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Breast lift (mastopexy) - series	Breast reduction (mammoplasty) - series	Breast augmentation - series

Cosmetic breast surgery

Definition

Breast augmentation is a procedure to change the size or shape of the breasts.

See also:

• Breast reconstruction - natural tissue
• Breast reconstruction - implants
• Breast lift

Alternative Names

Breast augmentation; Breast implants; Implants - breast; Mammaplasty

Description

Cosmetic breast surgery may be done at an outpatient surgery clinic or in a hospital.

• Most women receive general anesthesia for this surgery. You will be asleep and pain-free.
• You may also have medicine to relax you and ocal anesthesia. You will be awake and will receive medicine to numb your breast area to block pain.

There are many different ways to place breast implants:

• In the most common technique, the surgeon will make an incision (cut) on the underside of your breast, in the natural skin fold. Your surgeon will place the implant through this incision. Your scar may be a little more visible if you are younger, thin, and have not yet had children.
• Another technique is to place the implant through an incision under your arm. Your surgeon may use an endoscope (a tool with a camera and surgical instruments at the end that is inserted through a vein) to do the surgery. There will be no scar around your breast, but you may have a visible scar on the underside of your arm.
• In another technique, the surgeon makes a cut around the edge of your areola, the darkened area around your nipple. You may have more problems with breastfeeding and loss of sensation around your nipple with this method.
• A newer technique involves placing the implant through an incision near your belly button. The surgeon tunnels an endoscope up to the breast area. A saline implant is placed and filled.

Breast implants may be placed either directly behind the breast tissue (subglandular) or behind the outer layer of chest wall muscles (submuscular). Placement of the implants and the kind of implants will affect:

• How much pain you have after the procedure
• The appearance of your breast
• The risk of the implant breaking or leaking in the future
• Your future mammograms

Your surgeon can help you decide which procedure is best for you.

Risks

Risks for any surgery are:

• Bleeding
• Infection

Risks for any anesthesia are:

• Reactions to medicines
• Breathing problems, pneumonia
• Heart problems

Risks for breast surgery are:

• Difficulty breastfeeding
• Loss of feeling in the nipple area
• Small scars, usually in an area where they do not show much. Some women may have thickened, raised scars.
• Uneven position of your nipples
• Different size or shape of the two breasts
• It is normal for your body to create a "capsule" made up of scar tissue around your new breast implant. This helps keep the implant in place. Sometimes, this capsule becomes thickened and larger and may cause a change in the shape of your breast, hardening of breast tissue, or some pain.
• Breaking or leakage of the implant
• Visible rippling of the implant

The emotional risks of surgery may include feeling that your breasts don't look perfect, or you may be disappointed with people's reactions to your "new" breasts.

Review Date: 3/2/2009
Reviewed By: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardnes, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.