Breast Augmentation

So you’re seeking a way to enhance your breasts, perhaps planning to improve their overall appearance? Before rushing off to a surgeon's office, it’s important to educate yourself. We’ve compiled this information as a basic overview; however, this does not replace the advice of a professional surgeon.

Will breast implants affect cancer screenings?
Breast implants can complicate self-examinations because it is more difficult for women to feel their breast tissue properly. They can also make it more difficult for a mammogram to detect the presence of cancer. However, as screening technology becomes more advanced, the issue of implants preventing the detection of cancer becomes less of an issue.

Nevertheless, if you have breast implants, The American College of Radiology, the American Cancer Society, the American Society of Breast Imaging, and the American Society of Plastic and Reconstructive Surgeons recommend that you receive your breast examinations at a facility accredited by the American College of Radiology. Because they are capable of multiple, special views of the breasts, these facilities will be more equipped to make a proper evaluation than screening clinics, which often only screen using two basic views of the breast.

Your consultation
Before you undergo breast augmentation, you’ll meet with your surgeon. You should prepare for this consultation by thinking about what you like and don’t like about your breasts. Remember, you’re not seeking perfection, but improvement. Also be sure that you’re in good mental and physical health, overall, and that you have realistic expectations. This surgery is not going to solve problems for you.

Your surgeon will also need to take a detailed medical history, including any previous problems you’ve had with your breasts, including lumps. You also should be able to tell your surgeon of any medication you are taking.

How is a breast augmentation done?
The procedure will take about one to two hours. It will be performed either under general anesthesia (you’ll go to sleep) or local anesthesia with an oral sedative. You and your surgeon will determine this together.

Breast augmentation can be performed in one of several approaches. Your surgeon can perform the procedure via the crease under your breast (known as the inframammary fold); via the areola (known as the "nipple" incision); or via your armpit (known as transaxillary). Your surgeon will discuss all the possible methods with you and together, you will determine which best suits your needs.

Different types of implants are used as well, including saline or silicone gel. Your surgeon will discuss all your implant options with you.

There are two different ways for your surgeon to insert the implant: either under the breast tissue or behind the breast muscle. You can discuss the benefits of each one with your surgeon and make that determination together.

After the implants are placed, the incision sites will be stitched close, and your surgeon may also use drainage tubes. It’s very important that you follow your surgeon’s follow-up care for the incision site. Your breasts will be covered with a bandage of gauze or you may even be sent home with a surgical bra.

How do I prepare for a breast augmentation?
During your consultation, your surgeon will tell you which foods, medications, and vitamins you should avoid for a designated time period before and after your surgery. These include, but are not limited, to: aspirin; Vitamins E and C; ibuprofen (Motrin or Aleve); and certain foods or medications that contain salicylate. If you are a smoker, your surgeon may have instructed you to quit smoking for a certain period of time before and after the surgery. It’s crucial that you follow his or her instructions very closely as smoking can impede the healing process.

You should arrange for someone to drive you home from your surgery and also have someone who can stay with you the first night at least. You will need to take at least three days off from work, so plan accordingly.

Establishing a home recovery area
Before you undergo surgery, you should set up an area in your home for recovery. Make sure you have:

• Plenty of ice
• Container for ice, or freezer bags (frozen veggies like corn or peas work, too)
• Ointment or cream for incision sites as recommended by your surgeon
• Plenty of loose, comfortable blouses or shirts that button down
• Telephone within reaching distance of your main seating or lying area
• Magazines, books or movies

Recovery and follow up care
Your surgeon will give you a prescription to control pain, if necessary. If you have drainage tubes, your surgeon will tell you when to return to have those removed, as well as when to remove the gauze bandage. Your surgeon will probably remove your stitches in about one week. You should do no heavy lifting for at least four weeks; if you are physically active in sports, it may take up to six weeks for you to return to those activities.

What are the complications and side effects of a breast augmentation?
As with any surgery, there are side effects and you do risk certain complications.

Side effects can include soreness and increased sensitivity in the nipple region, bruising, or swelling. You may experience swelling for a few weeks.

Complications can include the formation of scar tissues, also known as capsule contracture; sagging of the implants in the breast, causing your breasts to droop; symmastia, which means the implants trend toward the middle of the chest and can give the appearance of one continuous breast; or even rupture or deflation. Other complications can include hematoma (blood collection in the surgical area), or fluid around the implant, also known as seroma.

As stated earlier, know that breast implants may also interfere with a mammography. It’s very important that you discuss all your concerns with your surgeon. If you are planning to breast feed, you should make your surgeon aware of this.

• Fever
• Abnormal discharge, such as pus, from incision site
• Rupture of stitches

Does insurance cover breast augmentation?
In most cases, breast augmentation is elective cosmetic surgery and therefore insurance carriers will not cover the procedure or any necessary follow-up visits and your premiums for future insurance coverage may increase. Additionally, insurance will not cover the procedure should you want your implants removed in the future. Therefore it is important to receive your doctor’s charges in writing.

However, if you are having implants put in as part of reconstructive surgery, your insurance carrier may provide coverage. It’s very important that you find out well in advance what type of coverage your carrier may provide.