Breast Augmentation Surgery

What is breast augmentation surgery?

Breast augmentation surgery is a common plastic surgery procedure. It's done to change the way the breasts look.

This surgery increases the size or the fullness of the breasts using sacs filled with fluid or gel. These sacs are called breast implants.

Why might I need breast augmentation surgery?

You may choose to have breast augmentation if you are unhappy with how 1 or both of your breasts look. Some reasons why people choose to have this surgery include:

• Their breasts have lost their size or fullness after childbirth

• Weight loss has changed the size and fullness of their breasts

• One breast is noticeably smaller than the other

What are the risks of breast augmentation surgery?

All surgeries have some risks. Some possible risks of breast augmentation surgery include:

• A bad reaction to the medicines used to put you to sleep during surgery (anesthesia)

• Bleeding

• A collection of blood (hematoma) or fluid (seroma) building up under your skin. This may need to be drained with a needle.

• Scar tissue

• Infection

• Changes in how your nipples or breasts feel. These may be temporary or permanent.

• Pain that continues after healing

• Blood clots in your legs that may travel to your heart or lungs

• Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

• Breast implant illness (BII)

You may have other risks that are unique to you. Be sure to discuss any concerns with your surgeon before the procedure.

Some long-term things you should also consider:

• You may not be happy with the final results and more surgery may be needed.

• Breast implants must be regularly checked for leaking. This sometimes uses an ultrasound or MRI. These should be obtained 4 to 6 years after your surgery and every 2 to 3 years after.

• The implant may leak or burst (rupture).

• The implant may become firm.

• You will need a second surgery to remove or replace the implant. Implants are not guaranteed to last a lifetime.

It’s important to know that most health insurance plans will not cover cosmetic breast augmentation. They will also not cover the cost of any related problems.

There is no evidence that breast implants raise your risk for breast cancer. But you should tell your surgeon if you have a family history of the disease.

You can still get regular X-ray images of your breasts to screen for breast cancer (mammograms) if you have implants. But you may need to have more X-ray images taken around the implants to check the breast tissue.

Talk with your surgeon if you plan to get pregnant in the future. Pregnancy can change the size and shape of your breasts.

How do I get ready for breast augmentation surgery?

Before surgery, you and your surgeon should discuss your breast implant choices. Saline implants are filled with salt water. Silicone implants are filled with an elastic gel. Talk with your surgeon about which type is best for you.  

Before the procedure, your surgeon may want to take pictures of your breasts for comparison after surgery. You may also be asked to get a baseline mammogram. This can be compared with future mammograms done after your surgery. This is also to make sure you don't have any suspicious areas that your healthcare provider didn't know about.

• Your surgeon will explain the procedure to you. Ask them any questions you have.

• You will be asked to sign consent forms to do the surgery and receive anesthesia. Read the forms carefully and ask questions if anything is not clear.

• Tell your surgeon and anesthesia provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general). Also tell your surgeon if you are pregnant or think you may be pregnant.

• Follow any directions you are given for not eating or drinking before surgery.

• If you are a smoker, stop smoking at least 6 weeks before surgery.

• Tell your surgeon if you have a history of bleeding disorders. Let them know if you are taking any blood-thinning medicines (anticoagulants), aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.

• Tell your surgeon about all other medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.

• If you may go home on the same day as surgery, have someone available to drive you home.

Your healthcare provider may have other instructions for you based on your medical condition.

What happens during breast augmentation surgery?

Breast augmentation surgery may be done at a hospital or in an outpatient facility. It can be done using medicines to put you into a deep sleep (general anesthesia). Or it may be done by numbing the area (local anesthesia) and giving you medicine by IV (intravenously) to make you sleepy.

Many people can go home on the day of surgery.

Generally, breast augmentation surgery follows this process:

1. You will be asked to remove any clothing, jewelry, or other objects that might get in the way during the procedure.

2. You will be asked to remove your clothing and will be given a gown to wear.

3. An IV (intravenous) line will be started in your arm or hand.

4. You will be placed on your back on the operating table.

5. Breast augmentation surgery may be done under local anesthesia. You will not feel the area to be operated on. You will get medicine in your IV before the procedure to help you relax. You will likely stay awake but feel sleepy during the procedure. Under local anesthesia, you will get oxygen through a tube that fits in your nose.

6. Breast augmentation surgery may also be done under general anesthesia. You will be asleep. Once you are asleep, your surgeon will put a breathing tube through your throat into your lungs. You will be connected to a ventilator. It will breathe for you during the surgery.

7. The skin over the surgical site will be cleaned with a sterile (antiseptic) solution.

8. The surgeon will make 1 or more cuts (incisions). These incisions will be made in areas that will not be easily seen after surgery. This may be under your breast, in your armpit, or around your nipple.

9. The implant will be put through the incision. It may be slid under your pectoral chest muscle. Or it may be placed directly under your breast tissue. Your surgeon will decide where to create the pocket for the implant based on your body and what you would prefer.

10. The incision will be closed using stitches, skin adhesive, or surgical tape.

11. In some cases, a small, thin drainage tube may be placed in the surgical area to keep fluid from collecting there while you are healing.

What happens after breast augmentation surgery?

You will be taken from the operating room to the postanesthesia care unit (PACU). You will be closely watched by the nurses until you have recovered from the anesthesia. You may have a bulky dressing, elastic bandage, or support garment over your breasts. Or you may be wearing a surgical bra.

Once you are alert, stable and can tolerate fluids well by mouth, your IV will be removed. It's important to get up and start walking as soon as possible. This can help keep blood clots from forming in your legs.

Once you get home, it’s important to follow all your surgeon's instructions and keep all your follow-up appointments.

You should be able to go back to a normal diet as tolerated. Follow your surgeon’s instructions for taking any pain medicines or medicines that fight infections (antibiotics).

Your breasts may be bruised and swollen. They may not look like you thought they would. This will go away as you heal and should be gone in about 1 month. The incision lines will also fade over time.

Your home care instructions may include:

• You may have to take sponge baths for the first few days. Your surgeon may let you take a shower after several days. Ask your surgeon when you can safely take a tub bath.

• During the first few days after surgery, you can expect to feel sore. This is especially true if the implants were placed under your chest muscles. Don’t lift, pull, or push anything until your surgeon says it’s safe.

• If the drain will be left in, you’ll be told how to take care of it at home.

• Dressings and drains may be removed by your surgeon within a few days. You may be given a special support bra to wear after the dressings are removed. Stitches or adhesive tapes may be removed in about a week.

• You will slowly be able to go back to your normal activities in a few days. You may need to wait a few weeks before returning to physical activities. Ask your surgeon when it is safe to return to work or go back to specific activities.

Call your surgeon if you have any of the following:

• More pain or pain that is not eased by prescribed pain medicine

• Any drainage, bleeding, redness, or swelling around your incision areas

• Fever

• Leg pain or leg swelling

Your surgeon may give you other instructions, depending on your situation.

Next steps

Before you agree to the test or procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure