Breast augmentation surgery involves placement of an implant either behind the muscle or just behind the breast tissue. At the present time, the implants used in breast augmentation have a solid silicone outer shell and are filled with saline, the same solution used in IV fluid. The procedure is offered to women (usually 17 years or older) whose breasts have finished developing. It can be performed on women either before or after having children but is particularly effective for women who have lost fullness in their breasts after childbearing.
Breast augmentation can be performed in combination with a breast lift to increase fullness in the breasts and elevate the position of the breast tissue and nipple. The main goal of breast augmentation surgery is to create a natural appearing and feeling breast. Many women have breast asymmetry prior to surgery, and while this can be improved, it may not be completely corrected.
Consultation
Because bra sizes vary, it is beneficial to bring to your consultation pictures of women with breast sizes that you feel would look good on you. Dr. Graivier will discuss your desired size and shape with you, and talk to you about the placement of the implant and incisions that will be used. He will perform a breast examination during your consultation and note at least three different size implants that may achieve your desired size.
During the consultation, Dr. Graivier will discuss the risks and goals of your surgery. The main risks include hardening of the tissue around the implant (capsular contracture), implant rupture, and implant malposition. Companies that make the implants offer a lifetime warranty on their products. In the event that an implant deflates, a replacement will be provided.
Before Surgery
You will be asked to stop taking aspirin and anti-inflammatory medications 10 days prior to surgery. If you smoke, you should stop three weeks before and after surgery.
Before surgery, the doctor will mark your breasts in the upright position. He will once again go over your size expectations before proceeding to the operating room.
The Procedure
The operation will be performed in an outpatient surgery center. The surgery itself can take one to two hours, and you will be kept in the recovery room for at least one hour after the surgery. At the time of surgery, an incision is made and the breast pocket formed. The patient is placed in an upright position while temporary breast implant sizers are positioned. The sizers are filled to a variety of volumes, until the breast size for the patient’s desires is determined. At that point, the implant sizers are removed and replaced with the appropriately sized permanent implants. This technique has been an excellent method of obtaining the desired breast size.
Dr. Graivier most commonly uses an approach through the armpit, making an incision less than one inch in length. He uses a fiberoptic endoscope to assist in the placement of the breast implants. He most commonly uses smooth saline implants place behind the chest muscle, but the approaches may vary depending on the patient’s anatomy as well as the presence of breast sagging.
Recovery
You will experience discomfort for the first 24-48 hours after your breast augmentation. You will have pain medication and antibiotics prescribed to lessen discomfort and decrease the risk of infection. A surgical bra will be placed after the surgery. If the procedure has been done through the armpits with the endoscope, an upper bra strap will also be placed. Ice should be applied to your sides for approximately 15 minutes every three hours over the first day and then for 15 minutes every four hours for the second day.
On the second day after surgery, you will be asked to remove the bra and use the bra strap alone to allow gravity to assist in the settling of the implants. You will be asked to massage your breasts at that stage of your recovery, gently rubbing the tissue in a downward and inward direction. You may also shower on the second day after surgery.
It takes approximately three to four weeks for the breast implants to settle into the proper position. Much of the swelling on the sides and in the breasts themselves will diminish in approximately 10 days to two weeks Stitches that are placed under the skin will dissolve, and the rest of the sutures will be removed during the first week after surgery.
Dr. Graivier will see you several times during the healing period. Your breasts may feel sore, and you may have burning or tingling sensations in the nipples for approximately six weeks following the procedure. This is because the nerves to the nipple are stretched with the placement of implants. Nipple sensation should eventually return, however, as well as the patient’s ability to breastfeed. You should avoid strenuous activity for three to four weeks following surgery. Most women can return to work, social activities, and some mild exercise in about five days. When you resume vigorous exercise, you should wear a good athletic bra for support. Still, we recommend that you wait at least six weeks to purchase new bras, after the swelling has completely subsided.
