Aesthetics and Plastic Surgery

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Breast Augmentation and Common Procedures


A woman's decision to have breast augmentation varies from person to person, which may include increasing feelings of confidence and self-esteem. Some of the common breast augmentation procedures include: breast lift, breast reduction, breast implants, and breast reconstruction.

The breasts consists of a framework of connective tissue and a system of glands and ducts that produce milk. Fat makes up the majority of the breast tissue. Behind the breast tissue are the Pectoralis muscles.

In most procedures, such as implants, incision sites are made as inconspicuous as possible, either in the armpit, around the areola, or under the breast. The implant can then be placed beneath the breast tissue.

Breast lift

Breast lift (mastopexy) is usually performed for drooping breasts, which may occur after a woman has had children. Mammograms (breast X-rays) and a routine breast exam are required before surgery.

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital. Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

After surgery, a bulky gauze dressing is wrapped around the breasts and chest. Sometimes a surgical bra is used. Pain is controlled by medication, and usually subsides in a day or two. Most patients stay in the hospital for two days. The dressing is replaced by a soft bra within the first week, and it must be worn for several weeks. Generally, the swelling and discoloration around the incisions subside within a few days. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition improves with time. Within two weeks of surgery, stitches (sutures) are removed.

Breast reduction (Mammoplasty)

Breast reduction is usually performed for enlarged breasts (macromastia), but may also be indicated by:

  • Cystic breast infections (polycystic mastitis)
  • Back pain, neck pain, shoulder pain, breast pain, or headaches
  • Loss of sensation in the breasts, arms, or fingers
  • Sleeping problems or poor posture resulting from large breasts
  • Pigmented bra-strap groove
  • Striae (scar-like lines) on the breasts
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Mammograms (breast X-rays) and a routine breast exam are required before surgery.

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital.

Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

For a reduction in breast-size, some of the breast tissue is removed and the nipples are relocated higher on the breasts for cosmetic reasons. After surgery, a bulky gauze dressing is wrapped around the breasts and chest. Sometimes a surgical bra is used. Pain is controlled by medication, and usually subsides in a day or two. Most patients stay in the hospital for two days.

The dressing is replaced by a soft bra within the first week, and it must be worn for several weeks. Generally, the swelling and discoloration around the incisions subside within a few days. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition improves with time. Within two weeks of surgery, stitches (sutures) are removed.

Breast Implants

Breast implants are medical devices that are implanted under the breast tissue or under the chest muscle to increase (augment) breast size or to rebuild (reconstruct) breast tissue after mastectomy or other damage to the breast. They are also used in revision surgeries, which correct or improve the result of an original surgery.

There are two types of breast implants approved for sale in the United States: saline-filled and silicone gel-filled. Both types have a silicone outer shell. They vary in size, shell thickness, shell surface texture, and shape (contour).

The information provided on this website is designed to support, not replace, the relationship that exists between a patient and a physician. We have provided this information to help women make informed decisions about whether or not to get breast implants:

Risks of Breast Implants

Some of the complications and adverse outcomes of breast implants include:

  • Additional surgeries, with or without removal of the device
  • Capsular contracture, scar tissue that forms around the implant and squeezes the implant
  • Breast pain
  • Changes in nipple and breast sensation
  • Rupture with deflation of saline-filled implants
  • Rupture with or without symptoms (silent rupture) of silicone gel-filled implants
  • Anaplastic large cell lymphoma, a type of non-Hodgkin's lymphoma (cancer of the immune system)

Implant Complications

The following is a list of local complications and adverse outcomes that occur in at least 1 percent of breast implant patients at any time. You may need non-surgical treatments or additional surgeries to treat any of these, and you should discuss any complication and necessary treatment with your doctor. These complications are listed alphabetically, not in order of how often they occur.

Saline-Filled Breast Implants

Saline-filled breast implants contain a silicone outer shell filled with a sterile saltwater (saline) solution. Some are pre-filled and others are filled during the implant operation. Saline-filled implants come in different sizes and have either smooth or textured shells. The FDA approved saline-filled breast implants for breast augmentation in women age 18 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.

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Silicone-Filled Breast Implants

Silicone gel-filled breast implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells.
Silicone gel-filled breast implants are approved for breast augmentation in women age 22 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.

Summary of Breast Implants Safety Information

Breast implants are not lifetime devices. The longer a woman has implants, the more likely it is that she will need to have surgery to remove or replace them. The most frequent complications and adverse outcomes experienced by breast implant patients include capsular contracture, reoperation, and implant removal (with or without replacement).

Other common complications include implant rupture with deflation, wrinkling, asymmetry, scarring, pain, and infection. In addition, women with breast implants may have a very low but increased likelihood of being diagnosed with anaplastic large cell lymphoma (ALCL).

MRI continues to be an effective method of detecting silent rupture of saline- and silicone gel-filled breast implants. If you have silicone gel-filled breast implants, the FDA recommends that you receive MRI screening for silent rupture 3 years after receiving your implant and every 2 years after that.

There is no apparent association between saline- and silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems. However, to rule out these and other complications, studies would need to be much larger and longer than those conducted so far.

Breast Tissue Expanders

Breast reconstruction may be performed after mastectomy, to rebuild injured or congenitally deformed breasts, or as part of gender reassignment surgery. As part of the reconstruction process, a breast tissue expander may be used to stretch the patient's tissue for insertion of an implant or the patient's own tissue. Tissue expanders are like thick-walled silicone balloons, come in different sizes and shapes, and may have a smooth or textured outer surface. They are implanted under the breast skin, tissue, or chest muscle, and are regulated by the FDA as medical devices. In immediate reconstruction, the expander is inserted immediately following mastectomy. For patients who choose delayed reconstruction, the expander is implanted in a separate surgery months or years later.

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Once the surgical incision is healed, the tissue expander is “inflated” during the course of weeks to months. Inflation may be through a series of saline solution injections at the health care provider's office, or through a patient-controlled device that releases carbon dioxide gas into the expander.

Because expanders are temporary medical devices, an expander is not intended to remain in place for more than six months. When expansion is complete, a new surgical procedure is performed to remove the expander and insert a breast implant or the patient's own tissue.

There are some risks in using tissue expanders. The use of tissue expanders may result in breast tissue injury and skin thinning, pain, especially during saline filling, and infection. The expander may rupture, and the site or port for saline injection may become infected.

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