasts are sagging, a breast lift may be recommended in conjunction with breast augmentation.
If you are planning to lose a significant amount of weight, be sure to tell us. We may recommend that you stabilize your weight before undergoing surgery.
If you think that you may want to become pregnant in the future, discuss this with us. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask Dr. Gruber.
Your Treatment Plan
Dr. Gruber will share recommendations and information with you, including:
- An approach to your surgery, including the type of procedure or combination of procedures.
- The outcomes that you can anticipate.
- Your financial investment for the procedure.
- Associated risks and complications.
- Options for anesthesia and surgery location.
- What is needed to prepare for the surgery.
- What you can expect to experience after surgery.
- Show before-and-after photos of cases that are similar to yours and answer any questions.
- We will fit you with different implant sizes in a sizing bra to help choose an appropriate implant for you.
How do I prepare for a Breast Enlargement Surgery?
We will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.
To help detect and track any changes in your breast tissue, we may recommend:
- A baseline mammogram before surgery.
- In advance of your procedure, your surgeon will ask you to:
- Stop smoking at least six weeks before undergoing surgery to better promote healing.
- Avoid taking aspirin and certain anti-inflammatory drugs that can increase bleeding.
- Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
- Breast augmentation is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What to expect on the day of surgery
Your breast augmentation surgery will be performed in the outpatient surgery center. Most breast augmentation procedures take at least one to two hours.
Medications are administered for your comfort during the surgical procedure.
General anesthesia is commonly used during your breast augmentation procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
Dr. Gruber will follow the surgical plan discussed with you before surgery.
After your procedure is completed, you will be taken into a recovery area, where you will continue to be closely monitored.
Following insertion and placement of breast implants, Dr. Gruber will use sutures to close the surgical incisions. The sutures are hidden and do not need to be removed. The skin is sealed with surgical adhesive and a bandage placed. A surgical compression bra is placed to provide support and assist with healing. Occasionally, drainage tubes may be used for a short time following surgery.
Breast augmentation with autologous fat transfer requires two procedures: liposuction and fat injection. Using liposuction techniques, Dr. Gruber will remove your fat cells from a predetermined location with a cannula, process the fat and then inject the fat into your breasts. You will wear compression garments over the liposuction areas and your breasts.
You may be permitted to go home after a short observation period unless you have arranged other plans for your immediate postoperative recovery.
Recovery and Aftercare for Breast Implants/Augmentation
Dr. Gruber will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your post-surgical care, including information about:
- Drains, if they have been placed.
- Normal symptoms you will experience.
- Potential signs of complication.
Immediately after breast augmentation surgery
After your breast augmentation procedure, you will be placed in a support bra or garment.
Breast augmentation surgery stretches the breast tissue and can be painful—especially when implants have been placed under the chest muscle. Typically, the most pain is experienced within the first 48 hours after breast augmentation surgery. Your level of pain will typically decrease each day and may be effectively treated with various pain medications.
Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy. You may experience difficulty raising your arms.
Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.
When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact us. You will also have some redness and swelling after the surgery. Contact us to find out if your pain, redness and swelling is normal or a sign of a problem.
Recovery time frame after breast augmentation
You should be able to walk without assistance immediately after breast augmentation surgery. It is very important that you walk a few minutes every few hours to reduce the risk of blood clot formation in your legs.
It is vitally important that you follow all patient care instructions provided. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. We will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first week
For two to five days, you may feel stiff and sore in your chest region.
Any surgical dressings will be removed within several days. You may be instructed to wear a support bra.
You will be permitted to shower between one and seven days after surgery.
If you have external sutures, they will be removed in about a week. If Dr. Gruber used tissue glue or tape, it will fall off on its own in a week or two.
You may be able to return to work within a few days to a week, depending on the nature of your job.
You should refrain from lifting, pulling or pushing anything that causes pain and limit strenuous activity or upper body twisting if this causes discomfort.
Two to six weeks
You should minimize excessive physical activity for at least the first couple of weeks after surgery. After that, take care to be extremely gentle with your breasts for at least the next month. Intimate contact will be guided by your comfort.
You should schedule routine mammograms at the frequency recommended for your age group. Following breast augmentation, you should continue to perform breast self-examination.
How Long Will my Breast Surgery Results Last?
Under normal circumstances, the results of your breast augmentation surgery will be long-lasting; however, it’s important to know that breast implants need to be replaced if they leak. Routine follow-up is important.
Fat transfer surgery has different expectations, including losing some volume over time.
Your breasts can change due to:
- Weight gain or loss
- Hormonal factors
After a number of years, if you become less satisfied with the appearance of your breasts, you may choose to exchange your implants, remove your implants or have a breast lift to restore a more youthful shape and contour.
Cost or Price of Breast Augmentation or Implants
The cost of breast augmentation varies one geographic area to another, and also from doctor to doctor. You can expect surgeons who are busier, with more experience, and better reputations to charge a bit higher. The national average surgical fee for breast augmentation is $4000. This does not include the cost of the implants, anesthesia, facility fees, labs, garments, medications and other costs which usually add another $3000 to $4000, bringing the total cost of breast augmentation to a national average of $7000-$8000. Dr. Gruber’s fees may be slightly higher than the national average, but well within the range that most experienced and skilled plastic surgeons charge for breast implant surgery.
Limitations and Risks
Fortunately, significant complications from breast augmentation are infrequent. Your specific risks for breast augmentation will be discussed during your consultation.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
- Adverse reaction to anesthesia
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Infection and bleeding
- Changes in sensation
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
- Other risks specific to breast augmentation are outlined below:
- Capsular contracture
- Implant rupture
- Mammography shadows affecting breast cancer detection
Breast Cancer Detection in Augmented Breasts
If you are of an age in which you get regular mammographic examinations, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts are often required.
In some instances, we may recommend other types of examinations, such as ultrasound or magnetic resonance imaging (MRI). It is possible that the presence of breast implants could delay or hinder the early detection of breast cancer.
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your breast augmentation surgery.
Implants and ALCL
In January 2016, the United States FDA provided an update to the 2011 safety communication that identified a possible association between breast implants and the development of ALCL, a rare type of non-Hodgkin’s lymphoma.
According to the World Health Organization, BI-ALCL is not a breast cancer or cancer of the breast tissue; it is a lymphoma, a cancer of immune cells. Women with breast implants may have a very low, but increased risk of developing ALCL adjacent to a breast implant.
Women with breast implants are encouraged to contact their plastic surgeon if they notice swelling, fluid collections, or unexpected changes in breast shape
In symptomatic patients suspicious for BI-ALCL, the implant should be immediately removed.
Breast implant associated-ALCL is very rare, and if it occurs, is highly treatable in the majority of patients. The FDA, ASPS, and ASAPS recommend that all women, including those with breast implants, follow their normal routine in medical care and follow-up, including mammography when appropriate.
The FDA as well as the Institute of Medicine (IOM) maintain that breast implants do not impair breast health and scientific evidence continues to support that FDA-approved breast implants have a reasonable assurance of safety and effectiveness.