Breast Augmentation Questions Frequently Asked
Will I be satisfied with the result?
Satisfaction rates with breast implant surgery are typically the highest reported, reaching above 90% in many studies. In Dr. Murphy’s practice, breast augmentation patients who are unhappy with their breast implants are very few. The time spent determining the appropriate breast implant size and shape helps to keep our re-operation rate to a minimum. Despite placing thousands of breast implants over the last 15 years, Dr. Murphy can think of only two patients who had their breast implants removed and not replaced.
Why do women have breast augmentation?
Contrary to the opinion of many people, most women want to have breast augmentation simply to balance their physique and bring themselves a confidence in their appearance they may have never had or have lost over time. Breast Augmentation patients can more comfortably wear more youthful and current styles of clothing. Breast enhancement allows them to be more self-assured, be it at the beach, dressed to the nines at a formal event, exercising or just choosing their wardrobe on a day-to-day basis. Patients who have had a breast augmentation love the freedom.
Why might breast augmentation not be appropriate for me?
You must be sure that your goals for breast enlargement surgery are not unrealistic. You need to ask yourself why you are considering a breast augmentation. Are you pursuing breast augmentation surgery to help meet your own personal desires rather than trying to affect the opinion of others? It is not going to dramatically change your life or how others think of you. There is a chance that your anatomy is not appropriate for simply a breast enlargement and you may require other complementary surgery such as a breast lift.
What are the benefits of silicone implants?
The majority of Dr Murphy’s Breast Augmentation patients are now choosing silicone gel breast implants. Silicone breast implants offer patients the best option to have the most natural feeling, and often most natural appearing, breasts. In relatively thin patients who do not have a lot of natural breast tissue, and especially if they wish to have larger implants, silicone breast implants are particularly beneficial. Silicone breast implants are much less likely to show any visible rippling around the edges and it is less likely that the implant will be felt underneath the skin. In the rare patient we place the breast implant above the muscle and in these patients, with the loss of the padding effect of the muscle, silicone breast implants are more appropriate.
Are silicone breast implants safe?
The currently available silicone breast implants are the safest and most reliable ever produced. Silicone breast implants have been rigorously investigated and thoroughly reviewed by the FDA. Overwhelming research evidence has shown no increase in systemic illnesses in women with silicone breast implants as compared to the rest of the population. A few years ago, even the editor of The New England Journal of Medicine supported the safety of silicone breast implants. The leakage rates of silicone breast implants in patients having breast augmentation are extremely low (less than 1% per year). The silicone gel currently used inside silicone breast implants is cross-linked and thicker than the silicone gel used in older silicone breast implants. Therefore, even silicone breast implants which have leaked are much less likely that the older breast implants to migrate or cause any problem in the breast.
What about saline breast implants?
Saline breast implants remain the implant of choice for many patients undergoing breast augmentation in Dr. Murphy’s office. . Typically these patients have more natural breast tissue and choose a smaller implant than average. Many patients are reassured that should their breast implants leak, the saline inside is harmlessly absorbed by the body and the leak is easy to determine. Replacing saline breast implants is typically easy to perform frequently under local anesthesia with minimal recovery.
Will my implants leak?
Dr. Murphy tells all his patients that breast augmentation is an operation you go into with the understanding that there is a good likelihood you will need another surgery at some point in the future. This is related to the likelihood of breast implant leakage. Although the chance breast implants will leak over the next 15 – 20 years is small, they may eventually leak. Leakage is more easily noticed with saline breast implants because as the body absorbs the saline the breast will visibly shrink. Leakage in silicone gel breast implants can be fairly accurately determined by MRI and all patients with silicone breast implants should consider regular assessments to be sure their implants are intact. Once any leakage has been established, the implants can be replaced during an office procedure. Breast Implant manufacturers also include warranties against leakage. My office staff can help clarify any questions on these breast implant warranties.
Does breast augmentation increase my risk of breast cancer?
Breast augmentation has not been shown to increase the risk of breast cancer. Similar studies have also shown that should you get breast cancer, the stage at diagnosis, treatment and outcome are no different in patients with breast implants as compared to those without. Dr. Murphy recommends all patients follow the guidelines of the American Cancer society regarding timing of mammograms both before and after their breast augmentation surgery. Screening exams such as mammography need to be performed in a facility familiar with patients with breast implants, and other modalities such as ultrasound may also be used. Remember that all of the breast tissue is over the top of the breast implant and is easily palpated during breast self exam.
What is the best incision?
Areolar (around the margin of the flat part of the nipple) or inframammary (in the fold beneath the breast) incisions have been proven to be the best due to the exposure they offer to the area where the breast implant needs to be placed. Each one typically heals with a barely noticeable scar. Frequently the final decision is made based upon the patient’s anatomy, personal desires or the implant chosen. Dr. Murphy has not found any difference in the occurrence of nipple numbness (about 1% in his practice) or infection or bleeding with either breast augmentation incision.
Is it important to place the implant under the muscle?
During a breast augmentation Dr. Murphy routinely places the breast implant under the muscle. With saline breast implants submuscular placement has proven very helpful to camouflage the shape of the breast implant and give the breast a more natural shape and feel. It makes it less likely there will be rippling or visibility of the breast implant. In some patients, the anatomy necessitates only partial placement under the muscle (dual plane technique). Submuscular placement of silicone gel breast implants remains important because the breast implants are much less likely to become hardened if placed under the muscle.
Will I need a breast lift or mastopexy as well as a breast augmentation?
The shape of the breast and location of the nipple give us very definite landmarks to help determine if a mastopexy (breast lift) is necessary for you. If your nipple seems to lie lower than the fold beneath your breast when you are standing, a breast lift may be necessary. Although this occasionally happens as the breast matures, it is more common after major fluctuations in weight or pregnancy. Most women have a good idea as to whether they need a breast lift along with a breast augmentation before they come in, and Dr. Murphy can help to assess this during your consultation.
What happens after the surgery?
At the completion of the breast augmentation surgery we wrap the chest in a snug dressing designed to help keep the breast implants in place. We check all breast augmentation patients the first postoperative day to assure that all is going well. The initial dressing is removed after four or five days and a supportive bra is placed. At eight to ten days any sutures are removed and the patient is taught to massage the breast implants around in the pocket to help keep them soft. During each early postoperative visit instructions regarding wound care and activities are reinforced. We continue to follow all breast enlargement patients at regular intervals over the first year and then yearly follow ups are offered. There are never any charges for follow-up visits in our office. Most patients take it easy in the house for few days but by five to seven days are driving and back to work. Exercising can start at 10 -14 days but more strenuous lifting and bouncing should be put off for six weeks after surgery to ensure that the implants do not migrate.
What about pain from breast enhancement surgery?
Dr. Murphy performs breast augmentation surgery with patient comfort in mind. He attempts to minimize pain, but all breast augmentation patients require some medications to help ease the discomfort. Pain control is paramount in Dr. Murphy’s practice and for all surgeries he typically prescribes two pain medications, a long acting anti-inflammatory type pain medication and a narcotic for more acute discomfort. Breast augmentation patients are given Valium tablets to help control muscle spasms and help in pain control. Although rarely necessary for breast augmentation patients, we have pain pumps available which pump in long-acting local anesthetic into the breast implant pocket for the first few days. Medications to help control nausea are also prescribed along with antibiotics.
Are there any other risks of breast augmentation surgery that should concern me?
There are small risks of infection or bleeding, both of which are less than 1 in 1000 in Dr. Murphy’s practice. Breast augmentation patients routinely complain of increased or decreased nipple sensation early after the procedure. The sensitivity almost always settles down. There is about a 1% incidence of permanent decreased nipple sensation after breast enlargement surgery. Studies have shown only a negligible change in ability to breast feed after breast augmentation.
The formation of a thickened/tightened layer of scar tissue around the breast implant (capsular contracture), is uncommonly reported after breast augmentation. Capsular contracture after breast augmentation surgery is typically corrected with a minimal surgery in the office. Should you have any further questions regarding breast augmentation surgery, our office staff is thoroughly up to date on any information regarding breast surgery. Please call to discuss this with our patient coordinators.