Joseph W. Rucker, MD, FACS
Many females with small breasts are dissatisfied with their body image. Breast Augmentation (augmentation mammoplasty) is a procedure designed to enhance fullness by enlarging a woman’s breast through the surgical placement of a breast implant.
The primary goal is to:
• Enlarge a naturally small breast, which is often an inherited condition
• Restore breast volume lost following a pregnancy or weight loss
• Achieve better symmetry when breasts are moderately disproportionate in size and shape
Augmentation mammoplasty, also referred to as breast enhancement or breast enlargement, involves placing silicone or saline breast implants either behind the breast tissue or beneath the chest muscle to add size, shape and fullness to the breast and to make the body more proportional.
Breast augmentation does not correct sagging breasts. Women who desire to improve contour as well as increase fullness, may want to consider a breast lift in conjunction with breast augmentation.
The best candidate
Adult woman of any age can benefit from breast augmentation. It is recommended that breasts be fully developed prior to the procedure. Breast augmentation does not generally interfere with a woman’s ability to breast feed. Good candidates for breast augmentation are defined as:
• Women who have a personal desire for enhanced breast size; not influenced by the opinions or desire of others.
• Healthy women who do not have a life-threatening illness or medical condition that can hamper healing.
• Women with a positive outlook and specific goals in mind for improving their own body image.
All patients will need a pre-operative consultation to review their medical history and perform a physical examination to determine if they are indeed, a candidate for the surgery. During this consultation, the procedure, recovery, expected outcome and possible risks or complications are discussed.
Breast augmentation is performed under a general anesthetic on an Out Patient basis. In the preoperative area, any last minute concerns are discussed and the chest wall is carefully marked to ensure accurate implant placement. Although there are several ways to insert the implant, I prefer to make a small (2-inch) incision beneath the breast. The implant is then placed behind the chest wall muscle. I prefer this approach for several reasons:
• It is easier to develop the pocket to house the implant
• To avoid the nerve which gives sensation to the nipple
• No nipple areola distortion, which may occur when placing the entrance incision around the nipple.
• Placement of the implant behind the chest wall muscle gives a more natural look.
The procedure takes approximately one hour. A support bra is then placed on the patient and they are discharged home, usually 2-3 hours after the procedure.
The implants differ, being filled either with saline (salt water) or silicone gel and come in varying sizes and shapes. In my experience, 80% of our patients prefer the feel and shape of the silicone.
Most patients rate the pain level as a 5 on a scale of 1 to 10. Patients are given written instructions and prescriptions for pain control and an antibiotic. Light activity is tolerated well in the first week. We see the patient one week after their procedure, when dressings and sutures are removed, recovery and activity levels are reviewed and an anticipated date for returning to work is discussed. Light employment is tolerated after two weeks, heavy lifting and regular activity in 3 to 5 weeks. Patients are given instructions for care of sutures to help prevent excessive scarring. A final consultation is scheduled five months after their procedure. Patients are happy with breast augmentation and often experience an increase in self-esteem and confidence. Most go from an A or B cup to a C plus cup after the procedure.