Breast enlargement or breast augmentation surgery is also referred to augmentation mammaplasty. It is one of the most common cosmetic surgeries performed throughout the world and is one of the most common procedures performed by Dr. Mezrow. Women with inherited small breasts or who loose breast volume following pregnancy can increase the size of their breasts using implants.
During the consultation, Dr. Mezrow will ask you about your particular concerns regarding your breasts. This will help determine your expectations and determine whether they can be realistically achieved.
After obtaining a comprehensive medical and surgical history, Dr. Mezrow will examine your breasts and chest wall. The breast volume, asymmetries, breast skin tone, presence of masses, nipple position and sensation will be assessed. Dr. Mezrow will also take measurements that will guide him in helping you choose the optimal size and type of implant for your body. Patients with droopy –saggy breasts may require an additional breast lift procedure known as mastopexy. Dr. Mezrow will discuss with you if require such a procedure.
A candidate for breast augmentation will typically have inherited small breasts, significant breast asymmetry or have lost breast volume with pregnancy and breast-feeding. Currently, there is no evidence that implants would increase the risk of any disease or pre-expose one to any medical condition. A mammogram can be safely performed in women with breast implants.
Currently, saline implants are used most commonly for breast augmentation. These have a silicone shell of varying sizes that are filled with different volumes of salt-water solution depending on the size of the implant. Silicone filled implants are FDA approved for cosmetic breast augmentation for patients that are at least twenty-two years old. The patients that will benefit most for silicone implants are patients that are thin and have minimal breast tissue. These patients will have improved cosmetic outcome having less implant rippling and a more natural feel and appearance compared to saline implants.
There are different incision options for inserting and positioning the breast implants. The incisions can be made in the armpit (axilla), on the lower aspect of the areola (periareolar), in the crease where the breast meets the chest (inframammary), or in the belly button (periumbilical). The method you choose will depend on where you want the incisional scar, as well as which incisional approach Dr. Mezrow discusses that you are a candidate for. The implants may be placed above (subglandular) or below the chest muscles (submuscular-subpectoral). Dr. Mezrow and most physicians are currently placing the implants under the muscle or partially under the muscle (sub-pectoral) in the majority of patients.
The muscle provides an extra layer of padding coverage to give a more natural appearance especially in patients with small breasts. In addition, placing the implants under the muscle may decrease the chance of firm or hard scar tissue formation around the implant (capsular contracture) and also allows for greater ease in reading mammograms. Body builders are an example of patients that may choose to have the implants over the muscle (subglandular) instead of submuscular because of risk of decrease muscle strength and altered chest aesthetics in competitive poses. After choosing an incisional approach and submuscular or subglandular placement of the implants, a pocket or space is created for the implant.
The procedure is performed as an outpatient. The procedure typically takes approximately one hour to perform. Most patients recover within 1 to 2 hours after surgery and are discharged home. It is important to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two.
Fortunately, significant complications from breast augmentation are infrequent, however, all surgery has risks. Dr. Mezrow will discuss with you, the risks, benefits and alternatives and answer all your questions.
Some potential complications include infection, bleeding, delayed healing, implant malposition, hardened scar tissue around the breast implant (capsular contracture), breast implant rupture or leak, altered nipple sensation, breast implant rippling, fluid accumulation around the breast implant and poor scarring.
Complications, which delays healing and prolongs recovery, are more common in diabetic patients and those who smoke. Preoperative and postoperative instructions will be given to you by Dr. Mezrow in attempt to reduce the likelihood of complications and make you as comfortable as possible with the whole process. Smokers will be instructed to stop smoking 4-6 weeks prior to surgery and not resume smoking to reduce the risk of delayed healing, wounds, infections and compromised outcome. Aspirin, anti-inflammatory medications as well as agents that cause bleeding should be discontinued two weeks prior to surgery (or as otherwise instructed by Dr. Mezrow and your primary physician) to reduce the likelihood of bleeding.
Medications are administered for your comfort during the surgical procedure. Typically, a general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will be placed is a surgical bra and have gauze dressings over your incisions.
You may be permitted to go home after recovery, unless you and Dr. Mezrow have determined that you will require a short stay in the hospital or post surgical facility.
You will be instructed to get out of bed for short walks to promote blood circulation and decrease the risk of blood clots. Strenuous activities should be avoided for the first several days, since these activities might cause compromised results including but not limited to increase swelling or even bleeding.
Sutures will not be removed, as they are resorbable. You will be instructed on taping of incisions to optimize healing of the scars.
You will have swelling and bruising, which will resolve with time. It is not uncommon to have some altered sensation of the breast skin and nipples. Nipple sensation may increase, decrease or be unchanged regardless of the incisional approach used. The incisions will be initially be reddish and then slowly fade over months resulting in permanent scars. It is important to realize, however, that the incision.
Depending on your physical condition, you may be able to return to non-strenuous work in approximately one week after surgery. During healing you may experience some mild, periodic discomfort and swelling, such feelings are normal. Severe pain should be reported to Dr. Mezrow.
Breast augmentation will enhance your breasts so that you can throw away those padded bras. It is not uncommon to feel more comfortable in your clothing, bathing suits and be more confident about your appearance.
Healing from your surgery is a process that takes up to a year for final result. You will be instructed to return to Dr. Mezrow’s office for follow-up care at prescribed intervals to monitor your progress and optimize your outcome.
If you have any questions or concerns prior to surgery or during your recovery, you should contact Dr. Mezrow.
