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Breast augmentation or breast enlargement is a surgical procedure to increase the size of woman’s breasts by placing breast implants under breast tissue or chest muscles. Some women feel that large breasts are more attractive than small or average size breasts. Their breasts did not develop to the desired size or they may have lost volume due to pregnancy, weight loss, or aging. For these women, breast augmentation may provide a more flattering, better proportioned figure, expanded clothing options, and feelings of greater confidence and self-esteem.
Breast augmentation, or augmentation mammoplasty, or is a surgical procedure that aims to increase the size, shape, or fullness of the breast. The surgeon places silicone, saline, or alternative composite breast implants under the chest muscles or breast tissue.

Breast augmentation is done to:
• Enlarge breasts that are naturally small
• Restore breast size and shape after pregnancy, weight loss or breastfeeding
• Restore symmetry when the breasts are asymmetrical
• Restore the breast or breasts after surgery

Plastic surgery includes reconstructive surgery and cosmetic surgery.
Reconstructive breast surgery may be done as a part of the treatment for breast cancer. Cosmetic breast surgery is done for esthetic purposes. Breast augmentation is normally cosmetic surgery.

A breast implant is a medical prosthesis that is placed inside the breast to augment, reconstruct, or create the physical form of the breast.

There are three main types of breast implants:
Saline implants are filled with a sterile saline solution, like salt water. The solution is held within an elastomer silicone shell. These implants can be filled with different amounts of saline solution. This affects the feel, firmness, and shape of the breast.
If a saline implant leaks, the solution will be absorbed and expelled by the body naturally.

Silicone gel-filled implants consist of a silicone outer shell filled with a silicone gel. If a silicone-filled implant leaks, the gel will either stay in the shell or escape into the breast implant pocket. A leaking silicone-filled implant may or may not collapse.
Patients choosing this type of implant should carry out more regular checks with their doctor compared with those on saline solution implants. An MRI or ultrasound scan can check the condition of the implants.

Alternative composite implants may be filled with polypropylene string, soy oil, or some other material.

Will breast augmentation increase my risk of breast cancer?

This is one of the most frequently asked questions by women considering this surgery. Many studies have shown that women who get implants are not at an increased risk for getting breast cancer. In addition, implants do not delay the detection of breast cancer. Numerous studies, as well as evidence from the National Cancer Institute, show that having implants does not hinder the patient or their physician in finding breast tumors. Finally, breast implant patients who do get breast cancer have the same chance of obtaining remission, or being free of cancer for 5 years, as women without implants.

Am I too old for the surgery?

Many women in their 40s and 50s have undergone breast augmentation surgery with good results. The most common patient for this surgery is a woman in her 30s with two children who has been considering this operation for many years. Whatever your stage in life, we encourage you to schedule a consultation to find the best path toward your cosmetic goals.

Should I wait until I am done having children to have augmentation?

Pregnancy will change the size and shape of a woman’s breasts whether she has implants or not. These changes may adversely affect the cosmetic appearance of any augmented breast. It is usually recommended that pregnancy be postponed until 6 months after the surgery. Breast-feeding with implants is still possible and has been shown to be safe for the baby and the mother.

Will augmentation work for me if I feel my breasts are sagging?

Women with sagging breasts, which is called “ptosis”, can also receive breast implants. Depending on how much the breast sags, an additional surgery may also be necessary. For breasts with nipples that droop below the lower crease of the breast, a breast lift surgery, or mastoplexy, is often required as well. This surgery will also add scars all the way around the nipple-areola unlike most breast augmentation surgeries. Without this additional surgery to remove excess skin, placement of the implant may not adequately correct the sagging.

How do I choose my new size?

This is often one of the most difficult decisions, and for many reasons, has the most potential for disappointment. During your consultation, your plastic surgeon will work with you to identify what size of breast you desire from augmentation. “Breast size” as measured by bra-size is variable and is often not a good way to measure final size. As a general rule, every 125-150cc of implant volume equals an increase in a single cup size. However, every patient’s body is different. By working with your surgeon and their clinical team, you can set obtainable and healthy expectations together. It is helpful for you to bring in a bra the size you would like to be to help in finding the right sized implant for you.

How much does surgery cost?

At your consultation you will receive a detailed summary of all costs associated with breast augmentation surgery at the University of Michigan and an explanation of our payment policies.

Will my nipple sensation or feeling change?

Most women will have loss of some feeling or sensation following breast augmentation surgery. For most of them, this lasts 6-12 months before returning to normal. 15% of women, however, have permanent alterations in nipple sensation.

How long until I can exercise?

It is recommended that patients begin walking immediately after surgery. However, women should not perform any intense physical exercise for six weeks following the operation. Physical exercise including weight lifting, biking, jogging, and other forms of intense activities may cause implants to shift position or cause wound healing problems that may alter the appearance of the breasts after surgery.

When can I return to work?

This depends on your job and its physical demands. Some general guidelines are: Upper arm movements, like reaching, should be avoided for the first 1-2 weeks. Lifting anything heavier than 5 pounds should be avoided for 6 weeks after the operation. This lifting restriction may prevent some women from returning to work.

How much pain can I expect?

The pain from breast augmentation surgery is usually in the moderate range and generally can be well controlled with medication in the first 1-2 weeks following the surgery. It is important to note that severe or untreatable pain following surgery can mean infection or another complication.

When can I drive?

Women may start driving a car one week after surgery as long as they are not taking any pain medications.

Will the new implants affect my physical functioning, can I lift heavy objects?

It is unlikely that you will experience long term changes in physical functioning. Depending on the size of the implant, most women find no trouble performing most physical activities following the surgery. Weight lifting or lifting heavy objects will not affect the implant once the area has properly healed.

Can I breast feed after augmentation?

Yes. Placement of the implant below the breast tissue, as in subglandular placement, does not affect the ability of the breast to produce milk. Similarly, submuscular placement, or implant placement below one of the chest muscles preserves proper breast functioning. With the peri-areolar incision, an increased risk of breast-feeding problems may exist. In one study, 7/8 patients reported problems with breast-feeding following peri-areolar breast augmentation surgery. For women who choose the infra-mammary or trans-axillary incision, (incisions under the breast and through the armpit), breastfeeding is usually not a problem. Be sure to discuss your breast feeding needs with your surgeon during your consultation.

Will I need additional surgeries?

Sometimes additional surgeries may be required for augmentation patients. To reach optimal symmetry, you may desire follow up breast lifts or other supporting procedures. Additional surgeries may be needed if you face any complications during your augmentation, like implant rupture or capsular contracture. In addition, implanted breasts will age just like any other body part and in the future some woman choose to have additional operations to correct the results of gravity and aging. During your consultation, you and your surgeon should discuss the possibility of additional procedures after breast augmentation.

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