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.
  
  

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using any of your present medications. These may include aspirin, ibuprofen, or blood thinners.
  
  
• Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.
  
  
• Tell your caregiver if you know or think you might be pregnant.
  
  
• You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
  
  
• You may need to have blood and urine tests, a mammogram, chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given a pill to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Do not wear contact lenses on the day of your surgery. You may wear glasses.
  
  
• Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem using anesthesia in the past.
  
  
• Caregivers may need to take pictures of your breasts. This will be used to compare the pictures of your breasts before and after the surgery.
  
  
• You will be asked to sign a legal piece of paper (informed consent). It gives a caregiver permission to do the procedure. If you are unable to give your consent, someone who has permission can sign this form for you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room. You will get medicine called general anesthesia to keep you completely asleep during surgery. Caregivers will clean your chest and the areas around the breast. Sheets will be put over you to keep the surgery area clean.
  
  
• Caregivers will make incisions in your breast area, armpit, or umbilicus. The breast implant will then be placed under the breast tissue or chest muscle. If an adjustable implant is used, the implant will be filled with saline. Thin rubber tubes may be put into your skin to drain blood from your incision. The incisions will be 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. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a wound near the area where surgery will be done.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You feel a lump in your breast or axilla (underarm), or see or feel other changes.
  
  
• You have discharge coming from your nipple.
  
  
• You have redness, swelling, or severe pain in the breast.

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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.