Breast Augmentation Surgery
Today, many women are able to alter the shapes of their breasts. Some with small, underdeveloped or asymmetrical breasts may choose to undergo breast augmentation, a safe, effective surgical procedure designed to improve the contour of a woman’s body by implanting specially designed breast implant materials beneath the breast or chest wall muscles.
Before Breast Augmentation Surgery
Prior to breast augmentation surgery, a complete medical history is taken in order to evaluate the general health of the patient. A thorough examination of the breasts is also made to determine the most effective surgical approach. The physician describes the type of anesthesia to be used, the procedure, what results might realistically be expected and the possible risks and complications.
Mammograms or x-rays may be taken as well as photographs. Preoperative instructions often include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily for the same reason. Antibiotics designed to prevent infection may be prescribed for a few days prior to breast augmentation surgery.
The Breast Implant Procedure
Breast augmentation is usually performed in a hospital or an outpatient surgical setting under general anesthesia with the patient asleep. A local anesthesia in which the patient remains awake and the area is numbed may also be used. The cosmetic surgeon may choose from a variety of surgical procedures, depending upon what changes are desired. Prior to surgery, premedication to relax the patient is administered and breasts are carefully marked to indicate where incisions are to be made.
Breast Augmentation - Saline Implants
Breast Augmentation - Silicone Implants
One of the techniques most frequently used is an incision made in the lower portion of the breast near the chest wall or around the lower portion of the areola (the dark pink area circling the nipple). A location less frequently used is in the armpit. When the incision is made in the lower portion of the breast, breast tissue is raised to create a pocket either under the breast tissue A breast implant containing a silicone gel, a saline solution, or a combination of the two is inserted into the pocket. In some cases, particularly those in which there is breast asymmetry, inflatable breast implants may be used. With this procedure, the cosmetic surgeon can adjust the amount of inflation.
After the breast implants are securely in place, small sutures are used to close the incisions. A breast augmentation can take two hours or more, depending upon the procedure and extent of the surgery.
Following Breast Augmentation Surgery
Following breast augmentation surgery, the patient wears either bandages or a special garment. These are usually replaced in a few days with a surgical bra which is worn for several weeks. Patients who are operated on in a hospital are released the day of surgery or after an overnight stay.
Pain connected with breast augmentation is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection. Instructions for the day of surgery include bed rest and limited activities. The physician determines when normal activities can be resumed; however, strenuous exercises and overhead lifting must be avoided for several weeks.
Sutures are removed in about five to seven days at which time the cosmetic surgeon may recommend massage to keep the breast supple. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from the incisions, although permanent, fade significantly with time.
Complications of infection and slow healing are rare; however there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the physician. Patients can minimize complications by carefully following directions given by the cosmetic surgeon. In some cases in which the breast becomes too firm due to the formation of scar tissue, a second breast augmentation procedure may be necessary.
What to expect after Breast Augmentation Surgery
Breast augmentation recovery typically requires that patients minimize physical activity for 3 to 7 days before slowly resuming more strenuous tasks. The amount of downtime required, and the amount of time needed to make a full recovery is largely dependent on the following:
- Location of the incision was placed
- Size of the breast implant
- Placement of the breast implant; above or below the pectoral muscle
Breast augmentation is the world’s most popular cosmetic surgery procedure, and techniques are being constantly refined in order to allow women to undergo surgery, recover, and resume their daily routines in the shortest timeframe possible. While the surgery and its results are the common focal points among those considering surgery, it is important to understand that recovery is a relatively brief, but crucial step in achieving the maximum benefits.
Choosing a qualified surgeon will reduce recovery time
If you are considering breast augmentation, you are probably spending considerable time deciding which surgeon to choose and how to budget for the cost of surgery. These are two very important aspects to consider, but it is equally important to budget for time you can spend away from work and other obligations, healing in a calm and relaxing environment and avoiding physical strain. Dr. Tony Mangubat is a Board-Certified Cosmetic Surgeon with more than 20 years of medical expertise. His deft touch allows for a better results and quick recovery.
Meanwhile, patients should understand that they will not have to spend their recovery lying in bed for a week; rather, they just have to take care to keep physical activity minimized, and take certain measures to ensure they heal properly.
Dr. Mangubat encourages anyone considering breast augmentation to spend time learning about all aspects of surgery, including the recovery period. By knowing what to expect, and preparing to follow your surgeon’s instructions closely, you can maximize the likelihood of a successful surgery that provides you with many years of boosted confidence and satisfaction with your appearance.
Submuscular versus Subglandular Placement
Breast implants are placed either above or below the pectoral muscle, according to the patient’s lifestyle, aesthetic goals, and other factors. During a breast augmentation consultation Dr. Tony Mangubat will advise you on the ideal placement. Submuscular placement is the more invasive of the two surgeries, because in addition to requiring an incision in the skin, this method requires separating a portion of the pectoral muscle to create room for the implant. This is often the recommended placement option for women who desire the most natural-looking results, and who do not regularly engage in activity that requires a great deal of upper body strain.
Because it is more invasive, submuscular placement usually requires about a week of downtime away from work and avoiding aerobic exercise, and can require about two to four weeks before doing any lifting. On the other hand, patients who choose subglandular placement are usually able to return to work within two to three days.
Healing garments are an important part of recovery, and they also differ according to implant placement. For submuscular placement, Dr. Mangubat recommends that patients wear a two-inch wrap-style bandage just above the breast. After surgery, the implant will eventually drop to a small degree as it achieves harmony with your muscle and breast tissues, resulting in a natural appearance.
If a patient chooses subglandular placement, she can wear a conventional bra, but it is recommended to wear one without an underwire, which can hinder the process of the implant dropping into place.
How much do breast augmentation costs?
Many patients are rightfully concerned about the cost of having breast augmentation. Sometimes it is confusing because there can be many additional fees that are not included in the original quote. Always inquire about ALL the fees that you will be charged and make an informed decision.
Dr. Mangubat feels that his quoted fees should reflect the total cost of having the operation (as much as possible). Since many surgeons operate in their own facility, it should be possible to deliver a global fee for the entire procedure that includes anesthesia, facility, and surgeon fee.
Costs often vary based on the surgeon’s expertise, the cost of the implants, and the geographic location of your surgeon. In addition, lower costs often means less time to spend with each patient and customer service can suffer.
Dr. Mangubat’s fees include operating room fees, doctor’s fees, anesthesia fees, implant costs, post-surgery garments and all pre and post- op visits. He performs surgery at his accredited surgical suite with state of the art technology.
If you are considering breast augmentation and have delayed surgery because of costs, his office can provide you with cosmetic surgery financing options. Most health insurance will not cover elective surgery, or any complications from surgery.
Remember that financial cost is not everything. Your time off from work requires sacrificing wages and using vacation and sick pay. If you have children, you may need additional childcare while you are recovering, especially for lifting and tending to children’s needs. When you consider the boost in your self-esteem, confidence and improved quality of life, you may decide the added expenses are necessary to achieve your goals.
The surgeon’s experience and your comfort with him or her are as important as the out of pocket costs. Silicone implants are often more than twice as expensive as saline implants.
Dr. Mangubat is a cosmetic surgeon, certified by the American Board of Cosmetic Surgery. This board requires a post – residency fellowship which reflects training exclusively in cosmetic surgery in all procedures in the face, breast and body, plus non-surgical cosmetic treatments and completion of a minimum of 300 cosmetic surgery procedures during this one year fellowship. This is in addition to a 3-5 year residency program. Recertification is required every 10 years.
As a dedicated educator, Dr. Mangubat has been the chairman of the highly acclaimed board review course that prepares young surgeon for the American Board of Cosmetic Surgery examination for the past decade. The state-of-the-art procedures, techniques and principles he uses are focused on enhancing a patient’s appearance. His goals are improving aesthetic appeal, proportion and symmetry. He will make it as safe and easy as possible for you to achieve the look and results you desire.
Call today for a complimentary consultation to learn about your surgical options, and discuss your expectations and goals. Dr. Mangubat offers customized treatment plans to achieve your goals. This is the time to ask your questions. He keeps an open line of communication so you feel comfortable and respected. Dr. Mangubat is committed to educating you to make informed decisions. Your satisfaction is his goal.
Breast Augmentation FAQs
- Which is better silicone or saline implants?
This will depend on your breast anatomy, body type and other factors. Your surgeon will recommend the best type for you. Many women prefer silicone gel implants because they are very difficult to detect by touch, feel softer and more natural than saline implants, pose less risk of folding or rippling, and pose no risk of deflation. Saline implants are more easily detected by touch or feel, and rupture more frequently than silicone implants; but require a smaller incision because they are inserted before they are filled with saline.
The main consideration is whether you have enough tissue to cover the implants. Saline implants tend to wrinkle and ripple more than silicone, however they are suitable for women with more body fat as the ripple effect is less noticeable. Thin women are more at risk of ripple from saline implants, and thus silicone would be the preferred type.
The difference between costs can be significant. Silicone is more expense, very soft, more undetectable and rarely have a ripple effect. The majority of implants go under the muscle to hide the implants. Above the muscle implants tend to age worse and faster as they have less support. Published capsular contracture rates are similar for both types. Most contractures are noted in the first year after surgery.
- What type of incisions will I have?
The most commonly requested incision is via the armpit. Dr. Mangubat prefers not to make incisions on the breast, because he doesn’t want to scar the anatomy that he is trying to make more beautiful. For saline implants the incision can be made via the belly button.
- Will implants make mammograms less accurate?
Implants make it more difficult to see breast tissue with a mammogram. But today, the protocols for mammograms for patients with breast implants has been expanded to include six views vs. the standard two, to create a more precise image of the tissue.
- How long will implants last?
Dr. Mangubat prefers Mentor Implants which are covered by a manufacturer’s warranty for 10 years. This warranty covers the cost of replacements. Saline implants last approximately 5-10 years. Warranty upgrades are available to extend the warranty for an additional 10 years. But there is no reason to change your implants unless you are having a problem. However, these are not lifetime devices. The longer you have them, the greater the chance that complications may develop which may require more surgery.
- How long should I take off work?
If you are not taking pain medications, you can return to work in one week. But, the type of work you do will also determine how long you take off. If you are not on pain medications, you will be permitted to drive after the first week. Raising the arms or straining to reach should be avoided for the first 2 weeks. You should not lift anything over 5 lbs for six weeks.
- How soon can I resume my exercise workout?
You should begin walking almost immediately after surgery. But you should not do any exercise that raises your blood pressure and heart rate for one month. Any intense activities like weight lifting, jogging, and jumping can cause the implants to shift, and should be avoided until then. And, you should not do any breast exercises for at least one month.
- Are silicone implants safe?
Yes, today’s silicone implants are safe. In 2001, the FDA declared that silicone implants do not increase the risk of disease. The risk of developing breast cancer is the same as in women who do not have implants. If you have implants and do develop breast cancer, you have the same survival rates as women without implants who develop breast cancer. Many studies have shown that silicone implant gel leaks are not related to or cause connective tissue disease, breast cancer or reproductive issues.
- What is capsular contraction?
Scar tissue forms around implants as a natural part of the healing process. It is not a problem unless it tightens making the breast feel firm, unnatural and even painful. About 9% of women will develop capsular contraction. Your doctors may prescribe antibiotics, massage and/or Vitamin E. In serious cases, surgery may be necessary.
- What happens if my implants rupture or leak? And how will I know?
Mechanical failure of implants is rare. Saline implants that leak or rupture will be obvious because the breast will appear deflated. While the saline that leaks is absorbed by the body, you may need surgery to remove the capsule, and replacement of the implant. The newest generation of silicone implants contain cohesive gel that is thicker and has a lower rate of rupture as compared with older silicone implants.
If a silicone implant ruptures, you may not be aware because the breasts usually remain stable in size, and the gel may remain inside the implant shell or in the scar tissue that surrounds the implant. These are called “silent ruptures”, and are not able to be detected by physical examination. If the gel ruptures and leaks outside the capsule, you may notice a change in breast size or shape, hard lumps over the implant, uneven appearance of the breasts, pain, tenderness, numbness, burning or change in sensation. Ruptures can be caused by capsular contracture, compression during a mammogram, aging of the implant, and trauma to the breast.
However ruptures are not life threatening. You and your surgeon will decide on the course of action if your implant has ruptured, and whether it should be replaced, or removed.
- Will I be able to breast feed?
Yes. Breast feeding after augmentation is safe. Placement of implants behind breast tissue or behind the chest muscles will not affect the ability to breast feed.
- Should I put off implants until I am done having children?
No. Many women have breast implants before having children. But it is a personal preference.
- Should I get the implants above or below the muscle?
There are advantages and disadvantages to each. Some surgeons prefer one over the other. Implants placed behind the chest muscles reduce the incidence of capsular contracture, and make mammograms easier. They are also less visible and result in less rippling of the skin.
“Excellent communication of anticipated results. Dr. Mangubat set realistic expectations.”
Please note that plastic surgery results can vary for different patients. Every patient is a unique individual and every surgery has unique aspects. Therefore no two surgical procedures will get the exact same results - even if patients are fairly similar and even if the procedures are performed by the same Plastic Surgeon.