Augmentation mammaplasty or breast augmentation is a procedure which uses an implanted device (breast implant) to enlarge the size of the breast. This is a purely elective procedure performed for aesthetic reasons. There is increasing use of fat injection for small augmentations and shape refinement of breast reconstruction which represents another option for a limited subset of patients.
The breast implants are constructed as a silicone shell which is filled with sterile saline after insertion. Implants have been in the media a great deal over the past few years. Different types exist. Both saline filled and cohesive silicone gel implants are available currently in the US. A variety of issues apply to silicone implants that are not as critical for saline filled implants. These will be discussed in more detail during the consultation and can be reviewed in information supplied by the manufacturers. Dr. Bass prefers to works with either of the two largest and most widely used manufacturers: Mentor and Allergan.
There is no evidence that the incidence of breast cancer is increased or decreased after augmentation mammaplasty. Implants are placed behind the breast tissue allowing normal examination of the breast by you and your doctor. The exam will feel different after augmentation and you must become accustomed to your new normal exam. In mammograms of women with implants, parts of the breast tissue cannot be seen because of the implant. A special mammogram is required which provides additional views. These mammograms require a radiologist experienced in reading mammograms in patients with implants. Mammograms for patients with implants may be more expensive than routine mammograms.
In addition, I will follow you yearly to evaluate the status of the implants. If you are not able to see me, another plastic surgeon should evaluate the implants yearly.
Any foreign material will have some interaction with the body which we will never completely understand. The best studies available at this time do not demonstrate an association between silicone and systemic disease in the body. Any effects of silicone are minimized by use of a saline implant with a solid silicone shell as used in many medical devices but no silicone gel which can migrate more easily into body tissues. This is discussed in more detail in the manufacturers disclosure form.
The operation can be performed under local anesthesia with sedation or general anesthesia depending on the surgical approach selected. Incisions can be placed under the breast fold, around the nipple or in the armpit area. I perform this procedure in our accredited office operating room or at the ambulatory surgery facility of a hospital. Endoscopic techniques are used to help improve the precision of the dissection.
What to Expect
You will experience temporary discomfort for several days after the operation. You will want to rest at home for several days. Pain relievers will be prescribed so that you will be comfortable. After that, you will be able to be more active but will still have some discomfort for up to two weeks. Bruising and swelling are common but subsides over the first few weeks.
During the consultation your preferences for breast appearance will be discussed as well as details about your medical history. In conjunction with Dr. Bass, decisions will be made about the location of the incision, size, shape, type and location of the appropriate breast implant for you.
In an effort to preserve the privacy of our patients, representative images of Dr. Bass’s breast surgery results can only be viewed in the office during a consultation.