Breast Augmentation



What Is Breast Augmentation?
Breast Augmentation is a procedure that alters the size and/or shape of a woman’s breast using implants made of saline or silicone gel for cosmetic (personal desire) reasons.  Breast augmentation an extremely popular surgery in the United States.


Who should consider Breast Augmentation?
As with any surgery it is always best to start off being healthy, and to be considering the procedure for the right reasons; that is, your choice, not something someone else wants you to do it.  Not widely known, most clothing is designed to specific proportions and if breasts are too small (or not present at all) garments don’t fit correctly.  Models sometimes need an enhancement for that reason.  Professional dancers for a slightly different reason.  Most women feel it will give them an enhanced sense of self-esteem, a more feminine contour.  Some women may have had previous surgery on their breasts, either a breast lift (mastopexy) or a mastectomy for breast cancer, and would like to add volume to their breasts.  A woman who was unlucky enough to be born with a breast abnormality might also consider this procedure.  A man living as a transgender or considering a sex change operation would benefit as well.

Why do people choose Breast Augmentation?
As with any cosmetic procedure, it’s to make us feel better about ourselves.  Many patients report great distress about their appearance in a variety of situations and seek a way to alleviate that feeling. Small breasted women choose to have the surgery to improve their confidence.  Others wish to add volume to their breasts to give them a more youthful appearance after childbirth or aging.  Whatever the reason, breast augmentation is a safe procedure to help people achieve the look and self confidence they’re dreaming of.

What are the risks?
Complications are rare however surgeries involving breast implants, whether for cosmetic or reconstructive surgery, carry risks common to many types of surgery.  These include adverse reactions to anesthesia, post-operative bleeding or fluid collection, surgical site infection or breakdown, breast pain or alterations in sensation, unfavorable scarring, interference with breast feeding, visible wrinkling, asymmetry and thinning of the breast tissue.  Any of these risks are a possibility but rarely happen.  Changes in sensation is the most common concern for patients and indeed it can change but it is usually a minor change and sometimes returns to normal many months later.  Scarring is not an issue in our practice as Dr. Sachse uses a waveline incision technique along the lower edge of the areola that is generally invisible when healed.  Breast encapsulation is also a risk of augmentation surgery.  Whenever a breast implant (or implant of any type) is placed in the human body, a thin layer of scar tissue surrounds the implant, which is normal.  But sometimes (rarely) the scar tissue thickens due to an immune response, which is still somewhat of a mystery to the medical community, and the breast becomes round and hard due to the thickened capsule of scar tissue.  Treatment varies; if caught right away ultrasound and deep massage therapy may work.  The capsule itself may have to removed as an additional surgical procedure, which oftentimes includes replacing the implant at additional cost to the patient.
Incorrect placement of a breast implant may happen and is the surgeon’s error.  An ethical surgeon will alleviate the problem with a minor cost to the patient for the OR fee.  “Bottoming out” is a term to describe the appearance of breasts in which overly large (and heavy) implants were placed in the patient and settled quite low in the pocket due to extensive undermining of the pectoralis muscle.  This causes the nipple/areola complex to rotate upward, looking somewhat skyward, incorrectly so.  In our office you will try on different size implants so you know what you will wake up with after surgery.

What is the recovery period?
Recovery time is different for each patient.  Patients are generally able to resume normal activity in approximately one week's time; others a couple of days less or a week more.  Sutures are removed in 2 weeks.  Women who have their implants placed underneath the muscle (subpectoral placement) will generally have a longer recovery time and experience more pain due to the muscle being lifted by the implant.  The implants appear high on the chest immediately following surgery and an elastic band is worn for 1-2 months across the top of the breasts to maintain a downward pressure into the pocket.  Softness and final settling are several months out as the pectoralis finally relaxes into its new position over the implant.  Exercise and strenuous physical activity will often need to be avoided for up to six weeks. 

Over the muscle placement (subglandular) is a more comfortable healing process.  There are three reasons women have sub glandular augmentation; they are afraid of experiencing the discomfort of sub pectoral placement, their breasts sag too much to get a good result from a sub pectoral placement, or if they into extreme or competitive weight lifting.  Swelling will always be present immediately following surgery and lessens over the next few weeks.

Dr. Sachse will further advise you about your choices during your complimentary consultation.