Breast Augmentation Surgery

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure to enhance breast size using breast implants or the patient’s fatty tissue. This procedure can help restore volume lost after pregnancy or weight reduction and add volume to smaller breasts. Implants may also be used for breast reconstruction after mastectomy (breast removal) or injury.

Breast augmentation can increase breast fullness and projection, improve breast-and-hip contour balance and help enhance a patient’s self-confidence. However, severely dropping breasts may need a breast lift along with breast augmentation. Breast enhancement procedures like augmentation involve many choices, especially the surgeon's choice. It’s essential to select a board-certified plastic surgeon member of the American Society of Plastic Surgeons (ASPS). Your plastic surgeon can help you make an informed decision about getting breast enhancements.

What To Expect Before a Breast Augmentation

During your consultation for breast augmentation surgery, disclose to your plastic surgeon the following:

• Medical conditions, previous treatments and any allergies
• Current medications or supplements you’re taking
• Whether you consume alcohol or tobacco
• Family history of breast cancer
• Results of previous mammograms or biopsies

Your surgeon will check your general health status, risk factors, or pre-existing conditions. Your breasts will be examined and measured in detail. Photos of the possible surgical site will also be taken for your surgeon’s reference. Your surgeon will thoroughly discuss the procedure’s risks, benefits, preparation and other details to help you set realistic expectations. They will recommend a treatment plan depending on your condition and goals. Take the consultation as an opportunity to ask questions about the procedure.

You may be a candidate for this procedure if:

• You’re physically healthy.
• You’re not pregnant or breastfeeding.
• Your breasts are fully developed.
• One or both breasts did not develop normally.
• Your breasts are asymmetrical or have an elongated shape.

What Is Fat Transfer Breast Augmentation?

Fat transfer uses liposuction to harvest fat from other parts of your body and inject it into the breasts. Fat transfer is an option for patients who prefer natural results and want a relatively small increase in their breast size.

What Are the Types of Breast Implants?

There are many types of breast implants to choose from. Discuss with your plastic surgeon about your desired outcome so they can help recommend a good implant option for you, which can be any of the following:

• Saline breast implants – FDA-approved for women 18 years or older, saline implants contain sterile salt water. In cases where the implant shell leaks, the implant collapses, and the saline will be safely absorbed and naturally expelled by the patient’s body.
• Structured saline breast implants – have an inner structure to help the implant feel more natural.
• Silicone breast implants – FDA-approved for women 22 years or older, silicone implants contain silicone gel, which may feel as natural as typical breast tissue. Silicone implants have a pocket where the gel can be included in case of leakage. A silicone implant will not collapse when leaking. Patients who opt for silicone may need to regularly visit their doctor and undergo MRI or ultrasound to check the implant’s condition.
• Gummy bear breast implants – also known as form-stable implants, gummy bear implants maintain their shape even when the implant shell is broken. This is because they contain thicker silicone than typical silicone gel implants, making them firmer than traditional breast implants. However, gummy bear implants may rotate out of place and require another correction procedure.
• Round breast implants – can usually make the breasts appear fuller than gummy bear breast implants.
• Smooth breast implants – may help give more natural movement to the breasts.
• Textured breast implants – have a textured surface to allow them to stick to the breast tissue and prevent them from moving around inside the breast. However, ASPS noted that a condition called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) most frequently occurs in patients who have textured breast implants. BIA-ALCL is an immune system cancer, not breast cancer.

Talk to your surgeon to understand all potential risk factors and complications of any breast augmentation procedures to help you make an informed decision about which option can be best for your health.

What Happens During Breast Augmentation With Implants?

Your surgeon may ask you to do the following to help you prepare for breast augmentation:

• Blood test
• Stop smoking and stop using recreational drugs
• Adjust your current medications or take other medications
• Avoid taking medications such as aspirin or drugs that can increase bleeding

What happens during augmentation will depend on the breast implant type, desired breast enlargement, the patient’s anatomy, and the patient and surgeon's preference. Here’s what a typical breast augmentation with implants looks like:

1. Your doctor will administer general anesthesia or intravenous sedation, depending on what’s recommended.
2. Incisions will be made in inconspicuous areas such as around the areola, underneath the breast or in the armpit to minimize visible scarring during healing.
3. The implant will be inserted into your pectoral muscle pocket or directly behind your breast tissue and over the pectoral muscle.
4. The incisions will be closed with layered sutures.

You will be taken into a recovery area immediately after surgery for close monitoring. You will be discharged once the doctor evaluates that your condition is stable, usually within the day. Your doctor will prescribe medications and give you instructions to help you with recovery and a follow-up appointment schedule with your plastic surgeon.

Note that breast implants may need to be replaced because they’re not lifetime devices. You need to see your surgeon for an annual examination so they can evaluate your implant’s integrity and breast’s health. Breasts will change over time due to hormonal factors, weight changes, aging and gravity. Some patients may opt for a breast lift or shift in the implant to restore a more natural look to the breasts.

What To Expect After Breast Augmentation Day by Day

Each patient’s recovery depends on a range of factors, so there is no definite timeline for what to expect day by day after breast augmentation. In general, post-surgery patients may experience the following:

• Days 2 to 4 after surgery – you may feel stiff and sore. You may also experience swelling and observe that your breasts are positioned unnaturally high on the chest.
• Days 5 to 13 – bruising and swelling may subside by Day 5. Your surgeon will remove the stitches around Day 7. It’s normal to experience some burning sensation or itching, but look out for any increase in swelling or discomfort. Avoid lifting heavy objects or bringing your arms above head level, as this may strain your incisions and cause bleeding.
• Day 14 – by this time, results from breast augmentation start to become more visible, and the breasts may begin to feel more natural. Your doctor may also allow you to stop wearing surgical bras. It’s normal to observe that one breast may look more realistic, but don’t worry about this, as this is part of recovery. Your doctor may allow you to resume low-intensity exercises, but you should still avoid workouts that involve the chest muscles.
• Day 30 – your breasts should look and feel more natural by this time. Your surgeon may allow you to perform more physically demanding activities, provided your wounds heal well.

What To Wear After Breast Augmentation

During your recovery, your surgeon will wrap your breasts and chest in gauze dressings.  Your plastic surgeon will instruct you to wear a bra-support garment to help minimize swelling and support the breasts while they heal. Depending on the surgeon’s instructions, some patients may need to cleanse the incision sites and put ointment, while others must keep the bandage or tape on.

Get as much rest as possible and limit physical activity for several days after surgery. Acute pain post-surgery may subside in five days. You may experience swelling and soreness for a few weeks. Your doctor will tell you when returning to normal activities or resume exercise is okay.

Schedule a Consultation

At Baptist Medical Network in San Antonio, TX, our plastic surgeons aim to help our patients understand realistic expectations from breast surgeries to help them achieve desired outcomes. Request an appointment with one of our San Antonio breast augmentation doctors for more information about your options for breast enhancement procedures.