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Frequently Asked Questions
About Breast Augmentation Surgery

  1. Who is a good candidate for breast enlargement surgery?
  2. How do I know what size breast implant is right for me?
  3. What type of breast implant should I choose?
  4. How does having breast enlargement surgery affect future breastfeeding?
  5. Will nipple sensation be affected by breast enlargement surgery?
  6. How will breast enlargement surgery affect my annual mammogram results?
  7. How is breast enlargement surgery performed?
  8. What can I expect after surgery?
  9. Are there any risks or complications associated with breast enlargement surgery?
  10. What is the cost of breast enlargement?
  11. What kind of results can I expect from breast enlargement?

1. Who is a good candidate for breast enlargement surgery?
Once a woman reaches 18 years of age, she may be a good candidate for breast enlargement surgery. By age 18, the breasts have reached full development. Additionally, it is imperative that a woman be physically healthy and emotionally mature to make this magnitude of a decision, one that will impact the rest of her life.

In general, a woman who chooses to have breast enlargement surgery does so to improve her self-image. The reason behind this decision can include:

  • Her breasts did not develop to the size she desired.
  • Her breasts are unequal in size or shape.
  • Her breasts have lost volume and changed shape due to pregnancy, weight loss, or aging.

2. How do I know which breast implant size is right for me?
Most women want a breast size that is complementary to her build. Going too large can result in looking disproportionate or top heavy. Going too small may leave you wishing you had chosen a larger size the first time.

Dr. Delgadoís patients find a useful tool in the rice test for finding the right implant size. Uncooked rice is placed in a nylon stocking and tied into a knot. A woman can test out the sizes and weights of the various sizes of implants by placing them in her bra with her own breasts.

A cup of dry rice represents 250 cc of volume. One may add to this volume in small increments to the desired size. One might try 1 cup, 1¼ cups, 1½ cups, 1¾ cups, et cetera, until the desired breast volume is achieved. Patients who have used this method have a high satisfaction rate with the implant size they ultimately chose.

There are three different diameters for the same volume implant: moderate, moderate plus and high profile implants. Dr. Delgado will show you these various styles of implants, explaining why one might be chosen over another and assist you with your final selection.

3. What type of breast implant should I choose?
There are essentially two implants used today, saline-filled and silicone-filled implants. Both implants have a pliable outer envelope, or shell, that is made of silicone, but the contents of the shell are either saline (saltwater) or silicone gel. Both implants are excellent, but in different ways. Dr. Delgado tends to favor the silicone implants because patients find they have a more natural feel.

In 1991, the FDA (Federal Drug Administration) began restricting the use of silicone breast implants, based on safety concerns. This stemmed from claims that silicone breast implants could cause autoimmune diseases in some women. In November 2006, after extensive research, it was concluded that there was no scientific evidence to support this claim and silicone breast implants were approved for general use (with certain restrictions, including that the patient has to be at least 22 years of age).

4. How does having breast enlargement surgery affect future breastfeeding?
Breast implant surgery does not affect the ability to breastfeed. Dr. Delgado has had many breast augmentation patients who later breastfed successfully. The surgical procedure does not damage nor alter the milk ducts.

5. Will nipple sensation be affected by breast enlargement surgery?
While there may be loss of sensitivity following breast enlargement surgery, it is almost always temporary. Typically, breast sensation returns after the swelling subsides and healing is complete. Nevertheless, there is always the remote possibility for sensory nerve injury to occur. This could result in some degree of permanent loss of sensation in the nipple-areola complex.

6. How will breast enlargement surgery affect my annual mammogram?
Surgical breast enlargement will not affect your annual mammogram. Mammograms can be safely and effectively performed on women who have breast implants. Breast implants do not hide or mask breast cancer.

7. How is breast enlargement surgery performed?
Before anesthesia is given, the surgeon draws a surgical map on the breasts and chest using a specially designed felt tip marking pen. This provides points of reference for the surgeon throughout the surgical procedure.

Breast implants can be placed through one of four incision locations:

  • Peri-areolar
    This incision is made on the border of where the darker skin of the areola meets the lighter skin of the breast. This is the approach Dr. Delgado uses most often because of its an excellent cosmetic result.
  • Inframammary-fold
    Underneath the breast, hidden in the skin crease.
  • Trans-axillary
    This incision is hidden in the underarm.
  • Trans-umbilical
    The surgery is performed through an incision in the navel (belly button). This approach is uncommon as only saline implants can be used and especially because it is very difficult to create natural-looking breasts using this method.

The breast implants can be placed either on top of the pectoralis muscle or below it. Dr. Delgado prefers to place the implants beneath the pectoralis muscle, because this method assures that the edges of the implants are not detectable.

During surgery, once the implants are in place, the patient is raised to a sitting position in order to assess the size, position and symmetry of the breasts.

A multiple layer closure is performed, closing the deeper tissue and finally the surface incision itself. A bra is placed and often a compression band is applied over the top of the breasts, as well. The compression band, which is worn only for a week or two, helps the breast implants to settle properly into the pockets newly created for them.

Some women have loose skin from childbirth, weight loss, or genetic predisposition. In these cases, the implants may be best placed partially under the muscle, above the nipple and partially above the muscle, below the nipple. This dual-plane technique ensures that the loose skin is fully stretched out over the breasts. However, if the skin of the breasts is very loose (ptotic), a lift in conjunction with enlargement may give the best results.

8. What can I expect after breast enlargement surgery?
The first few hours after breast surgery will be spent in the recovery room. When you are fully alert, you will be able to go home with the assistance of a friend or family member. For the first week, it is important to sleep with your head and back elevated to reduce swelling in your breasts. Two days after surgery, you may remove the dressings to shower, reapplying the band and bra afterward.

The discomfort after breast enlargement surgery is mild to moderate. Tenderness and soreness is more noticeable if have had your implants placed underneath the pectoralis muscle. You may want pain medication for the first day or two after your breast enlargement surgery. By the third day, you probably will no longer need it. However, if you tend to have a lower pain threshold than most people, you may still want pain medication for as long as five days post-op.

You should allow two weeks for your recovery from breast enlargement surgery and avoid heavy lifting of any kind during that time. Once the bruising and tenderness are gone, you can return to your normal activities. Most patients are able to drive and return to work or social activities after a week. You should abstain from strenuous exercise for three to four weeks after surgery, as this can cause the return of swelling and discomfort.

9. Are there any risks or complications associated with breast enlargement surgery?
As with any surgery, the risks of bleeding, infection and adverse reactions related to anesthesia exist. Nevertheless, each year thousands of women undergo breast enlargement surgery and experience no complications at all. An experienced, fully certified and licensed plastic surgery team reduces the frequency of complications. Marin Cosmetic Surgery Center operates with a board-certified plastic surgeon, a board-certified anesthesiologist, registered nurses and trained surgical technicians.

Complications specific to breast enlargements include deflation or rupture of the breast implant.

Saline breast implants deflate when the saline solution leaks through a damaged valve or through a break in the implantís shell. The implant deflation can occur immediately or progressively over a period of days. Since saltwater is naturally present in the body, leakage from a saline-filled implant will be safely absorbed. However, a deflated implant requires surgical removal and replacement with new implant.

The silicone implant can also develop a leak. This leak can be a silent leak that goes undetected. The silicone gel is not absorbed, but it stays in the pocket. Magnetic Resonance Imaging (MRI) is used to rule out whether a silicone implant has leaked or not. The Federal Drug Administration (FDA) suggests that a woman undergoing breast augmentation using silicone implants should have an MRI at three years and then every two years thereafter, to confirm that her implants are intact.

Breast contractures (advanced scar tissue around the breast implants) can occur over time. This problem is addressed with additional surgery to remove the fibrous capsule and replace the encapsulated implant with a new implant.

10. What is the cost of breast enlargement?
The cost of breast enlargement (including surgeonís fee, anesthesiologistís fee, operating room costs, including support personnel and the actual cost of the implants) is approximately $6300 for normal saline implants and about $7000 for silicone implants. If needed, financing is available.

11. What kind of results can I expect from breast enlargement?
Breast enlargement surgery is performed to enhance the appearance of the breasts. Having larger breasts can often boost a womanís self-esteem and confidence.

For the initial two weeks following surgery, the breasts are swollen with mild bruising, although this quickly dissipates. It takes approximately three to four months for the breasts to completely settle into their new shape and position.

Significant time and effort are invested preoperatively to select the best implant size and shape. This assures that each patient achieves an enhanced but natural appearance.

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