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By: Edwin Paul Magallona, MD

Breast augmentation or augmentation mammaplasty is an aesthetic and cosmetic surgery done to enlarge small, hypoplastic, underdeveloped breasts, performed to balance asymmetric breasts secondary to post mastectomy reconstruction, and provide breast volume to women who have given birth. The operation is usually performed when the breast reaches its mature and final size after puberty at approximately 18 y/o. There are instances however when it can be done earlier such as when one is dealing with congenital breast hypoplasia with significant patient confidence and social issues.

A patient interested in the procedure must have a comprehensive consultation with a certified cosmetic plastic surgeon. This is the first step one should do if entertaining thoughts of a breast augmentation or augmentation mammaplasty. One should always remember though that a good outcome is basically reasonable and realistic improvement and never unachievable and impossible "perfection". This is particularly true if the procedure is being done for reconstructive purposes as when performed after a mastectomy. All patients are thoroughly screened for emotional stability. Having a "new" look from a breast augmentation will never guarantee a glamorous and exciting life. The procedure will just enhance your appearance and potentially give you that push in self confidence. Realistically this is what breast augmentation may just achieve for you. There are no guarantees. How you cope with the positive physical gains of an augmentation mammaplasty is actually up to each patient. It should be kept in mind that the primary objective of breast augmentation are just breasts that look fuller and more natural in appearance.

A simple Breast augmentation takes approximately an hour or two. It may take longer to complete if combined with other cosmetic plastic surgery procedures. The procedure may be safely done in an outpatient setting or in a hospital basis under general anesthesia. Once under general anesthesia one will be sleeping soundly all throughout surgery. Local anesthesia may be infiltrated around the breasts in addition to general anesthesia.

There are several incisions which could be utilized by your plastic surgeon in his approach for placing the breast implant. The inframammary approach makes use of an incision just below the inframammary fold wherein the lower part of the breast connects with the chest. A periareolar approach is placed around the inferior border of the areola. The transaxillary approach utilizes an incision in the armpit. Each technique has its own advantages and potential downside.

Generally, the plastic surgeon lifts the breast tissue up together with the muscle to create a pocket for the implant. At times he may prefer creating a pocket without lifting the muscle. This is called the subglandular or subpectoral/submuscular placement of implants. There are numerous factors that come into play in deciding which technique to use. Your plastic surgeon will discuss everything with you.

Wound closures are always carefully and meticulously performed by your cosmetic plastic surgeon. Scars are natural consequences of any incision or surgery. Your cosmetic plastic surgeon will try his best to keep them well concealed and hardly noticeable as possible. Following surgery, dressings will be applied over the wounds while bandages shall have to be maintained over the superior pole of the breasts to hold in place and prevent migration of the implants.

All surgeries have potential risks which all patients should be aware of. Bleeding, infection, paresthesias, and healing problems are possible though relatively not so common. It is prudent to always inform your plastic surgeon of any bothersome and persistent concerns. Swelling and bruising/ skin discolorations are common and expected and usually resolve in a week or two. Bruisings are expected and go away in 1 or 2 weeks. A sense of numbness and tightness may be present which eventually improves and subsides. Post breast augmentation patients are instructed rest for at least a day and ordered to avoid any exertions. A sports bra shall replace the bandages in a few days while sutures will be out after a week. Most patients do return to work after approximately 2 weeks. Optimal results are seen after about 3 months.

All potential plastic surgery patients are strongly encouraged to consult with a certified cosmetic plastic surgeon. Everyone has to be properly and thoroughly informed regarding the procedures they would like to have. Your certified cosmetic plastic surgeon will display adequate knowledge, skill and care prior, during and after surgery.


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