There are a variety of breast surgeries available – most are to increase the size of the breasts through implants or fat transfer. Other surgeries, such as a breast lift, can improve the contour of the breasts or the size and proportion to the hips and body. Breast surgeries may also restore volume to the breast that is lost after losing a significant amount of weight or after pregnancy and breastfeeding. Many women find that they have an increase in confidence after a breast surgery.
There are a variety of breast surgeries available – most are to increase the size of the breasts through implants or fat transfer. Other surgeries, such as a breast lift or a breast reduction can improve the contour of the breasts or the size and proportion to the hips and body. Breast surgeries may also restore volume to the breast that is lost after losing a significant amount of weight or after pregnancy and breastfeeding. Many women find that they have an increase in confidence after a breast surgery.
Breast augmentation using implants can be performed to increase the size of the breasts. This can increase fullness of the breasts, and improve balance or symmetry. Types of implants include:
- Saline breast implants are filled with saline water. Should the implant shell leak, the implant will collapse and the saline will be absorbed by the body.
- Silicone breast implants are filled with silicone gel. The gel feels somewhat like natural breast tissue. If an implant leaks, the gel generally remains in the implant shell or pocket. A leaking silicone implant will not collapse.
- “Gummy bear” breast implants are thicker than traditional silicone implants. If the implant shell is broken, the implant will hold its original shape, although there is the potential for the implant to rotate and cause an unusual appearance that requires surgery to correct.
Breast augmentation using fat transfer can be performed to increase the size of the breasts. This can increase fullness of the breasts, and improve balance or symmetry.
Breast lifts, or mastopexy, can be done to improve the contour or position of the breasts. They can improve your profile by making breasts appear more uplifted or firm. Loss of firmness and skin elasticity can be due to pregnancy and breastfeeding, weight fluctuations, heredity or age. Breast lifts are often done at the same time as a breast augmentation or breast reduction.
Breast implant removal or replacement surgeries can be performed to remove or replace old implants. This can be done to improve the appearance, update the implant material, or address problems such as pain or a ruptured implant.
All breast surgeries are performed in Kaiser Permanente’s operating suite with either intravenous sedation or general anesthesia. Most breast surgeries use incisions that are below the breast or around the areola, and resulting scars are usually hidden in the breast crease.
Your Kaiser Permanente plastic surgeon will work closely with you. Be prepared to discuss your expectations and desired outcome. Make sure to address all of your questions and concerns.
Aspirin, Motrin, non-steroidal anti-inflammatory medications, and some over-the-counter herbal medications must be discontinued at least two weeks prior to surgery. These and other drugs and substances may cause excess bleeding and bruising. You can usually begin taking them again after a week or so.
If you are a smoker, it is important to quit at least four weeks prior to surgery and refrain from smoking until four weeks after surgery to ensure your wounds heal properly. Your plastic surgeon will discuss this in detail with you and you will also be given a sheet with a list of common medicines to avoid for a short period. Your plastic surgeon will detail the risks associated with surgery. Plan to have a family member or friend drive you to and from your surgery appointment and stay with you for at least one night following surgery.
Following your surgery, elastic bandages or compression garments will be used to cover your incisions and the areas treated. This will minimize swelling and to support your chest as it heals. Small tubes may be temporarily placed under the skin to drain excess fluid or blood that may collect.
The immediate recovery will depend upon what type of anesthesia that your Kaiser Permanente plastic surgeon will employ for the surgery. Various anesthetic agents affect patients differently and will dictate the patient’s recovery. Most surgeons will incorporate extensive local anesthesia into the tissues which can allow patients to wake up pain free. The local anesthesia will begin to wear off in three to four hours and most patients will experience mild to moderate discomfort at this stage. Pain is usually well controlled with pain medication prescribed by your doctor.
You will be given specific instructions on how to care of your incisions and drains, including any medications that you may need to take. We will arrange for your follow-up visit at our Kaiser Permanente office. Drains are typically removed after one to two weeks. For most plastic surgeries, there are no sutures to remove. It is most common to use absorbable sutures which melt on their own within a few months. You can shower the day after your procedure but should stay out of the ocean or pool for 2-3 weeks, or until your drain has been removed.
It is important to avoid strenuous activity for two to three weeks after surgery to avoid bleeding and other complications. One of the potential risks of surgery is infection and this usually manifests itself around five to seven days after surgery and is usually effectively treated with oral antibiotics. Numbness around the incisions is normal after surgery and can persist for several months.
Healing time is variable. A significant amount of the recovery occurs within 2-3 months; but it will take the external scar a year to soften/mature and the internal tissues undergo similar softening. For breast implants, the full recovery period is at least a year and this involves a gradual softening of the tissues around the implant and time for it to settle into its natural position