Breast augmentation is a surgical procedure to enhance the size and shape of a woman’s breasts for a number of reasons:

By inserting an implant behind each breast, surgeons are able to increase a woman’s bustline by one or more bra cup sizes.

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 surgery, think carefully about your expectations and discuss them with your surgeon.


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Beauty for life:
Enhancing your appearance with breast augmentation

If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:

• Increase fullness and projection of your breasts
• Improve the balance of your figure
• Enhance your self-image and self-confidence

Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Implants also may be used to reconstruct a breast after mastectomy or injury.

What it won’t do
Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Dr. Foley will assist you in making this decision.

Is it right for me?
Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Breast augmentation may be a good option for you if:

• You are physically healthy
• You have realistic expectations
• Your breasts are fully developed
• You are bothered by the feeling that your breasts are too small
• You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
• Your breasts vary in size or shape
• One or both breasts failed to develop normally

What to expect during your consultation

The success and safety of your breast augmentation procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer and results of any mammograms or previous biopsies

Dr. Foley may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast augmentation and any risks or potential complications
• Discuss the use of anesthesia during your breast autmentation

Preparing for surgery

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• Post-operative care and follow-up
• Breast implant registry documents (when necessary)

Dr. Foley will also discuss where your procedure will be performed. Breast augmentation surgery may be performed in an accredited office-based surgical center, outpatient ambulatory surgical center or a hospital.

You’ll need help
If your breast augmentation is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Procedural Steps:
What happens during breast augmentation surgery?

Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Foley will recommend the best choice for you.

Step 2 – The incision
Incisions are made in inconspicuous areas to minimize visible scarring. You and Dr. Foley will discuss which incision options are appropriate for your desired outcome. Incision options include:

Inframammary Incision

Transaxillary incision

Periareolar incision

Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.

Step 3 – Implant choice
Breast size and shape are important, so be honest and open about your expectations when talking with Dr. Foley. Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.

Options for Breast Implants

• Saline implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body.
• Silicone implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit Dr. Foley regularly to make sure the implants are functioning properly. An ultrasound of MRI screening can assess the condition of breast implants. Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available.

Currently Saline implants are FDA-approved for augmentation in women 18 years of age and older.

Currently Silicone implants are FDA-approved for augmentation in women 22 years of age and older.

Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

See www.breastimplantsafety.org for current information.

Step 4 – Inserting and placing the implant
After the incision is made, a breast implant is inserted into a pocket either:

• Under the pectoral muscle (a submuscular placement), or

• Directly behind the breast tissue, over the pectoral muscle (a submammary/subglandular placement)

The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and Dr. Foley’s recommendations.

Step 5 – Closing the incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.

Over time the lines will fade

Step 6 – See the results
The results of breast augmentation are immediately visible. Over time, post-surgical swelling will resolve and incisions lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.

Important facts about the safety and risks of breast augmentation

The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Dr. Foley and/or the Foley Plastic Surgery Center staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor healing of incisions
• Changes in nipple or breast sensation, may be temporary or permanent
• Capsular contracture, which is the formation of firm scar tissue around the implant
• Implant leakage or rupture
• Wrinkling of the skin over the implant
• Anesthesia risks
• Fluid accumulation
• Blood clots
• Pain, which may persist
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases.

Other important considerations:

• Brest implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants.
• Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime.

My recovery

After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at the direction of Dr. Foley. Over time, post-surgical swelling will decrease and incision lines will fade.

You will be given specific instructions that may include: How to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with Dr. Foley.

Be sure to ask Dr. Foley specific questions about what you can expect during your individual recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
  When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedures and another surgery may be necessary.

Be careful
Following Dr. Foley’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Dr. Foley will give you specific instructions on how to care for yourself.

The results will be long-lasting

The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of clothing and swim wear. Like many women who have had breast augmentation, you may also have a boost in self confidence.

Implants may need to be replaced or revised
It’s important to know that your breast implants are not permanent and may require replacement during your lifetime. You should expect to have future visits with Dr. Foley to discuss changes in your breasts.

Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour.

Continue to follow Dr. Foley’s instructions and attend follow up visits as scheduled.

How much will breast augmentation surgery cost?

Cost is always a consideration in elective surgery. Prices can vary greatly depending on the extent of the procedure, the combination of multiple procedures, and the time involved. You will receive a detailed quote following your consultation. Talk with the Foley Plastic Surgery Center staff about your payment options.

Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Implant cost

Most health insurance plans will not cover cosmetic breast augmentation surgery, related complications or another surgery to revise the appearance of your breasts. Some carriers even exclude breast diseases in patients who have breast implants. You must carefully review your health insurance policy.

Your satisfaction involves more than a fee
When choosing a plastic surgeon for breast augmentation, remember that the surgeon’s experience with breast implants and your comfort with him or her are just as important as the final cost of the surgery.

Words to know

Areola: Pigmented skin surrounding the nipple

Augmentation mammaplasty: Breast enlargement by surgery

Breast Augmentation: Also known as augmentation mammaplasty; breast enlargement by surgery

Breast Implants: Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel).

Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.

General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.

Hematoma: Blood pooling beneath the skin.

Inframammary incision: An incision made in the fold under the breast.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

Local anesthesia: Sedatives administered by injection during an operation to relieve pain.

Mammogram: An x-ray image of the breast.

Mastectomy: The removal of breast tissue, typically to rid the body of cancer.

MRI: Magnetic Resonance Imaging; a painless test to view tissue similar to an x-ray.

Periareolar incision: An incision made at the edge of the areola.

Saline implants: Breast implants filled with salt water.

Silicone implants: Breast implants filled with an elastic gel.

Submammary or subglandular placement: Breast implants placed directly behind the breast tissue, over the pectoral muscle.

Submuscular or subpectoral placement: Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall.

Sutures: Stitches used by surgeons to hold skin and tissue together.

Transaxillary incision: An incision made in the underarm area.

Ultrasound: A diagnostic procedure that projects high frequency sound waves into the body and records the echoes as pictures.