Breast Surgery

There are three options in breast surgery; augmentation, reduction and reconstruction. Learn what they are and what the risks are.

Breast Augmentation (Augmentation Mammoplasty)

Breast Augmentation is a breast surgery to enhance the breasts, either in appearance, size or contour of the breasts.

Why would someone get a Breast Augmentation?

Women consider getting breast augmentation for a variety of reasons. They may be unhappy with their size and this may affect their self-esteem. Some women’s breasts change with age, time, weight loss or pregnancy and they would like them to be more youthful, as they once were. Some women want to correct an asymmetry problem and have both breasts look the same.

What is a breast implant?

Breast implants are made up of a silicone shell filled with saline (a salt water solution) or silicone gel. Many women say the gel feels more like real breasts, however there is a much greater health risk if the implants leak.

Size is chosen during a trial fitting. This is up to the woman, but the doctor may have some recommendations, either in regards to looks or health issues.

What happens when you get a breast augmentation?

Breast Augmentations are considered minimally invasive. An incision can be placed in the axilla (armpit), areola or lower breast fold. The implant is placed either over the chest muscle or under the chest muscle. You are usually placed under general anesthesia, this allows you to sleep and be pain free during the procedure. The surgery takes about an hour or two.

The breasts are covered in gauze after the surgery. A drainage tube is inserted which will need to be removed after a few days. You may need to wear a surgical bra after the operation. You’ll need to take it easy for a few days after your breast augmentation surgery and avoid excess activity and heavy lifting for up to six weeks. You can take Tylenol for pain relief, or your doctor may prescribe something. There could be some swelling, which will go away and the scars will slowly fade over time.

As with any surgery there is always a risk to the patient. Make sure you visit with your surgeon and get all the facts, do not be afraid to ask any questions you might have. The surgery is performed as an outpatient procedure, but you may be able to opt to stay at the hospital over night.

How much breast implants cost depends on the location, doctor, and type of implant used. Typically, the breast surgery will range from $5,000 to $10,000. Because it is considered a cosmetic procedure, breast augmentation is usually not covered by medical insurance.

Because a woman’s breasts continue to grow and change, the woman must be at least 18 years old, by this time most women’s breasts have fully developed.

What are the complications of Breast Augmentation?

  • Breast pain
  • Changes in sensation in the nipple and breast
  • Formation of scar tissue and hardening in the area around the implant (capsular contracture)
  • Scarring
  • Bleeding
  • Infection
  • Problems with the size or shape of the implants (for example, the breasts may not be symmetrical)

It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. You will be aware when a saline implant ruptures because it will deflate, but silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.

Women who have silicone gel-filled implants will need to get an MRI scan three years after the implant surgery and then MRI scans about every two years to check for silent rupture. If your implants rupture, you will need to have them removed or replaced.

Try to chose a surgeon with at least 5 years of experience and is highly recommended and acknowledged, this will give you the foundation for a more favorable operation.

Breast Reduction

Why would someone get a Breast Reduction?

Reduction breast surgery is often for women who have very large, heavy, or uncomfortable breasts. They often have back pain, neck pain, numbness or weakness due to the weight of the breasts. This can stop the woman from playing sports, or make it difficult to participate in them.

Some women want to alter their appearance. Large breasts, especially when they are out of proportion to your height and weight, can be embarrassing. Teenagers and young women with large breasts may especially feel self-conscious wearing swimsuits and other types of clothing due to unwelcome attention to large breasts. It also may be difficult to find clothes that fit well.

This breast surgery will remove excess fat, skin and breast tissue.

It is possible that there will be a change in breast sensation after surgery, including the inability to breast feed.

What happens when you get a breast reduction surgery?

To remove tissue and skin from the breast, the surgeon first makes one or more cuts in the breast. After the excess tissue and skin have been removed, the skin is closed with stitches. Sometimes the nipple and areola have to be removed and stitched to a new spot. This can cause a loss of feeling in the nipple, since it has to be cut off from the nerves supplying it.

A breast lift is similar to breast reduction surgery. The only difference is the skin is removed from the bottom of the breast and the areola, it is then stitched back together, which causes the breast to lift from the removal of the excess skin.

Reduction breast surgery is done in a hospital or surgical center using general anesthesia. The surgery usually takes 3 to 5 hours. An overnight stay is not usually required.

The breasts are covered in gauze after the surgery. A drainage tube is inserted which will need to be removed after a few days. You may need to wear a surgical bra after the operation. You’ll need to take it easy for a few days after your breast augmentation surgery and avoid excess activity and heavy lifting for up to six weeks. You can take Tylenol for pain relief, or your doctor may prescribe something. There could be some swelling and bruising, which will go away in time and the scars will slowly fade over time.

Breast Reconstruction

Reconstructive breast surgery is often performed in women who undergo mastectomy as a treatment for breast cancer.

The procedure recreates the woman’s breast(s) with the desired appearance, contour and volume. The nipple and areola also are recreated, often through tattooing. Normal breast sensation and normal breast function, as with nursing, do not usually return when the sensory nerves or milk glands and ducts have been removed or significantly injured.

The breast can be recreated with implants or with a woman’s own tissue. If an implant is used, the implant is sized to match the opposite breast. When possible, the implant is placed beneath a chest muscle. A breast also can be recreated using a woman’s own tissue. At times, a segment of the lower abdominal wall, back muscle and skin or fat and muscle from the buttock can be used.

Reconstructive breast surgery can be done at any time after you have had a mastectomy. The procedure has no known effect on the recurrence of cancer and it does not appear to affect cancer surveillance. However, do remember to do regular self examinations and see your doctor regularly for checkups.