Cosmetic Surgery Procedures

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Breast Augmentation (Augmentation Mammoplasty):

Other associated terms: breast enlargement, mammoplasty enlargement, or the common slang term boob job



 Breast augmentation is the third most popular cosmetic surgery procedures performed in theUnited States, today. The goal of the procedure can either be the enhancement of breast appearance or the restoration of normal breast appearance. However, the enhancement procedure is not a new one. The interest in breast enlargement has been around for quite some time and early augmentation procedures were performed in the late 1800s, using paraffin injections. Sadly, these had less than desirable results. Subsequently, various materials were used, including glass balls and ground rubber. More recently, in the 1950s and 60s, synthetic materials were used. The most popular being silicon injections, which proved to be harmful to a significant number of patients. In some cases, mastectomies needed to be performed in order to treat the more serious side effects that came about as a result of these injections. Since then, a number of breast augmentation procedures have been developed that present far fewer risk factors and can be extremely beneficial to those seeking medical or cosmetic applications for augmentation.



 The benefits of breast augmentation are directly related to one's self image subsequent to the surgery. The goal of breast augmentation is either the cosmetic enhancement through the sizing, shaping and contouring of the breasts or the surgical repair of an existing issue, which is needed in order to restore appearance.


Types of Augmentation:

 Reconstruction: This procedure is indicated for those who have had one or both breasts removed as a result of a mastectomy performed as a result of cancer. The procedure is also indicated in cases of breast loss due to trauma or in instances where the breast has failed to develop normally. Gender reassignment can also be

 Revision-Reconstruction: This procedure is used to correct or improve the results of a previous reconstruction surgery.

Primary Augmentation: This procedure is used to increase breast size for desired cosmetic reasons.

Revision-Augmentation: This procedure is used to correct or improve results of a previous augmentation surgery.


Patient Characteristics:

Individuals who desire breast augmentation as a cosmetic procedure should possess characteristics that would assist them in making this decision. Also, it should be noted that it's extremely important to have an initial, detailed consultation with a qualified surgeon before any cosmetic procedure. The best indicators of breast augmentation candidacy are expectations of improvement as opposed to perfections. Age is also a factor and augmentation should be limited to those over the age of eighteen. Good physical and mental health are also necessary in order to be a good candidate for surgery. Studies have indicated a relationship between self-esteem and body appearance that improved significantly after a breast augmentation procedure. Other improvements, such as those in self-confidence, social life and sexual function have shown to be more transitory in long-term follow up studies.



 There are several different techniques that compose the group of surgeries that are considered breast augmentation. The simplest procedure involves making an incision, moving breast tissue, thus creating a space for the implanting of a device designed to alter the shape and size of the breast. That device is a packet containing a material such as saline or silicon-gel. Currently, saline is the most common material used in implants designed for cosmetic purposed. For reconstructive surgeries, silicon implants can be used. The reason for this is connected with controversy regarding the link with silicon implants and its' subsequent side effects. More recently, adjustable implants have been introduced. These are saline implants that can be adjusted through an additional small incision through which an injectable port can be accessed in order increase/decrease the amount of saline.


The size, anatomy of the patient, shape of the breast and the size of the implant will determine the positioning of the implant. The options are placement behind the muscles of the chest wall or placement behind the breast tissues, just behind the areola. This type of surgery usually lasts 1-2 hours and is performed under general anesthetic. The incisions are then closed using standard sutures. The chest area can also be reinforced with gauze bandages in order to protect the surgery area and to assist with healing. Temporary tube placement may also be used to facilitate drainage. The procedure can be performed in the cosmetic surgeon's office, a surgical clinic or a standard hospital operating suite. There will be a certain amount of pain as a result of the surgery and this can be managed with standard pain medication. It's recommended that you have someone to assist you for 1-2 days after surgery and you will need to have someone drive you home, directly after surgery.


Instructions before and after surgery will be discussed with your doctor and can include certain restrictions prior to surgery. Those restrictions may include item guidelines on smoking, eating, drinking and the use of medications/vitamins. Post-surgical instructions will also involve physical activity limitations and the appropriate time off from work will be indicated prior to surgery. It will also be very important to take any prescribed medications (such as antibiotics) after the surgery.

Risks Associated With Breast Augmentation Surgery:

 The risks associated with breast augmentation surgery are mostly those associated with any general surgery. The most important thing to understand about implants is that they are not permanent devices. When an implant ruptures, the results are obvious (change in breast size) and will require additional surgery for replacement of the implant. In the case of a saline implant, the saline solution is absorbed by the body within a few hours. The rupture can be caused by trauma or can occur spontaneously.


Another complication that can develop involves the hardening or tightening of the area surrounding the breast implant. This condition is known as capsular contracture and may necessitate further surgery in order to remove the scar tissue and, in some cases, the implant itself. However, this condition can be avoided/treated by frequent massaging following the surgery as well as other instructions that your doctor can give, regarding this condition.


Numbness and sensitivity can also occur after surgery and should disappear over time. Shifting of the implants can also occur which can result in "dents" or "ripples" on the surface of the implant which may require implant replacement. Infection can also occur and is usually treated with antibiotics. In some cases, implants may need to be removed when treating severe infection.


Procedure Costs:

 The cost of breast augmentation surgery can vary. However, the national estimate for the procedure, as provided by the American Society for Aesthetic Plastic Surgery is $3,375. That estimate is only for the surgeon's fee. Additional fees, to be considered, include anesthesia, facility expense, medications, lab tests and other miscellaneous fees. The total expense should be discussed in detail with your cosmetic surgeon during your initial consultation. While reconstructive breast surgery may be covered by most medical insurance companies, the same is usually not true for cosmetic procedures such as breast enlargement. Most surgeons offer financing options that can make the procedure affordable.


Things to Discuss with Your Surgeon During Your Consultation:

 It's important to discuss several items and to ask specific questions during consultation prior to surgery. You should also check your surgeon's qualifications, ask for patient references and review before and after photos before making your final decision regarding surgery.


15 Questions to Ask Your Doctor Regarding Breast Augmentation:

1. How long have you been certified by the ABPS (American Board of Plastic Surgery)?
2. Do you have hospital admitting privileges? If so, with which hospitals?

3. How many breast augmentations do you perform, on average, per year?

4. What is your rate of complications (capsule contracture, "rippling", infection, etc)?

5. What’s the most common complication your patients experience?

6. What is your re-operation rate with breast implants, and what is the most common re-operation you perform?

7. What incision site do you prefer, and why?

8. What placement do you prefer? Do you perform both over the muscle and under the muscle implants?

9. Do my breasts sag? Will breast implants provide some lift, or will I need a breast lift / mastopexy?

10. Do you recommend massage in order to prevent capsule contracture? Why, or why not?

11. Where do you perform your surgeries?  In a hospital, outpatient surgical center, or your own surgical suite? Is your facility accredited, and if so, by who?

12. What is your policy on repairs needed as a result of your initial surgery (lowering a crease, etc.)? Do you charge a fee for these things, and if so, how much?

13. Are all post-op visits free? If so – for how long?

14. Regarding reconstructive surgery vs. plain cosmetic breast augmentation, which do you perform more often?

15. Will I be seeing you after my surgery, or will I be seeing one of your assistants for my follow-up appointments?

Ultimately, the information provided by this site should serve only as a general guide. For those considering surgery, the most important step is a consultation with a qualified cosmetic surgeon.