Breast augmentation involves the placement of either saline or silicone breast implants to increase the size of the breasts. Saline implants are filled with salt water, and usually feel harder to the touch. Silicone breast implants are softer, but should be monitored with breast MRIs every 2-3 years. Either way, the breast implants are usually placed under the pectoralis muscle. If the implants are placed on top of the pectoralis muscle, the borders of the implant may be easier to feel.
In order to determine the appropriate breast implant size, patients should bring in a soft supportive bra with no inserts. We will have different size breast implants for you to try on over your breast and in your bra. Some women will also want to try on their clothes over the implant. You will try on many different size implants until you reach a size that you feel is too small and a size that is too big. This is the range of breast implant size that you feel is right for you. Every woman has a different idea of how she wants her breasts to appear. In addition, every bra company has a different sizing system so that a C cup in one company may be equivalent to a B cup in another company. Thus, the best way to determine the right size for you is to try different implants on for size yourself. It may also be helpful for you to bring in photos of breasts that look like the breasts that you want.
The breast implants are usually placed through one of two scars. For patients with very small breasts, the best scar is usually a periareolar scar, which is a small curvilinear scar that is placed along the edge of the “areola,” or the dark circle in the middle of your breast. Women with small breasts usually have small areola with sharp borders, so that their scars are well camouflaged when placed at the border. For patients with larger breasts, a periareolar or an inframammary scar can work well. This is a scar placed at the bottom edge of the breast border. Since the weight of larger breasts causes them to fall below the bottom border of the breast, or the “inframammary fold,” a scar at the inframammary fold is often well-concealed.
After a breast augmentation, patients usually do not need drains. There are dressings on the incisions, which remain in place for at least 48-72 hours. After the dressings are removed, the patient can shower. Sometimes, we will give patients an elastic band to push the implants down for shaping. Many patients can return to work in 1-2 weeks. Patients should avoid heavy lifting for 6-8 weeks. The breasts will be swollen initially, but the swelling subsides and the breasts settle over several months.