BREAST AUGMENTATION

M. TAVALLALI, M.D.

Breast augmentation is a procedure to surgically enlarge the breasts by placement of implants under the tissues of the chest. Its primary purpose is to improve the appearance of the body contour for women who, for personal reasons, feel that their breast size is small. Small breast size may be due to congenital reasons where one or both breasts do not develop, or may occur after pregnancy, where a loss in volume is not uncommon.

The size and shape of the breasts prior to surgery will influence both the recommended treatment and the final results. If breasts are not the same size or shape before surgery, it is unlikely that they will be completely symmetrical afterwards, although by placement of different size implants an acceptable degree of symmetry can be expected.

From their invention in 1963 and up through 1990, most breast augmentations in the U.S were carried out by plastic surgeons using silicone gel-filled implants. Following the questions raised regarding their safety, these implants were removed from the market. They have since been re-introduced for use in specific cases.

Currently, saline-filled implants are the most common implants used in breast augmentation procedures. These implants consist of a solid silicone shell which is filled with saline (an intravenous solution of salt water) by the plastic surgeon at the time of surgery. There are multiple sizes of implants and several different shapes depending on the particular needs of the patient.

The following information is provided to give you a better understanding of what is involved in having breast augmentation, and to answer some of the most common questions.

How is the surgery performed?

Breast enlargement is accomplished by insertion of the breast implant either behind the tissue or under the chest muscles. Incisions are made to keep the scars as inconspicuous as possible, and a number of different options exist. The most common method involves placement of the implant through an incision under the breast. The incisions may also be made around the areola (the pigmented skin around the nipple), in the armpit, navel or more recently through the nipple itself. Each of these methods has its own merits and possible complications which should be discussed with Dr. Tavallali.

What type of anesthesia is used?

The procedure is performed as an outpatient surgery in an ambulatory surgery center or hospital and is preferably performed under general anesthesia. The surgery lasts 1 and ½ hours.

What size will I be?

The size of the breasts is determined by the size of the implants that are placed, as well as the original breast size. In discussions with Dr. Tavallali you should be able to arrive at a size for the implants that matches your desired body form. Your weight, height, and own personal wishes will be taken into account.

Is there much pain?

It is surprising how little discomfort there is with breast augmentation using the modern techniques and medicines. Oral pain medication can readily control the soreness that you will experience for the first few days after the surgery, but within 3-5 days most patients are well enough to resume their work. Physical activity is limited for two to three weeks.

How will the implants affect mammography?

Mammography, the special radiological exam used to detect breast cancer, is affected by breast implants. The area of breast tissue that can be visualized is decreased by the implants, but with special techniques, the large majority of the breast tissue can be visualized. In some cases, other tests, such as ultrasound or MRI, may be needed to examine the breasts. It is important that patients inform their radiologist prior to radiological exams so the appropriate test can be performed.

Can I still breast-feed?

There is no evidence at this time that either breast-feeding or pregnancy are affected by breast augmentation. Many women have successfully breast-fed with no problems for themselves or their children. However, placement of the implant through the nipple will affect breast-feeding.

What will happen if the implant ruptures?

As with any man-made object, there is always a chance of implant failure or rupture after an accident, with leakage of the saline. Should this occur, the saline in the implant will be absorbed by the body tissues without any other untoward effect. The patient will require a second surgery to remove the implant and replace it with a new one.

Breast enlargement surgery is one of the surgeries with the highest levels of patient satisfaction. However, because of the number of different issues relating to the implants and the surgical techniques available, you are encouraged to consult at length with Dr. Tavallali. Perhaps the most important point that a patient must accept prior to undergoing this surgery is that future surgeries are a possibility at some point in the patient’s life, for repositioning of the implants, removal of scar tissue or replacement with new implants. With such acceptance, breast augmentation remains an excellent option for women with smaller breasts who are concerned with their appearance.

Hopefully, this information has given you a better understanding of breast augmentation. Please feel free to call our office at 703-876-9400 or 301-907-3838 to schedule a complimentary consultation with Dr. Tavallali. We look forward to seeing you soon.

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