Who is not suitable for breast enlargement surgery?
Those who have unrealistic expectations or who have significant risk factors such as heavy smokers are not suitable for the surgery. Patients who have undergone radiation in the chest area are not suitable for breast enlargement above the muscle. Patients with sagging breasts (ptosis) are not suitable for breast enlargement, they will have to first undergo a breast lift, together with the enlargement.
Prevalence of the Surgery
Breast enlargement surgery is one of the most common procedures in the field of plastic surgery. In the U.S. alone, 2 million breast enlargements were performed between 1963 and 1988. Since that time the numbers are constantly on the rise.
Doctor, how long will the surgery last?
The surgery should serve as a solution for many years. Although the implant manufacturers offer a lifetime warranty, you will probably have to replace the implants every 10 to 15 years.
Preparations before the breast enlargement surgery
Routine blood tests are required. In women over the age of 35, mammography is recommended (primarily among women who have not had any breast exam up to that point). If there are any cysts in the breast, they must be assessed using imaging before the surgery is performed. It is recommended that you stop smoking and stop taking anticoagulants.
The surgery is performed under general anesthesia and lasts about one hour. There are a number of methods of inserting the implants, through the fold under the breast, through the areola and through the armpit. Another method is to go in through the navel, which is only suitable for salt water implants. During the surgery, an incision is made, through which a pocket is created, above or below the muscle. After the pocket is created, we will use a sample implant to determine the right size implant for the breast. After the right size is determined, the permanent implant is inserted into the pocket. The pocket is sewn and the breast is bandaged with a pressure bandage or a sports bra, which you will have to wear for a month following the surgery.
Above or below the muscle?
There are differences of opinion as to the position of the implant. It is customary to say that half of the surgeons prefer placing the implant above the muscle and the other half below the implant. The table below presents the advantages and disadvantages of the different implant positions.
Subject of the discussion
Incidence of capsular contracture
Folds and wrinkles resulting from the implant
Mammography and other imaging methods
Appearance of the implant
Damage to the muscle
For sagging breasts
Pain following surgery
Above the muscle
Less accurate (however, better precision can be achieved with MRI)
The outline of the implant is more visible in a small breast
Doesn’t exist in this position
This is the right position
Below the muscle
Less (the implant is covered by the muscle and so the stiffening is felt less)
The implant is less visible in a small breast
The patient can generally go home the same day, a few hours after the surgery.
Doctor, how long will it take to recover and when will I see the final result?
Recovery lasts about one week to 10 days and you must wear a sports bra for about one month.
Does the surgery hurt?
Generally, there is a feeling of pressure in the chest that lasts for a few days following the surgery. As the edema dissipates, the pressure is reduced.
Side Effects and Complications
As in any surgery, there is the possibility of complications or side effects. However, in breast enlargement surgery, these complications are more prevalent. Among the complications:
1. Bleeding – takes place in one percent of all patients. If necessary, the blood is drained.
2. Infection – This complication is rare (happens in one in every 1,000 patients). If the implant or the area of the surgery becomes infected, the implant will have to be replaced. An infection may lead to the rejection of the implant by the body.
3. A leak or tear in the implant.
4. Capsular Contracture – the capsule is the connective tissue that contains the implant and separates it from the breast. Capsular contracture may lead to the crushing of the implant and induration of the breast. This phenomenon is reported in the literature at a prevalence of 5% of all cases.
5. Implant folds – In patients with thin skin, the implant folds are sometimes visible.
Will a breast enlargement surgery lift the breasts?
Since we add weight in a breast enlargement surgery, we cannot lift a sagging breast, on the contrary, there may be significant sagging as a result of the additional weight.
Does breast enlargement change the shape of the breast?
Breast enlargement surgery only enlarges the breast, i.e. the breast will look the same in terms of its shape prior to the surgery, just bigger. For example, the surgery will not cause an areola/nipple that is positioned on the side of the breast to move toward the middle.
Is there a connection between silicone and breast cancer or other connective tissue diseases?
The answer is no. In light of the many studies published on this subject, silicone does not constitute a risk for breast cancer or other connective tissue diseases. In 1999, the American Medical Academy determined “since more than 1.5 million adult women of various ages are carrying silicone implants in their breasts, some of these women are expected to develop cancer, connective tissue diseases, neurological diseases, or other systemic complaint or conditions. Evidence suggests that such diseases are no more common in women with breast implants than in women without them.”
Despite the long list of possible complications related to breast enlargement surgery, this surgery is one of the safest and most common surgeries. The surgery will lead to better balance and proportion between the size and structure of the patient’s breasts and the rest of her body.