What is breast enlargement surgery?

In breast enlargement surgery, the doctor makes the breasts larger by putting an implant under the breast tissue and often under the chest muscle. An implant is a soft silicone shell filled with a saltwater solution or a gel.

Your doctor will make a cut, called an incision. Then the doctor will put in the implant and adjust it to the correct shape, size, and position. Then the incision is closed.

You may have a breast lift at the same time as the breast enlargement. A breast lift is also called mastopexy. It can raise sagging or drooping breasts. It can also pull up the nipple and the area around it.

You will probably be asleep during surgery. You may be able to go home the same day. Depending on the type of work you do, you should be able to go back to work or your normal routine in 1 to 2 weeks. The incisions leave scars. But the scars will fade with time. Your doctor will try to make the incisions in line with the curve of your breast as much as possible.

Your new breasts may feel firmer and look rounder. It is very important to understand that your breasts will look and feel different after surgery. You will have scars where the doctor made the incisions in your skin. The skin on your breasts may be numb. This usually gets better with time. But you may always have some loss of feeling in the nipple area.

Most breast implants don't last a lifetime. Over time, you may need surgery to remove or replace your implants.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• For about 4 to 6 weeks, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child. Do not lift anything over your head for 2 to 3 weeks.
• Ask your doctor when you can drive again.
• Ask your doctor when it is okay for you to have sex.
• You can take your first shower the day after surgery if you do not have a drain near your incision. If you have a drain, you can shower the day after it is removed. This is usually in a few days. Do not take a bath or soak in a hot tub for about 4 weeks.
• Sleep on your back with your head and shoulders raised with a pillow. This will help keep your implants in place and prevent them from slipping or shifting.
• You will probably be able to go back to work or your normal routine in 1 to 2 weeks. This depends on the type of work you do and any further treatment.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fiber supplement. If you have not had a bowel movement after a couple of days, take a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. Your doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If you were given medicine for nausea, take it as directed.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If your doctor gave you specific instructions on how to care for your incision, follow those instructions.
• You may be wearing a tight elastic bandage after the surgery. Your doctor will tell you when you can switch to wearing a special bra. You will need to wear the bra all the time for several weeks, except when taking a shower.
• Ask your doctor when it is okay to wear an underwire bra. Consider buying a larger bra. Your old bra will be too small and can put too much pressure on the healing incision.
• If you have strips of tape on your incision, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. If you have a drain, gently clean the area daily with water. You will be able to shower once the drain has been removed.
• Keep the area clean and dry.

Exercise

• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Your doctor will tell you when to begin stretching exercises and normal activities.

Other instructions

• You may have one or more drains near your incision. Your doctor will tell you how to take care of them.

Breast implants may cause problems during mammograms.

• Having implants may make it harder to find abnormal breast tissue or breast cancer.
• Scarring and calcium deposits around the implant may look like cancerous tissue. This may make the mammogram harder to interpret.

During a mammogram, the breast has to be squeezed tightly to get accurate images. In rare cases, this causes a breast implant to leak or rupture.

Be sure to tell the person who schedules your mammogram that you have implants. The technician will need to know what type of implants you have (saline or silicone) and whether they are behind or in front of the chest muscle. The technician may need to take more views than during a typical screening. In some cases, MRI scans may be needed to get a clear image.

Breast enlargement surgery can increase your breast size by one or more bra cup sizes. It can also help your breasts match better in size and shape.

Most people who get breast implants are satisfied with the results. You are likely to be happy with the results if you are realistic about what you expect from the surgery. The surgeon can show you pictures of other people who got implants. This can give you a good idea about what to expect.

After the surgery you will probably feel weak. You may feel sore for 2 to 3 weeks, and you’ll likely have a lot of swelling. You may have a pulling or stretching feeling in your breast area. You can expect to feel better and stronger each day, although you may need pain medicine for a week or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery.

You may be able to go home the same day. Depending on the type of work you do, you should be able to go back to work or your normal routine in 1 to 2 weeks. Most stitches are removed in 5 to 10 days. The incisions leave scars that will fade with time. Your doctor will make as many of the incisions as possible in line with the curve of your breast.

In breast enlargement surgery, the doctor makes the breasts larger by putting an implant under the breast tissue or under the chest muscle. An implant is a soft silicone shell filled with a saltwater solution or a gel. After the surgery you will probably feel weak. You may feel sore for 2 to 3 weeks, and you'll likely have a lot of swelling. You may have a pulling or stretching feeling in your breast area. You can expect to feel better and stronger each day, although you may need pain medicine for a week or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery.

If your doctor closed your incisions with removable stitches, the stitches will be taken out in 7 to 14 days.

Your new breasts may feel firmer and look rounder. The skin on your breasts may be numb. It should get better with time. You may have some permanent loss of feeling in the nipple area.

A doctor will make a cut (incision) in the bottom crease of the breast, in the armpit, or along the lower edge of the nipple and the dark area around the nipple. The doctor will make a pocket under the muscle or breast tissue. Then the doctor will put in the implant and adjust it to the correct shape, size, and position. The incision is closed.

Some people have a breast lift (mastopexy) at the same time as the breast enlargement. A breast lift can raise sagging or drooping breasts and pull up the nipple and the area around it. To lift the breasts, the doctor removes excess skin from the bottom of the breast or from around the nipple. The remaining skin is sewn together. This tightens and lifts the breast. A longer incision is needed for a breast lift than for a breast enlargement alone.

Breast enlargements and lifts are usually done in a hospital or outpatient surgery center. An overnight stay in the hospital isn't needed unless there are problems during surgery. You will probably be asleep during surgery.

This surgery is done to make the breasts bigger and to enhance their shape. You may decide to get breast implants:

• If you think your breasts are too small. What is "too small" (or too large) is a personal opinion. If you are happy with the size of your breasts, they are not too small.
• To restore the size or shape of the breasts after pregnancy or losing a lot of weight.
• To make the breasts match better. In many women, one breast may be larger or sit higher than the other breast.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• Your doctor will use a marker to draw lines on your breasts. He or she will use the lines during surgery to reshape your breasts.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 1 to 2 hours.

The surgery takes 1 to 2 hours.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Don't smoke. Smoking can delay recovery. Stop smoking for at least a month before surgery. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Breast implants may make it harder for a mammogram to detect breast cancer.

Other risks include:

• Capsular contracture. This occurs when scar tissue around the implant hardens and starts to squeeze the implant. Surgery may be needed to remove the scar tissue or replace the implant.
• Loss of feeling in the nipples or breast. Often this doesn't last very long, but sometimes it's permanent.
• An unwanted change in the size or shape of the breasts after surgery.
• Changes in the implant. Over time, the implant may harden, develop ripples, or change shape or position. If this happens, you may need surgery to remove the implant.

Less common risks include infection, blood under the skin (hematoma), and abnormal scarring.

There is also a small risk of getting breast-implant-associated anaplastic large cell lymphoma (BIA-ALCL). This is a serious cancer that develops near the implant and can lead to death. The risk of getting this cancer seems to be higher for breast implants with a textured surface than for implants with a smooth surface.

The risk of problems after the surgery is higher if you have more than one surgery at the same time, such as a breast lift and breast enlargement.

In breast enlargement surgery, the doctor makes the breasts larger by putting an implant under the breast tissue and often under the chest muscle.

An implant is a soft silicone shell filled with a saline solution or a silicone gel. Silicone may create a more natural-looking breast, because its weight and texture are more like breast tissue.