Breast Augmentation
Breast augmentation surgery is a common plastic surgery procedure performed to increase the size of the breasts to achieve more harmony with the rest of the body. The breasts can develop a deflated appearance due to pregnancy, weight loss, or aging. Breast augmentation is typically performed with placement of an implant to achieve the desired volume. Breast augmentation can also be performed using the patient’s own tissue (referred to as fat grafting), however, there are limits on the amount of volume that can be achieved with fat grafting for augmentation.
Current breast implants are filled with either saline or silicone. You have a choice when deciding on the type of implant used for breast augmentation. Benefits of silicone implants include a soft, more natural feel. Drawbacks of silicone implants include a higher cost and the need for a slightly longer incision for placement. Benefits of saline implants include a lower cost and a smaller incision for placement. Drawbacks of saline implants include a less natural feel due to the difference in viscosity of saline versus natural breast tissue. Dr. Pierce is happy to answer any questions you have regarding implant options during your consultation.
There are multiple different incisions used for breast augmentation. The most common incision is placed in the inframammary fold along the bottom of the breast. This incision allows for a very safe surgery with excellent visualization of the planned implant location and superb healing in a natural skin crease. Other incision options include periareolar and transaxillary. The ideal location of the incision will be discussed during your consultation with Dr. Pierce.
There are two common implant locations currently used for breast augmentation. The subglandular position involves placing the breast implant below the breast tissue but above the pectoralis major muscle. This position can result in a more '“augmented” look because the upper pole of the implant is not covered by the muscle. The submuscular position involves placing the breast implant below the breast tissue and pectoralis major muscle. This position can result in a more subtle increase in volume with a less “augmented” appearance. Both implant positions have pros and cons that can be discussed at your consultation.
The doctor you choose as your plastic surgeon is one of the most important decisions you will make when considering breast augmentation. Dr. Pierce takes time during your consultation to understand your desires and goals for breast augmentation. He also strives to help you choose a volume that looks good immediately after surgery and for years to come.
Frequently Asked Questions:
Am I a candidate for breast augmentation?
Women who have small or deflated breasts and desire larger breasts that are more proportionate with their frame and are in otherwise reasonable medical health are candidates for breast augmentation.
Is breast augmentation covered by insurance?
Dr. Pierce does not perform breast augmentation surgery through insurance.
Can I have a breast augmentation if I am currently smoking cigarettes?
No, smoking cigarettes or any form of nicotine consumption significantly increases your risk of issues with wound healing and infection. You should be without nicotine for 6 weeks prior to and 6 weeks after your surgery.
How is a breast augmentation surgery performed?
Breast augmentation surgery involves making a small incision under the breast. Through this incision a pocket is created in the exact size of the planned implant. The implant is then placed into the pocket and the incision is closed with dissolvable stitches.
Where are the incisions located for a breast augmentation?
Breast augmentation incisions can be located under the breast (also call inframammary fold or IMF), along the bottom of the areola (periareolar), or in the axilla (transaxillary). Please visit our breast augmentation gallery to see typical incisions after breast augmentation.
How long does breast augmentation surgery take?
Breast augmentation surgery takes 1-1.5 hours to perform.
Will I have drains after a breast augmentation?
Dr. Pierce does not use drains for breast augmentation surgery.
How do you control pain during and after surgery?
Dr. Pierce uses an evidence-based approach to pain management for surgery called the ERAS (Enhanced Recovery After Surgery) protocol. This protocol uses a combination of local numbing medication, anesthesia blocks, anti-nausea medication, scheduled non-narcotic pain medication, and narcotic pain medication as needed to decrease the surgical pain and speed up your recovery.
Where do you perform breast reduction surgery?
Dr. Pierce performs breast augmentation surgery in an outpatient surgical facility. You will be able to go home the same day as your procedure.
Will I be able to breastfeed after a breast augmentation?
The ability to breastfeed after breast augmentation can depend on location of the incisions. A periareolar incision has a higher risk of inability to breast feed than an inframammary fold incision due to the potential disruption of the connections between the gland, ducts, and nipple.
Will my nipple sensation change after a breast reduction?
There is very low risk for permanent change in nipple sensation after breast augmentation. You may experience temporary nipple hypersensitivity after surgery that resolves with time.
What are the risks and complications associated with a breast augmentation?
The most common risks associated with breast augmentation are pain, bleeding, infection, delayed wound healing, scarring, and asymmetry. Complications related to implants included implant rupture, implant malposition, implant infection, and capsular contracture.
What is capsular contracture?
Capsular contracture is a thickening of the natural scar tissue that forms around a breast implant. In most patients, the capsule or scar tissue is very thin and soft (Grade 1). In some patients, the body overreacts to the breast implant and forms a thicker capsule. Thickening of the capsule can result in a firm breast (Grade 2), a firm breast with distortion (Grade 3), or a firm breast with distortion that is tender to the touch (Grade 4).
How do you treat capsular contracture after breast augmentation?
Capsular contracture after breast augmentation does not necessarily require treatment unless you are symptomatic. The treatment options consist of removal of the current implant and entire capsule with or without placement of a new breast implant.
When can I return to work after breast augmentation?
You can return to desk work 1-2 weeks after surgery. If you have a job that requires heavy lifting, we ask that you request to return to work with modified duties until 6 weeks after surgery.
When can I return to exercise after breast augmentation?
You can resume low-impact exercise (ex: walking, stationary bike, elliptical) at 1-2 weeks after surgery. You can resume high impact exercise (ex: running, cycling, weight lifting) with a supportive bra at 6 weeks after surgery.