Breast Augmentation

Two weeks before breast augmentation surgery:

• Stop smoking
• Stop blood-thinning medications
• Make arrangements for hospital transfer

One week before the surgery:

• Stop consuming alcohol
• Inform your doctor if you have any allergies, cold, cough, or any other ailment

One day before the surgery

• Prepare a bag for the hospital with loose fitting clothes, important medications, and simple snacks
• Take medications as advised by the surgeon
• Do not eat or drink anything after midnight on the day of the surgery

On the day of surgery

• Do not use any body lotion or antiperspirant
• Do not take any medications unless advised by the doctor
• Take a shower using normal soap and water
• Take medication for blood pressure, if advised

Firstly, an incision is made in the skin covering the breast and the underlying tissue region. A pocket is created within the tissue region to place the breast implant.

All kinds of breast implants that are available have a filling material covered by an outer shell, which is composed of silicone elastomer. They are available in different shapes such as circular, oval directed projection-type or contoured-type. The latter types are called anatomic implants with tapering tips and fuller size at the bottom. The shape of these implants closely resembles the natural shape of the breasts of a fully grown mature woman.

The movement, weight, and feel of silicone gel-filled implants are very similar to that of natural breasts. The modern generation gel-type implants have a thick viscous fluid called a cohesive gel that always stays in place even if the outer shell gets damaged. Gel implants come pre-filled and sealed and as a result, they cannot be adjusted further in the operating room.

• Silicone rubber shells are filled by surgeons with sterile salt water or saline in the operating room. If the implants start leaking, then saline used for an intravenous fluid of the body will be absorbed by the body without any harm. They are preferred because of their safety profile. The implants, in this case, are inserted empty by making a relatively smaller incision.
• The surface of the implant can be smooth or textured. The texturing is important since it is thought that hardened scarring can be prevented around the implants. There will be lower chances of implant rupture since the textured surface is thicker. The implant also gets stabilized due to texturing, which is desired at times.
• The pocket of the breast implants can be made in two positions. This is with respect to the pectoralis major muscle fascia, which is found deep in the breast or the breast tissue. When the pocket is made directly behind the breast tissue on top of the muscle fascia, then it is called subglandular placement. The advantage of this pocket is control of the shape of the breast and quick post-operative recovery. However, there remains a chance of seeing the edge of the implant under the skin.
• In case of submuscular placement for implants, the pocket is made underneath the muscles of the chest wall. The contour of the breast looks smooth in this case as muscles hide the edges of the implants. There will be a lower chance of developing hard scars around the rim of the implant. Even nipple sensation is well protected.

Postoperative discomfort will be pertinent in this case. The recovery period can also be long in this case. The ability to have the upper breasts filled centrally will be less.

Recovery after breast enlargement depends on a number of factors such as the elasticity of the breast tissues, the size of the implant, position of the implant, and whether it is under or on top of the muscle. In case the implant has been placed on top of the muscle, pain is minimal and recovery period does not stretch beyond two days. A patient who has had implants placed under the muscle can experience some pain and may take longer to recover.

It is advisable to abstain from lifting activities or any other strenuous activity for the next two weeks. Retention of fluid and subsequent swelling can be avoided by doing so.

Keep taking the drugs prescribed by the surgeon but refrain from using them beyond the advised dosage even if the pain is bothering. Contact the surgeon immediately if you experience some other discomfort, including swelling, bleeding, fever, or inflammation.