Cosmetic Augmentation Mammaplasty

WHAT YOU SHOULD KNOW:

• Cosmetic augmentation mammoplasty is also called breast augmentation surgery. This is surgery to increase the size of the breasts. It may also help give a fuller look to the shape of the breasts. Cosmetic augmentation mammoplasty is often done to match the breasts to the build of the woman's body. It may help a woman feel better and improve her self-confidence. After a cosmetic augmentation mammoplasty, the size and shape of your breast may be affected by certain conditions. These conditions may include pregnancy, lactation (breast milk production), and changes in weight.
  
  
• With breast augmentation, prostheses (implants) are used to add volume to the breasts. A breast implant has an outer silicone shell (cover) and an inner filling. The shell may be smooth or textured, which may make the shell thicker. The inner filling is usually saline (salt water) solution. A breast implant may be round or shaped like a natural breast, and may be adjusted to different sizes. The type and size of breast implant to be used will depend on why the surgery will be done. It will also depend on how much breast tissue you have and how you want your breasts to look. You may be offered an implant filled with silicone gel instead of saline. Ask your caregiver for more information about silicone gel implants.
  
  
• For this surgery, caregivers will make incisions (cuts) around the fold of the breast or areola (dark circle around the nipple). The breast fold is the area on the lower part of the breast that joins the chest. Caregivers may also do the surgery by making incisions in the axilla (underarm) or umbilical (belly button) area. An endoscope may be used to guide caregivers in placing the implants. This scope is a long, bendable tube with a light and camera on the end. Breast implants may be placed in between the breast tissue and chest muscle, or right under the chest muscle. You and your caregiver will decide which type of breast augmentation surgery is right for you.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• There are always risks with having surgery. You may bleed more than usual or get an infection. You may have allergies with the anesthesia or develop a reaction from the implants. Your breasts may lose some feeling or look unequal, or if you have a baby you may not be able to breast feed. Scar tissue may form around the implant, or the implant may wear out, burst, or leak.
  
  

• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  

• Sometimes, skin death may occur if you have a problem with healing. You may need to have more surgeries later on. Women who smoke are at a higher risk for problems. Call your caregiver if you are worried or have questions about your surgery, medicine, or care.
  
  

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicines right before surgery. Some medicines may make you feel sleepy and more relaxed. You may also be given antibiotics to prevent an infection. You will be taken on a stretcher to the room where your surgery will be done. Caregivers help you get comfortable on the bed. A belt may be put over your legs for safety. If you get cold, ask for more blankets.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
    
    
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your surgery:

• Caregivers will clean your chest area with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Sheets are put over you to keep the surgery area clean. Incisions (cuts) are made around the areola, in the breast fold, underarm, or umbilicus. A space is made under the breast tissue or under the chest muscle.
  
  
• The breast implant is then carefully inserted in the space. Caregivers may use an endoscope if the implant is inserted through the axilla, breast fold, or umbilical incision. If an adjustable implant is used, caregivers will fill the implant with saline through a small, removable fill tube. This tube is left attached to the implant and placed just under the skin for weekly breast size adjustments. This is removed until the desired size of the breasts is reached. Thin rubber tubes are put into your skin to drain blood from your incision. The incisions are then closed with sutures (threads) and covered with bandages.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. If you had general anesthetic, an adult will need to drive you home. Your driver or someone else should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

• Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
  
  
• Deep breathing and coughing: This is an exercise to help decrease your risk for a lung infection after surgery. Do the following:
  
  
  • Hold a pillow tightly against your incision (cut) when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breathes help open the airways that lead to your lungs. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
    
    
  • You may be given an incentive spirometer to help you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Food and drink after surgery: You will able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft food easily, you may slowly begin to eat solid foods.
  
  
• Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.