Many women considering breast augmentation are justifiably concerned about implant safety. Multiple studies have demonstrated no link between breast augmentation and breast cancer, arthritis, or other autoimmune disorders. Even in the case of a silicone implant rupture, there is no toxic or autoimmune response.

Each silicone and saline implants have benefits and detractors. The advantages of silicone implants are that they are soft and mimmic natural breast tissue and there is less incidence of rippling. The disadvantages are the implants require a slightly larger incision than saline implants for insertion and are slightly more costly than saline implants. Though rupture is uncommon, it may be difficult to detect and may require an MRI to determine The advantages of saline implants are that they are slightly less costly than silicone implants. There are more routes of insertion including transaxillary (via the armpit), periareolar, and inframmmary approaches require a slightly smaller incision for insertion. The disadvantages of saline implants are that they are slightly more firm than silicone implants depending on implant fill volume and there is a higher incidence of rippling, which may be an issue in women who are very thin or have very small breasts.

Women can and should breast feed following a breast augmentation.

Transient loss of nipple sensation is not uncommon following breast augmentation. Permanent loos of nipple sensation is uncommon. The incidence of sensation loss is roughly 5%. Loss of sensation is slightly more frequent when a periareolar incision is used.

Implant volume depends both on your natural breast size and your desired outcome. Implants each have a specific base diameter and height. Thus, the width of the breast is an important parameter. Breast measurements can be attained on examination, and implant volume can be estimated during consultation.

Mild breast ptosis (droopiness) can be corrected with an implant alone. Following pregnancy, breast tissue may involute, and an implant can simply replace lost volume. Larger degrees of ptosis may require a mastopexy (lift) with or without an implant. This is determined, in part, by a measure of the sternal notch to nipple distance, a measurement attained upon physical exam.

Upon rupture, saline implants simply loose their internal volume, and the released saline is reabsorbed by the body. The affected breast will return to its original shape and volume. When silicone implants rupture, this event may be difficult to detect. Because modern implants contain a cohesive gel, the material will usually adhere to itself staying within the confines of the breast pocket. An MRI may be required to determine the definitive integrity of a silicone implant.

Mammography is a routine contributor to breast health after age 40. The recommended age for mammography may vary depending on personal and family health history. Mammograms are possible and recommended following breast augmentation for women over 40. Additional images called Ecklund Views are often required to maximize surveillance of breast tissue in women who have undergone augmentation.

The popular press often quotes breast implant longevity to be 10 years. In reality, breast implants may last less than five years or greater than twenty years, depending on the patient. The key components to maximizing implant lifespan is choosing a size-appropriate breast implant and performing implant displacement exercises (breast massage) following surgery. When these factors are met, breast augmentation outcomes are optimized.

By far the greatest risk of breast augmentation is capsular contracture. This occurs when scar tissue encapsulates an implant, and breasts can become firm and distorted. This outcome is unlikely to occur when implants are placed in a submuscular plane and postoperative exercises are performed. Infection following breast augmentation occurs in less than 1% of individuals. Bleeding following surgery also occurs in few than 1%. Other very rare complications include implant malposition or extrusion.

By far the most common approach in Southern California is via a periareolar incision. This is an incision created at the juncture of the pigmented areolar skin and the breast skin. This incision heals with an inconspicous or nearly invisible scar. Some physician have attributed a slightly higher incidence of capsular contracture to this approach. An incision beneath the breast (inframammary fold) is also an option. This is an acceptable approach, but may leave a visible scar in the breast crease. An axillary (armpit) incision is also frequently chosen. The axillary approach will facilitate the use of only small volume silicone implants. Saline implants of any size can be placed through the axilla. The recovery time for this approach tends to be slightly longer than other approaches.

Generally, most women are able to return to work 2-3 days following augmentation. Return to a full exercise routine my be accomplished in about 3-4 weeks. Following surgery, patients return home and can function with some restrictions including no heavy lifting.

Women often equate breast augmentation pain to muscle soreness following vigorous exercise. The discomfort is easily controlled with pain medications which are prescribed prior to surgery.

It is ideal to see patients at one day and one week following surgery. After these appointments, follow up is tailored to each patients needs.

Antibiotics and pain medications may be necessary for several days. Implant displacement exercises are begun 1-2 days following surgery. Patients must avoid lifting more than 15 pounds for about 1 week.