Motivation: Women who seek breast enhancement do so for a variety of reasons; some of those which are more commonly cited are listed below:
1.Breasts did not develop as fully as desired.
2.Breasts are not proportional with the rest of the body.
3.Breasts changed significantly following pregnancy or weight loss.
4.Breast developmental anomaly or deficiency
5.Asymmetry between the breasts
6.Simply desire a fuller bust
Be assured (and reassured) that you are not alone whatever your circumstance.
Please let the plastic surgeon know how important it is for you to look “natural” and “proportional”. You will also be asked “how big” you want to be, another way of ascertaining what degree of change you are seeking. It is important that you understand plastic surgeons do not guarantee a particular cup size following an augmentation procedure. Be specific about what you want – it is the best way for the plastic surgeon to meet your expectations.
The term “natural” as used above is as relates to appearance. The implants are man made devices and as such will likely need to be replaced over the course of your lifetime – they should not be considered permanent. The term is used to convey an appearance following surgery which does not scream: “ I had implant surgery”. It is used to suggest a result which you might well have been gifted with naturally, one that compliments your body.
The Best Candidates for Breast Augmentation
A woman who has some tissue to cover the implant (“the more of you there is to cover “it” the better “it” will look.”). Regarding “drooping” or “sag” of the breasts; none or a moderate degree will result in a nice outcome, however if the breast is truly ptotic (the nipple is significantly below the inframammary crease or pointing toward the floor) a lift procedure may be required prior to or with the augmentation procedure. Modifications of technique and implant type (saline vs responsive cohesive silicone gel) will be discussed and recommendations made to provide you with the best outcome given your body type(anatomy / height / weight) and the degree of change you are seeking.
The Breast Augmentation Procedure
Plastic surgeons generally perform the augmentation procedure through a limited incision at or slightly above the inframammary crease (the junction between the breast and chest). For the vast majority of women the implants are placed below the muscle (sub-pectorally) but there is a variable amount of implant under / behind the lower portion of the breast gland. Virtually all patients receive a general anesthetic when having this procedure performed by a plastic surgeon. This procedure is considered suitable to be performed through our in- office ambulatory surgical facility and afterward you are discharged into the care of a responsible adult care giver. You should plan to have a responsible adult stay with you for the first day following your procedure. Admission to hospital following this procedure is on the whole not encouraged. The building in which the office is located is connected via sky bridge to Swedish Hospital and if it is your preference or required for any reason – admission to hospital post-operatively can be arranged.
Immediately following your procedure:
Your plastic surgeon, someone like Peter Capizzi MD will review your care and instructions with your designated adult care giver. You will be given prescriptions for medications (to be filled pre-operatively) to assist with the temporary discomfort associated with the procedure, (“the worst” of it generally lasts no more than three days; for women who have been pregnant it has been likened to the discomfort associated with your milk coming in), for antibiotics and for nausea and / or vomiting should you experience these symptoms (most patients do not). You will be instructed in exercises to perform following your procedure and it is strongly encouraged that you get out of bed and walk around shortly after your operation. You are generally able to resume a normal diet the day of your operation.
Short Term and Long Term Follow Up:
Your plastic surgeon will review the temporary restrictions (six weeks in duration) in activity level and attire with you. You will routinely be seen at one week, six weeks, six months and one year following your operation. Your plastic surgeon encourages all women to resume their routine self breast exams two months following surgery and to return to be seen for an annual examination indefinitely.