Breast Augmentation Surgery

(Breast Enlargement, Breast Implant Surgery)

Procedure overview

Breast augmentation surgery is a common plastic surgery procedure done to change the appearance of a woman's breasts. The surgery uses breast implants to increase the size or the fullness of the breasts.

Breast augmentation surgery may be done at the hospital or in another type of outpatient facility. It shouldn’t be confused with reconstructive surgery after a mastectomy or with breast reduction surgery. Breast augmentation surgery can be done under general anesthesia or local anesthesia with intravenous sedation, and many women can go home on the day of surgery.

Reasons for the procedure

You may choose to have breast augmentation if you are unhappy with the appearance of one or both of your breasts. Some reasons why women choose to have surgery include:

  • Their breasts have lost their size or fullness after childbirth.

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

  • One breast is noticeably smaller than the other.

Risks of the procedure

All surgeries carry certain risks. You will need to sign a consent form that explains the risks and benefits of the surgery and anesthesia. You should discuss these risks and benefits with your surgeon. Some potential risks of breast augmentation surgery include:

  • Reactions to anesthesia

  • Bleeding

  • Scar tissue

  • Infection

  • Changes in feeling over the nipples or breasts

  • Pain that continues after healing

  • Leaking or rupture of the implant

  • Formation of blood clots in the legs that may travel to the heart or lungs

  • A second surgery to remove or replace the implant

Although there is no evidence that breast implants increase your risk for breast cancer, you should tell your surgeon if you have a family history of breast cancer. You should know that breast implants may make diagnosis of breast cancer more difficult. Although you can still schedule regular mammograms, more images, such as ultrasound or MRI, may be needed for an accurate diagnosis.

If you may be pregnant, you should let your surgeon know. If you plan to get pregnant, you should discuss this with your surgeon. Implants may affect your ability to breastfeed. Pregnancy can change the size of your breasts and their appearance.

There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

Before the procedure

Before surgery, you and your doctor should discuss your options for the type of implant to be used. Saline implants are filled with salt water. Silicone implants are filled with an elastic gel. Both types have certain advantages and downsides.

Before surgery, your surgeon may want to take pictures of your breasts for comparison after surgery. You may also be asked to have a mammogram to compare with future mammograms after surgery.

If you are having general anesthesia (being asleep during surgery), your surgeon will instruct you on how soon before surgery to stop eating and drinking fluids. In most cases, you should not have anything to eat or drink after midnight on the night before surgery, regardless of the type of anesthesia. Other ways to prepare for surgery include:

  • If you are a smoker, you should stop smoking weeks before surgery.

  • You may be asked to stop taking aspirin, ibuprofen, or other medications that thin your blood and may increase bleeding.

  • Tell your surgeon about any medications you take, including herbal supplements and over-the-counter medications.

  • Tell your doctor if you or someone in your family has any history of bleeding or reactions to anesthesia.

  • Ask your surgeon if you should take your regular medications with a small sip of water on the day of surgery.

  • If you may go home on the same day as surgery, make sure you have someone who will drive you home and stay with you.

During the procedure

Whether breast augmentation surgery is done under general anesthesia or local anesthesia with intravenous (IV) sedation, an IV will be started. Medication will be given through the IV to make you comfortable during surgery. This is what may happen once the surgery begins:

  • One or more incisions will be made in areas that will not be obvious after surgery. These incisions may be under the breast, under the arm, or around the nipple.

  • The implant will be inserted through an incision and placed under a chest muscle or directly under the breast.

  • The incision or incisions may be closed using stitches, skin adhesive, or surgical tape.

  • In some cases a plastic drain may be left in place.

After the procedure

You will be taken from the operating room to the recovery area, where nurses will monitor you until you have recovered from the anesthesia. You may have a bulky dressing over your breasts, or you may be wearing a surgical bra. Once you can take fluids well by mouth, the IV will be removed. It will be important to get up and start walking as soon as possible to prevent the complication of blood clot formation in the legs.

Once you get home, it’s important to follow all your surgeon's instructions and keep all your follow-up appointments. Take all the medications that your surgeon prescribes as directed. These may be included in home-care instructions:

  • You should be able to resume a normal diet as tolerated.

  • You may be limited to a sponge bath for several days. Your surgeon may let you take a shower after about five days. Ask your surgeon when you can safely have a tub bath.

  • During the first few days after surgery you should expect to feel sore. You should avoid lifting, pulling, or pushing until your surgeon says it is safe.

  • 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 seven days.

  • You will gradually be able to return to normal activities over several 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 to specific activities.

Notify your surgeon about any of the following:

  • Increasing pain or pain that is not relieved by prescribed pain medication

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

  • Fever

  • Leg pain or leg swelling

  • Trouble breathing, chest pain, or heart palpitations