Breast Augmentation: What You Should Know

Breast augmentation is also known as augmentation mammoplasty, or a “boob job.” It’s an elective cosmetic surgical procedure designed to enlarge or bring symmetry to your breasts.

Breast augmentation can be performed either through the transfer of fat from an area of your body or, more commonly, through surgically inserting breast implants.

Candidates are people who simply want to increase the size of their breasts or those who have lost volume in their breasts due to a number of different reasons, which can include:

• weight loss (sometimes due to surgical weight loss procedures)
• pregnancy
• breastfeeding

Other candidates include people who want to even out the balance of their physical proportions. For example, someone who has smaller breasts and wider hips may want to enlarge their breasts.

People who have asymmetrical breasts may also wish to even out the size of their breasts through augmentation. Other candidates include people whose breasts didn’t develop as expected.

A person must have fully developed breasts before augmentation can be performed.

At a minimum, breast augmentations cost an average of around $3,718.00, notes the American Society of Plastic Surgeons.

Costs can vary, though. The quoted amount doesn’t cover things like fees for:

• the implants themselves
• anesthesia
• the surgical facility or hospital
• any tests or lab work that needs to be performed
• medications
• garments that must be worn during recovery

Health insurance doesn’t cover elective cosmetic procedures. Some insurance carriers also don’t cover conditions or complications that arise after or as a result of cosmetic surgery.

Also, consider the time costs involved in the procedure and recovery. While the initial recovery should only last from about one to five days, it could take a few weeks before the pain and swelling go away.

You’ll need to arrange vacation time away from work for the day of the procedure, as well as several days afterward while you recover from the initial pain.

Additionally, your doctor may prescribe strong pain medication that will make operating a vehicle dangerous. You’ll need a ride to and from your procedure. Someone will need to drive you while you’re taking any necessary pain prescriptions.

You can begin normal activities again once you have the all-clear from your plastic surgeon. They’ll let you know when it’s safe to begin activities like exercising again.

In breast augmentation, an implant or fat from your body is surgically inserted behind each of your breasts. The implants sit either behind the muscles in your chest or behind the tissue of your natural breasts. This can raise your breast size by a cup or more.

You can choose a contoured or round breast implant. The implant material works to boost the size of your breasts as well as provide shape in areas that may have previously felt “empty.”

Keep in mind breast augmentation isn’t the same procedure as a breast lift. A lift works to correct sagging breasts.

Implants are generally soft, flexible shells made of silicone that are filled with either saline or silicone. While there’s been some controversy surrounding the use of silicone implants, they’re still widely popular among people who choose breast augmentation surgery.

If you elect to have breast augmentation surgery, you’re most likely to have it done in an outpatient surgical center or similar facility. Most of the time, people are able to go home the same day as the procedure.

The procedure will most likely be performed under general anesthesia so you don’t feel any pain. Follow your surgeon’s instructions to prepare in the 24 hours before your procedure.

Your surgeon will place your breast implants using one of three types of incisions:

• inframammary (beneath your breast)
• axillary (in the underarm)
• periareolar (in the tissue surrounding your nipples)

Your surgeon will then create a pocket by separating the tissue of your breast from your chest muscles and tissue. Your implants will be placed inside these pockets and centered inside your breasts.

If you’ve opted for saline implants, your surgeon will fill them with sterile saline solution once the shell has been placed successfully. If you choose silicone, they’ll already be filled.

After your surgeon has placed your implants successfully, they’ll close your incisions with stitches, and then bandage them securely with surgical tape and surgical glue. You’ll be monitored in recovery, and then released to go home once the anesthesia wears off enough.

A common risk with breast augmentation surgery is the need for follow-up surgical procedures to correct any complications that may arise. Some people also later desire a different size implant or a lift as their skin stretches over time.

Other risks and side effects include:

• bleeding and bruising
• pain in your breasts
• infection at the surgical site or surrounding the implant
• capsular contracture, or the formation of scar tissue inside the breast (this can cause your implants to become misshapen, displaced, painful or more visible)
• rupture or leaking of the implant
• alteration of the feeling in your breasts (often temporary following surgery)
• “rippling” of the skin over where the implant is placed, often beneath the breast
• incorrect placement or movement of the implant
• buildup of fluid around the implant
• difficulty healing at the incision site
• discharge from the breast or at the incision site
• severe scarring of the skin
• severe nighttime sweating

As with any surgical procedure, the use of general anesthesia also carries risks, including death during the procedure.

Call your surgeon immediately if you:

• begin running a fever
• see redness in or around your breast, especially red streaking on the skin
• feel a warm sensation around the incision site

These could all indicate an infection.

After you’ve healed, any pain in the breast or armpit or change in breast size or shape needs to be evaluated by your surgeon. These could indicate a ruptured implant. It isn’t always easy to identify rupture right away, as implants tend to leak slowly.

Other rare complications include chest pain and shortness of breath. These are medical emergencies that may require hospitalization.

There’s also the risk of anaplastic large cell lymphoma (ALCL). It’s a newly recognized, rare form of blood cell cancer that’s been associated with long-term presence of breast implants, most commonly textured silicone implants.

At this time, there have been 414 reported cases worldwide that the U.S. Food and Drug Administration (FDA) is tracking. Based upon these reports, the estimated risk of getting ALCL associated with breast implants is between 1 in 3800 and 1 in 30,000 patients. To date, there have been 17 patient deaths thought to be linked with breast implant-associated ALCL.

The majority of these patients were diagnosed after they developed swelling, or fluid, in the breast around the implant, within 7–8 years after the implants were placed. With ALCL, the cancer usually stays within the tissue around the breast implant, although in some of the patients it did spread throughout the body.

Patients with breast implants should observe their breasts and see their doctor for any changes or new enlargement, swelling, or pain.

After your breast augmentation procedure, your surgeon will probably advise you to wear a bandage that compresses your breasts or a sports bra for the support you need during recovery. They may prescribe medication for pain, too.

Your surgeon will also make recommendations regarding when to return to regular work and recreational activities. Most people may go back to work in a few days, but you might need up to a week off for recovery. If your job is more physical, you might require longer time off work to heal.

When it comes to exercise and physical activity, you’ll need to avoid anything strenuous for two weeks at minimum. Following invasive surgery, you’ll want to avoid raising your blood pressure or pulse. Aside from that, too much movement will be very painful for your breasts.

It’s possible that you may need to have your stitches removed at a follow-up appointment with your surgeon. In some cases, surgeons may opt to put drainage tubes near the surgical sites. If you have those, they’ll need to be removed, too.

You’ll see results from your procedure immediately. Swelling and tenderness may make it difficult to assess final results until after you’ve had a chance to begin healing.

While results should be long-lasting, breast implants aren’t guaranteed to last forever. You may need follow-up surgeries to replace implants in the future. Some people also opt to reverse the surgery at a later time.

After surgery, maintain a healthy lifestyle. If you smoke cigarettes, quit. Smoking can delay healing.

To prepare for your procedure, you’ll need to follow preoperative instructions from your surgeon. You’ll probably be advised not to eat or drink starting at midnight the night before your procedure.

In the weeks before breast augmentation, your surgeon will advise you to stop smoking. Smoking raises your risk of complications and restricts blood flow in the body. This can prolong recovery after surgery. It’s also possible that smoking lowers your immunity, which raises your risk of developing an infection.

You can find a board-certified plastic surgeon through the American Society of Plastic Surgeons or American Board of Plastic Surgery.

Be sure to research the providers you consider. Read their patient reviews, and check out before and after photos of past patients.

Aside from reviews and qualifications, be sure you’re comfortable with your surgeon and confident in their abilities. Schedule a consultation to be sure you really want to work with a particular doctor. Breast augmentation is a delicate and private procedure. You’ll want to carefully choose a practitioner who’s right for you.