What is breast augmentation?

Breast augmentation comes in many names such as breast implant, breast enlargement, mammoplasty enlargement, augmentation mammoplasty, or the slang term “boob job”.  It’s basically a surgical procedure where prosthesis is used to change the size and shape of a woman’s breasts, often for cosmetic reasons.

There are two major types of implants: saline-filled and silicone-filled implants.  Saline implants are made of a silicone elastomer and the implants are filled with salt water after being placed in the body.  Silicone gel implants have a silicone shell filled with a viscous silicone gel of different compositions.

The time to complete breast augmentation approximately takes one to two hours, which are determined by the incision type, implant material, and implant pocket placement.

Incision Types:

• Inframammary – An incision is placed below the breast, in the infra-mammary fold (IMF), and usually the preferred technique for silicone gel implants.  This technique can leave slightly more visible scars.
• Periareolar – An incision is made along the areolar border.  Silicone gel implants can be difficult to install through this method due to the length of incision required for access.  Since scars appear on the edge of the areola with this method, they are often less visible in women with lighter areolar pigment. This type causes the most problems with breast feeding because the milk ducts and nerves that lead to the nipple are cut.
• Transaxillary – An incision is made in the armpit and the dissection tunnels medially.  While this approach causes no visible scars on the breast, it’s more likely to create asymmetry of the inferior implant position.
• Transumbilical (TUBA) – An uncommon technique where an incision is made in the navel and dissection tunnels superiorly.  This procedure isn’t appropriate for installing silicone gel implants because of the potential damage that the implant shell could receive in attempting to insert it through the small incision in the navel.
• Transabdominoplasty (TABA) – A method similar to TUBA, but the implants are tunneled up from the abdomen and then into dissected pockets while a patient is undergoing an abdominoplasty procedure at the same time.

Patients can generally resume normal activity in about a week’s time, but women who have their implants installed underneath the muscle will likely experience longer recovery time and a bit more pain due to the muscle being cut.  Exercise and strenuous activities need to be avoided for up to six weeks.  Scars from a breast augmentation procedure will commonly begin to fade a few months after surgery.

Women who are in their child-bearing years should first discuss breastfeeding with a surgeon before surgery, to allow them to make choices that will minimize damage to functional breast tissue, and lactation consultants who can advise on what to expect.