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http://www.mayoclinic.com/health/breast-augmentation/WO00125

http://www.mayoclinic.com/health/breast-augmentation/WO00125,

Breast augmentation:

Breast implants reshape self-image

Thinking about breast augmentation?

Understand the surgical process,

including what it means to have breast

implants, possible complications and

what you can expect from the surgery.

Breastaugmentation — surgery to enhance a woman's breasts

— ranks as the third most popular cosmetic surgery. More than

a quarter of a millionwomen opted for breast augmentation in 2005,

according to the AmericanSociety of Plastic Surgeons.

If you're considering breast augmentation, be sure you understandfully

what's involved in the surgery, have realistic expectations, andknow

the possible risks and complications associated with implants.

Why have breast augmentation done?

Your reasons for choosing breast augmentation are highly personal.

Breast augmentation may help you:

Enhance your breast appearance if you feel your breast size is too

small Adjust for a reduction in the size of your breasts after pregnancy

Reconstruct your breast after having breast surgery for cancer or other

conditions

Correct a defect in the development of your breasts, such as having

breasts of unequal sizes

Besides enhancing the breasts' appearance, some women find that

breast augmentation improves self-image and self-confidence. The

best candidate for breast augmentation is a woman looking for an

improvement— but not perfection — in her appearance. Your ideal

for how you want your breasts to look and the reality of the outcome

of the procedure may not match exactly. Discuss this with your

surgeon so that you candevelop a realistic expectation of what's

to come.

Before surgery: Consider pros and cons

Initially,you'll consult with a plastic surgeon about your preferences

for size,feel and overall appearance of your breasts. Your doctor will

describe the surgical techniques and provide you with educational

materials about the implant you select and the surgical procedure.

Review these documents carefully and keep copies of all pertinent

information for your records.

Before you decide to have surgery, consider some important factors

about breast augmentation:

Breast implants aren't lifelong devices. Your breast implants may

need to be removed and replaced at some point.

You might need more surgery after breast implant removal. If you

have your breast implants removed for any reason, you may

experience unacceptable cosmetic changes — such as wrinkling,

dimpling or droopy excess skin — which might require replacing the

implants. Or you may need a breast lift (mastopexy) to remove excess

skin and eposition your nipple.

Breast implants won't prevent your breasts from sagging after pregnancy.Some women actually need to consider a breast lift in

addition to breast augmentation to correct sagging breasts. Also,

depending on how it's done, breast augmentation surgery may make

breast-feeding more challenging.

Mammograms may be more complicated.Additional views are

necessary when obtaining images of your breasts.The quality of the

mammogram will depend on the experience and expertise of your

technician and the facility you select.

Insurance probably won't pay for the procedure.If it isn't medically

necessary, many insurance companies won't cover breast augmentation.

Be prepared to handle any financial obligations that accompany breast

augmentation surgery and any related operations you might need in the

future. Considering these points may trigger many questions about your

personal situation. Prepare a list of questions to review with your doctor.

You may also find it helpful to talk with other women who have gone

through the same procedure.

Breast augmentation: The procedure

Breast augmentation surgery — also known as augmentation mammaplasty

can be performed in a surgical center or hospital outpatient facility.

You usually go home the same day, but on occasion you might require

a hospital stay. Breast augmentation is usually performed under

generalanesthesia.

To insert the breast implant, your surgeon makes an incision in one

of three places:

In the breast fold. An inframammary incision runs along the crease

between the underside of your breast and your chest.

Around the nipple. Aperiareolar incision follows the natural line of the

dark skin aroundyour nipple (areola). This incision may leave a less

noticeable scar than does the inframammary incision, but it might also

impact your ability to breast-feed or affect sensation in your nipple.

Under the arm. The axillary incision is made in your armpit.Breast

implants may be smooth or textured, round or shaped like a teardrop.

They consist of a silicone shell filled with salt water(saline) or silicone gel.

For a number of years, only saline-filledimplants were available for

cosmetic use. But in November 2006, theFood and Drug Administration

(FDA) approved silicone gel-filled implants for breast augmentation.

This means that you now have a choice between saline-filled or silicone

gel-filled breast implants. Your doctor can help you decide which type

would be better for you.

After making the incision, the surgeon lifts your skin and tissue to create

a pocket either behind the breast glandular tissue or behind the muscle in

your chest (pectoral muscle). The surgeon inserts the implantand centers

it behind your nipple. Saline implants, when inserted, areempty. The

surgeon fills the implant with sterile saline once it's inplace. Silicone

implants are already filled at the time they're placed.

Breast augmentation surgery generally lasts one to two hours.

Recovering from breast augmentation surgery

You'll be sore the first few days after breast augmentation surgery, but

your doctor can prescribe medication to help relieve your pain. If you don't

have a physically demanding job, you may be able to return to workwithin

a few days. Getting back to normal activities may take longer —about two

to three weeks — as your breasts will be sensitive tophysical contact

or jarring movements. Follow your doctor'sinstructions for how long you

should wait before engaging in your regular activities.

You'll have stitches (sutures) in place after surgery. Often,absorbable

sutures are used, so you won't need to have them removed.Some women

also have drainage tubes in place after surgery, although not many

women require them. If you have drainage tubes, they'llprobably be

removed a few days after your surgery. Your doctor mayrecommend

using a compression bandage or sports bra for extra support nd

positioning of the breast implants during this time.

You may notice a burning sensation in your nipples for a few weeks,but

that usually goes away as you heal. Expect some pain, swelling,tenderness

and bruising as you heal. If you notice warmth and rednessin your breast

or you run a fever, you might have an infection. Contactyour doctor as soon

as possible. After surgery, your scars may initially appear firm and pink.

The scars fade gradually over time, but they won't go away completely.

The darker your skin, the more noticeable your scars may be.

Risks of breast augmentation

Be aware of the risks associated with breast augmentation surgery:

Repeat surgery. You may needmore surgery down the road, either to

replace the implants or to removethem altogether. In clinical trials studying

the safety andeffectiveness of saline-filled breast implants, as many as

one in fourwomen required a second operation within five years of the

initial surgery.

Rupture. Implants can rupture, causing fluid toleak into your breast and

surrounding tissue. This can happen as aresult of a blunt-force injury —

if you're thrown against the steeringwheel in a car accident, for example

— or from tiny cracks in the implant shell that can occur over time.

If you have a saline-filled implant, a rupture will cause yourimplant to lose

its original size or shape. If you have a silicone gel-filled implant, a rupture

may not be as obvious. Your doctor may use occasional imaging tests,

such as magnetic resonance imaging, to screen for rupture.

Deflation. A rupture or a slow leak can cause an implant to collapse,

deflating the size of yourbreast. This may result in breasts that are

noticeably different insize or in a change to the cosmetic appearance

of your breast, such assagging or wrinkling.

Capsular contracture. Fibrousscar tissue forms a capsule around your

breast implant. The scar tissuebuilds up over time and constricts your

implant — a painful andpotentially disfiguring condition. Surgery is usually

necessary to correct capsular contracture.

Infection. Breast augmentationsurgery can lead to infection. Medications

may help, but antibioticsaren't always successful in treating infections of

this type. Removingyour breast implants may be necessary if you develop

a severeinfection. You may have to wait six months to a year after implant

removal before you can get new implants placed.

Hematoma. Blood and otherfluids can pool around the implant, causing

pain, infection or other problems. If you develop a hematoma, you might

need to go back into theoperating room so that your doctor can find the

cause of the bleeding.

Pain. You could experiencesignificant pain after surgery — more than

what's considered normal —which indicates a bigger problem, such as

implant rupture or capsularcontracture. To remedy the problem, you

may need surgery to remove orreplace the breast implants.Other possible

risks include dissatisfaction with the results ofyour surgery. You might

experience changes in the sensation of yourbreasts and nipples, or you

might be able to feel the implant beneaththe surface of your breast tissue.

Debunking myths surrounding breast augmentation

To address health concerns about breast implants and breast

augmentation surgery, a committee at the Institute of Medicine (IOM)

reviewed the issues and concluded:

*** Were any of these committee members medical doctors,

Research scientists, or internal medicine or infectious

disease medical doctors ? ? ***

Breast implants don't increase breast cancer risk.The IOM found

evidence that breast implants don't cause breast cancer or the recurrence

of breast cancer. However, it's still essential that you undergo routine

screening for breast cancer — breast self-exams,mammograms and

clinical breast exams — just as you would if you didn't have breast

implants.How did this committee find this out?

did they do studies for enough years to even

know scientifically ? ? ?

Breast implants don't weaken your immune system.When your body

detects something foreign in your system, such as avirus or bacterium,

it responds by kicking your immune system into high gear.What immune system, it is gone now... However, the IOM found no evidence to

suggest this happens with breast implants. Nor did it find evidence linking

implants to any autoimmune or connective tissue disorder.

What study was this ? ?

Breast-feeding is safe. Your breast milk could

absorb some of the silicone from breast implants but in an amount that's

not considered harmful to your baby. Because breast milk is the best

thing you can feed your baby, the IOM ENCOURAGES women

with breast implants to breast-feed if they're able to

do so.

Satisfactory results can be achieved with saline-filled

breast implants.

Women with saline implants used to complain about sloshing — hearing

the liquid inside the implant — and being able to feel the implant

beneath the surface of the skin (rippling effect). Some women preferred

implants filled with silicone gel for these reasons, claiming they looked

and felt more natural. However, better results from saline implants are

now possible by slightly overfilling the implant..................................... WOULDNT OVERFILLING A IMPLANT BE THE SAME

AS OVERFILLING A PLASTIC BALL, AND WOULDNT

IT MAYBE GET WEAK SPOTS IN THE SHELL, AND

PERHAPS BURST AND/OR WEAR OUT MUCH

SOONER ? ?

and placing it behind, rather than on top of, the chest muscle. Know that

health risks associated with breast implants do exist.Take these risks into consideration, consult with your doctor, and beconfident that you're making

a fully informed decision before you proceed with breast augmentation.

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