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If you are considering breast augmentation, you probably already know that it is a procedure to enhance the size of your breasts by using breast implants. While breast augmentation is not the answer for everyone, many women find that the procedure has helped improve their appearance, and even their self-confidence. The next step now is deciding if it's right for you.
Breast implants, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:
- To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
- To correct a reduction in breast volume after pregnancy.
- To balance a difference in breast size.
- As a reconstructive technique following breast surgery.
WHAT GIVES THE BREAST ITS SHAPE?
The breast consists of milk ducts and glands surrounded by fatty tissue, and covered by skin. The fatty tissue gives the breast its soft feel and shape. Skin elasticity also affects breast shape. Pregnancy (during which the milk glands are temporarily enlarged) and the inevitable effects of gravity over time stretch the skin envelope and change breast shape. The pectoralis major muscle lies beneath the breast, and indirectly affects breast projection. The pectoralis major muscle helps with flexing and rotation of the arm and shoulder joint.
THE BEST CANDIDATES FOR BREAST AUGMENTATION
 Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have breast surgery, think carefully about your expectations and discuss them with your plastic surgeon.
The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate. Please view our breast augmentation photos.
HOW IS BREAST AUGMENTATION PERFORMED?
The technique used for surgery depends not only on your surgeon’s preferences, but also on your desired results. The incision is small and is usually made in one of three locations; underneath the breast just above the crease; around the lower edge of the areola; or within the armpit.
Once the incision is made, the surgeon creates a pocket into which the implant is inserted. This pocket is made either directly behind the breast tissue or beneath the pectoral muscle located below the breast tissue and above the chest wall.
Many women tend to think of their breasts in terms of bra cup size. For instance, if you are a 34 A now, you may know you would like to be about a 34C after your augmentation. At the same time, you may have concerns about breast shape and proportions that bra cup size alone can’t describe. You may know that you would like to have a certain amount of cleavage, or more of an “hourglass” figure. You should discuss your personal preferences with your surgeon; so that he or she can take them into account in choosing the right implant size and shape for you. By inserting a breast implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.
TYPES OF BREAST IMPLANTS
 A breast implant is a silicone elastomer (rubber) shell filled with a salt-water solution known as saline.
In 1992, the Food & Drug Administration (FDA) decided that more safety and effectiveness information was needed on the type of breast implant filled with silicone gel, and greatly restricted the use of these implants in the United States. Saline-filled implants continue to be available to breast augmentation patients on an unrestricted basis.
ALL SURGERY CARRIES SOME UNCERTAINLY AND RISK
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.
 As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.
A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after breast augmentation plastic surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.
Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear with time, but may be permanent in some patients.
There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body.
 If a break occurs in a gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all silicone gel in the breast tissue if rupture should occur.
A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants and the symptoms of what doctors refer to as "connective-tissue disorders," but the FDA has requested further study.
While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.
While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
PLANNING YOUR BREAST AUGMENTATION PLASTIC SURGERY
In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift, (also known as mastopexy.) Breast augmentation photos are available.
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