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Breast augmentation is a surgical procedure to enhance the size and shape of a woman's breast.

It is performed for a number of reasons:

To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
To correct a reduction in breast volume after pregnancy.
To balance a difference in breast size.
As a reconstructive technique following breast surgery usually for cancer.

By inserting an implant behind the breasts, it is possible to increase a woman's bustline by one or more bra cup sizes.

If you're considering breast augmentation, this will give you a basic understanding of the procedure -- when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please ask your surgeon if there is anything you don't understand about the procedure.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate.

Types of Implants

A breast implant is a silicone shell filled with either silicone gel or a saltwater solution known as saline.

All surgery carries some uncertainty and risk

Breast augmentation if done by a qualified plastic surgeon is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard.

The incidence of capsular contracture has reduced with the advent of newer implants.

Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, undersensitive, or even numb. These symptoms usually disappear within time, but may be permanent in some patients.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the manmade shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body.

If a break occurs in a gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all of the silicone gel in the breast tissue if a rupture should occur.

A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants.

There is no evidence that breast implants cause breast cancer. While the majority of women do not experience many complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.

Preparing for surgery

Prior to the surgery, the doctor will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

Where the surgery will be performed

The surgery is done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

Types of anaesthesia

Breast augmentation is usually performed with a general anaesthesia.

The surgery

The method of inserting and positioning the implant will depend on the patient's anatomy and the surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. All efforts are made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Through the incision, a pocket is created, either directly behind the breast tissue or underneath the chest wall muscle (the pectoral muscle). The implants are then centered beneath the nipples.

The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage is applied over the breasts to help with healing.

After the surgery

You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, the gauze dressings will be removed, and you may be given a sports bra. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

Getting back to normal

You should be able to return to work within a few days, depending on the level of activity required for your job.

Breasts will probably be sensitive to direct stimulation for two to three weeks, so much physical contact should be avoided. After that, breast contact is fine once breasts are no longer sore, usually three to four weeks after surgery.

Scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, scars will begin to fade, although they will never disappear completely.

For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance.

Regular examination by your plastic surgeon and routine mammograms for those in the appropriate age groups at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.

Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you are realistic in setting your goals, then you will be pleased with the outcome of the surgery.