Breast Augmentation | Breast Implants

What are the risks and possible complications of breast augmentation surgery?

All surgery comes with risk. The decision to have breast augmentation surgery in Orange County and whether or not the risks are acceptable are unique to each individual.

Capsular contraction

• Capsular contraction is the most common side effect, or complication, of breast augmentation surgery in Orange County. It can cause discomfort or pain. When the pocket for the breast implant is created, a scar capsule forms around it and under normal circumstances does not cause a problem. Capsular contracture occurs when the scar capsule that surrounds the implant shrinks or contracts, squeezing the implants, resulting in varying degrees of firmness. Capsular contraction can occur at anytime and develop in either breasts. It is possible that capsular contracture occurs as a result of a very mild infection.
• Textured breast implants may change how the scar capsule develops, which greatly reduces the risk of getting a capsular contraction.

Severe capsular contracture may require surgical intervention. Rarely, the contraction recurs and cannot be eliminated after multiple surgeries. In such cases, the implant may be removed and the breasts augmented with your own fat.

Wrinkling

• breast augmentation surgery using textured breast implants can cause visible wrinkling under the skin. Once in a while, the edge of the breast implant can be felt. This is usually mild, requires no treatment and frequently improves or disappears within a year.

Asymmetry

• If your breasts varied in shape before surgery, they may also be slightly different following breast augmentation surgery. If it becomes a problem after healing, a small adjustment can be made.

Loss of Sensation

• The nerves in the breasts may be cut or damaged during breast augmentation surgery. It does not happen all the time and the nerves recover in 1 to 2 years in 85 percent of the patients.

Implant Movement

• When the muscle contracts, the breast implants will temporarily flatten and/or pull upward. Occasionally, the breast implants may move higher than their original position.

Calcium Deposits

• A thin layer of calcium may occur in the scar capsule that surrounds the implant several years after breast augmentation surgery. Because the calcium adds to the density of the scar, there may be a reduction in the detectability of lesions close to the scar during a mammogram. However, breast cancer may still be detectable so long as specialized techniques are used.

Mammogram Interference

• Before a mammogram, let the technician know you have breast implants. There are special techniques applied in order to see as much of the breast tissue as possible, but some breast tissue may not be visible.
• Though rare, an implant may rupture due to the compression during a mammogram.

Breast Feeding Interference

• Breast augmentation surgery may interfere with the ability to breast feed, though many women with breast implants have done so successfully.

Deflation

• The breast implant may deflate if the implant fails, causing saline to leak. This is rare, not harmful and the body will absorb the saline. However, the breast implant will have to be replaced.

Loss of Skin, Nipple or Breast Tissue

• An extremely rare complication, loss can occur from an infection that causes the death of the involved tissues but will heal with good care. Usually only small areas are affected but secondary surgery may be required.

Exposure or Extrusion

• A rare complication is the erosion of the breast implant through the skin or scar, caused by severe wrinkling, infection, inadequate tissue coverage or capsule formation. The breast implant would most likely need to be removed temporarily.

Synmastia

• The loss of cleavage may occur when the skin over the breastbone pulls away from the bone, causing either the skin to tent in between the pockets or the pockets to merge and become one. Though this is unusual, secondary surgery will be needed.

Hematoma

• In a small percentage of women, bleeding may occur in the pocket with the implant. Minimal bleeding will be absorbed by the body over time but significant swelling will require the blood be removed by a secondary surgery.

Infection

• In rare occasions, an infection may develop. They are often mild and heal without further problems. If the infection is serious, the breast implants will be removed for several months until the infection heals.

Immune Disorders

• Claims regarding silicone gel implants contributing to connective tissue disorders such as systemic lupus, scleroderma, rheumatoid arthritis, etc. have been made. Other side effects involving the skin and nervous and immune systems have been reported. However, scientific studies have not found a direct relationship and the silicone implants are FDA approved.

Breast Cancer

• Studies show that breast cancer incidence in women with and without breast implants is roughly the same or lower in women with implants.

What is recovery from breast augmentation surgery like?

Day of Surgery your breast augmentation Surgery in Orange County

• breast augmentation is performed as an outpatient procedure so your stay in the Orange County surgery center is 1 to 2 hours in the recovery room. You should be accompanied home by a friend or relative until the anesthesia wears off.

Sleeping

• Sleep on your back for at least the first week after breast augmentation surgery in Orange County to ensure the breast implants are in a perfect position during the initial healing.

Painkillers

• Expect some soreness for a few days, though this can be controlled with prescribed painkillers. You should be up and around after 24 hours after your breast augmentation surgery.

Showering

• On the third day after breast augmentation surgery, remove the dressing, sponges, and gauze pads to take a shower. After showering, pat the incisions dry and wear a clean surgical bra or sports bra. Do not wear an underwire bra until you have completely healed or this may prevent your breasts from assuming their natural shape.

Work

• You should be able to return to work after a few days after breast augmentation surgery, depending on the level of activity required.

Activities

• Avoid activities that raise your blood pressure during the first week after breast augmentation surgery. This could cause bleeding at the operative site, which could result in a hematoma.
• Avoid exercises which directly stress the area of your breast augmentation surgery for 4 weeks. Avoid heavy lifting, contact sports, and jogging for up to 6 weeks. This will maximize healing and minimize scarring.
• Walking is okay during the first week.
• Cardiovascular activities, such as riding a stationary bicycle or brisk walking, is okay during the second week after breast augmentation surgery.

Driving

• Avoid driving if it causes pain. Typically driving can be reintroduced 7 to 10 days after breast augmentation surgery. Follow the directions for any pain medication regarding driving.

What to Expect

• The first post-operative visit occurs 5 days after breast augmentation surgery.
• You may experience a burning sensation in your nipples that can last up to 3 weeks. This will subside as the bruising fades.
• Swelling in your breasts can last up to 5 weeks. As a result of the swelling, your breasts may look shiny. As the swelling subsides, the skin will return to normal.
• Your two breasts may heal differently. One may swell more or feel more uncomfortable than the other and they may differ in shape. Once you have healed completely, your breasts should look similar and natural.
• You may hear or feel “sloshing” in your breast after surgery, though this does not happen often. It is caused by trapped air around the implant and the fluid that accumulates after an operation. This will subside in a few weeks.
• Avoid irritation around the surgical site. This can make swelling and fluid accumulation worse and cause problems, such as fluid collection, opening of the suture line or widening of the scar.
• Avoid excessive force, abrasion, or motion during recovery.

Massaging

• After the first week of recovery after breast augmentation surgery, breast massages are recommended to reduce the potential for capsular contracture. The proper technique for massaging the implants are taught during post-operative visits.

Scarring

• Scars will be firm and pink for about 6 weeks but healing is unique to each person. Scars should lighten and flatten out after about 9 months. It is important to protect scars from the sun, even through clothing.

Sensation

• You may experience tingling, burning, or shooting pains as the nerves regenerate. The nipples may become hypersensitive as well but any discomfort will subside with time. If however, this is accompanied by swelling or redness, infection, or bleeding, seek help.

Mammogram

• Continue routine mammograms as prescribed; the mammographic technician should use a special technique to ensure a reliable reading.

Emergencies

• Seek help immediately if you experience shortness of breath, chest pains, unusual heartbeats, fever, dizziness, nausea, vomiting or a general ill feeling. Or if there is an increase in swelling, drainage, pain, redness or bleeding in the breast augmentation surgical area.

What is the difference between subglandular, submuscular and subpectoral breast implant placement?

For breast augmentation surgery, subglandular refers to the breast implant being placed under the breast tissue but over the muscle. Submuscular refers to the breast implant being placed under the muscle of the chest wall. Subpectoral (or partially submuscular) refers to the breast implant being placed under the pectoralis major muscle only. This leaves 1/3 of the lower, outer implant not covered by muscle tissue but by the breast gland.

Which method is best?

For breast augmentation, whether to place the breast implants subglandular, submuscular or subpectoral is determined by the natural shape of the breasts and chest wall muscles and is different for everyone. However, in most cases of breast augmentation, the preferred placement is in a submuscular position for several reasons:

1. The breast implants tend to look and feel more natural due to more tissue covering the implants.
2. breast implants in a submuscular plane have lower risk of capsular contracture,- this occurs when the body develop scar tissue around the implant. Capsular contracture can change the shape of the implant and result in an asymmetrical look.
3. This method also results in less disruption to the normal breast tissue and nerves, and makes mammographic examinations easier.
4. Because the breast tissue is separated from the breast implant by the muscle, the quality of a mammography exam is much better.
5. Though submuscular implant placement is a bit more uncomfortable, it reduces the possibility of sagging due to weight loss or pregnancy since the muscle will support the implant.

What type of incisions can be used for breast augmentation?

1. Transumbilical – through the navel
2. Inframammary – under the breast fold
3. Transaxillary – through the arm pit
4. Peri-areolar – around the nipple-areola complex
5. Mastopexy – made for a breast lift
6. Through a scar or abdominal incision

The goal of any surgery is to minimize the size of any type of incision. Most patients with symmetrical breasts are good candidates for a transumbilical breast augmentation (TUBA). However, when it is necessary to change the shape of the breast, an inframammary incision allows enhancement of cleavage and/or the correction of breast asymmetries. Areolar incisions are best performed when breast augmentation and breast lift procedures are combined.

What is inframammary breast augmentation?

Inframammary breast augmentation uses a 1.5 inch incision that is placed at the mammary crease. Through this incision, the breast implant pocket is prepared and the implant is placed within the pocket. This approach leaves a thin scar within the mammary crease which is concealed by the augmented breast. If secondary surgery is ever needed, the surgeon can use the same mammary crease incisions. The inframammary incision is the most popular incision used for breast augmentation in the majority of cases.

What is transumbilical breast augmentation?

Transumbilical breast augmentation (TUBA) leaves a virtually unnoticeable scar since the incision goes through the belly button. A small fiber optic camera called an endoscope is used to see while a tunnel to the breasts is created and a dissection is made under the chest muscle. An expander is inserted and saline solution pumped into it in order to shape the breast. The final implant replaces the expander.

What is peri-areolar breast augmentation?

Peri-areolar breast augmentation makes an incision at the junction of breast skin and the pink areola. The incision is then extended through the breast tissue to the chest muscle. Implants can be placed above or below the muscle. If a secondary surgery is needed, the surgeon can use the same incision. Peri-areolar breast augmentation is suitable for women who require a small breast lift through a crescent mastopexy.

What is transaxillary breast augmentation?

Transaxillary breast augmentation involves a small incision in the armpit, or the axilla, through which the implant is inserted. Implants can be placed above or below the muscle. An endoscope is sometimes used to allow for a more direct placement of a submuscular implant. Transaxillary breast augmentation often takes longer to complete than other approaches since the procedure is more involved.